The urge to merge continues to surge. The Supreme Court’s decision in King v. Burwell, which for now halts legal challenges to the ACA, seems to have given insurers the certainty they need to buy and/or join. Deals proposed over the summer amount to $100 billion. Anti-trust issues are in play, however.
Even as the law withstands legal challenges and signs up millions of uninsured, there’s still concern that “young invincibles” will not participate enough to help dilute the risk. Perhaps more subsidies and the introduction of a “copper plan” would reinforce the foundation. Affordability remains an issue for many.
Government and other surveys are showing that the number of Americans without health insurance is dwindling, with credit going to the expansion of Medicaid and the ACA insurance exchanges.
State insurance commissioners wrestle with how narrow networks should be regulated so that insurers stay solvent and consumers are protected. A big concern: Surprise billing of patients who do not know that their favorite physician is no longer part of the panel. Meanwhile, specialists argue that they are underrepresented.
According to Milliman researchers, minimally invasive surgery (MIS) costs less than open surgery for four procedures: thoracic resection ($12,278 average allowed surgical procedure cost vs. open surgery), colectomy ($11,698), ventral hernia repair ($5,041), and noncancer hysterectomy ($749). Despite the benefits, “MIS remains underutilized in many U.S. regions and hospitals,” the study states.
The NIH would get a $9 billion shot in the arm, but some fear the FDA provisions will mean lax oversight of drugs and devices.
Brace yourself for astronomically priced injections. One on track for U.S. approval looks to treat a rare form of retinal disease.