News for Insurers
Top stories summarized by our editors
7/19/2019

An analysis of hospital data from 2018 collected by the Leapfrog Group found that a majority of hospitals did not meet the group's minimum volume safety thresholds for eight high-risk surgeries. Among the eight procedures, hospitals had the most favorable compliance rate for bariatric weight loss surgery at 38%, and compliance was least favorable at 2.5% for open abdominal aortic aneurysm repair.

7/19/2019

In response to President Donald Trump's executive order on kidney care announced this month, the CMS has proposed one mandatory and four optional alternative payment models for treatment of chronic kidney disease. The proposed mandatory end-stage renal disease treatment choices model, which will start next year and end on June 30, 2026, would link Medicare payments to use of home dialysis and successful transplants, while the four optional models would be based on the Primary Care First and Direct Contracting models, and their goal is to delay disease progression and educate and support patients.

7/19/2019

A meta-analysis published in Diabetologia involving more than 12 million people found that women with type 1 diabetes had more than fivefold higher risk of developing heart failure compared with women who did not have diabetes, while HF risk among women with type 2 diabetes was almost doubled. Men with either type of diabetes also had higher risk of HF than men without diabetes, but the increase in risk was not as high as for women.

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diabetes
7/19/2019

Oscar Health has partnered with Montefiore Health System to launch a Medicare Advantage product in New York, and the companies plan to start selling the private plans this fall for the 2020 plan year, pending regulatory approval. The New York-based insurer also plans to sell MA plans in Houston starting this fall.

7/19/2019

President Donald Trump is working on an executive order directing HHS to oversee pursuit of a better flu vaccine and promote mass vaccination, sources say, though budget officials and Congress have yet to approve any additional funding. Trump also plans to form an interagency task force that will track progress and explore economic incentives to encourage vaccine development.

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Politico
7/19/2019

The Environmental Protection Agency denied a petition by various environmental groups calling for a ban on the pesticide chlorpyrifos, which the groups said has been associated with adverse pediatric health outcomes, such as low birth weight, attention disorders and lower IQ. The agency said the petitioners failed to prove a link, while the groups said they will continue to fight the decision.

7/19/2019

Research published in JAMA Network Open found using a traffic light food labeling program in the Massachusetts General Hospital cafeteria that was linked to employee identification cards was associated with a 6.2% reduction in calories per transaction over two years. Data also showed a 23% reduction in calories associated with the least healthful food options per purchase.

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HR Dive
7/19/2019

A study in the journal Vaccine showed that only 59% and 39% of adults aware of the human papillomavirus vaccine expressed support for policies mandating pediatrician offering of HPV vaccines to youths ages 11 to 18 and adding the vaccine to school requirements, respectively. The findings also showed lower odds of support for either policy among those who thought the science behind HPV immunization was uncertain, while support for required physician offering of the HPV vaccine was more likely among women.

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HPV vaccine, HPV
7/19/2019

New York City is expanding its Pharmacy to Farm program to 16 drug stores in Manhattan, Brooklyn and Queens. The program allows pharmacists to give people who receive Supplemental Nutrition Assistance Program benefits and are taking medication to treat high blood pressure $30 monthly vouchers redeemable at farmers markets.

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The New Food Economy
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New York City
7/19/2019

US District Judge Dan Aaron Polster says pharmacy benefit managers have voluntarily changed their coverage policies to discourage improper prescribing of opioids. Studies have shown that the three largest PBMs are able to ensure at least 80% of initial opioid prescriptions meet CDC guidelines.

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Legal Newsline