 |
| “There is a tremendous amount of focus on access — and we certainly agree that Americans should have access to care. I don’t think there’s nearly enough focus today on outcomes. We think that what we’re building out can make a meaningful difference in terms of engaging consumers around their health.” | ||
| -Larry Merlo, CEO, CVS Health |
| Individual
Insurance Market Performance Data, Third Quarter 2019 Per a recent analysis from Kaiser Family Foundation, the average individual market medical loss ratio in Q3 2019 was 75%. The average individual market gross margin per member per month was $131.17 ($133 average for non-Blue insurers; and $129 for Blue Insurers). The average individual market monthly premium per person was $515; while the claims per person as $384. Finally, the average individual market monthly hospital patient days per 1,000 enrollees was 23.2 for the same time period. Source: KFF: Individual Insurance Market Performance in Late 2019 |
|
Average Third Quarter
Individual Market Medical Loss Ratios, 2011-2019 1. 2011: 82% 2. 2012: 84% 3. 2013: 84% 4. 2014: 93% 5. 2015: 97% 6. 2016: 91% 7. 2017: 81% 8. 2018: 71% 9. 2019: 75% Source: KFF: Individual Insurance Market Performance in Late 2019 |
|
|
 |
Health Care Is Going Through a Digital Revolution, Providence
St. Joseph CEO Says
Rod Hochman, Providence St. Joseph Health chief
executive officer, discusses his predictions for health care in
2020 with Bloomberg's Taylor Riggs from the JPMorgan Health Care
Conference in San Francisco. |
||
Check out
HealthshareTV, the
home for health care videos |
||||
|
Next Generation ACO model hasn't saved money, study
finds The experimental Next Generation Accountable Care Organization model didn't save Medicare money during the first two performance years, according to an analysis released Friday from the agency. Rather than reducing Medicare spending, the Next Generation ACO model, which is now in its fifth and final year, added $93.9 million to net Medicare spending during 2016 and 2017, the first two years of the program, the analysis found. Modern Healthcare, January 10, 2020 Reduce Health Costs By Nurturing The Sickest? A Much-Touted Idea Disappoints Improving health and lowering costs for the sickest and most expensive patients in America is a dream harder to realize than many health care leaders had hoped, according to a study published Wednesday by the New England Journal of Medicine. Researchers tested whether pairing frequently hospitalized patients in Camden, New Jersey, with nurses and social workers could stop that costly cycle of readmissions. The study found no effect Kaiser Health News, January 8, 2020 Medicaid expansion improved health in Southern states: Study A new study finds that Medicaid expansion improved people’s health in Southern states, resulting in fewer declines in people’s health. The study published in Health Affairs finds that Medicaid expansion made declines in health status 1.8 percentage points less likely in states that expanded the medical coverage. The Hill, January 7, 2020 Why Amazon Makes A Big Pharmacy Move In 2020 Amazon is quietly talking to health insurance companies about new ways to integrate its online pharmacy services into their medical plans and employer health benefits. The online retail giant, working under the PillPack by Amazon pharmacy brand rolled out in the last year, is winning over health insurers through their health plan enrollees. Forbes, December 30, 2019 |
|
AMA and RedCrow collaborate to promote
innovation The American Medical Association (AMA) and RedCrow, a direct investment platform for health care innovation, today announced a collaboration to drive engagement between physicians and entrepreneurs that fosters innovative health care startups with insight, guidance and funding to help grow promising companies. AMA, January 14, 2020 Hospitals, nonprofits tackle social determinants of health with digital network A year ago, a woman arrived at Griffin Hospital’s emergency room with breathing problems. It wasn’t the first time she had turned up with those troubling symptoms, and physicians at the Derby hospital wondered what kept triggering her asthma. Instead of just treating the problem and sending her away, the doctors arranged a home visit. The CT Mirror, January 14, 2020 Teladoc-InTouch Health Deal Is a Move Toward Telehealth Integration Teladoc Health is looking to combine telehealth and telemedicine with a major acquisition announced over the weekend. The