This Week in Managed Care: December 14, 2018
December 14, 2018
December 13, 2018 – Jaime Rosenberg
December 13, 2018 – AJMC Staff
What We're Reading: Bill Targets Maternal Mortality Rates; Cutting Drug Prices; US Biosimilar Adoption
December 12, 2018 – AJMC Staff
December 11, 2018 – Allison Inserro
What We're Reading: Democrats Split Over Single Payer; Generic Drug Probe; Virginia Work Requirements
December 10, 2018 – AJMC Staff
December 07, 2018
December 04, 2018 – Allison Inserro
November 30, 2018 – Allison Inserro
This Week in Managed Care: December 14, 2018
This week, the top managed care news included a report that found uninsured rates were on the rise in 2017; an analysis of rising health insurance costs for families; predictions for cardiology trends in 2019.
Uninsured rates were on the rise in 2017, health insurance costs rose for families, and enrollment on the exchanges is off for the coming year.
Welcome to This Week in Managed Care, I’m Laura Joszt.
Uninsured Rate Increases
The share of Americans without health coverage rose last year for the first time since 2014, according to a report from the Kaiser Family Foundation.
The number of uninsured people rose by 700,000 in 2017, representing the first increase since the Affordable Care Act took full effect. The large increases came in states that did not expand Medicaid, and occurred among African Americans and those living just above the poverty line.
After trying to repeal the ACA, the Trump administration made several changes:
- It used the 2017 tax law to repeal the individual mandate
- It allowed several types of short-term plans that do not require essential health benefits
- It allowed association health plans for employer groups
Financial Burden of Insurance
The Commonwealth Fund also reported this week that healthcare costs rose sharply in 2017, growing 5.5% for family plans and 4.4% for single coverage.
As premiums have climbed, so have employee contributions. After rising an average of 4.6% each year for 5 years, premium costs for family coverage rose 6.8% in 2017.
Said lead author Sara Collins, “The cost of employer health insurance premiums and deductibles continues to outpace growth in workers’ wages. This is concerning, because it may put both coverage and healthcare out of reach for people who need it most—people with low incomes and those with health problems.”
Meanwhile, enrollment on the exchanges for 2019 appears down as open enrollment comes to a close December 15.
Sign-ups appear down by about 12% heading into the final week of enrollment, and experts listed several reasons, including:
- The end of the individual mandate
- New enrollment options off the exchange
- Virginia’s addition of Medicaid expansion
- Fewer insurers exited the market, so more consumers will be auto-enrolled. These sign-ups won’t be reported until after enrollment ends.
Cardiology Predictions for 2019
The American College of Cardiology has published its annual forecast of predictions for 2019. Featured in Cardiology Today, the predictions cover therapy, surgery, technology, and value-based care.
Among the trends expected are:
- More use of direct oral anticoagulants.
- Increased interest in the use of artificial intelligence
- Greater use of wearable technology and integration of patient-collected data into care
- More focus on the cost-effectiveness of PCSK9 inhibitors, in light of new cholesterol recommendations and steps by drug makers to cut prices
Finally, the current issue of Evidence-Based Oncology™ looks at what’s next in cancer care, featuring cover stories about upcoming trends in cancer screening, and novel financing mechanisms to pay for investment in pediatric cancer research.
In an essay, The Future of Cancer Care, Editor-in-Chief Joseph Alvarnas, MD, discusses the challenge of balancing innovation and cost, writing: “It will be impossible to deliver the transformational level of care that genomics and innovative therapeutics promise equitably, effectively, or sustainably unless we create a transparent, data-rich system of care that can sustain and deliver these consistently. … This linkage between the needs and voice of the patient, genomic testing data, and the creation of a care ecosystem that aligns clinical risk, goals of care, the patient experience, and meaningful outcomes with reimbursement, is perhaps the best finish line for the end of the beginning of our road toward sustainable, patient-centered oncology care.”
For all of us at the Managed Markets News Network, I’m Laura Joszt, Thanks for joining us.