Top news of the day from across the health care landscape.
Members of the 115th Congress, who will be sworn in today, will seek to dismantle the Affordable Care Act as their first plan of action, according to the Associated Press. In addition to repealing President Barack Obama’s health care law, the all-Republican leadership will take on an ambitious agenda of tax cuts and regulation rollbacks. However, they will be met with challenges, since Senate Democrats hold the power to filibuster legislation, the Associated Press reported.
As part of a big push under the Obama administration to reinvent Medicare, large-scale cardiac and hip fracture experiments are gearing up to test whether better coordination among clinicians, hospitals, and rehab centers can ward off complications, prevent avoidable hospital readmissions, and help patients achieve more stable recoveries, according to ABC News. The experiments will focus on traditional Medicare, and the cardiac experiment will involve heart attack and heart bypass patients. The experiments will include physicians, hospitals, and rehab centers that will be paid the regular Medicare rates, ABC News reported. However, the hospitals will be given responsibility for overall cost and quality measured against benchmarks set by Medicare. Hospitals that meet or exceed the goal will earn financial bonuses, which can be shared with other services, according to ABC News. However, if the hospital comes up short, it may have to pay the government.
As insulin prices continue to soar, patients with diabetes are becoming increasingly concerned with higher insurance deductibles and changes in the prescription brands covered by some insurers. According to USA Today, CVS Caremark will no longer cover the insulin branded medication, Lantus, in favor of the new biosimilar version, Basaglar. Between January 2013 and October 2016, the cost for Humalog—–as well as many other insulin brands––increased from approximately $300 to $500, GoodRx reported. During the same time period, Lantus increased about 60%, from $240 to $380, reported USA Today. “It’s definitely unfortunate prices are going up so much and impacting the people who need it to stay alive,” said Henry Anhalt, a pediatric endocrinologist in Englewood, New Jersey, as reported by USA Today. “But I think a big part of the problem is how much (insurers) cover and how much they fight you.”