This week’s Innovation Partners BioBlog takes a look at several aspects of the business of healthcare. First, the impressive news that the Cigna, Express Scripts deal to acquire PBM was approved by shareholders in both companies, a move that goes against expert predictions. Over 150 medical organizations and groups praise the Trump Administration’s efforts to reduce paperwork but caution against cuts in pay. This and much more in this week’s BioBlog.
Cigna, Express Scripts shareholders approve $67B deal
Shareholders overwhelmingly approved the Cigna, ExpressScripts deal to acquire PBM, with Cigna shareholders voting 90% approval and ExpressScripts shareholders approving the deal with 78% voting ‘yes.’ This comes after weeks when noted analyst Carl Icahn raised doubts whether shareholders would allow the deal. The pending deal must still pass muster with the Department of Justice, but the shareholder vote was seen as the first major hurdle.
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North Carolina Medicaid Opens Bidding on RFP
The North Carolina Department of Health and Human Services opened bidding for its Medicaid program, announcing the release of an RFP open to managed care organizations seeking to provide Medicaid services. Aetna Inc., Anthem, Inc. and Centene Corp. have already formed partnerships with providers and other local entities in North Carolina as the state prepares to move some 1.5 million enrollees from fee for service to managed care beginning in November 2019.
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17 health systems join former CMS administrator to build digital tools for Medicaid patients
Seventeen health systems representing more than 280 hospitals have signed on to the Medicaid Transformation Project, an effort led by the healthcare innovation network AVIA and former Centers for Medicare & Medicaid Services (CMS) Administrator Andy Slavitt, the founder and general partner at Town Hall Ventures. Five health systems will anchor the project: Advocate Aurora Health, Baylor Scott & White Health, Dignity Health, Geisinger and Providence St. Joseph Health. Twelve more systems, including Rush University Medical Center, Memorial Hermann Health System and Spectrum Health System have signed onto the initiative. The new collaboration will focus on five key areas of concern for the Medicaid system including emergency room visits, women and infants, behavioral health and substance abuse disorder.
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HealthPartners collaborates with Oncology Analytics to support high-cost cancer treatment
HealthPartners is implementing Oncology Analytics Benefits Management Consulting Services for members in HealthPartners fully and self-insured plans. Oncology Analytics will use its utilization management platform and board-certified oncologists to ensure that high-cost cancer drugs are the most effective, safe and affordable option. If a better treatment plan is available, board-certified specialists from Oncology Analytics will call a patient’s doctor to discuss the alternatives. During the pilot program, 80% of treatments reviewed by Oncology Analytics confirmed that the treatments prescribed were safe, effective and affordable.
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House and Senate leaders push HRSA to finalize 340B regulations on drug pricing, penalties
A coalition of both Republicans and Democrats is asking the Health and Human Services Administration to push forward new rules concerning 340B drug pricing. Four members of the House and Senate have asked the agency to implement a binding Administrative Dispute Resolution (ADR) process to resolve compliance disputes, impose civil monetary penalties against manufacturers or knowingly overcharge the 340B program and issue “precisely defined standards of methodology” for calculating 340B ceiling prices.
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Integra Connect Becomes CancerLinQ Platform’s First Certified Electronic Health Record
Integra Connect’s EHR Solution for Oncology has been recognized as the first CancerLinQ Certified Electronic Health Record (EHR) System. CancerLinQ and Integra Connect have entered into an agreement to collaborate on products and services geared toward improving the quality of cancer care and the access of the CancerLinQ platform to oncology practices.
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Doctors Would Like Trump To Reduce Paperwork Without Cutting Their Pay
Medical groups praised the Trump Administration’s efforts to curb paperwork for doctors; 150 groups praised the administration’s efforts to ease documentation requirements. However, they caution against making billing codes so simple they cut doctors’ pay. Overall, the effort to cut paperwork is praised but the risk is reducing remuneration for services.
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