Democrats’ prescription drug collapse

Posted on by • Posted in ACA, Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Drug Prices, Medicare Drug Price Negotiation, Medicare Expansion, Pharmaceutical Industry • Leave a comment
https://www.axios.com/democrats-prescription-drug-congress-collapse-692c3cfd-036f-4024-a1ca-150b9055d84c.html?stream=health-care&utm_source=alert&utm_medium=email&utm_campaign=alerts_healthcare

After campaigning on health care one election cycle after another, Democrats have put forward a social policy framework that does nothing to lower prescription drug prices, expands Medicare benefits to only include hearing coverage, and temporarily builds on the Affordable Care Act.

Why it matters: The framework may be the best the party can do with razor-thin vote margins in Congress. But some health care advocates say it’s unacceptable — and voters may not be thrilled either.

The big picture: Democrats can certainly claim some health care victories.

  • The framework would extend the enhanced ACA subsidies that the party enacted earlier this year, although only through 2025. This has been plenty of moderate Democrats’ primary health care goal.
  • The framework also makes ACA subsidies available to people in the Medicaid coverage gap in states that have chosen not to expand, another major priority for many Democrats. This would also last through 2025.

The other side: Progressives have a much tougher pill to swallow. And when it comes to drug prices, nearly the entire party has campaigned on lowering them.

  • Progressives, championed by Sen. Bernie Sanders, have been pushing for Medicare to cover dental and vision benefits, as well as hearing. And that’s a far cry from what they actually want, which is Medicare to be offered to more or all Americans.
  • Lowering drug costs and expanding Medicare benefits are also very popular with voters — particularly seniors, who vote in large numbers.

What they’re saying: “We are outraged that the initial framework does not lower prescription drug prices,” said AARP in a statement. “Americans are fed up with promises that have not been kept.”

  • “The president and Democratic leaders are on the record fiercely supporting drug price negotiations and Medicare dental benefits. These are wildly popular benefits that almost all families across this nation want. Unfortunately, this small number of intransigent Democrats, who are schilling for lobbyists and drug companies, are standing in the way,” Families USA wrote in a statement.

What we’re watching: What’s out today is just a framework, and some key Democrats are vowing to keep fighting.

  • Energy and Commerce Chairman Frank Pallone and Senate Finance Chairman Ron Wyden both told reporters that drug prices are still being discussed.
  • And plenty of other Democrats, especially those in vulnerable seats, may be very sensitive to the prospect of failing to follow through on the party’s commitment.

FTC tightens reins on merger control: 6 things to know

Posted on by • Posted in Antitrust, Federal Trade Commission (FTC), Health System, Hospital, Hospital Industry, Market Consolidation, Mergers & Acquisitions • Leave a comment
https://www.beckershospitalreview.com/hospital-transactions-and-valuation/ftc-tightens-reins-on-merger-control-6-things-to-know.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G
Federal Trade Commission (FTC) Definition

The Federal Trade Commission announced Oct. 25 it is restoring its practice of requiring companies that previously pursued an anticompetitive merger to get prior approval for future transactions. 

Six things to know: 

1. The FTC will now require companies to get prior approval from the agency for any transaction “affecting each relevant market for which a violation was alleged” for at least 10 years. 

2. The FTC said in some situations it may seek prior approval provisions that cover broader geographic markets beyond just the relevant markets affected by the merger. The agency will consider several factors to make the determination, including the level of market concentration, the degree to which the transaction increases concentration and evidence of anticompetitive market dynamics. 

3. The FTC is less likely to pursue a prior approval provision against merging companies that abandon their transaction, the commission said. 

4. The FTC is reinstating the prior approval practice after the commission voted in July to repeal a 1995 policy statement that prevented the agency from imposing these merger restrictions. 

5. The agency said it has already implemented the policy by imposing strict limits on future acquisitions by Denver-based DaVita after the company’s acquisition of University of Utah Health’s dialysis clinics.  

6. “The FTC should not have to waste valuable time and resources investigating clearly anticompetitive deals that should have died in the boardroom,” Holly Vedova, director of the agency’s bureau of competition, said in a news release. “Restoring the long-standing prior approval policy forces acquisitive firms to think twice before going on a buying binge because the FTC can simply say no.” 

9 hospital deals called off

Posted on by • Posted in Deals Called Off, Divestitures, Health System, Hospital, Hospital Industry, Market Consolidation, Mergers & Acquisitions, Unwind • Leave a comment
https://www.beckershospitalreview.com/hospital-transactions-and-valuation/9-hospital-deals-called-off.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G
How to pronounce Called Off - YouTube

In the last six months, several health systems have canceled plans to merge, acquire a hospital or unwind an existing partnership. 

Here is a breakdown of nine of them:

1. Ascension, AdventHealth to unwind partnership
Ascension and AdventHealth are unwinding their Amita Health partnership after working together for nearly seven years, the organizations announced Oct. 21.

