Posts tagged with "Medicare"

CVS reaches $10.6 billion deal to buy clinic owner Oak Street Health

February 9, 2023

CVS Health has agreed to acquire Oak Street Health for about $10.6 billion, including debt, in the latest sign of the growing tie-ups between health insurers and primary-care doctors, reports The Wall Street Journal.

The all-cash deal, for $39 a share, is expected to close in 2023, the companies said on Wednesday, February 8.

The acquisition would wide  CVS’s healthcare offeringsadding about 600 physicians and nurse practitioners and Oak Street’s network of 169 senior-focused clinics to the COVID-19 vaccinations, strep tests and other medical services that CVS already provides through its pharmacies.

It would also further the consolidation of firms that manage health benefits, pay for medical care, and provide the treatment.

Founded in 1963 as a retailer focused on beauty and health products, CVS has used acquisitions to become one of the biggest U.S. healthcare companies. In addition to its roughly 10,000 pharmacies, CVS, based in Woonsocket, Rhode Island, is the parent of large health-insurer Aetna and CVS Caremark, one of the biggest managers of drug benefits in America.

Last fall, it announced a deal to acquire home-care provider Signify Health for about $8 billion.

CVS Chief Executive Karen Lynch has said that adding primary-care doctors was a company priority. Acquiring physicians would help it to more closely manage and guide the care of patients, as well as bring down costs, she said. CVS also wants to push further into forms of healthcare payment that are supposed to reward value, rather than reimbursing for every service.

“We said that we wanted to make sure that the asset that we acquired in primary care had the right management team, the right tech, the right ability to scale—and we believe that this asset meets all those criteria,” Lynch said in an interview. Adding Oak Street “positions us, combined with Signify Health for that matter, on our journey for value-based care.”

The value-based setups—which often involve paying doctors set amounts to manage patients rather than fees for each visit or service—have advanced the furthest in the private version of Medicare, the plans offered by insurers and known as Medicare Advantage.

CVS executives, demonstrating in a call with analysts how the units would work together to expand the business, said a home-care patient could receive a checkup from a Signify doctor; who might determine that person needs more care and then direct them either to an Oak Street practice or to a CVS in-store clinic.

Under the setup, the executives said, patients also would have options to go to other, non-CVS clinics; while CVS services, doctors and others would be available to patients using insurers other than CVS’s Aetna.

Research contact: @WSJ

Erectile disfunction pills may be linked to reduced risk of heart attack, scientists say

January 20, 2023

Good news for dudes. Taking erectile dysfunction drugs may not just help you get your mojo back—it may, per a new study, be linked to lowered risk of heart problems, too, reports Futurism.

Published in the journal, Science Advances, the study—out of the Huntington Medical Research Institute in Pasadena, California—has found what appears to be a link between taking ED meds like Viagra and Cialis and reduced rates of heart problems, including heart disease and death from a heart attack.

Known as Phosphodiesterase-5 (PDE5) Inhibitors or PDE-5i medications, this class of drugs—generally used to manage erectile dysfunction—has in the past been accused of leading to high blood pressure; but in the past 20 years, studies have suggested that they can both improve heart health and help with diabetes and cancer, too.

Looking at a large insurance and Medicare database, and drawing from prior research about ED drugs’ potentially cardioprotective effects, the HMRI team, along with researchers from the University of California-San Francisco, found that, compared to their ED-having counterparts who didn’t take medication for it, men who take PDE-5i drugs for their advertised purpose seemed to experience a 17%t lower rate of heart failure, a 15% lower need for angioplasty or heart stints, and a whopping 39% lower rate of death from heart disease-related complications.

What’s more, the researchers also observed a “25 [%] lower rate of death due to any cause” among men who take ED drugs than those who don’t take them, a press release about the study notes.

Drawing from anonymized patient records in an American private insurance and Medicare claims database, the researchers looked at a huge cohort of information gleaned from 2006 until 2020 — and of those claims viewed in retrospect, the researchers found that the greatest benefits seemed to be found in men who had heightened risk for cardiovascular problems, including those with diabetes. Part of the explanation, of course, may be related to the fact that sex, itself ,appears to be correlated with a longer life expectancy.

As with most data-based retrospective studies of this kind, the paper’s authors cautioned against declaring a direct correlation or cause between taking PDE-5i’s and lowering one’s risk for heart problems and advised further study on the subject. They also noted that they can’t name the exact nature of this link until more research is done on it.

