Morning Briefing
Summaries of health policy coverage from major news organizations
Federal Judge Temporarily Blocks Several Parts Of ACA Exchange Rule
Modern Healthcare: Key ACA Exchange Rule Provisions Blocked By Federal Judge
A federal judge temporarily blocked several parts of a rule Thursday that would have made major changes to the Affordable Care Act exchanges. The U.S. District Court for the District of Maryland blocked several provisions of a sweeping Centers for Medicare and Medicaid Services regulation from going into effect July 20. (Early, 7/16)
More about the high cost of healthcare and prescriptions —
Stat: UnitedHealth Signals Employer Health Insurance Premiums Likely To Rise
UnitedHealth Group smashed through investors’ earnings expectations in the second quarter, with executives confidently saying this new level of profit is durable for the foreseeable future. (Herman, 7/16)
Modern Healthcare: Why Health Systems Are Scaling Back Provider-Owned Health Plans
A growing number of regional health systems are exiting the insurance business as rising costs squeeze margins and market share remains concentrated among the national carriers. Provider-owned health plans are running into trouble as they navigate expensive care and administrative costs, while also trying to keep premiums competitively low. The largest insurers, such as UnitedHealthcare and Aetna, are well-oiled operations with multibillion-dollar balance sheets. For systems, insurance is often an add-on business and not part of the core care delivery operation. (Hudson, 7/16)
KFF Health News: Watch: ‘Robust’ Primary Care, Transparency Top Employers’ Reform Wish List
In this “How Would You Fix It?” interview, Julie Rovner, KFF Health News’ chief Washington correspondent and host of the What the Health? podcast, sat down with Elizabeth Mitchell, the president and CEO of the Purchaser Business Group on Health, which represents many large employers and other institutional buyers of healthcare coverage. Mitchell noted that employers, which offer coverage to more than 160 million Americans, are a big player in the nation’s healthcare system — a role they came into because of “an accident of history,” she said. (Rovner and Norman, 7/17)
MedPage Today: Medicaid Could Save $$ Under 'Most Favored Nation' Pricing, Study Finds
A new program to base Medicaid drug prices on the lowest drug prices in other countries -- known as "most favored nation" (MFN) pricing -- could result in substantial savings, researchers found. (Frieden, 7/16)
MedPage Today: New Maternity Billing Codes Better Reflect Modern Care, Ob/Gyns Say
Maternity care billing is getting an overhaul that ob/gyns say is long overdue and will likely improve patient care and physician compensation -- as long as it's rolled out effectively. For decades, there's been a global system for pregnancy care billing in which all patients got the same package of 13 visits and clinicians were paid in a lump sum for this bundle. But starting Jan. 1, ob/gyns can individualize patients' care plans and bill for specific services thanks to new maternity billing codes adopted by the American Medical Association (AMA). (Robertson, 7/16)
In other healthcare industry developments —
Stat: Experts Expelled From ADA Conference Embroiled In New Controversy
Turmoil at the American Diabetes Association has taken a fresh turn, with leaders blocking editors at its flagship journal from publishing an opinion piece and first-person accounts detailing a high-profile controversy at the group’s own annual meeting just last month. (Cooney, 7/16)
St. Louis Post-Dispatch: SSM Preps $783 Million Bond Sale, One Of Largest Of Its Kind, For Children’s Hospital
SSM Health, one of the largest hospital systems in the region, plans to issue $783 million in tax-exempt bonds to finance construction of its new Cardinal Glennon Children's Hospital. Some of the money is also earmarked for refinancing and smaller projects in Missouri, Oklahoma and Wisconsin, the healthcare giant disclosed this week in a notice filed with the state. (Bauman, 7/16)
Modern Healthcare: GE HealthCare, Catholic Health Agree To Imaging Tech Deal
GE HealthCare is locking in one of its largest-ever health system partnerships: a 10-year, $500 million deal with Long Island-based Catholic Health to modernize the system’s imaging, AI and diagnostic capabilities across more than 40 sites. The partnership, known as a care alliance, is part of Chicago-based GE HealthCare’s broader push into AI imaging and is meant to significantly enhance Catholic Health’s high-tech medical offerings. (Asplund, 7/16)
Axios: CVS Wants To Become The AI Front Door To Health Care
CVS Health is betting it can drive customer engagement with an AI assistant it developed with Google to help schedule checkups, fill prescriptions and check what insurance covers. (Reed, 7/16)
Stat: MDCalc Is Scoring The Clinical Calculators Used By Millions Of Doctors
Every day, doctors turn to specialized calculators to make decisions about their patients’ care. Kidney performance? There’s a calculator for that. Chance of a successful vaginal birth after a previous C-section? There’s a calculator for that. (Palmer, 7/17)
