In this month’s recap of the top B2B trends and news you can use when marketing to health insurers, health systems and health technology firms, COVID-19 continues to make waves by inciting policy and regulatory changes, telehealth innovation and more. This December, even more headlines were made with the first doses of the vaccine being issued to front-line healthcare workers in the US.
As always, we’re here to help you dig out of the unread news in your inbox from over the holidays and have highlighted some of the big stories below.
As of December 30, 2.7 million individuals had received the first dose of the COVID-19 vaccine, according to the CDC, the first of which were received by front-line healthcare workers and individuals in long term care facilities starting on December 14.
After a record number of COVID-19 cases mid-month following the Thanksgiving holiday and existing ICU shortages, experts predict hospitals will experience continued difficulty with accommodating patients.
On December 15, the FDA cleared an at-home screening test developed by Ellume for COVID-19. While the tests are available without a prescription, they are expected to be in limited supply. The clearance for the self-administered test comes following a November emergency use authorization for a different Lucira at-home test, which does require a prescription.
Since the beginning of the year, hospitals and health systems report nearly a 20% decline in operating margins due to the pandemic, with ER visits taking the biggest hit to volume.
LEGAL & REGULATORY NEWS
In addition to the stimulus and funding for public health programs, the legislature included provisions about surprise billing, $3B into the Medicare physician fee schedule, and the FCC’s telehealth program funding.
With a goal of expanding patient access to personal, digital health information and increase information-sharing for care coordination purposes, the HHS proposed amendments to the Privacy Rule that defines certain terms such as EHR, as well as adjust minimum necessary requirements for use of PHI by health plans and case managers.
The rule, which was set to go into effect in January 2021, was intended to lower prescription drug costs by using a price-setting rule for Medicare Part B drugs based on manufacturer pricing for countries similar to the US. But would have reduced payments to hospitals for the drugs they purchase, according to the American Hospital Association.
In an effort to prioritize primary care and chronic disease management, the new fee schedule increases provider reimbursement for greater time spent with patients. But physician groups, including the AHA, opposed the final rule due to a budget neutrality requirement, citing what would be an 11% decrease to the Medicare conversion factor. As part of this final rule, 60 additional services were added to Medicare’s telehealth list on a permanent basis for beneficiaries in rural areas.
Walmart under fire for unlawfully dispensing opioids
The justice department has filed suit against the retailer for filling invalid prescriptions for controlled substances as well as failing to report suspicious prescriptions to the DEA, alleging that Walmart denied their pharmacists the right to refuse to fill said drugs.
According to a recent report from CMS, while spending growth was down from 4.7% in 2018, 2019 saw increased spending on hospital care and retail drugs as well as lower health insurance spending incited by the suspended ACA tax.
Following this year’s Healthcare.gov open enrollment period, over 8 million people signed up or were automatically enrolled in a health insurance plan. This marks a 6.6% year over year increase in ACA enrollment.
Early this month, Tenet agreed to a $1.1B purchase of up to 45 of SurgCenter Development’s ambulatory surgery centers. Following, the organization agreed to an $80M sale of its urgent care platform.
Fierce Healthcare recaps deal activity in a year that was marked by a global pandemic, prompting vast telehealth adoption as well as mergers and acquisitions in the home health and hospice space, pharmacy and more.