All the same, this research is extremely promising—and, if nothing else, could reduce the stigma against taking ED medication.

Research contact@futurism

Senate Democrats, including Joe Manchin, (finally) strike a deal

July 29, 2022

On Thursday, July 28, the word was out: Senate Democrats unveiled a surprise, pulled-from-the-ashes $670 billion spending plan that has the blessing of the mercurial centrist Senator Joe Manchin (D-West Virginia) It’s an outline to help lower drug prices, give Americans more subsidized health coverage under Obamacare, and mitigate climate change, The Hill reports.

It would be paid for with higher taxes on corporations and the wealthy, which sounds similar to proposals Manchin previously rejected.

Scheduled to become law before the Senate escapes for its August break, the proposed reconciliation package needs all 50 Democrats and a tie-breaking vote from Vice President Kamala Harris, as well as approval by the House. It would be a big win for President Joe Biden—and Republicans have said they are opposed.

“It’s like two brothers from different mothers, I guess. He gets pissed off, I get pissed off, and we’ll go back and forth. He basically put out statements, and the dogs came after me again,”  Manchin told Politico in an interview about talks with Senate Majority Leader Charles Schumer (D-New York). “We just worked through it.”

In a shocking development, Manchin struck a deal with Schumer after more than a year of hemming and hawing in talks over a number of proposals that had been unable to garner his backing.

Headlining the rejuvenated bill are $369 billion in funding for energy and climate programs over the next ten yearswith the goal of reducing emissions by roughly 40% by 2030 and an additional $300 billion to reduce the deficit.

According to a summary released by the two senators, the blueprint would raise $739 billion in new revenue through a variety of proposals:

  • $313 billion via a 15% corporate minimum tax;
  • $288 billion from empowering Medicare to negotiate lower drug prices;
  • $124 billion from strong IRS enforcement of tax law; and
  • $14 billion from closing the carried interest loophole for money managers.

The Hill reports that the newly announced proposals will be tacked on to a bill that includes items that were expected to dominate as part of an even-slimmer package—a multiyear extension of Affordable Care Act subsidies aimed at preventing premium increases that is extended through the end of Biden’s first term and provisions aimed at lowering prescription drugs.

According to the two Senate Democrats, the bill will be brought to the floor next week before the upper chamber recesses in August.

The breakthrough hands the party a massive and a seemingly improbable victory that very few, if any, had anticipated. Senator Maria Cantwell (D-Washington) told  The Wall Street Journal  that she only learned of the bill while on the way to the chamber to vote on Wednesday evening.

“Holy shit. Stunned, but in a good way,” Senator Tina Smith (D-Minnesota) said.

Research contact: @thehill

It took a ‘Magic Minute,’ but the House delivers Biden a huge win

November 22, 2021

It took 10 months, 16 days, and an eight-and-a-half-hour speech from Minority Leader Kevin McCarthy but House Democrats finally passed their $1.75 trillion social welfare spending bill on Friday morning, November 19, reports The Daily Beast.

By a vote of 220-213, Democrats passed the bill with just one Democrat joining all Republicans in opposition to the Build Back Better (H.R. 5376) legislation: Representative. Jared Golden of Maine.

It was a victory on multiple levels for Democrat— most notably on a policy note. The bill would provide $550 billion for climate change, $400 billion for child care and universal preschool, $150 billion each for affordable housing and Medicaid’s home-care program, expanded child tax credits, and expanded Medicare provisions and subsidies, among other priorities.

But the victory was made sweeter on a personal level, after McCarthy’s antics late Thursday night and early Friday morning. The California Republican was able to delay the vote by taking advantage of the so-called “Magic Minute”—a courtesy extended to the leaders of both parties that allow them to speak for as long as they want with it only counting as one minute toward the allotted time for debate.

By the time McCarthy ended at 5:10 a.m., all but a handful of Republicans who sat behind McCarthy as a C-SPAN backdrop had departed the Capitol. Democrats swiftly recessed, and gaveled back in at 8 a.m. on Friday.

At that point, members continued their few final minutes of debate and House Speaker Nancy Pelosi (D-CA) took her turn at the podium. She quipped at the start of her remarks, “With respect to those who work in this Capitol and as courtesy to my colleagues, I will be brief.”

