Friday, December 13, 2019

TGIF

Health Payer Intelligence reports that
America’s Health Insurance Plans (AHIP) submitted a statement to the House Energy and Commerce Committee opposing current single-payer proposals in the United States.
“Americans are facing an escalating crisis of affordability across our health care system. Cost pressures are becoming more intense for all who pay the tab for health care in the United States, whether they be consumers, employers, or governments,” the organization explained. “AHIP and our members believe that the best way to bring down costs is to improve what’s working and fix what’s not, so that everyone has affordable coverage, access to high-quality care, and control over their health care choices.”
Amen to that.

On the prescription benefit manager front --
  • Per Fierce Heathcare, Express Scripts has unveiled the first apps to be added to its curated digital health formulary.  The idea behind the formulary, which other PBMs are adopting, is to "make it easier for health insurers [and self funded employers] to vet the tools for their members, especially as the number of solutions available in the market continues to grow." The list of ESI approved apps may be found here.   
  • Healthcare Dive informs us that CVS Health "unveiled a precision medicine program for oncology patients Thursday designed to increase access to broad-panel gene sequencing tests for patients with specific advanced stage cancers."
The Department of Health and Human Services' Office for Civil Rights, which enforces the HIPAA Privacy and Security Rules announced its second settlement with a healthcare provider, Krounda Medical of Florida, over allegations that the provider had not complied with the Privacy Rule's requirement on individual access to medical records. The provided agreed to pay a $85,000 penalty and take remedial actions.

The Boston Globes STAT reports that
In this week’s New England Journal of Medicine, we report that home has become the most common place of death among Americans dying of natural causes for the first time since the early 20th century, while deaths in hospitals and nursing facilities have declined. Our analysis of data from the Centers for Disease Control and Prevention and the National Center for Health Statistics also showed striking differences in place of death according to who you are and what you die of: individuals who are nonwhite or those dying from diseases other than cancer are less likely to die at home than those who are white or those who die from cancer.
It appears to be time for health plans to review their in home hospice coverage.  

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