Mid-week update

Aetna announced that like United Healthcare it will be sharing prescription drug manufacturer rebates with fully insured commercial plan members at the point of sale next year. Fierce Healthcare noted HHS Secretary Alex Azar quickly complimented Aetna's decision on Twitter.

OPM's community rated contracts with Aetna's and UHC's HMOs participating in the FEHBP would permit those carriers to extend this new practice to FEHBP enrollees. OPM's experienced rated contracts with nationwide carriers don't allow this flexibility. That's unfortunate.

Avik Roy in Forbes offers Secretary Azar some advice on how to accomplish the desired healthcare system change to patient driven care.

As Azar himself as admitted, moving to a more patient- and consumer-driven “will require some degree of federal intervention,” he said, “perhaps even an uncomfortable degree…but the status quo is far from a competitive free market…facilitating a competitive, value-based marketplace is going to be disruptive to existing actors.”
This will be the acid test of Azar’s leadership at HHS. Too often, Republicans have accepted the health care status quo, under the premise that changing the status quo would require–egads!—federal intervention.
But federal intervention—of the wrong kind—is the fundamental reason why American health care is so costly today. It will take meaningful policy changes—both by Azar’s agency and by Congress—to repair 70-plus years of Washington’s handiwork.

Mr. Roy suggests simplifying federal laws to allow patients to get and share their health care data, work with the Justice Department and the Federal Trade Commission to improve competition and less consolidation among healthcare providers, and cut drug prices for consumers like these UHC and Aetna moves will do.

Fierce Healthcare also reports on an interesting CNBC interview with Aetna's CEO Mark Bertolini.

What do Aetna CEO Mark Bertolini and Warren Buffett of Berkshire Hathaway agree on regarding healthcare? It's stranglehold on the economy.
"Warren Buffett said healthcare is a 'tapeworm' on the U.S. economy. It's true," Bertolini said Monday on CNBC. Taming that tapeworm will require a shift towards community-focused health, he added.
Bertolini was referencing Buffett's statement earlier this year when the Berkshire Hathaway CEO announced a healthcare venture with Amazon and JPMorgan. Buffett said he believes the private sector can have more success in lowering healthcare costs than the federal government.

Ditto.  The FEHBlog is concerned that the ACA's "consumer protections" will complicate Buffett's efforts as it does for other health plans. In that vein, Mr. Bertolini added that "he hopes combining the three massive companies on the project will yield good results due to the necessary resources needed. 'I'm hopeful, but don't expect any miracles,' he added. \"

Finally, a couple of new surveys:

• Becker's Hospital Review discusses a WalletHub survey identifying the ten best and ten worst states for physicians. 
• The same publication discusses a U.S. News survey identifying the 36 healthiest counties in our country.