Morning Briefing
Summaries of health policy coverage from major news organizations
Anthem Blue Cross Reverses Anesthesia Coverage Policy After Outcry
Anthem Blue Cross Blue Shield said Thursday that the health insurance provider is reversing a policy that was set to go into effect in February of that would have limited anesthesia coverage during surgeries and other procedures, a change that had prompted an outcry from some physicians and lawmakers.聽The policy, which would have covered Anthem's plans in Connecticut, New York and Missouri, was disclosed in recent weeks. ... The policy would have excluded people under 22 years old and maternity care. (Picchi, 12/5)
More on health care costs and coverage 鈥
For the first time in over a decade, employers are bracing for health care cost increases that are growing at rates not seen in years. Many businesses reported higher-than-expected expenses in 2023, with projections for 2024 and 2025 signaling even sharper growth. This cost trajectory has forced many organizations to reconsider long-standing partnerships and explore new strategies for cost management. Employers are expected to respond with increased request-for-proposal activity, seeking greater transparency and accountability from vendor partners. These efforts will likely disrupt current arrangements but are designed to improve long-term outcomes, including patient experience, affordability, and quality of care. Businesses will also explore alternative approaches, such as direct contracting with centers of excellence and steering employees toward high-value providers. (Shryock, 12/3)
Billionaire Elon Musk on Thursday weighed in on the cost of health care in the U.S., questioning the value Americans get for the coverage they receive. "Shouldn鈥檛 the American people be getting their money鈥檚 worth?" Musk, who was tapped to co-lead the incoming-Trump administration's Department of Government Efficiency (DOGE) alongside Vivek Ramaswamy, replied to a post on X. His comment was in response to a post highlighting data from the Peter G. Peterson Foundation that says that the U.S. has the highest health care admin costs (per capita) compared to OECD (Organization for Economic Co-operation and Development) countries. (Genovese, 12/5)
As a historic wave of baby boomers reaches retirement age, finding affordable long-term care is a challenge. 鈥淲e鈥檙e going to have a major storm coming in our country with all these folks that can鈥檛 take care of themselves,鈥 Rep. Tom Suozzi, D-New York, said Thursday at the Employee Benefit Research Institute policy forum in Washington, D.C. (Konish, 12/5)
In the U.S., having health insurance is necessary, but not sufficient to ensure access to affordable medical care.聽While the U.S. lacks a universal health care system like those that exist in most other wealthy nations, most Americans over 65 are insured through Medicare. Yet many still struggle to afford care, with high out-of-pocket costs putting necessary medications and doctor visits out of reach, according to聽research from The Commonwealth Fund, a nonprofit that works to promote an equitable health care system.聽(Cerullo, 12/5)
Hospitals have expanded their legal push for the federal government to boost Medicare reimbursement. More than 500 hospitals last week sued the Health and Human Services Department for allegedly miscalculating a 40-year-old Inpatient Prospective Payment System base reimbursement rate that providers say has lowered years of subsequent Medicare payments to hospitals. The lawsuit is the latest in a series of similar complaints that allege the Health and Human Services Department must increase Medicare inpatient pay. (Kacik, 12/5)
Also 鈥
Technology giant Amazon is聽expanding a program that connects its users to digital health companies. Amazon is adding virtual musculoskeletal health company Hinge Health to its聽Health Condition Programs, the companies said Thursday. The programs allow users to input information about their insurance plan and potentially identify covered services such as Hinge鈥檚 virtual physical therapy.聽(Turner, 12/5)
Stanford Health Care, Essentia Health, Winona Health and Boulder Community Health have joined Civica, a nonprofit company that looks to increase access to generic drugs and stem persistent shortages. Palo Alto, California-based Stanford, Duluth, Minnesota-based Essentia, Winona, Minnesota-based Winona and Boulder, Colorado-based Boulder Community are now part of Civica鈥檚 network of about 60 health systems and 1,400 hospitals, Civica said Thursday in a news release. (Kacik, 12/5)