Medicare beneficiaries who take a lot of pricey medications will get a big break in 2025. That's when the $2,000 annual cap on out-of-pocket costs for drugs bought at the pharmacy or through mail order takes effect. The limit is one of the 2022 Inflation Reduction Act's most consequential provisions to lower prescription drug prices for Medicare enrollees. The law also instituted a $35 monthly cap on insulin prescriptions, enabled beneficiaries to get more vaccines at no cost, allowed Medicare to negotiate the prices of certain medications and required drug makers to pay a rebate to Medicare if they hike prices faster than inflation. Before the law, there was no cap on what Medicare enrollees might have to spend on medications covered by their Part D drug plans. They were on the hook for 5% of their drugs' cost in the so-called catastrophic coverage phase, which, in 2023, began when they hit $7,400 in out-of-pocket spending. The federal government paid 80% of the cost, while insurers paid 15%.
A deal reached Monday afternoon will prevent any disruptions in care for some patients of Ohio State University's medical facilities. Ohio State University Wexner Medical Center announced the multi-year deal Monday afternoon with Anthem Blue Cross and Blue Shield. The deal allows more than 110,000 people to continue to receive care through Ohio State University's medical facilities, including the Ohio State University Comprehensive Cancer Center, at in-network rates. A previous deal between the insurance company and the medical facility had been set to expire at the end of the year.
Krohn Clinic and Black River Memorial Hospital are combining into Black River Health, effective immediately. The hope is that the merger can better serve Jackson County and western Wisconsin. Black River Health says reports show folks in Jackson County have worse health outcomes than the average county in the state.
Nurses licensed in 42 other states and jurisdictions will be eligible to practice in Massachusetts — both in person and via telehealth platforms — as part of the "Nurse Licensure Compact," an agreement aimed at easing nurse staffing shortages. Massachusetts' joining the compact has been in the works for years: a proposal was first filed in the state Legislature over a decade ago. The change to nurse licensure requirements, codified in the economic development bill Governor Maura Healey signed into law last month, could boost health care providers' abilities to hire new nurses at a time when there are many vacancies and high turnover, which especially plague nursing homes, home health care services, and adult day facilities. Advocates hope joining the compact will eliminate administrative burdens for nurses maintaining licenses in multiple states and bolster the nurse workforce in Massachusetts. However, the state's nurses union fears this change will allow hospitals to apply a short-term fix to staffing challenges and ignore the root causes of high nurse turnover, such as difficult working conditions and inadequate pay.
An outpouring of public rage against health insurers in the wake of the killing of a top UnitedHealth Group executive has drawn scrutiny to the country's largest healthcare company. UnitedHealth recorded $372 billion in revenue last year—making it about the same size as Apple. It owns the biggest U.S. health insurer, and has expanded into almost every corner of the medical field. The company was founded in Minnesota in the 1970s. Its growth came in part through scores of acquisitions, some with price tags that were never made public. The company has confronted and mostly overcome antitrust challenges to its influence over healthcare markets. UnitedHealth said the company accounts for less than 10% of a "highly fragmented and competitive healthcare market," and that "fragmentation is a core problem for patients and providers, diminishing outcomes, quality and affordability, and our approach is intended to make healthcare work better for all."