Virgil Dickson, Modern Healthcare
"Faced with the rising costs of generic prescription drugs, health insurers increasingly are turning to tiers and preferred lists on their formularies to keep costs down. Those strategies previously were used only for brand-name and specialty drugs. Experts say those approaches will increase out-of-pocket costs for patients and could make them less likely to adhere to drug regimens.
For years, insurers have encouraged patients to choose generic drugs because they were less expensive than their brand-name counterparts, and most prescription drugs currently used are generics.
But over the past year the cost of generic drugs has skyrocketed, including for products that have been on the market for many years. A study by Pembroke Consulting comparing CMS data for average generic drug acquisition costs between July 2013 and July 2014 found that half of the generic drugs listed rose in cost, with the median increase nearly 12%. Some drug prices saw extreme increases.
Darius Tahir, Modern Healthcare
"Healthcare information-sharing is largely stuck in neutral, according to the Office of the National Coordinator for Health Information Technology's annual report on electronic health-record adoption, released Thursday.
While standards and services have been established to support information-sharing, “practice patterns have not changed to the point that healthcare providers share health information electronically across organization, vendor and geographic boundaries,” the report argued.
Information-sharing is seen as a key component in the move from a fee-for-service approach in U.S. healthcare to a quality of care approach, so signs that the sharing isn't happening could spell trouble for progress toward that shift."
Michelle Stein, Inside Health Policy
"CMS says that states should reimburse Medicaid managed care plans for the Affordable Care Act's health insurance provider fee, and says that the fee itself should be incorporated into plans' capitation rates, however, as the firm JP Morgan notes, the agency leaves some “wiggle room” on whether states should also factor in other potential effects of the fee, such as its non-deductibility status. Medicaid Health Plans of America President Jeff Myers said CMS' recently released frequently asked questions document provides certainty for plans, particularly in states that hadn't yet agreed to cover those fees.
Myers said the plans are gratified CMS decided to move forward with the FAQ, and the release of the FAQ and the 2015 Managed Care Rate Setting Consultation guide suggest that CMS would like to play a more involved role in rate setting for managed care. Since plans have been asking for more transparency around rate setting, CMS' involvement could be a net positive, Myers said.
Sarah Hurtibise, Daily Caller
"The Obama administration has already debuted its new, improved version of HealthCare.gov, but still won’t release premium rates on the website until after the Nov. 4 elections.
The Department of Health and Human Services unveiled the updated federal Obamacare exchange on Wednesday. The website is, by all accounts, in much better condition than last year.
HHS secretary Sylvia Burwell has said that the administration has put the new version of HealthCare.gov through its paces. And the administration has allowed insurers to test the site out themselves — although they made clear that insurance companies are not allowed to share their results with the media."
Nic Horton, Jonathan Ingram and Josh Archambault, Forbes
"As we have written before, Arkansas’ “Private Option” ObamaCare Medicaid expansion has been a disaster for taxpayers, patients and politicians alike. Costs have run over budget every single month since the program’s launch. The Medicaid director who spearheaded the program abruptly resigned to “pursue other opportunities.” The program’s chief legislative architect, a three-term Republican state representative, lost his primary for an open Senate seat to a political newcomer, despite a significant fundraising advantage. And it’s a disaster for patients as well: the ObamaCare expansion plan is already prioritizing coverage for able-bodied adults over care for truly needy patients like Chloe Jones."
Lisa Aliferis, KQED
"A majority of the state’s voters support extending current health insurance programs to all low-income Californians, including undocumented immigrants, according to a new statewide poll released today.
The poll was commissioned by The California Endowment, a foundation that has been actively working to expand health insurance access to all people, regardless of immigration status. The Affordable Care Act expressly bars undocumented immigrants from receiving any of its benefits, including subsidies to purchase health insurance. (Note: The California Endowment funds some of KHN’s coverage.)"
Donna Gordon Blankinship, Associated Press
"SEATTLE — As Washington's health care exchange prepares for its second open enrollment period, officials were still trying to resolve billing and computer problems involving about 1,300 accounts from the previous round of sign-ups.
Exchange officials began with about 24,000 problem accounts that were detected as people started to use their insurance earlier this year."
Elisabeth Rosenthal, NY Times
"The prices of some generic drugs have soared more than 1,000 percent in the last year, and federal officials are demanding that generic drug makers explain the reasons for the increases or potentially face new regulation.
The increased use of generic drugs has been one of the rare success stories in national efforts to curb the nation’s $2.8 trillion medical bill, since generics have historically been far cheaper than name-brand versions. More than eight in 10 prescriptions are filled with generic drugs, according to the Food and Drug Administration. In the 10-year period from the beginning of 2003 through 2012, generic drug use has generated more than $1.2 trillion in savings, according to the Generic Pharmaceutical Association."
Julie Appleby, Kaiser Health News
"Thousands of consumers who were granted a reprieve to keep insurance plans that don’t meet the federal health law’s standards are now learning those plans will be discontinued at year’s end, and they’ll have to choose a new policy, which may cost more.
Cancellations are in the mail to customers from Texas to Alaska in markets where insurers say the policies no longer make business sense. In some states, such as Maryland and Virginia, rules call for the plans’ discontinuations, but in many, federal rules allow the policies to continue into 2017."
Alaina Busch McBournie, Inside Health Policy
"CHICAGO -- There is a “better than 50/50” chance the ACA's device tax will be repealed if Republicans win the Senate in November, Evan Bayh, former Democratic Indiana senator and governor, said Tuesday (Oct. 7) at the Advanced Medical Technology Association’s medtech conference. A Republican-controlled Congress likely would first vote to repeal the Affordable Care Act, and after that measure is vetoed would settle on other changes to the law, such as a repeal of the industry-opposed excise tax, said Bayh, now a partner at McGuireWoods."