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ASCO Releases 2016 Policy Agenda and ACA Proving to be Unprofitable for Health Insurers


IP Blog | Dave Melin | December 20, 2015

BioBlog Weekly oncologyThis week in healthcare: ASCO releases the highlights of 2015 as well as their 2016 policy agenda, and a report suggests that ACA business was “unprofitable” for most insurers in 2014, and may also be in 2015.

A Banner Year for Moving ASCO Policy and Practice Agenda Forward

This release from ASCO highlights notable events in cancer care and successes for the advocacy organization during 2015, including the repeal of SGR, the release of ASCO’s Value Framework, and a new policy statement on site-neutral payments.

Report: ACA Business Unprofitable for Most Health Insurers

A new report suggests that “Affordable Care Act exchange business was unprofitable for most health insurers in 2014 and will likely be in 2015.” The report also notes that the ACA’s impact is greater on insurers for whom exchange patients represent a larger proportion of their business.

Even with Smaller “Donut Hole,” Medicare Cancer Pill Costs Stay High

Despite government efforts to scale back the so-called “donut hole” gap in Medicare coverage, a study suggests that “seniors insured by Medicare may still face high out-of-pocket costs for oral cancer medicines.”

UnitedHealthcare Broadens Two of Its Oncology Management Programs

UnitedHealthcare recently announced that “it has expanded two of its efforts aimed at providing high-quality cancer care efficiently through its collaborations with physicians.”

Hospitals Launch Specialty Pharmacies to Curb Drug Costs

As specialty drug spending continues to grow, some larger health systems are beginning to go into the specialty pharmacy business themselves, arguing that they can compete with larger pharmacies because “they can do a better job overseeing the use of the drugs they dispense.”

Turing Pharmaceuticals Replaces Martin Shkreli as CEO

Martin Shkreli, who recently made headlines for raising the price of a drug by 500% overnight, has resigned as CEO of Turing Pharmaceuticals after his arrest following allegations of fraud.

Cancer: More than Just Bad Luck?

Findings from a new study are sparking discussion about whether cancer is about bad luck or something more avoidable: the study suggests that “environmental exposures, lifestyle choices and other factors that could be changed or avoided account for between 70% and 90% of the gene mutations that make cancerous tumors progress, leaving “intrinsic factors” to account for the minority of malignant tumors.”

Humana-ACO Partnership Improves Health Measures

One year after beginning a partnership, Humana and the Delaware Valley ACO “have been able to improve health measures among Medicare Advantage members.”

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