Morning Briefing
Summaries of health policy coverage from major news organizations
'The Storm Is Here': Lower ACA Uptake, Higher Healthcare Costs Hurting Americans, Analysis Shows
The Washington Post: Millions May Lose Their ACA Coverage As Costs And Premiums Spike, Report Finds
The affordability crisis for many people who have health insurance under the Affordable Care Act came into sharper focus Tuesday, with a new analysis projecting that higher premiums will cause millions more people to lose insurance this year. Another sign of economic distress: Average deductibles for policyholders are now the highest ever, a result of people switching to the exchange’s cheapest “bronze plans” in response to premium hikes, according to the report released Tuesday by KFF, a health policy research organization. (Rowland, 5/19)
More about the high cost of healthcare —
Stat: This Spine Surgery Usually Costs $1,400. Under No Surprises Act Arbitration? $34,000
When health insurers contract with providers, they agree on prices for all kinds of procedures. For a lumbar laminectomy, a common spine surgery for ailments like herniated discs or arthritis, the median price is $1,400. Out-of-network providers, those that don’t contract with health insurers, are getting 24 times that amount for the same surgery at the median — nearly $34,000 — through the No Surprises Act’s arbitration process. Some are even getting north of $100,000. (Bannow, 5/19)
Becker's Hospital Review: Hospital Expenses Per Inpatient Day Across 50 States
Below are the adjusted expenses per inpatient day in 2024 for nonprofit, for-profit and government hospitals in every U.S. state, based on the latest estimates provided by Kaiser State Health Facts. The figures are based on information from the 2024 American Hospital Association Annual Survey. They are an estimate of the expenses incurred in a day of inpatient care and have been adjusted upward to reflect an estimate of outpatient service volumes, according to the KFF. (Gamble, 5/19)
Modern Healthcare: How Providers Are Responding To Elevance’s Out-Of-Network Policy
Elevance Health is expanding a policy that penalizes hospitals making out-of-network referrals — and providers aren’t having it. Hospital associations say the insurer’s policy, which applies to Elevance’s Anthem Blue Cross Blue Shield commercial plans, is another attempt to shortchange hospitals. The insurer argues the policy will help control rising care costs and limit exorbitant reimbursement requests. (Hudson, 5/19)
More news about the healthcare industry —
MPR News: Capitol Cash Injection Will Keep HCMC Open, Hennepin Co. Commissioner Says
Millions of dollars are on the way to HCMC, Minnesota's largest trauma center, now that the state legislative session has ended and lawmakers approved a healthcare bill. The safety-net hospital serves more low-income and uninsured patients than any other facility in Minnesota and is expected to lose more than $1 billion in the next decade. (Bright and Levin, 5/19)
Bloomberg: GHO And CBC Combine To Form $21 Billion Healthcare Asset Manager
Global Healthcare Opportunities and CBC Group have agreed to combine to create a healthcare investment firm with more than $21 billion of assets under management, according to a statement Wednesday. The firm will have over 200 employees in 13 offices in North America, Europe and Asia Pacific, which account for about 90% of global healthcare research and development spending, Singapore-based CBC said, adding that it will be the world’s biggest healthcare investment manager. GHO is based in London. (Cao, 5/20)
Kansas City Star: KU Med Settles More Lawsuits Involving Heart Surgery Devices
The University of Kansas Hospital Authority has settled six lawsuits alleging that a contaminated device used during open-heart surgeries led to serious and sometimes fatal infections in patients. (Thomas, 5/19)
Modern Healthcare: Hospitals Revamp Operating Rooms As Surgery Demand Grows
Health systems are revamping their operating rooms to protect a key revenue driver as demand for surgeries increases and reimbursement declines. Providers are deploying new technology, redesigning surgical suites, reorganizing scheduling models and strengthening oversight as part of broader operating room overhauls. Even modest efficiency gains can significantly increase health system margins as they treat more patients, direct the most complex procedures to hospitals and reduce costs. (Kacik, 5/19)
Chicago Tribune: UChicago Medicine Performs Rare Quadruple Organ Transplant
It took some time for Jasmine Jones to absorb the news that doctors wanted to replace four of her organs at once. She had been through so much already because of cystic fibrosis, a genetic disease that can damage the lungs and other organs. The 28-year-old South Side woman had become almost numb to the situation. (Schencker, 5/20)
On AI in healthcare —
Stat: OpenEvidence Makes Its Pitch To Hospitals: 'We’re Not Crazy Monsters'
OpenEvidence rode the wave of early enthusiasm for large language models by building a free chatbot for doctors. Physicians, especially trainees, have flocked to the platform to help make patient care decisions; the company claims that about 650,000 U.S. physicians use it actively. (Palmer, 5/20)
Modern Healthcare: Hospitals See Promise In AI Tools Detecting Sepsis Cases
Artificial intelligence has shown promise in flagging sepsis cases in hospitals, and new AI models are focusing on earlier detection of the condition responsible for one in three deaths of hospitalized patients. Detecting sepsis is a compelling use case for AI because it can present differently depending on the patient, creating diagnostic uncertainty. Sepsis occurs when the body has an adverse response to an infection. In the U.S., 1.7 million adults develop sepsis annually, according to data from the Centers for Medicare and Medicaid Services. (Famakinwa, 5/19)
Stat: How AI Helped Find A Treatment For A Newborn With An Ultra Rare Disease
In the first, tenuous weeks of her life, Jorie Kraus and her parents faced her possible death repeatedly. Muscles throughout her tiny body simply didn’t work properly. Her heart. Her legs. Her larynx. Even the involuntary action of breathing was labored, and constantly faltering. (Ross, 5/19)
Stat: 23andMe Offers To Connect Users’ DNA Data With Medical Records
23andMe plans to give its customers the capacity to import their medical records, allowing what it calls “a 360-degree view of their personal health.” The offering will include an AI-written 23andMe Health Summary, which the company said is in development and will be available to some beta testers. (Herper, 5/19)
