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Dec 03 2013

So who is happy with the reform law?  Not physicians, who are waking up to a reality of lower reimbursement and narrow provider networks for plans insurers are selling on the exchanges.  Payers say the changes are necessary to create competitive plans.

http://www.modernhealthcare.com/article/20131126/NEWS/311269951/white-house-hears-earful-from-doc-groups-about-narrow-provider?AllowView=VW8xUmo5Q21TcWJOb1gzb0tNN3RLZ0h0MWg5SVgra3NZRzROR3l0WWRMWGFWZjhIRWxiNUtpQzMyWmFxNVhvWUpibWdiUUEzemxjY3IyZVlHZUUwemlPUnA4T3JIOXEwUmEwUEJ1VUZ6cW51TXFYazZKRlZlY21ENlZnZ0E2UTdublpQdWZFeVRYL3NuUjlJNkFDbEdKN3Q=
Dec 02 2013

The excellent Altarum Institute index on health inflation showed only a 1% year-over-year increase in September, with even hospital prices rising only at 1.5%.  Utilization increased 2.7% on a per capita basis.  The bad news is that overall health spending in real terms continues to outpace economic growth.

http://altarum.org/sites/default/files/uploaded-related-files/CSHS-Price-Brief_November%202013.pdf
Dec 02 2013

Towers Watson has purchased private health insurance exchange vendor Liazon to add to its capabilities and to its earlier purchase of Extend Health.  All of the large benefits consultants are aggressively engaged in providing this capability to clients.

http://eba.benefitnews.com/health-insurance-exchange/news/towers-watson-private-exchange-advantages-of-liazon-purchase-2737820-1.html?gpt_units=/HIX&utm_source=editorial&utm_medium=email&utm_campaign=utm_hix_112613&hix
Dec 02 2013

Displaying the cost of lab tests in an EHR led to a reduction in orders for the tests by primary care physicians, according to research in the Journal of General Internal Medicine.

http://link.springer.com/article/10.1007/s11606-013-2672-1
Dec 02 2013

iVantage Health Analytics, which serves primarily hospitals, has acquired Xylem Consulting to boost its capabilities in helping health systems with payer contract negotiation and analysis.

http://www.healthdatamanagement.com/news/analytics-vendor-acquisitions-hospital-knowledge-taking-risk-46937-1.html?ET=healthdatamanagement:e4080:3722900a:&st=email&utm_source=editorial&utm_medium=email&utm_campaign=HDM_DAILY_112713_112613
Dec 02 2013

The number of issues relating to the reform law is embarrassing and we don't want to appear to be piling on by mentioning them all, but the Administration has had to delay by a year the program to allow small business to purchase health insurance on the health exchange.

http://www.modernhealthcare.com/article/20131127/NEWS/311279950?AllowView=VDl3UXpKSzRDUE9CbkJiYkY0M3hla0tyaUVVZEQrWT0=&utm_source=link-20131127-NEWS-311279950&utm_medium=email&utm_campaign=hits&utm_name=top
Dec 02 2013

CVS Caremark is buying the home infusion of Apria Healthcare, Coram, for about $2.1 billion.  This will make CVS the largest provider of home infusion and a bigger player in specialty drugs.

http://www.bloomberg.com/news/2013-11-27/cvs-agrees-to-buy-apria-s-coram-unit-for-2-1-billion.html
Dec 02 2013

More trouble for the formulation of CMS' quality measures, as a University of Michigan study finds that that the data used by Medicare to compare hospitals on how well they do at preventing bedsores is seriously flawed and inaccurate, since in some cases it is based on claims data and in some cases on actual nurse bedside exams.

http://www.uofmhealth.org/news/archive/201310/hospital-report-cards-hospital-acquired-bedsores-how-good
Dec 02 2013

A study at Duke finds that an intervention to improve medication adherence by patients after a hospital stay did a good job at that but did not significantly affect readmissions.

http://hin.com/Healthcare_Business_Weekly_Update/2013/11/25/staying-on-medication-%20%20may-not-lower-hospital-readmissions/
Nov 29 2013

OIG Strategic Plan 2014

http://oig.hhs.gov/reports-and-publications/strategic-plan/files/OIG-Strategic-Plan-2014-2018.pdf
Nov 29 2013

The HHS Office of Inspector General releases its annual strategic plan, which is must reading for anyone involved with Medicare, Medicaid or other government programs.  EHRs will be a focus of investigations.

http://oig.hhs.gov/reports-and-publications/strategic-plan/files/OIG-Strategic-Plan-2014-2018.pdf
Nov 29 2013

According to a statement by the publicity department at CMS, Medicare beneficiaries saved about $3 billion in drug costs this year due to the reform law's gradual closing of the "donut" hole.

http://cms.gov/Newsroom/MediaReleaseDatabase/Press-Releases/2013-Press-Releases-Items/2013-11-26.html
Nov 29 2013

According to a Mercer survey of large employers, health care insurance costs per employee have risen 4.5% this year and the employers expect a larger increase next year.

http://www.latimes.com/business/money/la-fi-mo-employer-healthcare-costs-20131126,0,5748812.story#axzz2lqNSNZ4i
Nov 29 2013

HHS has released the final rule on the tax on health insurance plans, which will be passed on to consumers in the form of higher premiums.

http://www.ofr.gov/OFRUpload/OFRData/2013-28412_PI.pdf
Nov 27 2013

A study published in the Annals of Internal Medicine surveys research on the effect of patient portals and finds little evidence that this form of communication between patients and doctors either improves quality or lowers costs, although patients do like using them.

http://annals.org/article.aspx?articleid=1770672
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About this Blog

Kevin RocheThe Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at khroche@healthy-skeptic.com.

Healthy Skeptic Podcast

Research

This is an outstanding report on total global drug spending and trends, with projections out to 2025.  It helps you understand this important area of health care, which does much...
June 1, 2021
The Office of the Actuary annual report on national health spending, covering 2018.
December 7, 2019
2019 Kaiser Family Foundation Employer Health Benefits Report
October 1, 2019
MedPAC 2019 Report to Congress
June 18, 2019

Headlines

IKS Health, a British company with a US subsidiary that offers “care enablement” and mentions AI, of course,  is buying TruBridge for $557 million.  TruBridge offers revenue cycle management and...
April 30, 2026
Innovacer, which basically collects data on a patient from multiple sources and aggregates it, raised an astounding $275 million in new capital, supposedly at a valuation of almost $3.5 billion....
April 22, 2026
A company called Whoop raised a ridiculous $575 million in new capital at a supposed $10 billion valuation.  The press release was released on April 1, so I would like...
April 5, 2026
Big deals continue in health care financings.  eMed, which manages weight loss medications for employers, raises a hefty $200 million, giving it a valuation of $2 billion, which seems crazy....
March 31, 2026

Tags

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About This Blog

The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry through Roche Consulting, LLC. Mr. Roche is available to assist health care companies through consulting arrangements and may be reached at khroche@healthy-skeptic.com. © Roche Consulting, LLC. Terms of Use.

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