What we're reading, October 21, 2015: influential Republican's on health committees oppose the Affordable Care Act's reinsurance program for insurers; shareholder's of Aetna say yes to the company's merger with Humana; and the genetic testing company will once again start sharing health information with consumers.
Republicans Reignite Insurance Bailout Debate
Influential Republicans who serve on health committees, including Fred Upton (R-MI) who chairs the d House Energy and Commerce Committee, have submitted a letter to acting administrator, Andy Slavitt, urging CMS to reduce reimbursement or deny participation for certain plans under the controversial “reinsurance” program of the Affordable Care Act. “We urge you to consider adopting lower reimbursement rates for years 2015 and 2016 and to end the regulatory requirement that self-insured companies and multi-employer health plans contribute to the reinsurance program,” the letter states.
Read the letter here.
Shareholders Approve Aetna-Humana Merger
Shareholders of insurance giants Aetna and Humana have approved the proposed merger of the 2 companies in separate meetings. About 99% of Aetna’s shareholders agreed to allow the issuance of common shares to Humana stockholders associated with the acquisition.
Read more here.
23andMe Will Start Sharing Genetic Data With Customers
Following a setback in 2013 wherein the FDA stopped the molecular testing company 23andMe from sharing health information that lacked regulatory approval, the company now has the FDA’s go-ahead. 23andMe will begin providing information on the “carrier status” of people who have genetic mutations that could lead to a disease in their offspring. According to Anne Wojcicki, co-founder and chief executive of 23andMe, the company is now “working from within the system so the consumer will have a sense of ownership and a voice in that system.”
Read more here.
Urticaria Diagnosis Challenged by Overlapping Pruritic Skin Conditions
April 23rd 2025Urticaria is complicated to diagnose by its symptomatic overlap with other skin conditions and the frequent misclassification in literature of distinct pathologies like vasculitic urticaria and bullous pemphigus.
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New Research Challenges Assumptions About Hospital-Physician Integration, Medicare Patient Mix
April 22nd 2025On this episode of Managed Care Cast, Brady Post, PhD, lead author of a study published in the April 2025 issue of The American Journal of Managed Care®, challenges the claim that hospital-employed physicians serve a more complex patient mix.
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Personalized Care Key as Tirzepatide Use Expands Rapidly
April 15th 2025Using commercial insurance claims data and the US launch of tirzepatide as their dividing point, John Ostrominski, MD, Harvard Medical School, and his team studied trends in the use of both glucose-lowering and weight-lowering medications, comparing outcomes between adults with and without type 2 diabetes.
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ACOs’ Focus on Rooting Out Fraud Aligns With CMS Vision Under Oz
April 23rd 2025Accountable care organizations (ACOs) are increasingly playing the role of data sleuths as they identify and report trends of anomalous billing in hopes of salvaging their shared savings. This mission dovetails with that of CMS, which under the new administration plans to prioritize rooting out fraud, waste, and abuse.
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