Healthcare Reform

Administrative Costs for Medicare Plans Increase Slightly in 2021

Retrieved on: 
Tuesday, September 13, 2022

In 2021, administrative expenses for Medicare plans increased by 0.6% per member compared to a 5.6% increase in 2020.

Key Points: 
  • In 2021, administrative expenses for Medicare plans increased by 0.6% per member compared to a 5.6% increase in 2020.
  • That edition of the Sherlock Benchmarks analyzes the results of in-depth surveys of 10 Medicare-focused plans serving 1.6 million members in Medicare Advantage and Medicare SNP plans who together served 12.3 million members in Comprehensive Products.
  • In March 2022, members in Medicare Advantage plans accounted for 46% of Medicare-eligible beneficiaries, up from 43% in 2021 and 13% in 2005.
  • Besides the Medicare-focused universe, other universes include Blue Cross Blue Shield Plans, Independent / Provider Sponsored plans, Medicaid plans, and Larger Plans.

 Abacus Insights’ Clinical Data Solution Offers Health Plans a Breakthrough in Creating Longitudinal Patient Records to Improve Care

Retrieved on: 
Tuesday, September 13, 2022

Abacus Insights, a healthcare technology leader with the only cloud-based data transformation platform built specifically for health plans, is rolling out a data solution that enables health plans to create comprehensive longitudinal patient records.

Key Points: 
  • Abacus Insights, a healthcare technology leader with the only cloud-based data transformation platform built specifically for health plans, is rolling out a data solution that enables health plans to create comprehensive longitudinal patient records.
  • The Clinical Data Solution helps payers by:
    Accessing, combining, and validating different sources and systems of clinical data from electronic health records, health information exchanges, Centers for Medicare and Medicaid Services, labs, dentists, member devices and apps, claims, enrollment, and more into a cohesive clinical data ecosystem.
  • The Clinical Data Solution is one in a suite of solutions that Abacus Insights is developing to support key payer functions.
  • Abacus Insights is a healthcare technology leader with the only data transformation platform and solutions built specifically for health plans.

H.I.G. Capital Completes Recapitalization of Navitas Life Sciences

Retrieved on: 
Tuesday, September 13, 2022

"), a leading global alternative investment firm with over $50 billion of equity capital under management, is pleased to announce that one of its affiliates has completed the recapitalization of Navitas Life Sciences (Navitas or the Company).

Key Points: 
  • "), a leading global alternative investment firm with over $50 billion of equity capital under management, is pleased to announce that one of its affiliates has completed the recapitalization of Navitas Life Sciences (Navitas or the Company).
  • H.I.G., with its global network and diverse experience across healthcare and life sciences, is an ideal partner to support Navitas continued growth as a Global Next Generation CRO.
  • We are excited to leverage H.I.G.s capital and resources to accelerate our own growth initiatives while continuing to deliver outstanding service to our clients.
  • As technology becomes an integral part of drug development value chain, we expect Navitas to become an increasingly important strategic partner to life sciences companies.

AHF Protests Gilead over Drug Pricing @ Morgan Stanley Conference

Retrieved on: 
Tuesday, September 13, 2022

Key Points: 
  • View the full release here: https://www.businesswire.com/news/home/20220912005989/en/
    AHF has been targeting Gilead Sciences, Inc. as "Greediad" over the drug company's AIDS drug pricing and policies as well as illegal restrictions Gilead is placing on access to its lifesaving drugs through the 340B program.
  • Gilead officials will be presenting at the conference and the advocates will protest Gilead as Greediad over the drug companys latest, and illegal move to undermine safety net providers access to 340B program benefits.
  • AIDS Drug Pricing PROTEST targeting Gilead Sciences, Inc.
  • In March of this year, Gilead became the 15th drug manufacturer to place unlawful restrictions on 340B contract pharmacy programs.

From Recovery to Reception: Kidney Transplant Collaborative Grant Funds Innovative Program to Increase Transplant Rates Nationwide

Retrieved on: 
Monday, September 12, 2022

Recipients of the Kidney Transplant Collaborative (KTC)s 2022 grant program are already making important progress to help increase kidney transplants and reduce barriers among patients and donors nationwide.

