Tenet Healthcare Corp. (THC +1.4%) signs a new three-year agreement with UnitedHealthcare (UNH -0.9%) that provides United members with in-network access to Tenet's 79 hospitals, 193 outpatient centers and more than 1,800 physicians. The new contract becomes effective on August 1, 2014.
Saying that most custom-mixed medicines are either ineffective or overpriced, pharmacy benefit manager Express Scripts (ESRX +0.6%) plans to drop coverage for 1,000 drug ingredients found in compounded meds. The company states that the move will reduce employers' spending on compounded prescriptions by 95%. Express Scripts SVP Glen Stettin says, "What we are eliminating is, pure and simple, wasteful spending. These drugs are being used when there are other things available that are already approved by the FDA and are less expensive." The cuts will take effect on September 15, 2014 unless customers specifically ask to continue paying for them. Firms who want to opt out of the cuts must notify ESRX by Thursday (not sure if this means today).
Predictably, compounding pharmacists lack enthusiasm for the move saying that it will deprive patients of much-needed medications.
Some health insurers intend to join more state Obamacare exchanges next year, a development that could lead to more moderate price increases, or even prices falls, as competition increases.
In Washington state, for example, four insurers plan to sell coverage for the first time in 2015, while in Indiana, the number of providers could double to eight.
Of the insurers, UnitedHealth Group (UNH) is set to offer new plans in the states mentioned, adding to five exchanges that it already operates on.
The providers could be hoping to benefit from "second-mover" advantage whereby they will look to sign up the increased number of younger and healthier people who are forecast to purchase coverage next year as the penalty for not doing so increases. Those who are in worse health and bought coverage last year are expected to remain with their existing plans.
Meanwhile, the Center for American Progress (CAP) think tank, which is close to the White House, has called for President Obama to appoint a CEO with private-sector experience to oversee Obamacare's federal and state online health insurance exchanges. The idea is that the exchanges would run as e-commerce sites. The CEO would also oversee insurers and market regulations, although not Medicare or Medicaid. (CAP report)
Eight million people have enrolled for health insurance under Obamacare, President Obama said yesterday, easily surpassing earlier projections by the Congressional Budget Office for 6-7M signups by the end of March.
The high number of enrollments was achieved despite the technical problems that the online exchanges suffered, particularly when the Affordable Care Act was launched last year.
Around 35% of those who purchased coverage were people under 35, who are thought to be less likely need to treatment and so can help balance the cost of claims for those who need care.
However, Obama didn't provide details about the number of enrollees who already had insurance before Obamacare was introduced.
In response to insurers' reticence over covering behavioral interventions, California tightens its rules over insurance coverage for autism to improve access to treatment. Now, coverage must be on par with doctor visits despite the fact that most therapies are administered by non-M.D.'s.
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