2. SSM Health ditches deal to sell Missouri hospital to Quorum
St. Louis-based SSM Health has abandoned its plan to sell a Missouri hospital to Brentwood, Tenn.-based Quorum Health.

3. North Carolina system severs ties with Atrium, joins UNC Health
Carolinas HealthCare System Blue Ridge, a two-campus system in Morganton, N.C., cut ties with Atrium Health and partnered with UNC Health. Carolinas HealthCare System Blue Ridge and UNC Health finalized their management services agreement Oct. 1. Under the partnership, Blue Ridge will be renamed UNC Health Blue Ridge.

4. Tower Health won’t sell hospitals, pursues alliance with Penn Medicine
West Reading, Pa.-based Tower Health abandoned plans to sell the entire health system and instead will remain independent. It also signed a letter of intent to develop a strategic alliance with Philadelphia-based Penn Medicine.

5. Iowa hospital exits MercyOne affiliation
Mercy Iowa City (Iowa) is ending its affiliation with MercyOne’s health network in West Des Moines, Iowa.

6. LifePoint, Prisma Health call off hospital sale
A deal to sell the three hospitals in South Carolina fell through. Brentwood, Tenn.-based LifePoint inked a deal to sell the three hospitals and an ER to Greenville, S.C.-based Prisma Health, but the parties canceled the deal April 9. The health systems said significant delays and challenges with the Federal Trade Commission “made it prohibitive to move forward.” Medical University of South Carolina in Charleston later purchased the three hospitals.

7. Sentara, Cone Health nix merger
Norfolk, Va.-based Sentara Healthcare and Greensboro, N.C.-based Cone Health have abandoned plans to merge into an $11.5 billion system, the organizations said in a joint statement June 2. 

8. CommonSpirit’s plan to sell 14 hospitals to Essentia abandoned
Duluth, Minn.-based Essentia Health and Chicago-based CommonSpirit Health have abandoned a deal that would have added 14 hospitals and three clinics to Essentia Health’s network.

9. 2 hospitals to part ways with U of Kansas Health System
HaysMed, a single-hospital system in Hays, Kan., and Pawnee Valley Community Hospital in Larned, Kan., will depart from the University of Kansas Health System. The organizations mutually agreed to part ways.

Schumer: Medicare, prescription drugs hold up final deal

Posted on by • Posted in Health Insurance Coverage Adequacy, Health Policy, High Deductible Health Plans, High Drug Prices, Medicaid, Medicare, Medicare Drug Price Negotiation, Medicare Expansion • Leave a comment

https://thehill.com/homenews/senate/578547-schumer-medicare-prescription-drugs-among-holdups-to-final-deal?userid=12325

Do Not 'Cave to Big Pharma': 60+ Groups Tell Schumer, Pelosi to Deliver on Drug Pricing Reform

Senate Majority Leader Charles Schumer (D-N.Y.) told reporters Tuesday that negotiators still haven’t reached agreement on language to expand Medicare benefits and lower the price of prescription drugs, two major pieces of their agenda, but insisted “a final deal is within reach.”

Schumer signaled to reporters that Democrats are much closer to agreement on climate provisions, which he promised would make a “robust” contribution to addressing global warming.

But he acknowledged that two of Senate Budget Committee Chairman Bernie Sanders’s (I-Vt.) top priorities, expanding Medicare and cutting the cost of prescription drugs, remain unresolved.

The other holdups are a disagreement over creating a Medicaid-type program to expand health care coverage in states that opted out of expanding Medicaid under the Affordable Care Act, the length of a national paid family leave program, and a proposal to empower the IRS to broadly review banking activity to find unreported tax obligations.

“I believe that we will get this done and we will get it done soon,” Schumer said after a caucus meeting. “No one ever said that passing transformational legislation like this would be easy but are on track to get it done.

“There is universal consensus in our caucus that we have to come to agreement despite the differences in views on many issues,” he added. “I believe a final deal is within reach.”

Schumer said negotiators are making good progress on the climate provisions, despite a recent decision to drop the $150 billion Clean Electricity Performance Program, which was a top priority of progressives who want to tackle carbon emissions.

“There’s going to be a very strong, robust climate package. And our goal is to meet the president’s goal and there are different ways to get there,” he said.

But he acknowledged the dispute between Sanders and Sens. Joe Manchin (D-W.Va.) and Kyrsten Sinema (D-Ariz.) over expanding Medicare benefits and empowering the federal government to negotiate lower prescription drug prices remains unresolved.

“We’re working on both those issues now. As I said, we’re making progress. We’re not there yet on either of them but it’s important to do,” he said.

Schumer said earlier in the press conference that expanding Medicare benefits is one of his top priorities telling reporters: “I believe strengthening Medicare is very, very important.”