Top Healthcare News, week of August 5th, 2019 | The Healthy Muse
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Let’s get into this week’s news.
Big Tech’s plans for better access to medical information
Making healthcare accessible.
As a part of its ever-ongoing push into healthcare, the various Big Tech firms were in DC this week alongside plenty of other healthcare players at the 2019 Blue Button Developers Conference.
At the conference, the coalition, called the CARIN Alliance, formed draft guidelines that will 1) set the standard for sharing medical claims data, and 2) make it easier for patients to access that claims data across healthcare companies.
How it (might) work.
The coalition is taking “Common Payer Consumer Data Sets” and making them easier to operate between platforms in order to make it easier for patients and plans to access the information. Keep in mind — as CNBC pointed out, this data isn’t clinical data, but rather claims data, which is a bit less useful.
All the big health systems and tech companies are playing nice for now, which could lead to some exciting results for consumers down the road.
The Remarkable Evolution of Diabetes Treatment
A modern marvel.
With the rising costs of insulin, diabetes has frequently found itself in the news as a hot-button disease for policymakers and journalists alike. A lesser-probed topic is the remarkable transformation that has taken place in diabetes management and monitoring — to the relief of patients.
The transformation of disease management.
The WSJ highlighted some ways that diabetes treatment and monitoring (paywall) is changing — for the better:
Continuous glucose monitors measure the body’s glucose levels constantly and can send results or warnings to multiple smartphones. Insulin pumps can either automatically or manually adjust levels in the body.
Medical device growth.
As the WSJ points out, glucose monitors growth have skyrocketed in the past few years. According to the companies that produce the monitors, the market is huge.
It makes sense — this type of product is great for the consumer. Diabetes patients get more autonomy, (much) fewer finger pricks, and better disease control.
A large market, you say?
With the boon of chronic disease management and medical device connectivity, it was only a matter of time until the Big Tech players got involved. All of Alphabet, Amazon, and Apple are developing new tools and services for diabetes management.
Amazon’s PillPack runs into trouble
Drama in PBM land.
This ordeal is probably as close as we’ll ever get to soap opera levels of drama for PBMs. PillPack is suing a company called Surescripts, which is a company that supports PBMs through “e-prescription,” or a fancy word for electronically transferring patient prescription data between healthcare organizations and pharmacies.
So what’s the beef?
In order to access patient data and prescriptions, Amazon’s PillPack partnered with a firm called ReMyHealth. ReMyHealth would then access the Surescripts database to give PillPack the appropriate patient prescription information.
More speedbumps for PillPack.
Everything was going pretty smoothly for PillPack…until Surescripts suddenly sued ReMyHealth and kicked the firm out of their database, claiming that they were illegally accessing Surescripts’ database and violating their terms by fraudulently handing over patient medication history to PillPack.
According to Surescripts, ReMyHealth apparently mis-represented who they were providing the data to, since the PillPack partner vaguely claimed that the prescription data was meant for “providers caring for patients in hospitals.” Surescripts has stated that the case is being handed over to the FBI. Meanwhile, PillPack sent Surescript a cease-and-desist notice. Yikes.
In other Amazon news…
Pfizer creates a generic drug giant
A generic merger.
This week, Pfizer announced its plans to spin off its generic drug making unit in order to combine that unit with Mylan, which is also a…generic drug making company.
This thing is gonna be massive. The newly combined company is expected to have about $19 billion in revenue, with Pfizer owning 57% and Mylan owning the other chunk (you do the math).
Some big-name generic drugs that the newly combined company makes includes the short-supplied EpiPen and the anxiety-reducing Xanax (heard of them?). The merger comes as a big sigh of relief to Mylan — the company has been struggling heavily lately.
Read the deal announcement here.
Get your popcorn ready.
Don’t worry fam, I’m here to sift through all of the policy noise for you. Let’s get after it.
Trump’s executive order on pricing disclosure.
As I’m sure everyone here has heard by now, Trump — through CMS — is trying to mandate hospitals and insurers to publicly disclose their secretly negotiated healthcare prices.
The industry speaks out.
While most legal experts are 50/50 as to whether or not CMS even has that authority, hospital and other healthcare interest groups are already spicing up their rhetoric, blasting the executive order by calling it a “misguided attempt” that fails to give patients the information they actually need (personal aside — do interest groups have some sort of handbook they follow for language to use in these situations? I’m genuinely curious).
Also, forcing the public disclosure of negotiated prices might even be a First Amendment violation of free speech, which would be a pretty wild conclusion to this whole ordeal.
How the executive order would work…if it makes it.
In summary, CMS would require for hospitals to disclose the prices of 300 healthcare services, 70 of which would be selected by CMS (with the rest selected by the individual hospital). The apparent fine for non-compliance would be $300 per day, or about $110,000 annually.
In other Trump news…drug importation.
In an effort to lower prescription drug costs, the Trump administration is mulling over the idea of importing drugs from other countries — namely, Canada, for starters. While this exact policy might not be implemented, the fact that importation from other countries is being considered (for the first time ever, actually) means that they’re pulling out all the stops.
Importing drugs from other countries, where they generally cost quite a bit less, sounds good in theory. But in reality, it might be tough to get other countries onboard with that idea. I’m sure Canada wants drug shortages.
Partial Medicaid expansion in Utah gets denied.
In other news, the Trump admin denied partial expansion of Medicaid in Utah. Something about how only partially expanding Medicaid is illegal.
Finalized payment rulings for hospice and inpatient rehab facilities.
On the CMS end of the policy spectrum, the institution finalized post acute rulings, which will result in payment increases for inpatient rehab facilities, hospice,skilled nursing, & more. Read more about thethree proposed 2020 rules here, too.
- Health Insurance Innovations, Inc. might be selling the company.
- Private equity is having no troubles raising new funds. WCAS’ latest $4.3 billion fund was oversubscribed
- Looks like SmileDirectClub is the next healthcare ‘tech’ company to go public. They’re looking to raise a billy (that’s $1 billion for you common folk).
- Anthem launched a new consumer app — with texting capabilities. TEXTING CAPABILITIES!!
- The generic drug price-fixing case just hit a major roadblock.
- Trinity Health is challenging non-compete clauses in Michigan
- California gets a $70 million settlement from drugmakers. The state is also trying to fight deals that would delay generic drugs coming to market.
- Colorado is becoming the third state to allow doctors to recommend good ole Mary Jane instead of opioids
- Health-Care Spending Soars (paywall) in New York State
- Data breaches in 2019 are already DOUBLE of how many there were in all of last year
- Are you wondering which places have the most medically inadvisable foods? The Cheesecake Factory and Jimmy John’s are #1 and #2.
- A View From Inside Cigna’s $67 Billion Acquisition Of Express Scripts
- Here’s more of an opinion/commentary article: despite calls to start over, the US Health System covers 90% of people
- The U.S. News just released its 30th Annual 2019–20 Best Hospitals Rankings
- Doctors in the U.S. Use CRISPR Technique to treat a genetic disorder for the first time.
- A Question Rarely Asked: What Would Medicare for All Cover?
My favorite reads this week:
Thanks for reading!
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Originally published at https://www.healthymuse.email on August 5, 2019.