Texas-based developer of consumer-to-provider telehealth solutions is adding provider-to-provider services with its planned purchase of InTouch Health. Announced prior to the J.P. Morgan Healthcare conference this week in San Francisco, the $600 million deal shakes up the upper echelons of connected health and pushes the industry even further toward integrated, enterprise-level virtual care. mHealthIntelligence, January 13, 2020 'Concierge' Medicine Gets More Affordable But Is Still Not Widespread Some people spend $200 a month on the golf course or on a fancy cable TV package, says David Westbrook, a hospital executive in Kansas City, Mo. His splurge? He pays Dr. John Dunlap $133 a month for what he considers exceptional primary care. "I have the resources to spend a little extra money on my health care to my primary care physician relationship," Westbrook says. "Because I have that access — and am very proactive in managing my personal health — I think I'm going to be healthier." NPR, January 13, 2020 Health-care companies use technology and data to boost primary care services In baseball, high-salaried home run sluggers have always gotten the glory. The equivalent in health-care may be high-priced drugs and medical specialties that help save lives in critical cases. But 20 years ago, there was a big shift baseball. Leveraging data analytics, the Oakland A’s found success with undervalued players, who reliably hit singles and doubles to rack up runs. Chronicled in Michael Lewis’ “Moneyball,” their story ushered in a new era in the game. Health-care may be looking at its own Moneyball moment. CNBC, January 10, 2020 California could be 1st state to sell its own prescription drugs California could become the first state to make its own prescription drugs under a proposal announced Thursday by Gov. Gavin Newsom, who says it would “take the power out of the hands of greedy pharmaceutical companies.” The Democratic governor wants the nation’s most populous state to contract with generic drug companies to make medications on its behalf so it could sell them to its nearly 40 million residents. The goal is to lower prices by increasing competition in the generic drug market, Newsom said. Associated Press via PBS, January 9, 2020 New nonprofit to address health care worker shortage Kaiser Permanente and Service Employees International Union-United Healthcare Workers West (SEIU-UHW) have partnered to establish Futuro Health, a new $130 million nonprofit organization dedicated to growing the largest network of certified health care workers. Efforts will start in California and spread throughout the nation. California’s projected demand is approximately 500,000 new health care workers by 2024. Kaiser Permanente, January 8, 2020 States can do more to make healthcare affordable, report says States aren't doing enough to make healthcare more affordable for their residents, according to a report Tuesday from research and consulting organization Altarum. Nearly every state has expanded healthcare coverage in recent years. But many haven't made inroads on healthcare affordability, even though voters on both sides of the aisle say that it's one of their top priorities. Modern Healthcare, January 7, 2020 Bundles cut spending on joint replacements, but not for other conditions Medicare's voluntary bundled-payment program for hip and knee replacements reduced spending by 1.6% from 2013 to 2016 — less than previously estimated — with no overall change in quality, according to a new study in Health Affairs. Another new Health Affairs study reported that lower extremity joint replacement is the only type of clinical episode in Medicare bundled-payment programs that has produced savings so far. Modern Healthcare, January 6, 2020 Patient satisfaction may decline after hospital acquisition Medicare quality-of-care data reveal that when a hospital is acquired by another hospital or hospital system, readmission and mortality rates are not affected but patient satisfaction deteriorates modestly. “These findings challenge arguments that hospital consolidation, which is known to increase prices, also improves quality,” according to a research team led by Nancy Beaulieu of the Department of Health Care Policy at Harvard Medical School in Boston. Reuters, January 1, 2020 |
Follow Health Policy Publishing:
|
| Health Change Bulletin, a publication
of Health Policy Publishing LLC 1101 Standiford Avenue, Suite C-3, Modesto, CA 95350 © 2020, Health Policy Publishing LLC |