Aetna Drops on Rising Costs for Dismissed Workers

According to Alex Nussbaum at Bloomberg, Aetna Inc., the third-largest U.S. health insurer, slipped the most in two months in New York trading after the company said it was spending more than expected on health benefits for workers who lost their jobs or feared dismissal.
The shares dropped 10 percent, or $2.52, to $21.88 at 4:15 p.m. in New York Stock Exchange composite trading, Aetna’s biggest one-day fall since March 5. The Hartford, Connecticut- based insurer said expenses were pushed higher by dismissed workers who continued buying insurance through the government- subsidized Cobra program, as well as those who ramped up medical treatment as firings loomed.

Will more health insurance carriers face the same troubles as Aetna or will this be a temporary set back for the insurance giant?

Drug Pricing Based on Patient Outcomes

According to this post in FierceHealthcare pharma companies have started adjusting pricing on their drugs to reflect its performance on improving patient outcomes. Merck has agreed to adjust pricing on Januvia and Janumet, which are diabetes drugs, based on how well they treat type 2 diabetes.

Performance-based pricing for meds is extremely rare, but with increased pressure coming from insurance companies it is only a matter of time before we will see more and more pharma companies following this pattern.

Read more about this piece on the NY Times

World Bank triples funds for healthcare amid crisis

As the global economic crisis continues, the World Bank has tripled its funds for healthcare in order to provide relief to developing countries. Reuters reports that a new World Bank report said it would increase its healthcare funding from $1 billion last year, with evidence already that some governments are facing difficulties in affording HIV/AIDS drug therapies.
Preliminary findings from a March 2009 World Bank survey in 69 countries, which offer treatment to 3.4 million people on anti-retroviral treatment, shows that eight countries now face shortages of anti-retroviral drugs or other disruptions to AIDS treatment. No word yet if this tripling of funding will include help for Mexico's swine flu epidemic.

Doctor + iPhone = Better Healthcare By Christine Chang, Datamonitor Healthcare Analyst

The next time you go to your doctor’s office, check to see if he/she is using an iPhone, along with a stethoscope and blood pressure cuff, to evaluate your health. With Apple’s announcement that it is allowing third party developers to create applications on the iPhone, Datamonitor believes that healthcare technology applications – particularly electronic health records (EHRs) and clinical decision support (CDS) – will be more likely to be adopted by physicians, translating into better healthcare for patients.

EHRs allow providers to access all the information on a patient in one place, giving them more information at the point of care. CDS tools help providers sort through the huge amount of patient data and medical literature now available, checking, for example, if the medication they are about to prescribe will interact with a drug the patient is already taking.

Physicians have been slow to adopt EHRs and CDS during the past few years, in part because using a computer in the middle of a patient exam disrupts the dynamic of the patient/provider relationship and it slows down doctors’ normal work patterns. Mobile devices like the iPhone can help alleviate these issues and encourage more doctors to use these new life-saving technologies.

The iPhone, however, stands out from the rest of the currently available devices because of its functionality, easy of use and, quite frankly, appearance. The iPhone’s functionality is undisputed – as a phone, camera, media device and web browser all in one device – who needs anything else? Healthcare providers don’t want to carry around a beeper, hospital-issued phone, cell phone, BlackBerry and Tablet PC with them as they run through the corridors of a hospital. They want to carry around one device that can do everything and that’s what the iPhone is.

Why does a physician need a camera or iPod you might ask? Well, if you go to your primary care physician with a strange rash on your arm, your doctor could, hypothetically, take a picture of it and send it to a dermatologist for a second opinion. If you can’t remember what kind of medication you’re on, but you can remember what it looks like, your doctor can pull up pictures of drugs, right on the iPhone, that fit your description and figure out what you’re taking. For the iPod function, a doctor may want to take a quick refresher course on the different sounds a heart makes when the heart valve isn’t functioning properly. The possibilities are endless.

