healthy muse healthcare news.
Open enrollment for Medicare is here, and everyone’s getting ready.
Open season, open enrollment. Open enrollment season for Medicare starts within a week as aging Baby Boomers continue to enter the program. This year, several new companies are making notable moves into the growing Medicare market:
Walmart: everyday low healthcare prices.
Earlier in October, Walmart announced its partnership with **Clover** for a MA plan in Georgia. Walmart also partnered with recently IPO’d **Oak Street Health** in Texas
- Now this week, Walmart announced its plans to become a MA broker in all 50 states, servicing plans from United, WellCare, Humana, and others. Notably missing? CVS/Aetna, a Walmart Health competitor given the HealthHUB strategy.
Clover.
- Speaking of Clover Health, the MA startup is going public in a $3.7 billion blank-check deal, touting its performance as the highest growing MA player in the nation. Read more about its plans to pivot to direct contracting.
The payor incumbents.
- United is planning its largest MA expansion in 5 years, covering 300 more counties. Cigna is expanding its MA plans into 67 new counties and 5 new states. So is Humana.
On the horizon.
- All of this expansion news comes at a time when Medicare advisers are considering an MA payment overhaul as everyone continues to expand into the space.
A major deal in rehab.
This week, Select Medical purchased fellow post-acute operator Kindred Healthcare’s skilled nursing and senior living service line (AKA, RehabCare) for an undisclosed-but-probably-large sum of money.
- My thoughts: In an industry where skilled nursing is currently suffering, Select probably thinks it can buy low, turn around operations, and expand its post-acute footprint at a reasonable price.
Coronavirus updates.
- How about a dose of optimism about the pandemic for once, folks?
- The promising antibody treatment that Trump took during his run in with the ‘Rona shows a lot of promise, but there’s no evidence (yet) that it’s a cure. Currently, Regeneron and Eli Lilly are producing antibody treatments that could prove to be effective treatments.
- According to Operation Warp Speed, first vaccine approvals might be targeted around Thanksgiving weekend.
- Is a second wave coming as we approach the winter months? Unfortunately, numbers are on the rise.
Quick Hits
Biz Hits
- We don’t need that: HCA returned all $6 billion in federal aid $$$ it received and reported strong Q3 preliminary results on the back of a favorable payor mix and an increase in patient acuity.
- In the M&A rumor mill: Shares of Amwell jumped big-time after UnitedHealthcare was rumored to show interest in purchasing the telehealth player.
- M&A finalized: Atrium Health and Wake Forest Baptist sealed their merger previously announced on April 2019. The $11.5 billion in revenue system will serve patients along the east coast in ACC territory. Paladina Health is acquiring direct primary care peer Healthstat. And Novant Health’s $5.3 billion deal for New Hanover Regional Medical Center in North Carolina was approved.
- NEMT: Lyft announced its integration with Epic this week. That means that any hospital running Epic’s system can arrange rides for its patients.
Policy Hits
- Supreme Court: Health care is for sure going to be a major focus during SCOTUS nominee Amy Coney Barrett’s hearing. Meanwhile, many politicians are calling on Barrett to recuse herself from upcoming court cases – namely, the ACA & election case.
- Medicaid: Where the states currently stand on Medicaid expansion. How many Americans have lost employer-based health insurance?
- Post-Acute: Payment reform and Covid might derail a unified post-acute payment system.
Other Hits
- Sticky situation: Companies are struggling to predict next year’s health care costs as their employees choose to defer treatments during the pandemic. (WSJ Paywall)
- Uninsured: Children’s uninsured rates rose by the largest annual jump in more than a decade.
- Chemistry: Two CRISPR scientists won the Nobel Prize in chemistry.
Thought-Provoking Editorials
- A CBO roadmap to universal healthcare. (Niskanen)
- Medicare Advantage for all, perhaps? (JAMA)
- Attention, Walmart patients. (Medium)
Healthy Muse Top Picks
- A review of the Clover SPAC. (Medium)
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