The Big Stuff.
Must-Reads from the Week
Before we get started, I wanted to give a shoutout to a couple other great healthcare newsletters that I enjoy.
- FemTech Insider is a newsletter focused on women’s health and technology.
- Healthcare Pizza is a weekly healthcare blog that focuses in on certain healthcare topics in an easy to read format.
The whole point of the Healthy Muse is to get more people talking about our healthcare system. If you’re interested in other healthcare-focused newsletters and sites I follow, you can check out the following pages:
- Newsroom
- Our Favorite Resources
- The 10 best Healthcare newsletters
- The 5 Best Healthcare news sites and blogs
Now on to this week’s stories.
States reject the $18 billion opioid settlement offer.
On Friday, Feb. 14, attorneys generals from 20 states rejected the drug distributors’ settlement offer of $18 billion, the WSJ reports. The settlement would have resolved all litigation surrounding opioids. According to the WSJ, “the dissenting states want the wholesalers to contribute between $22 billion and $32 billion.”
- Companies affected by the news include McKesson, AmerisourceBergen, and Cardinal Health. All of these companies prefer to settle their involvement in the opioid crisis all at once, rather than in multiple court cases over several states.
Coronavirus. I’ll keep it brief.
The coronavirus continues to dominate headlines…but I’m sure you’re just as tired of hearing about it as I am. Unless there’s a MAJOR development, we won’t be covering it here.
- You can check Axios’ live coverage article if you’re interested in staying in the know on infections.
Electronic Health Record shake-ups.
A few big electronic health records stories hit the wire this week amidst the larger interoperability controversy going on. The first is that AdventHealth is dropping Cerner in a big win for Epic. The two firms are heavyweights in the space – according to HealthLeaders, Epic’s market share (28%) is slightly above Cerner’s (26%).
- In another development, the Department of Defense is delaying its go-live with Cerner due to a slower than expected build time.
- Finally, here’s an article from HealthLeaders on the whole interoperability split – data privacy versus innovation?
Learning more about the Humana – Private Equity senior-focused primary care partnership.
In our February 3rd edition, I covered a joint venture involving Humana, a large health insurance company, and Welsh, Carson, Anderson, & Stowe (WCAS), a major private equity firm. TL;DR: The JV will be focused on providing preventive care services to Medicare beneficiaries.
- On February 11, a WCAS partner discussed the significant unmet need for senior-focused primary care. That’s what the Humana-WCAS partnership aims to address. Over the next three years, the JV will invest $600 million to create ~50 clinics for senior-focused primary care.
Medical loss ratios are trickling upward.
A great write-up from Healthcare Dive this week noted that ALL of the major health insurance payors saw increased medical loss ratios in the fourth quarter (medical cost ratio = medical costs paid by the insurer for its members’ health coverage DIVIDED by the total premiums the insurer collected from its members. It will generally be in the mid-high 80%’s).
Things that might drive a higher MCR would include a stronger flu season or more than expected routine visits for members.
- This higher MCR trend might continue, but payors will also benefit from increased growth in their Medicare Advantage segments, which may offset higher medical cost trends.
More spending stuff.
The Health Care Cost Institute is out with its 2018 annual healthcare spending and utilization report.
- The big takeaway: Employer health plan spending outpaced Medicare and Medicaid spending, growing 4.4% in 2018. That growth seems to slowing.
In the miscellaneous category…
- Here’s a pretty interesting, innovative perspective I hadn’t even thought of. Could a futures market solve healthcare cost inflation?
- Ochsner Health, a large Louisiana system, will begin to pay for up to 30 doctors’ medical school tuition if those future doctors commit to working at Ochsner for 5 years. These sorts of deals are starting to pop up more and more frequently.
Digital Health – Innovation, Collaborations, and Tech Stories
- Snapchat’s new wellness push
- Google Health has more than 500 employees.
Election 2020 weekly update
The healthcare irony of Bernie Sanders winning the nomination.
