As March rounds out the first quarter of 2023, the Activate Health team has pulled together a collection of top healthcare stories for busy healthcare marketing and PR professionals.
Multiple regulatory updates hit the wire this month, from CMS negotiating drug prices to the DEA placing restrictions on drugs prescribed via telehealth appointments. New research also reveals important insights on prior authorizations and the future of employee benefits.
M&A NEWS
Elevance agrees to purchase La. Insurer for at least $2.5B
While Elevance Health Inc. agreed to pay $2.5 billion for Blue Cross and Blue Shield of Louisiana in January, new conditions of the contract may increase the transaction value by $1 billion.
Transcarent will acquire virtual primary care 98point6’s care delivery division
98point9’s AI-powered chatbot, physician group, self-insured employer business and 150 directly employed doctors and support staff will be acquired by Transcarent in a deal worth up to $100 million.
REGULATORY NEWS
Biden’s $6.8T budget: 15 healthcare takeaways
The $6.8 trillion budget proposed in March includes plans to extend Medicare’s solvency by 25 years, support innovative approaches to grow the nursing workforce and make COVID-era ACA subsidies permanent.
CMS lays out plans for negotiating drug prices
The initial guidance outlines broad principles for Medicare to negotiate drug prices; however, many details will later be announced by CMS when negotiations for the first 10 medicines begin in 2024.
DEA to restrict telehealth prescriptions for certain drugs
The DEA’s proposed changes will require doctors to evaluate patients in person before writing prescriptions for schedule II medications and narcotics, including drugs like Adderall and OxyContin.
Judge strikes down ACA’s preventive care mandate
Texas U.S. District Judge Reed O’Connor ruled against a component of the ACA that requires insurers to cover certain types of preventative care. The Biden administration could request a stay of the ruling as it appeals.
HEALTHCARE COSTS
Eli Lilly caps insulin at $35 a month
Effective March 1, Eli Lilly capped out-of-pocket insulin product costs to $35 a month, affecting approximately 30% of Americans with diabetes who rely on insulin.
Poll: 37% of US adults skip Rx fills because of costs
A survey shows 37% of U.S. adults have cited high costs as the reason for not filling a prescription. Households with an annual family income less than $50,000 were more likely to skip filling prescriptions.
LATEST RESEARCH & EMERGING TRENDS
Almost half of companies planning to cut back employee benefits in 2023, report finds
A survey suggests that 95% of leaders plan to re-examine their strategies, while nearly half of respondents are looking to cut back benefits. But while benefits as a whole are expected to decrease, some employees may actually get more out of their benefits package.
Study: In-person follow-up not needed for most virtual primary care visits
A study conducted by Epic Research ruled that 61% of telehealth visits do not require an in-person follow-up visit. The study reviewed more than 18 million telehealth visits from March 1, 2020 to October 15, 2022.
Physicians say prior authorization rules harm patients, AMA survey finds, as CMS works toward new policy
While insurers use prior authorization requirements to manage costs and quality control, about 60% of physicians said these same requirements lead to serious adverse events for patients including hospitalizations, permanent impairment or death.
PAYER UPDATES
‘We’re not deaf to the complaints’: Big payers moving to cut prior authorization requirements
United Healthcare and Cigna are planning on trimming their prior authorization programs, while Aetna is working to automate their process due to providers criticizing the program requirements.