News for Insurers
Top stories summarized by our editors
9/20/2017

A recent study showed that Medicare's bundled reimbursement model reduced the cost of knee replacements by around $1,200 per patient without sacrificing quality, but the number of procedures performed increased at hospital systems that enrolled in the bundled payment program, compared with hospitals not in the program. "In trying to reduce the cost of health care, we should work on increasing the efficiency of specific services," writes Peter Ubel. "But if we don't also pay attention to the volume of services, we may be creating unintended consequences."

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Forbes
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Medicare
9/20/2017

CDC researchers reviewed government vital statistics from 2000 to 2015 and found that opioid overdoses, which more than tripled over the period, accounted for most of the 3.5-month decrease in US life expectancy caused by drug-related overdoses by 2015. Though overall life expectancy rose during that time frame, a slight drop in life expectancy from 2014 to 2015 was the first since 1993 and was driven by rising death rates from chronic liver disease, Alzheimer's disease and unintentional injuries, which includes drug overdoses, according to the study in the Journal of the American Medical Association.

9/20/2017

National Institute of Allergy and Infectious Diseases researchers examined 442 children and found that those with elevated exposure to indoor cockroach, cat and mouse allergens during the first three years of life were less likely to develop asthma by age 7, compared with those with lower indoor allergen exposure. The findings in the Journal of Allergy and Clinical Immunology also showed that prenatal exposure to maternal smoking and maternal stress and depression was tied to increased odds of pediatric asthma.

9/20/2017

A survey by the Kaiser Family Foundation and the Health Research & Educational Trust found average premiums for family health coverage increased by 3% to $18,764 this year, the sixth straight year of modest growth, and 4% for single coverage, which averaged $6,690. The increases mark a clear contrast with the 20% premium hikes seen in individual insurance markets this year, but employees are shouldering a greater portion of the total cost, with employees covering $5,714 for family coverage and $1,213 for single coverage.

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Kaiser Health News
9/20/2017

A survey by the National Business Group on Health found 96% of major employers intend to offer telehealth services next year in states where it is permitted as a way of managing costs, and 56% will provide telehealth for behavioral services. Telehealth utilization is growing, according to the report, with almost 20% of employers reporting 8% or higher rates of utilization among employees.

9/20/2017

Oscar Health is investing more in outreach ahead of the Affordable Care Act open enrollment period following the government's announcement that it will slash its own ACA advertising budget and totally eliminate television advertising. Oscar is targeting the six states where it does business, with early messages focusing on enrollment dates and encouraging people to "get covered."

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National Public Radio
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Oscar Health
9/20/2017

American Express offers 20 weeks of paid parental leave as well as a concierge program to help employees take advantage of the benefit. Tammy Yee, vice president of benefits and mobility, said the program gives new parents information and advice and helps managers and supervisors address problems that may affect the employee's workload.

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Employee Benefit News
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American Express
9/20/2017

One way in which pharmacy benefit managers keep drug costs affordable is by harnessing competition within drug classes, according to the Pharmaceutical Care Management Association. "In classes where several products may be considered therapeutically equivalent, PBMs can negotiate with drug manufacturers for higher rebates, which in turn benefit patients and payers," according to the PCMA.

9/20/2017

Despite the pharmaceutical industry's opposition, legislation targeting drug prices has been sent to Gov. Jerry Brown for his signature. Another California bill that would have required pharmacy benefit managers to disclose confidential information was withdrawn after Brown's administration expressed concern.

9/20/2017

The attorneys general of 41 states collectively issued subpoenas to manufacturers and distributors of opioid drugs, seeking information on marketing to health care professionals and patients. The AGs seek "to uncover whether or not there was deception involved, if manufacturers misled doctors and patients about the efficacy and addictive power of these drugs," said New York Attorney General Eric Schneiderman.

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National Public Radio