TOP STORIES
The insurance industry is in consolidation mode with at least a few national payers in play, according to media reports Anthem made a takeover approach to Cigna Corporation. After months of discussion, Anthem made two takeover bids and their efforts have been rebuffed by Cigna. UnitedHealth has also apparently made overtures to Aetna for a takeover deal. There has also been continued speculation about Humana being up for sale.
The consolidation fever stems from the transformation of the health insurance industry following the passage of the Affordable Care Act. Payers view these deals as a way to cut costs and out them in a better position to negotiate deals.
As The Wall Street Journal points out, Anthem’s power play, even if it were accepted, poses certain challenges:
Blue Cross and Blue Shield plans hold geographic rights to use the Blue brand only in a particular area, and they also agree to certain limits on their non-Blue business. It is unclear how Anthem would manage the legacy Cigna business in states where another insurer is the local Blue.
The Centers for Medicare and Medicaid Services paid out $1.3 billion to nearly 2,000 hospitals to ease the Medicare claims appeals backlog. The payout stems from a deal CMS offered last August to pay 68 percent of the value of inpatient claims. The payout also accounted for 300,000 claims.
LIFE SCIENCES
A Deep-dive Into Specialty Pharma
A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Scientists developed a new way to analyze bacterial populations through a potential tool that makes it easier to fight pathogens and antibiotic resistance.
The American Cancer Society found that smoking is to blame for about half of US deaths caused by certain cancers.
PAYERS-PROVIDERS
Boston Children’s Hospital has a new chief innovation officer to fill the vacancy left by Naomi Fried when she moved to Biogen last year. John Brownstein currently serves as director of the hospital’s computational epidemiology group. Here’s a description of his experience:
He is a global leader in HCIT and, in particular, the emerging fields of informatics and big data analytics. He currently runs a 50-person multi-disciplinary team focused on digital innovations that span clinicians and consumers. He is a successful entrepreneur having developed new technologies, started multiple companies and outlicensed technologies. John has extensive experience establishing industry/academic partnerships, including work with Google, Twitter and Uber.
Thomas Jefferson University and Hospital inked a $2 million deal with Independence Blue Cross Blue Shield to identify and invest in entrepreneurs. The deal will also create an entrepreneur-in-residence at Jefferson, provides funding for a fall 2015 “hackathon,” an entrepreneurship curriculum, and a business speaker series for medical students and faculty.
New research conducted by Accenture found that about one-third of employees would quit their job within a year if employers didn’t fully sponsor the employees’ health benefits.
Canadian startup Milestone Pharmaceuticals received an infusion of $17 million for a Series B round intended to get the company through Phase two clinical trials for its calcium channel that treats paroxysmal supraventricular tachycardia.
TECH
A Johnson & Johnson subsidiary that produces over the counter medications — McNeil Consumer Healthcare — has launched an app using SickWeather’s API. Healthyday pulls together data from social media sites such as Twitter and Facebook to give users a map of where cold, flu and allergy trends are popping up. The company represents the first major customer for Sickweather’s API.
Catalia Health snagged $1.25 million in seed funding from Khosla Ventures for robots that provide healthcare information and support for people with chronic diseases like diabetes, arthritis, cancer and heart disease.
MedVenture Technology Corporation, announced the expansion of its product design and development operations. The medical device design and manufacturing company create minimally invasive catheter-based devices.
POLITICS
While defending the law, Hillary Clinton said she’ll propose fixes to Obamacare during her presidential campaign.
The Supreme Court decided not to review North Carolina law that would’ve forced women to have a “narrated ultrasound” before having an abortion.
The Department of Health and Human Services gave a greenlight to three states to set up health insurance marketplaces for individuals and small group markets: Pennsylvania, Arkansas and Delaware. Concerned about the potential fallout of the upcoming King v Burwell case before the Supreme Court, some states have moved to set up their own marketplace to protect the sought alternatives. The addition of these three states brings the total number of states with state run exchanges in various points of development at 17.
A LITTLE EXTRA
3D-printing company MX3D, based in Amsterdam, developed a robotic 3D printer that can print structures in air. The company is planning on using this technology to build a bridge over a canal in the heart of Amsterdam.
The Morning Read provides a 24-hour wrap up of everything else healthcare’s innovators need to know about the business of medicine (and beyond). The author of The Read published it but all full-time MedCity News journalists contribute to its content.
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