Top Stories

  • The federal government, led by the National Institutes of Health and the Substance Abuse and Mental Health Services Administration, will award $350 million in grants over three years to research sites in Kentucky, Massachusetts, New York and Ohio focused on reducing opioid overdose deaths by as much as 40 percent. The initiative, coordinated by North Carolina-based RTI International, will engage 60 towns in studying the impact of evidence-based prevention, treatment and recovery in states hit exceptionally hard by the opioid crisis. (The Wall Street Journal)
  • Finalized rules from the Centers for Medicare and Medicaid Services will attempt to encourage the use of lower-cost generic treatments by permitting health insurers to institute co-pay accumulator programs beginning in 2020, blocking drug manufacturer coupons from applying to patients’ annual out-of-pocket maximums when a generic is available. CMS will also cut exchange user fees and recalculate the amount that subsidized Affordable Care Act enrollees must pay toward premiums for the benchmark plan, a change that would increase out-of-pocket maximums for enrollees. (Modern Healthcare)
  • The Montana Legislature passed legislation to extend Medicaid expansion for another six years, maintaining health coverage for about 96,000 low-income residents, and Democratic Gov. Steve Bullock said he will sign it into law. Under the bill, the program, which will levy a hospital tax to obtain more federal funding, will remain intact even if the Trump administration rejects proposed work requirements and is expected to bring the state about $720 million in federal funding in each of the next two fiscal years. (The Associated Press)

Chart Review

Events Calendar (All Times Local)

04/22/2019
Kaiser Family Foundation forum on the Trump administration’s HIV initiative 10:00 am
World Class: A conversation with author Dr. William A. Haseltine 5:00 pm
View full calendar

The Brands That Define American Culture and Commerce

Morning Consult analyzed over 400,000 survey interviews to determine this year’s rankings. See who made the list.

General

Private equity infuses healthcare with $63B investment
Alex Kacik, Modern Healthcare

Global private equity-backed healthcare deals rose almost 50% to $63.1 billion 2018, the highest level since 2006, according to a new report. The provider sector continued to be the most active, with global transaction value surging to $35 billion across 159 deals, compared with $18.9 billion across 139 deals in 2017, Bain & Co.’s 2019 private equity and corporate M&A report found.

Number of Uninsured Americans Jumps 1.4 Million in Trump Era
Shira Stein, Bloomberg Law

Over 1 million Americans lost health insurance between the end of the Obama administration and end of the second year of the Trump administration, according to new information from the Congressional Budget Office. The number of uninsured Americans under age 65 climbed from 27.5 million in 2016 to 28.9 million in 2018, the CBO said.

Legislation Overhauls Maryland Medical Network’s Board
David McFadden, The Associated Press

Maryland’s governor signed fast-tracked legislation Thursday to overhaul a major medical network’s board of directors following revelations of numerous questionable financial arrangements involving board members, including Baltimore’s mayor. Mayor Catherine Pugh, who joined the volunteer board in 2001, has become the public face of the University of Maryland Medical System’s “self-dealing” scandal.

Risk Scores Assess Ties Between Genes and Obesity, Disease
Betsy McKay, The Wall Street Journal

Researchers are developing new ways to mine growing stores of genetic data to predict risk of disease. The latest such tool, which assesses the risk for obesity, illustrates both the promise and the limitations of this emerging area of research.

Parents of 3 NYC children face $1,000 penalty for violating measles order
Lena H. Sun, The Washington Post

New York City health officials issued summonses to parents of three children Thursday for failing to have their children vaccinated against measles, a violation of the city’s emergency order mandating immunizations to control a surging outbreak.

Judge Upholds Mandatory Measles Vaccinations As New York Closes More Schools
Francesca Paris, NPR News

A Brooklyn judge has sided with New York health officials to uphold a mandatory measles vaccinations order, dismissing a lawsuit from a group of parents who claimed the city had overstepped its authority. Judge Lawrence Knipel on Thursday refused parents’ request to lift the vaccination order that was imposed last week to stem a severe measles outbreak.

Stocks Mixed in Holiday Hit Trading; Dollar Steady: Markets Wrap
Cormac Mullen and Todd White, Bloomberg

Stocks in Asia traded mixed Friday after modest gains in their U.S. counterparts, ahead of a holiday weekend in many countries. The dollar was little changed.

