The Democrats’ capture of the House will bring new focus to health care, the uninsured, prescription drug pricing, and Medicare Advantage programs. Here’s the prognostications.
Nov
8
Insight, analysis & opinion from Joe Paduda
Nov
7
Medical tourism looks to be exploding, growing much faster than many (your author included) had expected. The latest figures indicate a half-million Americans sought care overseas last year.
Much of the care is delivered in Canada and Mexico, but lots of folks are traveling to India and Thailand for complex medical procedures. And the quality appears to be quite high in many of the facilities.
Nov
6
Coventry’s public statements and documents point to a possibility that the big managed care company will be looking to expand it’s workers comp offerings through acquiistion. The business, known to the cognoscenti as First Health Workers Comp, has made little progress since it was acquired by Coventry almost two years ago. FH is suffering from a lack of attention by Coventry senior management, flat revenues, and serious competition from Aetna and others.
While acquiring more WC entities may help FH, basic logic would indicate that before you add to a company, you ought to make sure the company you have is running smoothly.
Otherwise all you’re doing is putting lipstick on a pig.
Nov
6
By any accounting, Part D has been a boon to the pharmaceutical industry (free registration required). Revenues and profits at Pfizer, Lilly, and other manufacturers have jumped. This will undoubtedly lead to more research dollars available to search for cures for awful diseases, an effort exclusively funded by the US taxpayer that will benefit the entire world.
Aren’t we generous?
Nov
3
The annual Medicare physician price cut season is on us. Next year’s reduction will average 5%, although payments for office visits (evaluation and management codes) will increase by up to 30%, but reimbursement for other procedures will be slashed up to 20%.
Don’t expect this to actually happen; every year the Medicare reductions are reversed by Congress. And this year will be no different. I’d expect Congress will do something to reverse the cuts, at least in part.
Nov
2
Jason Shafrin of Healthcare Economist fame is hosting this edition of HWR. Jason’s measured, analytical style makes for intriguing perspective on this week’s contributions.
Nov
2
Retail pharmacy chain CVS is buying pharmacy benefit manager Caremark in a deal that will create a really big vertically integrated drug company.
Here’s what is behind the deal.
CVS wants more control over its customer base, and with more and more consumers buying their drugs through PBMs, they get more control by creating the industry’s biggest PBM. As I’ve noted before, the market power of PBMs will only increase as Part D becomes the primary force driving retail drug purchasing behavior.
CVS decided that rather than be at the end of the supply chain, it had to move up if it was to control its destiny.
Nov
1
United HealthCare’s bare-knuckle approach to contracting may cost it members. Employers in the San Francisco bay area are deciding to go with other health plans as UHC experiences ongoing difficulties in recruiting and retaining docs.
One of UHC’s competitors is aggressively pursuing UHC customers by offering to sign them up at the same rates UHC was charging.
Nov
1
Finding malfeasance, mismanagement, incompetence, or just plain fraud related to workers comp is pretty easy if you confine your search to Ohio. The latest comes from the Plain Dealer in a report on vocational rehab companies that have benefited enormously from their cozy relationships with managed care firms.
Oct
30
The world (at least the very small part of it that I inhabit) has been buzzing about Wal-Mart’s announcement that it will be pricing almost 300 generic drugs at $4 for a 30 day supply. Newspapers, private equity firms, PBMs, drug manufacturers, insurers, policy makers, and politicians are all rambling on about the various significant impacts this will have on the world, among them improving the lives of the uninsured.
I don’t get it.
Continue reading Wal-Mart’s $4 drugs – much ado about not much
