Medicaid and Medicare are in the news this week, with Medicaid spending analysis anticipating a slightly lower than expected per enrollee cost. Alabama seeks to change Medicaid requirements and the Trump Administration unveils $1 billion in grants to combat the opioid crisis. This and more in this week’s Innovation Partners BioBlog.
Medicaid spending hit $581B in 2016. Here’s how it’s projected to grow over the next decade
Medicaid projected that over the next 10 years, expenditures are expected to grow at an average annual rate of 5.7%, reaching over $1 trillion by 2026. Currently expenditures stand at $580.9 billion for 2016. Annual per enrollee costs are projected to grow by 4.2 percent, or at a 0.1-percent lower rate, from 2016 to 2025.
Payer Roundup—CMS reviews Alabama work requirements; Drug prices are still climbing
The Trump administration will review an application from Alabama to implement work requirements in the Medicaid program. The state’s proposal would require residents with Medicaid coverage to work, attend job training or do community service 35 hours a week, while parents of children younger than six would be required to work 20 hours. Alabama’s argument is that working parents are healthier for children. More, including updates on UnitedHealthcare and others, in this week’s Payer Roundup.
Intermountain further solidifies research reputation with new innovation center
Utah-based Intermountain Healthcare has opened a new 120,000-square-foot innovation center aimed at accelerating care transformation. The Kem C. Garder Intermountain Transformation Center will house institutes for leadership development simulation, research and clinical training, among others. On-site clinicians plan to conduct research into 3D printing of organs for transplant, for example, as well as other cutting-edge interventions and treatments.
Kaiser, Aetna lead the way in NCQA’s Medicare plan ratings
Kaiser and Aetna comprehensive Medicare plans are leading the competition, according to the National Committee for Quality Assurance. Kaiser Foundation Health Plan, which offers plans in just eight regions, had six plans with a perfect score of 5. All of its plans scored a 5 in the prevention category. All but 8 of Aetna’s 70 Medicare plans that were rated received an overall score of 4 or higher.
Study: Drug prices rise twice as fast as expected in a shortage
Researchers at the University of Pittsburgh and Harvard found that drug prices increased more dramatically than expected in 2016 drug shortage. Researchers compared pricing of 617 formulations of 91 drugs between December 2015 and December 2016. The increase was around 16% for drugs in shortage compared to about 7% for drugs that were not in a shortage. Price hikes were especially notable for drugs produced by three or fewer suppliers, which increased by about 12% ahead of a shortage and about 24% within 11 months of a shortage. Experts believe companies took advantage of the shortage to slip increases in under the radar.
Healthcare Roundup—$1B awarded for grants to respond to opioid crisis; Senate bill would speed generics to market, CBO says
The Trump Administration announced this week $1 billion in grants to combat the opioid crisis. Groups receiving the grants focus on areas congruent with the Department of Health and Human Services’ 5-Point Opioid Strategy. Advertising and news coverage of the growing crisis has made it a priority in the midterm elections.
CVS Unveiled New Approach to Manage Specialty Drugs
CVS Health unveiled a new approach to managing certain specialty drugs based on data from the Institute for Clinical and Economic Review (ICER). Industry experts have not reached consensus on how it may impact drug pricing overall. The new approach allows clients to exclude those medications that come onto the market with a price more than $100,000 per quality-adjusted life year (QALY) as determined by publicly available ICER analyses. Drugs to which the FDA has given breakthrough therapy status will not be eligible for exclusion.