Editor’s note: Each Wednesday, Talk Business & Politics provides “Health Beat,” a round-up of health-related topics. –––––––––––––––
CENTENE MANAGEMENT CARE ENROLLMENT JUMPS 17% IN ARKANSAS, UP TO 50,700
Healthcare giant Centene Corp. said in its first quarter financial results that it offered health insurance to 50,700 Arkansans in 2016, up 17.4% from 43,200 in 2015. Overall, the St. Louis-based healthcare provider said its managed care membership is now at 11.5 million, a 152% increase from 7.1 million members in the first quarter of 2015.
Centene, which reported a first quarter loss of $24 million, or 13 cents per share on revenue of $7 billion, is one of four healthcare insurance providers for Medicaid expansion in Arkansas. In 2015, individuals could obtain health insurance coverage through the state’s Medicaid private option from Centene’s Ambetter Arkansas, Arkansas Blue Cross and Blue Shield, the Blue Cross and Blue Shield Association, and Qualchoice. United Healthcare, which began offering plans on the exchange at the beginning of this year, announced last month that it was pulling out of marketplace exchanges in Arkansas and Georgia at the end of 2016.
HHS ISSUES MAJOR RULE MODERNIZING MEDICAID MANAGED CARE
The federal Department of Health and Human Services on Monday (April 25) issued a final rule on managed care in Medicaid and the Children’s Health Insurance Program (CHIP). The rule, which is the first overhaul of Medicaid and CHIP managed care regulations in more than a decade, advances the Obama administration’s efforts to transform the health care system. The new rule supports state delivery system reform efforts, strengthens the consumer experience and key consumer protections, strengthens program integrity by improving accountability and transparency, and aligns key rules with those of other health coverage programs.
Currently, 39 states and the District of Columbia contract with private managed care plans to furnish services to Medicaid beneficiaries, and almost two-thirds of the 72 million Medicaid beneficiaries are enrolled in managed care. The final rule will affect Medicaid managed care plans and the beneficiaries enrolled in them, including low-income children and families, pregnant women, elderly, and individuals with disabilities. The provisions of the final rule will be implemented in phases over the next three years, starting on July 1, 2017. Read more here.
STUDY: U.S. DRUG SPENDING GROWTH REACHES 8.5% IN 2015
Total spending on medicines in the U.S. reached $310 billion in 2015 on an estimated net price basis, up 8.5% from the previous year, according to a new report issued by the IMS Institute for Healthcare Informatics.
The surge of new medicines remained strong last year and demand for recently launched brands maintained historically high levels. The savings from branded medicines facing generic competition were relatively low in 2015, and the impact of price increases on brands was limited due to higher rebates and price concessions from manufacturers. Specialty dug spending reached $121 billion on a net price basis, up more than 15% from 2014.
The study, called “Medicines Use and Spending in the U.S.: A Review of 2015 and Outlook to 2020,” also found that longer-term trends continued to play out last year, driven by the Affordable Care Act and ongoing responses to rising overall healthcare costs. The full version of the report, including a detailed description of the methodology, is available here.