With no little buttons to push, the iPhone’s touch screen brings easy to use technology to even the most techno phobic provider. Zoom in capabilities (that will be particularly useful when looking at x-rays, MRIs, etc.) and the ability to flick through screens are other features that will make it easier, rather than more difficult, for providers to enter in and sort through patient information. Furthermore, because the iPhone connects to Wi-Fi networks, and most hospitals have or are currently installing Wi-Fi, accessing the internet is easy and fast. Of course, if no wireless internet connection is available, an application on the iPhone will still be able to function. The fact that the iPhone has become a kind of status symbol and is attractive to look at and own doesn’t hurt the prospects for provider adoption either.

Developing an application on the iPhone, as opposed to other mobile devices, allows for increased functionality and innovation as Epocrates, a clinical information and decision support tools company, has already demonstrated. While the current exclusive contract with AT&T is a drawback for end-user adoption, healthcare technology vendors nevertheless should be clamoring to create applications specific to the iPhone. Doctors want to use this device; for the first time, they’re waiting for technology to catch up to them.

Related Research:
2009 Trends to Watch: Pharmaceutical Technology

2009 Trends to Watch: Healthcare Technology

Brought to you by:

Florida changes Medicaid distribution

In a recent article at The Miami Herald, the Florida house has decided to restructure the panel that recommends how to distribute Medicaid money. Currently, of the $2 billion available to Medicaid, roughly 30% comes from the tax payers of Miami-Date county. For the full story, read here.

Panel Established for Global Healthcare

Reported today in The Boston Globe, a senior level committee has been give $10B to establish a plan for global health care. According to the article, the bipartisan Commission on Smart Global Health Policy, whose members include Senators Jeanne Shaheen of New Hampshire and Olympia Snowe of Maine, was given a mandate yesterday to identify a more comprehensive strategy for spending the estimated $10 billion dedicated each year to assisting the most disease-plagued nations.
Retired Navy Admiral William J. Fallon is heading up the initatitive and the group plans to show their ideas early next year to President Obama. The commission's 26 members include several members of Congress; former top diplomats and intelligence officials such as John Negroponte; leaders of nonprofits such as the Bill and Melinda Gates Foundation; former Health and Human Services Secretary Donna Shalala; the president of Barnard College; and executives from major corporations such as Exxon Mobil, Coca Cola, and drug giant Merck and Co.

Lincare sees fall in profits

Lincare Holdings of Clearwater, Florida, a company that provides oxygen and respiratory therapy to patients in their homes, has seen a decrease in the first quarter 2009 revenue. This follows a 9.5% drop in reimbursements for certain Medicare supplies in addition to drug reimbursements that were $220 million lower. For the full story, read here.

Virtual colonoscopy and Medicare

The LA Times has an article about the new debate over virtual colonoscopies. With the Obama administration promising to make spending for Medicare more efficient, this debate arises. Colonscopies can be done in the traditional method or through a new virtual procedure, which often costs less. The government is now debating whether this procedure should be covered. Read the article here.

OFFICIAL CALL FOR PRESENTERS PATIENT ASSISTANCE PROGRAMS

Official Call For Presenters

PATIENT ASSISTANCE PROGRAMS
From: Courtney Leonard, Conference Producer
Re: Call for Speakers & Presentations
Event Date: October 26-27, 2009
Event Venue: Capital Hilton, Washington, DC

INDUSTRY ALERT: OFFICIAL CALL FOR PAPERS

The Institute for International Research (IIR) is currently seeking presenters for the 2009 Patient Assistance Programs event. This 2-day event will take place October 26-27, 2009 in Washington, DC. We invite you to submit a proposal for a speaking opportunity directly to Courtney Leonard, by May 01, 2009. Please send to cleonard@iirusa.com.

Submission Guidelines & Details

CUSTOMIZE YOUR CONFERENCE AGENDA!

We are currently recruiting pharmaceutical and biotech professionals who can share first-hand perspective, insights, and real-world case studies on what has worked at their organizations. Some of the topics to be addressed at the 2009 event are:

• Improve and enhance medication assistance programs
• Improving State wide medication assistance programs; Best practices from other states
• Web based PAP enrollment
• Medicare Part D
• PAPS Automating the PAP enrollment process
• How to utilize patient profile data
• How to survive an audit
• Legal consideration in PAP administration
• Bulk Replacement Programs
• Growing need for copay assistance
• Expansions of PAP programs
• Oncology driven PAP Programs
• Ensuring PAP compliance with changing government regulations
• Effective PAP marketing strategies
• Specialty pharmacy role and management in PAPS

MAKE SURE YOUR BIGGEST ISSUES ARE ADDRESSED!

