Antitrust Law Enforcement in Healthcare Tighter under President Joe Biden, with mixed results.
The Federal Trade Commission has kept the health system from getting bigger, but the Justice Department has challenged insurer UnitedHealth Group’s unsuccessful acquisition of health financing and billing data firm Change Healthcare. rice field.
Hal Andrews, CEO of healthcare analytics firm Trilliant Health, thinks the regulators are all wrong. In a chat with Ruth, Andrews suggested better ways to keep costs down than blocking mergers and acquisitions.
This interview has been edited for length and clarity.
How should antitrust regulators treat healthcare?
I think it’s a consent order approach that seeks to acknowledge that there are basic capital and operational inefficiencies that could be addressed by closing the facility.
So why not oppose mergers and acquisitions?
Instead of blocking the deal, I said, ‘You can close it, but I want you to build a 20,000 square foot ambulatory care facility with primary care imaging and set up an emergency department. , I need to build three of them, and I’ll tell you where you need to build them.”
I think it’s a much more appropriate place than saying “no you can’t do that”.
Do you agree with the Federal Court’s decision allowing UnitedHealth to acquire Change Healthcare?
United makes $1 billion in revenue per day. Billion. According to them, they employ or partner with her 65,000 doctors, which is his 10% of US practitioners. If that’s not the problem, I don’t know what else.
DOJ is considering CVS’s acquisition of home health care company Signify Health. What do you think?
I think it’s a more ridiculous pursuit. Other than gas stations and liquor stores, I don’t know of any industry that is more family owned than the home health industry. And I don’t know how Signify changes that. I don’t know how to claim that it could influence the market or create an anti-competitive situation.
By comparison, we can [UnitedHealth’s pharmacy benefit manager] Is Optum using the Change Healthcare dataset in ways that hurt others? Sure.
Here we explore the ideas and innovators shaping healthcare.
How bold are you when it comes to food? Are you daring enough to try lab-grown meat? Cultured meat company executives hope you will be able to buy their products in restaurants soon.
Share other thoughts, news, tips and feedback with Ben Leonard. [email protected]Ruth Leader [email protected]Carmen Pawn [email protected] or Erin Shoemaker [email protected].
Send tips securely Via SecureDrop, Signal, Telegram, or WhatsApp.
paid by private health insurance companies in 2020 It’s about the same amount for online visits as it is for in-person visits, according to. New analysis From the Kaiser Family Foundation.
The findings could dampen the enthusiasm of health care providers and insurers to push telemedicine as a cost-cutting measure, the report said. However, using telemedicine makes it easier for patients to consult their doctors.
In the early stages of the pandemic, the federal government expanded telemedicine reimbursement to keep people out of the virus’s path, and private insurers followed suit, raising rates, the analysis said.
Researchers who analyzed more than 76 million claims concluded that most doctors were paid the same for telemedicine and in-person consultations.
Payments were similar for mental health therapy, virtual or not.
“At this time, we do not know whether private insurers will continue to pay for telemedicine on par with in-person care,” the researchers said. “However, if telemedicine payments remain the same as for in-person care, it raises the question of whether telemedicine will reduce spending on general health services, as some have predicted. .”
But the pay equity research doesn’t surprise most employers. Nearly two-thirds of business leaders believe telemedicine has already disrupted them financially, and only 4% expect costs to rise as telemedicine use increases 6% say they believe costs will be reduced.
“A key benefit of expanding telemedicine could be improved access to services and convenience for registrants,” the researchers wrote, adding that most employers believe telemedicine will enhance access. He added that he believes it will play an important role in doing so.
Amazon launches A new service called RxPass lets Prime members get eligible generic prescription drugs for $5 a month. It lists over 50 drugs that treat about 80 conditions.
The new service competes with discount drug companies such as Mark Cuban’s Cost Plus Drug Company and GoodRx, as well as online prescription delivery services from major pharmacy brands such as CVS.
Online pharmacies have been around for years but have so far failed to gain traction.Most people still go to their local pharmacist to pick up their medication. However, the pandemic has accelerated the use of online prescription ordering and delivery.
Since 2018, Amazon has launched several healthcare initiatives, including telemedicine services, which have since been shut down. Navigator acquires primary care chain One Medical.