Opinion

CA Reveals Small Biz Rates, Univision Obamacare Deal Could Be Big for WellPoint/Blues, Chart Review – Exchange Interest by Race

Today’s Washington Read:Health Insurance Rates for California’s Small Businesses Unveiled
from LA Times by Marc Lifsher

California’s small businesses next year will have a range of competitively priced options offered by a new state government health insurance exchange. The agency, Covered California, unveiled its portfolio of policy options for smaller businesses Thursday. They include both health maintenance organizations and preferred provider networks and will be available in all parts of the state as of Jan. 1. Rates in most of the state’s populous counties are expected to be significantly below premiums now charged by insurers for similar plans. Average premiums for a 40-year-old employee are slated to fall 17% in southern Los Angeles County and 13% in the northern part. Rates for younger and older workers are expected to drop proportionally, Covered California said.

Today’s Business Strategy Read:

Univision Obamacare Deal Could Put WellPoint, Blues Ahead of Competitors
from Kaiser Health News by Jenny Gold

Some 10 million Latinos stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market. WellPoint and other Blues insurers in six states including Florida have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, “Salud Es Vida,” which means Health Is Life. The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it’s a path that could take a detour around some competitors who are offering plans: because of a little-known rule proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer.

Today’s Chart Review:

Minority Interest in Purchasing on the Health Exchanges by Insurance Status
from National Health Tracking Poll by The Morning Consult

AFRICAN-AMERICAN

TMC_African American Interest

HISPANIC

 TMC_Hispanic Interest


Mark Your Calendars (All Times Eastern):
Friday: Quarterly earnigns – Accretive Health

NEWS ARTICLES
1-4: General
5-8: Payers
9-10: Providers
11-12: Pharma/Biotech/Device

OPINIONS, EDITORIALS, PERSPECTIVES
13: The New Republic
14: New York Times
15: Forbes
16-17: Health Affairs

 

NEWS ARTICLES
General1) House GOP to Vote on Repealing Health Care Law for 40th Time Before Leaving on Summer Break
from Washington Post by Associated Press

Maybe the 40th vote to repeal President Barack Obama’s health care law will be a charm for opponents of the overhaul. House Republicans are scheduled to vote Friday on a bill that would prevent the Internal Revenue Service from enforcing or implementing any part of the law they call “Obamacare.” It’ll mark the 40th vote by the Republican-controlled House to repeal some or all of the law.

2) Budget Truce Seems Out of Reach as Congressional Recess Looms
from Washington Post by Lori Montgomery

The House bill would have embraced the sequester, deep automatic budget cuts designed to shrink the federal government. The Senate bill would have ended it, restoring billions of dollars for housing, roads and bridges. This week, congressional Republicans tacitly rejected both approaches to next year’s budget, leaving frustrated lawmakers wondering how they will manage to keep the government open past September, much less resolve a broader conflict over the rising national debt. As Congress prepared to leave town for a five-week summer break, the prospects for progress on any front in the endless Washington budget war appeared excruciatingly dim. Without an agreement to deal with the sequester and fund federal agencies in fiscal 2014, the government will shut down Oct. 1 – barely three weeks after lawmakers return to town. A few weeks after that, the Treasury will face the risk of default unless Congress can agree to raise the $16.7 trillion federal debt limit.

3) Deal Keeps U.S. Health Care Contribution for Congress
from New York Times by Robert Pear

The Obama administration told Congress on Thursday that it would allow the federal government to continue paying a large share of the cost of health insurance for members of Congress and their aides, averting a problem for many who work on Capitol Hill. However, under the arrangement, lawmakers and many of their aides will have to get coverage through new health insurance marketplaces, or exchanges, being set up in every state.

4) U.S. Stock-Index Futures Little Changed Before Jobs Data
from Bloomberg by Sofia Horta e Costa

U.S. stock-index futures were little changed, after the Standard & Poor’s 500 Index rose to a record yesterday, as investors awaited an employment report to assess whether policy makers will reduce their bond-buying program. S&P 500 futures expiring next month rose 0.1 percent to 1,702.3 at 8:07 a.m. in New York after rallying 1.3 percent yesterday. Contracts on the Dow Jones Industrial Average added 17 points, or 0.1 percent, to 15,567 today.


