ICYMI: 4 Must-Knows From the Healthcare News

February 24, 2020

News about UnitedHealth, Alkermes, M4A, and MA that you need to know about. 

A trend to watch: Insurers as providers
The old dividing lines in healthcare get blurrier and blurrier. The Wall Street Journal(behind a paywall) posted a story yesterday about insurance companies steering members toward clinics they own. The newspaper reported that UnitedHealth Group  is offering a plan in Los
Angeles organized around doctors that work for its growing Optum arm. Aetna, now a Russian nesting doll within CVS Health, has plans that don’t charge copays for members who go to CVS’s MinuteClinics. And, the newspaper reports, Blue Cross and Blue Shield of Texas started a plan last year includes free primary-care visits at 10 retail clinics owned by Sanitas.

The healthcare docket: Alkermes sued for death allegedly related to Vivitrol
Lawsuits related to opioid treatment may be the next legal wave related to the opioid epidemic. TheBoston Globe (behind a paywall) reported Sunday that the parents of a 26-year-old California man are suing Alkermes, the maker of Vivitrol, The newspaper says the wrongful death suit alleges that the company failed to warn people about the risk of overdosing after they stop taking the treatment drug and start abusing opioids again.

Politics and policy: Medicare for all, altogether unrealistic?
Veterans of the sausage making of health care legislation seem to have a dim view of the real-world prospects of Medicare for all. On Friday at a symposium at Penn, we heard Princeton’s Paul Starr, who helped put together the ill-fated Clinton managed competition plan, dis the political chances of M4A. On the same day, John McDonough, who as a Senate health committee staff helped write and pass the ACA, had an item on the Health Affairs blog that made similar get-real arguments. “Too much time has been spent in this presidential campaign season arguing about Medicare for All,” wrote McDonough, who is now a professor at the Harvard T.H. Chan School of Public Health. “It is not because it’s a bad idea. It is because, for the foreseeable future, Medicare for All has zero political chance to become law.”

Related: Paul Starr Reality Checks Medicare for All

Medicare Advantage: Medicare (unfair?) Advantage
A growing number of Medicare beneficiaries are enrolling in Medicare Advantage plans, much to the delight of insurers. A longish piece in the New York Times (behind a paywall) reports on the possible drawbacks of MA plans for members; for example, if they cast their lot with a MA plan it may be next-to-impossible to switch back to traditional Medicare because the cost of the Medigap policy will be prohibitively high. And they may want to switch back if the MA plan’s network doesn’t include a specialist they want to see. The Times story, which was posted on Friday, also reports on rules and policies, some of them new in the Trump administration that give MA plans a leg up over traditional Medicare.