Cartoon – Let’s Pretend that Matters
Monthly Archives: December 2016
Cartoon – As Is the Norm
Catholic Health Initiatives pulls out of insurance business
As more hospitals across the country consider launching their own health insurance plans, one big hospital operator is pulling out of the business.
Catholic Health Initiatives (CHI), a large nonprofit health system based in Colorado, no longer plans to develop a “wholly owned and nationally driven” insurance business, according to The Wall Street Journal. Instead, it’s going to sell portions of the health insurance business.
The provider, which operates 103 hospitals in 18 states, lost nearly $110 million during the last fiscal year, according to the article.
Dean Swindle, chief financial officer and president of its enterprise business lines for CHI, didn’t agree to an interview for the latest news, but told the publication in April that “it’s tough in the health plan business. You lose money. You make mistakes. You plow forward. It takes cash.”
CVS Health launching an analytics-based initiative to deliver personalized diabetes care
Dive Brief:
- CVS Health will launch the Transform Diabetes Care program in early 2017 to help its pharmacy benefit management clients.
- The program will use data analytics to personalize care for diabetes patients and CVS hopes it will allow each participating diabetic client to save as much as $5,000 annually.
- The goal is to reduce spending on diabetes patients by offering them personalized strategies to improve medication adherence, control over blood glucose levels, and make healthy lifestyle changes.
Partners HealthCare suffers $108M in operating losses in FY 2016
Dive Brief:
- Operating revenues at Boston-based Partners HealthCare increased 7% from the previous year to $12.5 billion, but $12.6 billion in operating expenses canceled out those gains, according to the health system’s financial statements.
- The operating loss is the largest posted in the system’s 22-years of history, which has struggled financially since it acquired Neighborhood Health Plan in 2012, a Medicaid managed care subsidiary that had a $89-million operating loss two years ago.
- A nursing strike and implementation of a new EHR system also contributed to poor financial performance at Partners in fiscal year 2016, according to the Boston Herald.
Why Catholic Health is bowing out of the insurance field
http://www.healthcaredive.com/news/why-catholic-health-is-bowing-out-of-the-insurance-field/421923/
Dive Brief:
- Tired of steep losses, Catholic Health Initiatives is looking to sell its health plan subsidiary, Modern Healthcare reported.
- QualChoice Health, previously known as Prominence Health, sells Medicare Advantage and commercial plans to employers in six states.
- CHI began buying up health plans three years ago as a way to adhere to the Affordable Care Act and compete with other carriers.
Aetna/Humana-DOJ trial: Prosecutors battle over Medicare Advantage plans
Dive Brief:
- The Department of Justice (DOJ) argued against the viability of Aetna’s plans to sell off assets to counter concerns over its proposed $34 billion merger with Humana, The Wall Street Journal reports.
- Aetna had agreed to sell $117 million in assets, representing nearly 30,000 Medicare Advantage enrollees in 21 states, to Molina Healthcare.
- Federal prosecutors questioned whether Molina’s purchase of those assets be enough to sustain competition in the market for private Medicare plans in the markets where Aetna and Humana operate.
Uncertainty. Opportunity. It’ll all be there for healthcare in 2017, PwC says
You reap what you sow. The idea is the push behind countless movie plots and rock songs but it’s also a central theme to PricewaterhouseCooper’s (PwC) Health Research Institute’s (HRI) new report on healthcare trends to watch out for in 2017. The seeds for next year were planted in 2007, according to the new report.
There will be certain uncertainty over the fate of the Affordable Care Act next year. However, many of the trends that should be on top-of-mind for hospital administrators next year will relate to value-based care, Trine Tsouderos, PwC’s Health Research Institute director, told Healthcare Dive. “If you think about the political changes as the waves on the surface of the ocean, there’s a very strong current underneath that is the shift to value-based care,” she said. “We do not see that changing. We see the shift continuing industry-wide despite any changes in Washington, DC.”
For example, only 90 or so retail clinics were in operation and about one in 10 consumers have been to one in 2016. Today, more than 3,000 such clinics have been propped up across the U.S. with one in three consumers having visited one. This drift highlights the continued move to more convenience in healthcare access as well as price transparency for patients.
Sticking with the nautical theme, Tsouderos likened the healthcare industry to a battleship in explaining why ideas from 10 years ago are now coming to fruition. It takes a long time to change the course of such a large and complex ship. “You can’t turn [the industry] on a dime,” she said.
What emerging trends administrators should know for 2017
https://www.pwc.com/us/en/health-industries/top-health-industry-issues.html
Cartoon – I’m not sure what’s worse
Cartoon – Healthcare Reform
HENRY KOTULA 