- #FeeltheBern Bernie Sanders took home the New Hampshire primary on February 11.
Why did health insurance stocks rise? Doesn’t Bernie want Medicare for All?
Investors think that a Bernie nomination will result in a Trump win, which they believe is better news for health insurance co’s (and stocks in general).
Now that Bernie is winning a bit, moderate Democrats in Congress are speaking out against some of his policies. FeeltheBern’s policies include ideas like cancelling all medical and student debt and full implementation of Medicare for All.
- This legislative branch backlash all but ensures that Bernie would face major congressional roadblocks to pass any policy that would drastically change healthcare – or any other industry, for that matter.
Next primary up? Nevada.
Labor unions speak out on healthcare before the Nevada primary.
In Nevada, Bernie Sanders is facing rare union opposition over Medicare for All.
- Pete Buttigieg was chided by the flight attendants union head for a tweet he sent out on Feb. 12, stating that labor unions ‘fought hard’ for private health insurance plans.
In the miscellaneous category…
- Elizabeth Warren is weak on healthcare, and it’s hurting her in the primaries. (WSJ)
- How Democrats’ disagreement over health care is splitting the primary. (CNN)
- What Iowa and New Hampshire tell us about Medicare for All. (Axios)
Policy Corner
Medicaid work requirements get the boot.
- In a big loss for Trump, Medicaid work requirements were struck down by an appeals court in Arkansas on Friday, February 14.
Over in Congress…
Senate Republicans don’t know what they want on key healthcare agenda items like drug pricing and surprise billing. When asked what the issue was, Mitch McConnell alluded to internal divisions within the party.
- Republicans will need to reconcile their differences in order for anything to get done on these two high-profile healthcare topics.
And…surprise billing.
Conservative lawmakers warned Pelosi about any sort of ‘rate-setting‘ surprise billing fix. It seems as if they’re pretty opposed to a benchmarked rate-setting policy proposal.
- Read more: 3 surprise billing proposals compared side by side.
Other stuff to know.
- Read more about Trump’s proposed budget, which is largely symbolic.
- Congress is asking CMS to revisit reimbursement cuts to physical therapists, social workers
- CMS: Changes to prior authorization are coming this year
Quick Hits
Biz Hits
- Following leadership changes, acquisitions, and layoffs, Athenahealth is focused on getting back to the roots of the company.
- CVS swings to $6.6B profit in 2019, buoyed by Aetna.
- Juul bought ads on children’s networks, according to Buzzfeed.
- Roman’s health guide.
- Is SmileDirectClub safe?
- Small-Cap Healthcare stocks are outperforming in 2020. (WSJ)
- The economics of freezing your eggs (WSJ)
State Hits
- On February 10, Asante launched a historic plan to improve access to health care in Southern Oregon – by investing $1 billion in the community.
Other Hits
- People born blind are mysteriously protected from Schizophrenia.
- What’s new with Elizabeth Holmes’ court case?
- Analysts everywhere rejoice…Microsoft Excel gets its new powerful XLOOKUP function
- Four ways to reduce healthcare costs.
- Millennials want mental health benefits, and companies are trying to keep up. (WSJ)
- U.S. Indian Health service doctor indicted on charges of sexual abuse (WSJ)
Thought-Provoking Editorials
- Medicare-for-All is not Medicare, and not really ‘For All.’ So what does it actually mean? (ProPublica)
- Medicare for All Could Mean Doctors for None (WSJ)
- The U.S. has a weirdly high maternal death rate. It’s a symptom of a sick health care system. (Bloomberg)
- When your ancestry test entangles others. (WSJ)
Thanks for reading.
Save yourself some time by subscribing to our all-in-one newsletter. Subscribers get the first edition – every Monday night.
About the Healthy Muse.
The Healthy Muse was created to educate people on the healthcare system. It’s one weekly e-mail updating you on all the major election news, broader trends, big stories, and policy updates. Learn more about our vision here.
- Get smarter and sign up below today.