"None of the obesity drugs

... have actually been shown to improve health outcomes, such as cardiovascular events (e.g., heart attack, stroke) or cardiovascular deaths of patients. There is some evidence that they decrease weight in the short term, blood pressure and blood glucose control. However, this does not always translate into improvements in the health of the patient. In addition, we don't know what the long-term harms are associated with the drugs. So for these manufacturers to actually show a health benefit along with these drugs is incredibly difficult, because the weight loss is so modest that it would take a huge study to show any kind of health benefit and it would also take a pretty good-sized study to show the harms associated with the drugs."

— Jim Carlson, Pharm.D., vice president for professional pharmacy services at OmedaRx, told AIS's Drug Benefit News.

$454 million

... in Medicare funds were saved in 2014 by CMS's Fraud Prevention System, up 80% from two years ago, according to the third annual report on the program released by the agency on July 14.

Factors that contribute to successful private health insurance exchanges

1.    Increasing administrative requirements

2.    Employer Mandate

3.    Employers maintaining coverage

4.    Cadillac Tax

Source: "What makes private health insurance exchanges successful?", The AWANE Blog, July 21, 2015

Mortality, Hospitalizations, Cost Has Decreased For Medicare Beneficiaries

The Journal of the American Medical Association recently publihsed a study on the mortality, hospitalization, and expenditure trends for the Medicare population age 65+. Here are some key findings from the article:

·         All-cause mortality for all Medicare beneficiaries declined from 5.3% in 1999 to 4.45% in 2013.

·         The total number of hospitalizations per 100,000 people decreased by 8,344 from 1999-2013.

·         Hopitalizations in the last 6 months of life dropped from 131.1 to 102.9 per 100 deaths.

·         Inpatient expenditures per Medicare fee-for-service beneficiary dropped from $3290 to $2801.

·         70.5% of beneficiary deaths required 1 or more hospitalizations in 1999, compared to 56.8% in 2013.

·         Inpatient expenditure per death was $15,312 in 1999, $17,423 in 2009, then decreased to $13,388 in 2013.

Source: JAMA, July 28, 2015

According to a recent survey of independent physicians:

• 17% are participating in accountable care organization
• 7% are aligning with patient-centered medical home models
• 24% are considering ancillary or subscription-based services to generate new revenue streams over the next three years

Source: "Many U.S. Doctors will Leave Private Practice for Hospital Employment, Accenture Reports," Accenture News Release, July 29, 2015, https://newsroom.accenture.com/news/many-us-doctors-will-leave-private-practice-for-hospital-employment-accenture-reports.htm

In 2015

86% of consumers who were eligible to purchase coverage in the Health Insurance Marketplace, could choose from at least three issuers, up from 70% in 2014.

Source: "Competition and Choice in the Health Insurance Marketplace Lowered Premiums in 2015," U.S. Department of Health and Human Services, July 30, 2015, http://www.hhs.gov/news/press/2015pres/07/20150730a.html  

34%

... fewer providers are included in the networks of insurance plans sold on public exchanges than those of commercial plans offered outside the exchanges, according to an analysis from Avalere Health LLC.