The pushback continues against the impending enactment in 2020 of a tax on medical devices, part of the Affordable Care Act legislation that’s been delayed for ten years. Humana reports favorable results with its Medicare Advantage plans and provides evidence that it both saves money and improves outcomes. UnitedHealthcare will open MA centers in Walgreens store in five test markets. This and more are the top stories in this week’s Innovation Partners BioBlog.
Humana’s Medicare Advantage value-based programs reduce healthcare costs by $3.5 billion, report shows
Humana’s 5th annual value-based care report states that Medicare Advantage plans save over traditional Medicare. The fee-for-service model saves approximately $3.5 billion and reduces hospital admissions by 27%. Emergency room visits were reduced by 14.6%. Humana’s Medicare Advantage plan continues to grow in popularity and accounts for the company’s increased third-quarter earnings. It appears to be a win-win, with benefits for Humana and the people it covers.
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Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC
The final analysis of part 1 of the two-part CheckMate 227 trial, which has a complex design, was presented at the European Society for Medical Oncology (ESMO) Congress 2019 and published online simultaneously in TheNew England Journal of Medicine. The report indicates that a combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227. Nivolumab/ipilimumab also improved overall survival compared with chemotherapy in the total study population as well as in patients whose tumors had low expression of PD-L1 (ie, < 1%).
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Payers, business groups roll out massive lobbying effort to get delay for ACA insurer tax
Both business groups and payers are pushing back to delay a $16 billion tax mandated by the Affordable Care Act that is scheduled to go into effect in 2020. Advertising campaigns and other grassroots efforts are rolling out in full force, and members of various special interest groups are working on a bipartisan effort to suspend the tax. Some call suspension “must-pass” legislation.
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Lobby groups call for permanent axing of delayed and much maligned medical device tax
Life sciences groups are calling for the elimination of a medical device tax. The 2.3% tax on importers and manufacturers of medical devices is worth about $20 billion over ten years, according to government estimates, and was enacted in 2010 as part of the Affordable Care Act. Delays have stalled it with the final delay pushing its enactment to 2020. Now, however, groups continue to call for its repeal and elimination.
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UnitedHealthcare to open Medicare service centers in Walgreens stores
UnitedHealthcare plans to open Medicare service centers in five markets next year. These centers will be inside Walgreens stores and provide information on benefits. A total of 14 centers in markets including Las Vegas, Cleveland, Phoenix, Denver, and Memphis, are part of the test. United Healthcare Medicare Advantage members may also schedule wellness visits through the centers as part of the insurer’s House Calls program. The program aims to expand access to UnitedHealthcare’s MA services by bringing them into retail spaces frequented by their customers.
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Trump Administration’s Transparency Rules Are Part of Larger Effort
The Trump Administration unveiled two new rules in November (one final, one proposed) outlining price transparency requirements for hospitals and health insurers. Industry experts warn that the move won’t benefit patients and will, instead, harm private negotiations to lower prices. All standard charges must be made public and available in paper format or on the internet. Negotiated rates with in-network providers and historical allowed amounts to out-of-network providers must also be made available to the public in “standardized, regularly updated machine-readable files.” The administration believes this will improve competition rather than harm it.
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Production at Teva API plant halted until next year
Teva Pharmaceuticals announced that production at its Italy plant will stop until next year. The company stated in a letter to customers that Italian regulatory authorities had asked Teva to submit new registrations for products manufactured at the site. The company has downsized its manufacturing facilities over the past few years to cut $3 billion in operating expenses, a move the company made to shore up its finances and reduce its debt incurred after purchasing Actavis, a generic drugmaker.
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