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This Week in Managed Care: July 14, 2017

This week, the top managed care news included insurers staying away from HealthCare.gov, where you live can affect your chance of surviving cancer, and a new deal could help people on Medicare with diabetes.


Insurers stay away from HealthCare.gov, where you live can affect your chance of surviving cancer, and a new deal could help people on Medicare with diabetes.

Welcome to This Week in Managed Care, I’m Kelly Davio.

Insurers Avoiding HealthCare.gov Exchanges

Consumers shopping for coverage on HealthCare.gov will have far fewer choices in 2018, according to data CMS released this week. Thirty-eight percent fewer health insurers filed plans to sell coverage on the exchanges next year, and based on recent trends, the current total of 141 could shrink before final decisions are due in September.

Said CMS Administrator Seema Verma, “This is further proof the Affordable Care Act is failing. Insurers continue to flee the exchanges, causing Americans to lose their choice for health insurance or lose coverage all together.”

However, supporters of the ACA say uncertainty over the fate of its subsidies have troubled insurers. They note that Senate Majority Leader Mitch McConnell delayed the Senate recess to seek votes for a bill to replace the ACA. To learn more about a new version introduced this week, visit ajmc.com.

Rural Americans Face Higher Cancer Mortality Risks

People who live in rural America are less likely to get cancer. But when they do, they are more likely to die from the disease than those who live in more populated areas. That’s what CDC researchers found in a new surveillance study published in a recent Morbidity and Mortality Weekly Report.

The study found:
  • Cancer rates fell nationwide from 2006 to 2015, but they fell faster in metropolitan counties.
  • Cancer rates were higher in the most rural counties, compared with other areas, from 2011 to 2015.
Said Acting CDC Director Dr. Anne Schuchat, “While geography alone can’t predict your risk of cancer, it can impact prevention, diagnosis, and treatment opportunities—and that’s a significant public health problem in the US. Many cancer cases and deaths are preventable and with targeted public health efforts and interventions, we can close the growing cancer gap between rural and urban Americans.”

Novartis' CAR-T Therapy on Cusp of Being First FDA-Approved Gene Therapy

Novartis’ chimeric antigen receptor T-cell therapy for pediatric leukemia, better known as CAR-T cell therapy, is on the cusp of being the first gene therapy approved by FDA. An FDA advisory panel gave the therapy, called CTL019, a green light on Wednesday after a hearing that focused on Novartis’ plans for post-marketing studies.

The therapy, developed at the University of Pennsylvania’s Children’s Hospital of Philadelphia, has worked wonders for some patients but also presents unprecedented safety challenges. Said Dr. Stephen Shuster of Penn, “We’re saving patients who three or four years ago we were at our wit’s end trying to keep alive.”

For more, visit ajmc.com.

Deal Between Dexcom and Ascensia Paves Way for Medicare Diabetes Bundle

Finally, an agreement between Dexcom and Ascensia Diabetes will soon speed delivery of continuous glucose monitors to eligible Medicare beneficiaries with diabetes. CMS’ historic decision to pay for Dexcom’s G5 hit a snag earlier this spring when suppliers wanted clarity on rules that require diabetes supplies to be shipped together in a bundle.

Dexcom’s G5 will be shipped with Ascensia’s Contour blood glucose monitoring system, which patients will use twice a day to calibrate the Dexcom system.

For all of us at the Managed Markets News Network, I’m Kelly Davio. Thanks for joining us.

 
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