Payers5) Univision Obamacare Deal Could Put WellPoint, Blues Ahead of Competitors
from Kaiser Health News by Jenny Gold

Some 10 million Latinos stand to gain health insurance under the Affordable Care Act, and the Spanish-language media network Univision is positioning itself as a direct path to this potentially lucrative market. WellPoint and other Blues insurers in six states including Florida have signed deals with Univision for undisclosed sums to be the exclusive health insurance sponsor of the network’s Peabody-award winning health initiative, “Salud Es Vida,” which means Health Is Life. The deals include a special plan-sponsored Univision website that will be able to connect Latinos with coverage on the online markets, or exchanges, that will serve individuals beginning in October. But it’s a path that could take a detour around some competitors who are offering plans: because of a little-known rule proposed by the administration in June, customers will be able to buy their subsidized Obamacare insurance directly from the insurer.

6) Health Insurance Rates for California’s Small Businesses Unveiled
from LA Times by Marc Lifsher

California’s small businesses next year will have a range of competitively priced options offered by a new state government health insurance exchange. The agency, Covered California, unveiled its portfolio of policy options for smaller businesses Thursday. They include both health maintenance organizations and preferred provider networks and will be available in all parts of the state as of Jan. 1. Rates in most of the state’s populous counties are expected to be significantly below premiums now charged by insurers for similar plans. Average premiums for a 40-year-old employee are slated to fall 17% in southern Los Angeles County and 13% in the northern part. Rates for younger and older workers are expected to drop proportionally, Covered California said.

7) Ohio Becomes Latest Battleground in Obamacare Premium Wars
from Politico by Jason Millman

The fight over Obamacare premiums has a new home base: Ohio. Customers in the key swing state can expect to pay 41 percent more on average for individual health insurance coverage next year because of Obamacare, according to projections released by the state’s Republican insurance commissioner Thursday. While Obamacare-friendlier states like New York have reported major rate reductions as a result of the health care law, Ohio insurance commissioner Mary Taylor says Obamacare’s mandated benefits and rating rules are driving up the cost of insurance in a state with historically lighter regulation.

8) Virginia Approves 11 Health Plans for New INsurance Exchange, 4 Other Health Plans Under Review
from Washington Post by Associated Press

Eleven health plans have been approved by Virginia officials to compete on a new federally run insurance exchange. But Virginia’s approval of the plans is simply a recommendation. The federal government will decide which plans will compete on the exchange and the rates that they can charge, Jacqueline K. Cunningham, insurance commissioner with the State Corporation Commission, told the Richmond Times-Dispatch. The SCC Bureau of Insurance approved five proposed plans for individual insurance coverage and six proposed plans for small businesses. Four other propose individual market plans were still under review at the close of business Wednesday.


Providers9) Value of Healthcare Mergers, Acquisitions Up Dramatically
from FierceHealth Finance by Ron Shinkman

Mergers and acquisitions (M&A) in the healthcare sector rose quarter-over-quarter, with the value of deals exploding, according to Irving Levin & Associates, but the volume is lower compared to the second quarter of 2012, and hospital deals were down significantly. According to Irving Levin, a Connecticut-based firm that tracks M&A activity, the number of deals in the healthcare sector was up 10 percent in the second quarter of 2013, compared to the first quarter of the year. Altogether, 223 deals were reached during the second quarter, compared to 203 that took place during the first quarter.Mergers and acquisitions involving hospitals were down significantly, with 15 deals closed during the second quarter, compared to 22 in the first quarter of 2013. Volume is down even further compared to the second quarter of 2012, when 26 transactions were completed, a drop of 42 percent.

10) Tenet, Health Management Accused of Paying Kickbacks
from Bloomberg by Edvard Petterson

Tenet Healthcare Corp. (THC), the third-biggest publicly traded U.S. hospital chain, and Health Management Associates Inc. (HMA) were accused in a lawsuit of paying kickbacks to a Georgia clinic in exchange for referrals. The two hospital chains were sued under the Federal False Claims Act in a whistle-blower lawsuit brought by Ralph Williams, a former chief financial officer of Health Management Associates, on behalf of the U.S. and Georgia. The lawsuit, filed in federal court in Athens, Georgia, was ordered unsealed yesterday.


Pharma/Biotech/Device11) AstraZeneca Ups China Investment as Rivals Face Scrutiny
from Bloomberg by Daryl Loo and Natasha Khan

AstraZeneca Plc (AZN) is increasing its investment in China, where sales rose 21 percent in the second quarter, as the country continues its crackdown on malfeasance in the health-care industry. The U.K.’s second-biggest drugmaker has added more sales people in China as the country’s medical coverage expands, even as prices have declined, AstraZeneca Chief Executive Officer Pascal Soriot told journalists yesterday on a conference call to discuss earnings.

