1. Vaping Related Illnesses are Spiking
The Vaping Epidemic.
The CDC is reporting hundreds of vaping-related illnesses across 29 separate states, which is a huge spike in what most might think is a ‘safer’ practice in vaping. Apparently, most of the incidents are happening because of third party, foreign substances (like THC) somehow making their way into the vapes.
The exponentially increasing number of reports shows us just how far behind vaping regulations are when it comes to preventing these sorts of things. Forget about the shady marketing tactics. Now, real health scares are coming into the picture as a result of the wild-west vaping industry. Look for more potential regulation to hit the main stage soon.
2. Audits for Medicare Advantage
CMS wants to audit Medicare Advantage.
Medicare Advantage (AKA more or less Medicare plans managed through big insurance companies) has been a huge boon for the health insurance industry and the main driver of growth on quarterly earnings calls. So it comes as no surprise that the big insurers would strongly oppose any regulation on their biggest growth vehicle.
What’s the looming regulation?
As Axios reported this week, the Centers for Medicare and Medicaid want to audit Medicare Advantage plans to make sure that the plans are not billing Medicare for more services than they ought to be. They’re calling the audits “risk adjustment data validation.”
Insurers Hate This One Thing!
Insurance companies had plenty to say about the pending regulation. Centene even had enough nerve to warn that the regulatory action could cause further market consolidation…
Read the full Axios article here.
3 Wal-Mart’s Healthcare Expansion
Enter: Wal-Mart Health Clinics.
In direct competition with the likes of CVS and other direct to consumer primary care-type offerings, Wal-Mart has decided to make an even more serious push into healthcare by opening up primary care clinics.
Its pilot store opens in Georgia and looks to offer quite the decent selection of offerings for consumers, including dental, optical, audiology, and other entry-point services for…you guessed it…everyday low prices!
Read more about the offering here.
4 The Wellness Trend
Banking on Wellness.
This week, Peloton filed its S-1 form – they’re expected to IPO later this year. As Nathaniel Meyersohn noted on Twitter, there was a little nugget in their S-1 that noted the wellness trend happening in the U.S. has been a huge boon for the Peloton business. As we all know, Peloton sells overpriced, glorified stationary bikes with a fitness subscription on top of it (and they’re still not profitable…that is beyond me).
Health and wellness boom is driving Peloton. Retailers take note. pic.twitter.com/Ukfb8gsv6U
— Nathaniel Meyersohn (@nmeyersohn) August 27, 2019
But Peloton’s recent success shows the push that wellness has made into society, especially among employers, who are now offering wellness programs that include everything from on-site yoga to stress management (I should note that the jury’s still out as to whether or not these types of programs are effective), to more robust offerings like mental health screenings, tele-health, and women’s health.
Fitbit jumps in to care management.
Don’t stop with just the employers, though – traditional ‘generalized’ medical wearable makers like Fitbit and Apple are jumping in on the trend, too. In fact, the former is looking into piloting a care management program for its users later this year.
5. Policy Corner
Obamacare, meet Trump-Care.
Some additional clues about “Trump-Care” emerged this week from an NPR feature. Some components of the plan might include recommendations made in a white paper published by the Department of Labor in 2018. The white paper made note of various reforms like expanding the roles of health savings accounts, heightened anti-trust scrutiny, and (ironically) easing restrictions around Medicare Advantage plans.
Read the full article for more insights into a potential Trump-Care offering. Also, don’t forget that the ACA is still tied up in court and might make it back to the Supreme Court for a third showing.
Be on the lookout for any potential healthcare proposals this month as Uncle Sam ramps back up for the fall.
Quick Hits
Biz Hits
There’s definitely going to be one big loser if surprise billing legislation passes…Envision and TeamHealth
Epic is gathering records of 20 million patients for medical research (HIPAA compliant, of course)…
Per SeekingAlpha, SmileDirectClub (SDC) plans to offer 58,537,000 Class A common shares at $19 – 22 in its IPO. Gross proceeds should be ~$1.2 billion
Community Health rallied over 30% from Tuesday – Friday of last week after strong insider buying. The hospital operator also just sold 2 more hospitals to AdventHealth in Florida.
Purdue Pharma just offered a $10 – $12 billion settlement to get rid of all of its opioid lawsuits.
AdventHealth, GE Healthcare just opened the nation’s largest….medical mission control?
State Hits
Lawmakers are currently fielding complaints about Aetna’s handling of the Managed Medicaid program in Kansas. Basically, they’re telling Aetna to shape up or SHIP OUT. The Kansas Hospital Association thinks they can shape up.
Kaiser Health is under pressure in its home state of California – a bill passed the state’s legislature that would require each Kaiser facility to report profits.
Similarly to Kansas, Louisiana is working on issuing an emergency Medicaid contract as the state holds talks with major Managed Medicaid insurers after a long dispute.
Other Hits
So…it looks like Medicare just wasted a few hundred million dollars casually by paying for hospice drugs twice – once on Part A and once on Part D.
According to the CDC, the U.S. is on the verge of losing its measles elimination status. Sheesh.
And Americans don’t trust insurers with their data.
My favorite reads this week
In the Straits: An Inmate Turned Millionaire Turned Lone Survivor
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