Gregg's Top Three Health Policy Articles

Health policy impacts everyone, but it can be hard to know what is important. If you can only read three things about health policy this week, I suggest...

The Top Three...

Modern Healthcare: Healthcare Bankruptcies In 2023 Hit Highest Level In 5 Years Healthcare company bankruptcies soared in 2023 to their highest level in the last five years, according to a report released Thursday by Gibbins Advisors. The advisory firm's report, which looked at Chapter 11 bankruptcy case filings from 2019 to 2023, found 79 healthcare companies with more than $10 million in liabilities filed for bankruptcy protection last year. Pharmaceutical and senior care companies made up nearly half of the list. The next-highest year for bankruptcies was 2019, when 51 companies filed for protection. (Hudson, 1/25)

Axios: Obamacare Sign-Ups Surge, Especially In Red States States with the largest year-over-year increase in sign-ups include West Virginia (80.2%), Louisiana (75.9%), Ohio (62.2%), Indiana (59.6%) and Tennessee (59.5%), according to data from the Centers for Medicare and Medicaid Services, which oversees the marketplaces. Seven other states saw increases of 45% or more: Mississippi, Arkansas, Alabama, South Carolina, Georgia, Arizona and Texas. Enrollment in Texas increased by just over 1 million to 3.5 million. In Florida, enrollment increased by just shy of 1 million to 4.2 million, the most of any state. Enrollment decreased only in Maine (-2.6%) and Washington, D.C. (-1.4%). (Millman, 1/24)

The Wall Street Journal: It Is Going To Be A Bad Year (Or More) For The Medicare Business America’s seniors are going to keep up their elevated use of the medical system throughout the year. That is the message from Humana’s earnings release on Thursday, which is sending stocks of insurance giants sliding. The health insurer plunged over 10% on Thursday morning while competitors UnitedHealth, CVS Health and Centene were all down sharply. All four companies have significant Medicare Advantage businesses that have been facing pressure from slowing growth and tougher scrutiny by the Centers for Medicare and Medicaid Services. The higher costs, which Humana says it expects will affect the whole industry, are only the latest bit of bad news, one which raises questions about how insurers’ internal modeling could be so off. (Wainer, 1/25)

For a Deeper Dive...

KFF Health News: Senate Probes The Cost Of Assisted Living And Its Burden On American Families A U.S. Senate committee on Thursday launched an examination of assisted living, holding its first hearing in two decades on the industry as leaders of both parties expressed concern about the high cost and mixed quality of the long-term care facilities. The federal government has minimal oversight of assisted living, which is regulated by states, unlike skilled nursing homes. Both the Democratic and Republican leaders of the Senate Special Committee on Aging said their inquiry aimed to detail the financial practices and quality levels in the industry so that consumers would be better able to choose facilities. Lawmakers expressed little appetite for Congress to take a more direct role in regulating the sector, such as by setting federal standards for staffing levels and how workers are trained. (Rau, 1/25)

Stat: Key Senate Panel Considers Medicare Bonuses For Hospitals That Prevent Drug Shortages A key Senate committee is proposing that Medicare pay bonuses to hospitals that take measures to prevent drug shortages. It also wants to change the way doctors are paid to administer drugs in outpatient settings. (Wilkerson, 1/25)

Modern Healthcare: How PBM Legislation Could Affect Caremark, Express Scripts, OptumRx The pharmacy benefit manager industry could look a lot different soon if Congress follows through with bipartisan efforts to pass bills governing the sector. PBMs such as CVS Caremark, Express Scripts and OptumRx would face new transparency requirements that would give health insurance companies, employers, customers and regulators new insights into how they negotiate prices for prescription medicines—and how much of the savings they generate find their way to patients and plan sponsors. Pending legislation also would prohibit lucrative practices such as spread pricing. (Berryman, 1/24)

Axios: Patients Are Drowning In Notifications Got an upcoming doctor's appointment? Perhaps a prescription to refill or a dental cleaning? Odds are your phone has been pinging away with incessant reminders about it. It's not just you. There's a growing flood of emails, texts, phone calls and other prods to patients that — beyond just potentially becoming another digital annoyance — may make them tune out the important stuff. (Reed, 1/25)

KFF Health News: With Trump Front Of Mind, New Hampshire Voters Cite Abortion And Obamacare As Concerns Health care issues are important to Lana Leggett-Kealey, who works as a genetic genealogist. But on Tuesday, as she walked out of her polling place at a local high school and into a frigid New England morning, she said she had something bigger on her mind when she cast her vote. “I want to make sure we have someone competent in the White House,” she said. She wrote in President Joe Biden’s name on her ballot in New Hampshire’s Democratic primary. (Galewitz, 1/24)

Axios: How AI Will — And Won't — Change Health Care Even AI optimists don't envision the technology fundamentally remaking the U.S. health care system anytime soon, but there's widespread agreement that it has the potential to vastly improve the quality of care and trim costly waste. The scale of change that AI could bring to health care not only impacts patients but also the millions of people the system employs — who will ultimately shape how widely it's adopted. (Owens, 1/22)

For the Visual Among Us...

A few years ago I started a weekly e-mail for friends and colleagues who want to keep up on major federal health policy developments but did not have time to plod through all the minutiae--they were busy doing important things like running organizations and taking care of patients! Much to my surprise, it became pretty popular. I have now converted to a weekly newsletter format so you can manage your own subscription preferences and forward to others that might be interested.

These summaries represent my judgement on health policy issues that may not on the front pages, but are relevant to clinicians, administrators, and educators. I monitor many news sources and clipping services to identify content for this newsletter and I try hard to be as factual, balanced, and non-partisan as possible. While the articles are written by others (with credit attributed), the choice of what to include is entirely mine. If you are interested in receiving a daily summary of health policy news, you might consider signing up for the KHN Morning Briefing. If you enjoy podcasts, I suggest What the Health? and Tradeoffs.

-Gregg S. Margolis, PhD