Wednesday, November 1, 2017
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In a bid to
out-big Amazon, CVS is wooing Aetna, according to media reports. If the acquisition succeeds, CVS will lock in Aetna members for its pharmacy benefits management, drug store and other services—plus add a huge pool of member data to its portfolio. Amazon received approval for wholesale pharmacy licenses in at least a dozen states last week, further fueling rumors it will soon shake up the brick-and-mortar pharmacy marketplace. (
The Wall Street Journal)
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Late Friday, the Centers for Medicare & Medicaid Services proposed a rule giving states more say over what constitute “essential health benefits.” The rule gives states more flexibility and is intended to stabilize local health care marketplaces; it takes effect in 2019. CMS also gave states wiggle room in setting health plan medical loss ratios, it also exempted student health insurance plans from rate review. (
Modern Healthcare)
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Innovation & Transformation
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Health care quality measures should improve patient care, safety or outcomes, rather than simply burden physicians. That’s the basis of the Center for Medicare & Medicaid Services’ newest initiative. “Meaningful Measures” was introduced Monday by CMS Administrator Seema Verma to reduce regulatory burden while focusing on patients; the agency will review all measures, Verma said, with an aim to keep program outcomes measures and jettison unnecessary process metrics. (
Healthcare Informatics
)
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Collecting data about social factors that affect health may become more standardized and measurable. A recent National Quality Forum Strategy Session panel identified a list of high-priority social determinants of health as a first step to develop best practices for standard data, measurement and outcomes research. (
National Quality Forum;
HealthAffairs
blog)
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The American Board of Internal Medicine’s Choosing Wisely campaign was intended to raise awareness of unnecessary and harmful health care services among physicians. Three years later, a study shows no significant change in awareness of the campaign or the way doctors talk to patients about more than 500 services they should avoid. Barriers to changing doctors’ minds include fear of malpractice claims, patient demand and the need for more evidence that the targeted interventions don’t work. Researchers recommend focusing on the most-overused practices to make the biggest impact on care. (
HealthAffairs;
MPR;
10 most overused tests and treatments)
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Consumers are avoiding care and paying high costs without question, displaying a passive pattern incongruent with every other category of consumer spending. Consumers in high-deductible health plans are looking for change, but need transparency in health care price and quality to smartly navigate the terrain. If health care decision making is too complicated for consumers to crack, it’s merely a sign that they need better tools to do it, the author says. (
Forbes
blog)
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Rhode Island leaps to front of the class:
The Leapfrog Group released hospital safety grades yesterday, and Rhode Island ranked first in the country; it was 50
th
in 2012. Leapfrog’s Leah Binder says Rhode Island’s evolution demonstrates the positive impact of transparency on patient safety. (
Leapfrog Group
)
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Opioid billionaire charged with bribing doctors: The same day President Trump declared the opioid crisis a public health emergency, authorities arrested the founder of the company making Subsys, a Fentanyl spray, for bribing doctors to use it, and lying to insurers to have the cost covered, among other charges. Doctors have admitted to accepting kickbacks and bribes in exchange for writing prescriptions for fentanyl for patients whose diagnoses weren’t appropriate for the highly addictive opioid. (
Bloomberg;
Los Angeles Times)
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A doctor in a rural county health department uses a telestethoscope to listen to a patient’s heart and lungs, and sends the reading to a specialist 90 miles away in a real-time telehealth visit. The Alabama Department of Health is creating a comprehensive telehealth network, overcoming the challenge of inadequate rural broadband by boosting bandwidth in health departments. Georgia and Mississippi have enacted payment parity laws to encourage rural telehealth uptake; other states may soon follow suit. (
Alabama Public Radio)
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MarketVoices...quotes worth reading
“You've either used telemedicine, or you will use telemedicine. It's gonna happen.”– Ron Sparks, former director of the Alabama Office of Rural Development,
quoted on
Alabama Public Radio.
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Editor
Sandy Mau
Roxanna Guilford-Blake
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