RealClearHealth Morning Scan -- 04/21/2016
Today's Top Stories
Cigna/Anthem Not Exiting Obamacare
Suzanne O'Halloran, Fox Business
Is Obamacare in a death spiral? Not necessarily. UnitedHealth’s (UNH) decision to exit most health exchanges by 2017, announced on Tuesday, would on the surface seem like a death knell for the Affordable Care Act. However, other insurers have more to gain by staying put, and some are doing just that.
United Hasn't Given Up on ACA Altogether
Laura Lorenzetti, Fortune
CEO Stephen Hemsley said during the company’s earnings call Tuesday that the exchange market set up by the Affordable Care Act (ACA) has been riskier and more expensive than expected for UnitedHealth, and that the company “cannot broadly serve it on an effective and sustained basis.” But that doesn’t mean UnitedHealth UNH 2.63% is ditching the individual exchange market altogether—and it’s not a sure signal that other large insurers will also ditch their Obamacare plans anytime soon.
Tavenner: ACA Premium Increases Coming
Caitlin Owens, Morn. Consult
Marilyn Tavenner, a premier spokeswoman for insurers, is concerned about 2017 health care premiums. As president and CEO of America’s Health Insurance Programs, she says the culmination of market shifts that insurers have faced over several years will cause a stark rise in health insurance rates on Obamacare exchanges.
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Blue Cross and Blue Shield (BCBS) companies are committed to addressing the nation’s growing opioid crisis community by community, nationwide. Learn more about the BCBS commitment.
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New Insurance Market Unfolds in Real Time
Dan Gorenstein, Marketplace
It’s been a busy week for health insurers. First, UnitedHealth announced plans to pull out of most Obamacare exchanges. Cigna talked about taking a completely different tack, by expanding in those same exchanges. And we’ve learned that Anthem is teaming up with 15 hospitals in Wisconsin to form a new insurance company. What all these headlines suggest is that the health insurance industry is evolving in real time. What the giant insurers offer – that all hospitals crave – is data; data that help hospitals keep patients out of expensive care.
Patient Screening May Lead To Medicare Penalties
Jordan Rau, KHN
The puffiness along Carol Ascher’s left leg seemed like normal swelling, probably from the high dose of chemotherapy Dr. Karl Bilimoria had injected the previous day. But it could have been a blood clot. He quickly ordered an ultrasound. “We were just being abundantly cautious,” he said. Such vigilance is a point of pride at Northwestern Memorial Hospital. But the hospital’s tests have identified so many infections and serious blood clots that the federal government is cutting the institution’s Medicare payments for a year, by about $1.6 million.
Is There a Better Measure for Patient Safety?
Nancy Derringer, Bridge
When the federal government’s Centers for Medicare & Medicaid Services released its annual ranking of hospitals by how well they protect patients from harm late in 2015, it didn’t spark front-page headlines. Even with a searchable database to look up hospitals in one’s own backyard, the story flew under the radar. But the “hospital-acquired condition” rankings, which rate hospitals by how well they control infections and other conditions that patients can pick up within their walls, and penalize those that fall short, resulted in a combined loss of $13 million for 24 Michigan hospitals.
Some Firms Offer Employees Free Surgery
Michael Tomsic, NPR
Lowe's home improvement company, like a growing number of large companies nationwide, offers its employees an eye-catching benefit: Certain major surgeries at prestigious hospitals are free. How do these firms do it? With a way of paying that's gaining steam across the health care industry, and that Medicare is now adopting for hip and knee replacements in 67 metropolitan areas, including New York, Miami and Denver.
No Signs of Compromise in Contraception Case
Louise Radnofsky, WSJ
The Obama administration and religiously affiliated employers in a final round of legal briefs Wednesday moved no closer to a compromise for covering contraception in workers’ insurance plans, likely leaving it to the eight-member Supreme Court to settle the dispute.
Congress Takes Another Look at Meaningful Use
Neil Versel, MedCity
Wednesday, a bipartisan group of representatives and senators introduced a succinct bill that would shorten the Meaningful Use reporting period to 90 days for 2016 only, rather than the full year. Providers would be able to choose any quarter they like this year, according to the two-paragraph Flexibility in Electronic Health Record Reporting Act (H.R. 5001).
House Democrats Hammer GOP Over Public Health
Sarah Ferris, Hill
House Democrats are sharpening their attacks against GOP leaders who missed their budget deadline, accusing them of ignoring pleas from “expectant mothers and poisoned children” for more funding. A group of Democrats, led by House Minority Leader Nancy Pelosi (D-Calif.), blasted the GOP on Wednesday for ignoring public health crises such as the Zika virus, the national opioid epidemic and lead-contaminated water in Flint, Mich.
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Blue Cross and Blue Shield (BCBS) companies around the country are undertaking initiatives to help patients, families, health professionals and communities address the opioid epidemic. These programs are reducing the misuse of opioids while ensuring those who need access to pain medication can get it, when they need it. Learn more about the BCBS commitment to fight substance use disorder and help prevent opioid addiction.
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