Key Points: 
  • Recipients of the Kidney Transplant Collaborative (KTC)s 2022 grant program are already making important progress to help increase kidney transplants and reduce barriers among patients and donors nationwide.
  • The Kidney Transplant Collaborative grant is allowing us to explore innovative ways to increase the number of transplantable organs, shared Brian Roe, Chief Clinical Officer for KODA.
  • We established the Kidney Transplant Collaborative to encourage stakeholders across the industry to work together and learn from one another.
  • About the Kidney Transplant Collaborative:
    The Kidney Transplant Collaborative (KTC) is a 501(c)(4) nonprofit organization dedicated to increasing kidney transplants and decreasing financial obstacles and other problems kidney patients, donors, and their families experience with the kidney transplant process.

Dr. Jane Goodall and Vivodyne Issue Open Letter to Congressional Leaders to Include FDA Modernization Act as a Rider in the Food and Drug Amendments Act of 2022

Retrieved on: 
Thursday, September 8, 2022

We cannot continue to vainly expect caged animals to accurately predict human drug responses.

Key Points: 
  • We cannot continue to vainly expect caged animals to accurately predict human drug responses.
  • Mandating that such promising drugs are tested on animals where they are guaranteed to fail, will only inhibit their further development.
  • Importantly, these modern approaches do not rely on the use of embryonic stem cells or other materials that raise ethical concerns.
  • We thank you and appreciate your support for the FDA Modernization Act by including it in the FDA User Fee package.

AHF Condemns Texas Ruling Denying PrEP Coverage

Retrieved on: 
Thursday, September 8, 2022

AIDS Healthcare Foundation ( AHF ) strongly condemns the decision of U.S. District Court Judge Reed OConnor in the Northern District of Texas that would allow private employers to deny access to HIV prevention medication based on the Religious Freedom Restoration Act.

Key Points: 
  • AIDS Healthcare Foundation ( AHF ) strongly condemns the decision of U.S. District Court Judge Reed OConnor in the Northern District of Texas that would allow private employers to deny access to HIV prevention medication based on the Religious Freedom Restoration Act.
  • The judge ruled on September 7th that a provision of the Affordable Care Act that mandates free coverage of certain drugs violates the religious beliefs of a Christian-owned company.
  • The judges ruling gives private employers the ability to opt out of providing access to pre-exposure prophylaxis (PrEP) medication that prevents the transmission of HIV.
  • said Michael Weinstein, President of AHF.

On Average, Two Nurses Are Assaulted Every Hour, New Press Ganey Analysis Finds

Retrieved on: 
Thursday, September 8, 2022

Nurses take an oath to do no harm, and many put their own safety and health at risk to help a patient.

Key Points: 
  • Nurses take an oath to do no harm, and many put their own safety and health at risk to help a patient.
  • However, violence should not be considered just part of the job, said Jeff Doucette, DNP, R.N., NEA-BC, FACHE, FAAN, chief nursing officer, Press Ganey.
  • Whats especially concerning about these numbers is that they are likely even higher, as assaults generally go underreported by healthcare professionalsand nurses in particular.
  • Today Press Ganey offers an integrated suite of solutions that enable enterprise transformation across the patient journey.

CareJourney Announces Major Upgrade to its Market-leading Provider Cost and Quality Module, Now Available Through a Variety of Delivery Options

Retrieved on: 
Wednesday, September 7, 2022

CareJourney, the healthcare industrys leading source of provider cost and quality data, today announced enhancements to its provider performance module on the CareJourney platform.

Key Points: 
  • CareJourney, the healthcare industrys leading source of provider cost and quality data, today announced enhancements to its provider performance module on the CareJourney platform.
  • The module offers comprehensive provider performance indicators that combine demographic and affiliation information with cost, outcome, and referral metrics.
  • The new distribution options offer easy integration into back-end or front-end applications including customer relationship management systems (CRMs), provider directories, referral applications, and provider contracting systems.
  • CareJourney's data offering has enriched our internal databases with robust, detailed and vast provider cost and quality metrics, said Vivek Gursahaney, Director, Payer Provider Consulting, Guidehouse .

Passage of the PASTEUR Act Critical to Efforts to Fight Antimicrobial Resistance

Retrieved on: 
Wednesday, September 7, 2022

That includes building momentum for Congress to act.

Key Points: 
  • That includes building momentum for Congress to act.
  • The Pioneering Antimicrobial Subscriptions to End Upsurging Resistance (PASTEUR) Act is essential to paving a sustainable path forward for research and development of new novel antibiotics and antifungals.
  • The bipartisan PASTEUR Act will address the challenges in the antimicrobial marketplace and encourage the development of much-needed medicines.
  • The PASTEUR Act is a significant opportunity for our Congress to lead the way forward in support of innovation and consistent delivery of new antimicrobial treatments to patients when they need them.