12) Smith & Nephew CEO Has $1.5 Billion for Acquisitions
from Bloomberg by Allison Connolly

Smith & Nephew Plc (SN/), the U.K.’s biggest medical-device maker, has $1.5 billion to spend on acquisitions and is scouting wound-care companies in the U.S. as well as potential deals in trauma and sports medicine. Smith & Nephew also is looking to buy distributors and manufacturers in emerging markets to support a new focus on more affordable products for countries such as India, China, Brazil and Russia, Chief Executive Officer Olivier Bohuon said in an interview yesterday. The company plans to introduce its first so-called mid-tier wound products this year, he said.


OPINIONS, EDITORIALS, PERSPECTIVES
The New Republic

13) Six Reasons Hipsters Will Bite on Obamacare
from TNR by Jonathan Cohn

One survey, published on Wednesday, came from the online newsletter The Morning Consult. The poll measured interest in buying health insurance through Obamacare’s exchanges and, conveniently, the pollsters broke down responses by age. In the survey, about 40 percent of young people said they were “about certain” or “very likely” to buy insurance, while another 40 percent said they were “about 50-50.” Only about a quarter of respondents said they were “not too likely” or “not likely at all” to get insurance. It would be a mistake to interpret these surveys too literally. It’s one thing to tell a pollster you think health insurance is important. It’s quite another to spend what it will take to buy insurance. Some of the enthusiasm that the polls are picking up may be sheer political sentiment, which may or may not translate into how people actually behave once Obamacare marketplaces open for business. In the Morning Consult poll, older Americans were actually less interested in health insurance than younger Americans, despite their greater health needs. That’s probably because older Americans are less enthusiastic about Obama.

New York Times

14) The Sleeper in Health Care Payment Reform
from New York Times by Uwe Reinhardt

In late June news organizations reported on a practical application in the United States of “reference pricing” for hospital care. The concept has been well known for decades to health policy wonks and already applied to prescription drugs in many other countries, but it is still novel in the United States. In the arsenal now being assembled on the payment side of health care to address rising costs, reference pricing may well turn out to be the sleeper, because it is a potentially powerful method of “putting the patient’s skin in the game,” the delicate phrase we use for “cost-sharing by patients.” As it is able to shift significant market power from the supply side to the payment side of the health sector, reference pricing is much feared by the providers – physicians, hospitals, pharmaceutical companies and others. Reference pricing also leads to concerns that it could be used simply for rationing by income class in disguise, unless good care is taken to enforce high quality standards for the health care being delivered.

Forbes

15) Can We Build a Kickstarter for Cancer?
from Forbes by Paul Howard

Starting you own band, writing your first novel, or re-publishing your favorite ’80s tabletop RPG are all cool goals. You can do them all onKickstarter. What would be cooler? How about funding a virtual biotech company with one goal: Saving or extending the life of a cancer patient who doesn’t respond to “standard of care” treatments. Building large analytical databases to mine clinical and molecular data, and scan the scientific literature to identify better treatments for cancer patients is happening today. But what about patients who fall outside what we already know – whose cancer subtypes haven’t been discovered yet, and who don’t have access to the technologies that could make a difference in unraveling the aberrations driving their cancers?

Health Affairs

16) Implementing Health Reform: Verifying Income, Combating Discrimination
from Health Affairs by Timothy Jost

We are in the very depths of summer and should all be at the beach. But with the exchanges set to open their doors in less than nine weeks time, there is little rest for federal and state agency staff charged with opening those doors. After three years of hard work, the regulatory infrastructure needed to set the exchanges in motion is mostly in place. HHS still has its final program integrity rule to publish, Treasury must finalize its individual and employer responsibility regulations (although the employer regulation is now less urgent), and there are an infinite number of technical details to nail down. But regulatory drafting is nearly done, and with Congress leaving shortly for its August recess – and thus a seemingly endless series of repetitive and often pointless oversight hearings coming finally to an end – agency staff can turn their attention to finishing putting the Affordable Care Act 2014 reforms in place.

17) Health Industry Price Inflation at Historical Low
from Health Affairs by Jeff Goldsmith

One hesitates to make too much of a single report, but the Altarum Institute’s July Report, “Health Care Price Growth at 20+ Year Low,” certainly commands one’s attention. According to Altarum’s analysis, the health sector pricing trend ran at a 1.0 percent annual rate in May 2013, lowest since January of 1990. What is striking about Altarum’s health care pricing trendline is that it has declined for the last three years in spite of an alleged economic recovery.

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