And she was. Pelosi spoke for just over 10 minutes, hitting on the usual Democratic talking points about the substance of the bill and suggesting the legislation will be a “pillar of health and financial security in America.”

Upon conclusion of her speech, Republicans pulled out one last stop: A motion to recommit the bill to committee, which failed by a 208-220 vote. And then passage of the bill was swift.

Instead of passing the bill late Thursday night, all that McCarthy accomplished was pushing the vote to the daylight hours of Friday morning.

House passage now offloads the BBB burden to the Senate, where time will tell whether Democratic problem children, Democratic Senators Kyrsten Sinema (Arizona) and Joe Manchin (West Virginia) are ready to push the measure through. Any changes to the bill in the upper chamber, including a likely removal of paid leave provisions, would send the BBB back to the House in a game of legislative ping pong.

But that’s if the bill can ever pass the Senate. Manchin and Sinema have yet to sign on, even with a topline cost that largely hews to their demands, The Daily Beast says.

The Congressional Budget Office said Thursday in a preliminary analysis that the bill would cost $367 billion over 10 years, but they didn’t add in a key offset to the legislation. They said increased IRS enforcement would bring in an additional $207 billion over the next decade, bringing the total cost to $160 billion—and that’s with an estimate that the White House believes is overly pessimistic.

The Biden administration thinks increased IRS enforcement—essentially making people pay their taxes—would bring in $400 billion. That means that some Democrats believe the $1.75 trillion bill would ultimately have a positive budgetary impact on the debt. Or, at least, a minimal cost.

Democrats accomplish offsetting the new provisions by implementing a number of new corporate taxes. There’s a 15% minimum tax for large corporations, a 1% tax on corporate stock buybacks, a new tax on income above $10 million and $25 million, and new limits on what deductions businesses can take for losses—among other corporate tax law changes.

But for Republicans, the cost of the bill was simply unacceptable. Even before McCarthy’s eight-and-a-half hour rant, GOP lawmakers made it clear they thought the bill spent recklessly and without consideration for future generations.

Still, Democrats were more than happy to pass the bill and give themselves a long list of accomplishments to run on in 2022, including popular provisions like capping monthly insulin costs at $35 a month.

As the end of the vote neared, Democrats rallied near the front of the chamber—cheering and applauding the tally. Republicans, meanwhile, insisted on order in the chamber to announce proxy votes for colleagues who hadn’t showed up to the House floor Friday morning.

One of the Republicans insisting on quiet was Representative Kat Cammack of Florida. She announced that she and other Republicans would be voting “Hell no” on the “Build Back Broke” legislation and she offered Democrats an ominous sign-off.

“Good luck in the Senate,” she said.

Research contact: @thedailybeast

Mitch McConnell: GOP intends to gut Social Security, Medicare, and Medicaid after midterms

October 26, 2018

It’s the talk of the Beltway, according to the Los Angeles Times: Did Senator Mitch McConnell (R-Kentucky) just admit that the GOP intends to dismantle Social Security, Medicare, and Medicaid after the midterm elections?

The scuttlebutt started, the Times reported on October 19, after the Senate majority leader gave an interview to Bloomberg  on October 16, in which he singled out “entitlements”—that’s political code for Social Security, Medicare, and Medicaid—as “the real drivers of the debt” and called for them to be adjusted “to the demographics of the future.”

To make it short and sweet, McConnell intends to cut benefits.

Indeed, Bloomberg said, the Senate Majority Leader blamed rising federal deficits and debt on “a bipartisan unwillingness to contain spending on Medicare, Medicaid, and Social Security.”

What’s more, although Republican legislators spent most of last winter trying to gut the Affordable Care Act, McConnell also telegraphed a plan to try again to repeal healthcare coverage after the midterm elections.

That’s despite indications that the ACA is becoming more popular with the public, not less, and voters’ concerns about preserving its protections for those with preexisting conditions may be driving them to the polls — and not to vote Republican. A poll released on October 18 by the Henry J. Kaiser Family Foundation, found that fully 71% of U.S. voters say healthcare is the most important issue driving them to the polls in the midterm elections.

In an October 17 interview with Reuters, McConnell commented that the GOP’s failure to repeal the ACA was “the one disappointment of this Congress from a Republican point of view.”  He said Republicans could try again to repeal Obamacare if they win enough seats in U.S. elections next month.