Are your biggest issues not addressed here?
Contact Courtney Leonard to ensure that your pressing issue gets the attention it deserves! cleonard@iirusa.com or 919.518.8294.

Do you want to reach this audience?

We have a limited number of slots available for solution providers/consultants.
People who wish to become part of the program should contact , Andrew Sinetar, Sponsorship Manager, at 646.895.7484 or e-mail asinetar@iirusa.com.
Sessions will be 30-45 minutes including Q & A.

Former Senator Tom Daschle Announced as MDRP Summit Keynote

MDRP Summit has just announced that Former Senator Tom Daschle will be a keynote speaker. As Senate majority and minority leader from 1994–2005 and the architect of President Obama’s healthcare plan, he is an outspoken advocate for reform, and a well-connected voice between the healthcare industry and Washington policy-makers. His recent book, Critical: What We Can Do About the Healthcare Crisis, offers exciting new solutions on changing America's healthcare system providing the framework for Obama’s plan.

Don't miss your chance to see him at this year's Medicaid Drug Rebate Program Summit in Chicago, IL on September 21-23, 2009.

What will a public plan for health insurance mean for Medicaid Managed Care

On April 1st millions of children previously uninsured became eligible for CHIP. This leaves just over 40 million additional adults who are currently uninsured. The Administration seems committed to a reform plan which would expand previously existing public program such as Medicaid. There will no doubt be tremendous debate and a contentious political fight regarding how this should be achieved. For 17th years the Medicaid Managed Care Congress has brought together the nation’s leading Medicaid Health Plans and the States at the forefront of Medicaid Managed Care to operationalize best practices that drive measurable cost savings and quality improvements in Medicaid. This year is a year like no other and we have assembled the faculty who can ensure sustainability and success in this changing political landscape.

With budget so tight how can you justify your investment in this year’s Medicaid Managed Care Congress:

The top three issues for Medicaid Plans - reimbursement, reimbursement, and reimbursement – attending MMCC gives you the insights to understand the impact of reform and State budgets on reimbursement rates and Medicaid payments so you can ensure sustainability even if tough economic times.

As the Federal government looks for ways to fund expansions, they will no doubt look to eliminate fraud and abuse within the system, this means increased oversight and auditing at MMCC you will hear the latest strategies to prevent waste, fraud and abuse from the nation’s most esteemed experts in this area.

States have started to deny payment for “never events”, hear from CMS and the states who have eliminated payments including Minnesota, New Jersey and Connecticut on what they expect of managed care plans to ensure provider self-reporting and ensure that your providers have tools in place to identify and trans never events if they occur.

Prevention and value based purchasing are of top priority for this Administration, which means this is where the money will flow and States will be looking to plan who can deliver the most effective combination of performance measures and incentive to achieve quality results at MMCC you’ll hear from the State who have achieved measurable results from implementing these programs.

Over 200 of the Nation’s leading Medicaid Managed Care executives convene once each year to focus on the issues and challenges that pertain specifically to the business of improving quality and outcomes in Medicaid while controlling costs with so much uncertainty, you can’t afford to miss the reliable and practical tools and strategies they will be sharing.


Source: U.S. Dept of Health & Human Services

2010 rates for Medicare to be confirmed today

According to the Wall Street Journal, it will be announced today whether the 2010 Medicare Advantage rates will be finalized. If they are, then many private Medicare Advantage health plans for seniors will likely be cut. Read the full story here.

Changes for private organizations offering Medicare

Obama has made changes for the private health care organizations offering Medicare. Some of the changes are:

- winnowing the number of versions of a plan that insurers can offer
- protecting patients with chronic diseases from excessive co-payments
- banning a practice by some plans that can add even more to the costs of brand-name drugs

For the full story, read the article here.