Payers

Washington set to be 1st state with long-term care benefit
Rachel La Corte, The Associated Press

Washington is poised to become the first state to establish an employee-paid program creating an insurance benefit to help offset the costs of long-term care, a step advocates say will help an aging population that is likely not prepared for the increasing costs needed for daily assistance.

Providers

Should Ohio hospitals need licenses? DeWine weighs options
Kaitlin Schroeder, Dayton Daily News

Ohio is the only state in the U.S. that does not license hospitals and Gov. DeWine’s administration is looking at whether that should change. Hospital officials, however, say that while they aren’t licensed, they are already highly regulated for patient safety and quality.

Pharma, Biotech and Devices

Lower dose of Pfizer-Lilly painkiller misses main goals in late stage study
Aakash Jagadeesh Babu, Reuters

A lower dose of non-opioid painkiller developed by Pfizer Inc and Eli Lilly and Co failed to meet main goals in a late-stage study in patients with moderate-to-severe osteoarthritis of the hip or knee, the companies said on Thursday. The drug, tanezumab, belongs to a new category of pain medications that target nerve growth factor, a protein involved in the growth of nerve cells, and has been touted as a potential blockbuster.

Pricing is taking a toll on the reputation of the pharmaceutical industry
Ed Silverman, Stat News

When it comes to improving its image, the best that the pharmaceutical industry can do is go sideways. Just 41% of patient groups thought the pharmaceutical industry had an “excellent” or “good” reputation last year, which is within striking distance of the 43% notched in 2017 and 38% in 2016, according to a survey by PatientView, a research firm that canvassed more than 1,500 patient groups from 78 countries between last November and this past February.

A biotech startup’s lofty goal: Kill cancer with pills that target RNA instead of proteins
Adam Feuerstein, Stat News

Arrakis Therapeutics is named for the desert planet in the legendary “Dune” series of science-fiction novels. It’s an apt name because the Waltham, Mass., startup is trying to achieve a feat once thought to be biotech fantasy: Develop oral medicines — pills — that can target RNA, the messenger-like molecules that turn genetic instructions into proteins.

Health IT

Crowdsourced AI learns to target lung tumors for radiation
Linda Carroll, Reuters Health

In many parts of the world there are not enough radiation oncologists to design and deliver radiation treatments for lung cancer patients, but that gap could one day be filled with the help of artificial intelligence, researchers suggest in a new study.

The Future of Wearable Tech Is Called a Hearing Aid
Josh Dean, Bloomberg

When Brandon Sawalich started at Starkey Hearing Technologies in suburban Minneapolis, he was 19 and there were about 70 companies worldwide making hearing aids. That was 1994.

Opinions, Editorials and Perspectives

When It Comes to Alzheimer’s, Important Changes Are Coming for MA Beneficiaries
George Vradenburg and John Dwyer, Morning Consult

The majority of experts agree that because Alzheimer’s disease is significantly underdiagnosed and underreported, a large number of people may not know they have it.

Research Reports

Value-Based Care in America: State-by-State
Change Healthcare

States are taking varied approaches in transitioning to value-based care, and some are much further along the spectrum than others. In its 2019 analysis, Value-Based Care in America: State-by-State, Change Healthcare details the progress of each state to give you a comprehensive understanding of the current payment-reform landscape.

Health Insurance Coverage for People Under Age 65: Definitions and Estimates for 2015 to 2018
Congressional Budget Office

In the United States, most people under age 65 are covered by private health insurance that they or their family members obtain through their employers (referred to as employment-based, or group, coverage). A smaller number of people buy private health insurance individ- ually (through what is known as the nongroup market).

‘Corporate Reputation of Pharma in 2018 – the Patient Perspective’
PatientView

The ‘Corporate Reputation of Pharma, 2018’ Global report is based on the findings of a PatientView November 2018-February 2019 survey exploring the views of 1,500 patient groups worldwide (one of the highest response rates attained by this annual survey). 

Creating a treasure trove of data for health plans
Ralph Judah et al., Deloitte Insights

By 2040, health data will be continually updated and reflect much deeper insights into the drivers of health and health care costs. Health plan organizations should invest in a strategy with an eye toward this future.

Morning Consult