The CBO projects the current fiscal year deficit at $973 billion, and says it expects annual deficits to exceed $1 trillion into the next decade. The CBO attributed much of the deficit to “recently enacted legislative changes. … In particular, provisions of the 2017 tax act.”

The Congressional Budget office sees things differently. The CBO projects the current fiscal year deficit at $973 billion, and says it expects annual deficits to exceed $1 trillion into the next decade. The CBO attributed much of the deficit to “recently enacted legislative changes. … In particular, provisions of the 2017 tax act.”

Research contact: @hitzikm

Healthcare CEOs are not ‘bleeding money’

May 4, 2018

The Axios new site revealed the annual compensation of five chief executives in the healthcare industry on May 3—and their bank accounts are extremely robust.

In fact, Axios reports, some of these pay packages for pharmaceutical leaders represent “hundreds of times more than the median employee at their companies” is making.

The CEO numbers are calculated using actual realized stock gains, instead of the estimates that are displayed in company filings. (Employee figures are the only numbers listed in filings and may only include estimated stock.)

Biogen (Therapies for neurological and neurodegenerative diseases)

  • CEO Michel Vounatsos: $4.9 million
  • Pay ratio: 33:1 (median employee made $148,904)

Celgene (Medicines for inflammatory disorders and cancers)

  • CEO Mark Alles: $4.5 million
  • Pay ratio: 21:1 (median employee made $213,089)
  • Retired CEO Bob Hugin, who is running for U.S. Senate (R-New Jersey), made $40.5 million.

DaVita (Dialysis treatments)

  • CEO Kent Thiry: $15.6 million
  • Pay ratio: 258:1 (median employee made $60,332)

Exact Sciences (Early detection of colorectal cancer)

  • CEO Kevin Conroy: $32.3 million
  • Pay ratio: 328:1 (median employee made $98,724)

Sage Therapeutics (Medicines for central nervous system disorders)

  • CEO Jeff Jonas: $28.2 million
  • Pay ratio: 73:1 (median employee made $383,682)

These compensation packages have drawn attention from the American public and legislators. At a press conference in January 2017, U.S. President Donald Trump accused the pharmaceutical industry of “getting away with murder” and said that he would change the way the country bids on drugs to bring prices and spending down, according to a report by The Washington Post.

“Pharma has a lot of lobbies, a lot of lobbyists and a lot of power. And there’s very little bidding on drugs,” Trump said during the event at Trump Tower in New York. “We’re the largest buyer of drugs in the world, and yet we don’t bid properly.”

To date, the federal government has not been allowed to negotiate with drug companies to bring down the price of medicines for seniors using Medicare.

Even if legislation were passed to enable such deals, these high pay packages likely would make the process more difficult.

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Medicare doesn’t measure up to eldercare in 10 other countries

December 16, 2017

Although a Harvard School of Public Health survey, found that 72% of Americans age 65+ have a favorable opinion of Medicare, a new, 11-country survey has disabused us of that sentiment. In reality, Medicare pales against the health coverage offered to older populations by many other nations.

Based on the findings of the Commonwealth Fund’s International Health Policy Survey, people who rely on Medicare receive a lower level of medical protection and maintenance than those in 10 other countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom.

They also are more likely to go without needed care because of costs.

There is one caveat: America has a significantly higher rate of high-need older adults (43%) than most of those other countries, the researchers noted. And, they said, high-need elderly individuals are more likely to suffer economic hardship, experience depression and anxiety, live alone and feel socially isolated and be at greater risk for falls than those who aren’t high need.

America also has the highest proportion of people 65+ with multiple chronic conditions.

And while some countries spend $2 on social services for every dollar devoted to healthcare, America spends less than 60 cents.

“U.S. seniors face more financial barriers to care than those in other countries and are, in effect, hit with a triple whammy — higher healthcare costs, higher out-of-pocket costs and—because the U.S.A. doesn’t invest heavily in social services, they are more likely to struggle to have their basic needs met,” said Robin Osborn, lead author of the study and vice president and director of the International Program in Health Policy and Practice Innovations at The Commonwealth Fund.

Said Commonwealth Funds President Dr. David Blumenthal: “Clearly there are struggles everywhere, but here in the U.S., we are hearing loud and clear that many of our seniors, especially those who are sickest, need more support if they are going to get the health care they need and live healthy lives.”

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