Medicare Rule Change Could Lift Outpatient Provider Payments By $6.2B
Modern Healthcare reports on the complexities of a proposed Medicare reimbursements rule change that could take effect next year, increasing payments to outpatient providers. Meanwhile, UnitedHealthcare is set to offer $0 insulin and epipens under certain limited conditions.
Modern Healthcare:
Hospital Outpatient Providers Could See $6.2B Pay Bump In 2023
Hospital outpatient providers could see a $6.2 billion increase in Medicare reimbursements next year under a proposed rule issued Friday. (Goldman, 7/15)
On insulin and epi-pens —
Stat:
UnitedHealthcare To Offer $0 Insulin, Epi-Pens, But Only For Some Members
Next year, UnitedHealthcare will offer employer health plans that have no copays or out-of-pocket costs for five vital drugs — insulin, epinephrine, glucagon, naloxone, and albuterol — but those discounts will only be a guaranteed for less than a quarter of UnitedHealthcare’s membership for now. (Herman and Bannow, 7/15)
On a massive health care spinoff —
Reuters:
GSK Spins Off Haleon In Biggest European Listing For A Decade
In a long scripted overhaul of its business, British drugmaker GSK (GSK.L) spun off its consumer health business on Monday in the biggest listing in Europe for more than a decade. The new company, Haleon, becomes the world's biggest standalone consumer health business, home to brands including Sensodyne toothpaste and Advil painkillers. (Grover and Raitano, 7/18)
The Wall Street Journal:
GSK Spins Off $36 Billion Consumer-Healthcare Business Haleon
GSK GSK 2.56%▲ PLC completed the spinoff of its consumer-healthcare business, a bet that greater focus on innovative drugs and vaccines will help accelerate growth at the pharmaceuticals giant. (Roland, 7/18)
On other industry matters —
Stat:
Health Care's High Rollers: As The Pandemic Raged, CEOs' Earnings Surged
Health care’s top executives sat comfortably atop their perch during the second year of the pandemic, cushioned more than ever by the rising fortunes of their stock ownership. (Herman, Sheridan, Parker, Feuerstein and Ravindranath, 7/18)
The Wall Street Journal:
ForSight Robotics Grabs $55 Million For Cataract Surgeries
Israeli startup ForSight Robotics Ltd. has raised $55 million in new venture capital to develop robotic systems designed to improve cataract surgeries and make them more widely accessible. The company, which raised a $10 million seed financing last year before closing this Series A round of funding, says it has applied its technology successfully in an animal eye model and plans to use this funding to move its platform into clinical trials. (Gormley, 7/18)
The New York Times:
Do Cancer Centers Push Too Many Tests?
Medical societies and the independent U.S. Preventive Services Task Force publish guidelines about who should be screened for lung, prostate and breast cancers and how frequently, among many other prevention recommendations. But websites for cancer centers often diverge from those recommendations, according to three studies published recently in JAMA Internal Medicine. (Span, 7/17)
KHN:
Biden’s FTC Has Blocked 4 Hospital Mergers And Is Poised To Thwart More Consolidation Attempts
Fresh off the Federal Trade Commission’s successful challenges to four hospital mergers, the Biden administration’s new majority on the commission is primed to more aggressively combat consolidation in the health care industry than it has in past years. Although hospital mergers were supposed to improve cost efficiency, experts agree that the creation of huge conglomerates and hospital networks has driven up U.S. medical costs, which are by far the highest in the world. Many enjoy near-monopoly pricing power. (Meyer, 7/18)
Also —
KHN:
FTC Official: Antitrust Push In Health Care Must Focus On A Merger’s ‘Human Impact’
President Joe Biden has ordered the Federal Trade Commission to combat consolidation in the health care industry, saying that it is driving up prices for consumers and limiting their access to care. The new Democratic majority on the FTC has signaled that it not only will be looking at traditional mergers among hospitals and other health care providers but also is interested in some legal theories of antitrust enforcement that have been less frequently used. That includes questioning whether a merger affects labor market conditions and increasing its scrutiny of vertical mergers, in which hospitals, insurers, or other types of health care companies seek to merge with companies that provide needed products or services. (Meyer, 7/18)
