Senate Report Examines Exploding Drug Prices

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Recent headlines on the exploding cost of prescription drugs have not gone unnoticed by Washington D.C. lawmakers.  The United States Senate Special Committee on Aging has issued a 130 page report examining the cost increases to previously affordable drugs that were acquired by pharmaceutical companies off patent.

Traditionally, the prescription drug industry recouped the cost of research and development by holding a new drug’s patent and being the sole manufacturer for a period of years before generic production was allowed ...

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Milwaukee health rank drops, still compares favorably

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The Commonwealth Fund’s 2016 Scorecard on Local Health System Performance is out, and it gives interesting perspective on the state of healthcare in the U.S. Wisconsin and the Upper Midwest scored well overall, while most Southern states did not. Milwaukee’s ranking dropped 17 spots from the 2012, the year the first edition of the Scorecard was released, yet it still compares favorably to other major cities.

The latest Scorecard measured changes in the country’s 306 ...

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Madison area providers explore partnerships

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Two health systems and their affiliated insurance companies are exploring a strategic partnership in Wisconsin. This is yet another example of the trend of consolidation among health care providers and insurance companies.

UW Health and UnityPoint Health announced two non-binding letters of intent regarding a future joint operating agreement last month. One letter describes a plan to “create an integrated clinical enterprise with a shared strategic direction.” The second letter describes a possible combination of ...

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Carrier megamerger now in doubt

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Eleven months ago four of the country’s largest health insurance companies announced two merger plans to consolidate in what would be among the largest transactions in U.S. history. In early July 2015, Aetna agreed to purchase Humana for more than $37 billion. Later that month, Anthem agreed to purchase Cigna for more than $54 billion.

The merger agreements must be approved by state insurance officials and federal anti-trust regulators. ...

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Study finds Wisconsin has high healthcare prices

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A study released this month by the nonprofit Health Care Cost Institute found that Wisconsin has the second highest healthcare prices among the 41 states it surveyed. The study was based on claims data from UnitedHealthcare, Aetna, and Humana, which the Institute said represents 34% of total commercial claims in Wisconsin. The study found that prices in Wisconsin for over 200 common medical services were on average 81% higher than the national average, and that the ...

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New Provider-Carrier Partnerships Expand Across Wisconsin

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The first four months of 2016 have already seen three new partnerships announced between Wisconsin health systems and insurance companies. Looking down the road, it appears that provider-led health plans may soon become a major force in Wisconsin health insurance.

In January, Aspirus and WPS Health Solutions announced that they are forming a new health insurance company in north-central Wisconsin that will be called Aspirus Arise Health Plan of Wisconsin. In April, Anthem Blue Cross and Blue ...

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Is Retail Medicine Really a Smart Choice?

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Smart Choice MRI and ThedaCare announced this month that the Appleton-based health system is investing $3 million in the Mequon-based stand-alone MRI provider. In the announcement, ThedaCare’s senior vice president of Systems of Care Support, Keith Livingston, described the partnership as a collaboration with a competitor that is “consistent with our need to learn how to better meet consumers’ needs in the evolving retail health marketplace.” Livingston also told the Milwaukee Journal Sentinel that “[h]ealth care ...

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Drug Costs Continue To Rise

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Although the rate at which overall health costs are rising is historically low, employers, experts, and politicians are expressing alarm at the rising cost of prescription drugs. According to a recent Aon analysis, the average health care rate increase for mid-size and large companies in 2015 was 3.2%. Prescription drug costs, however, jumped by 10% last year according to a report by Truveris that was publicized by the Business Health Care Group.

In general, hospital expenses account ...

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ThedaCare to Leave Network Health

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ThedaCare announced last week that it will leave Network Health on December 31, 2016. The Appleton-based health system first informed the Menasha-based health insurer last month that it would not continue the five year partnership that was due to expire at the end of July. The new extension will give Network Health employer groups and members extra time to adapt to the change, but will still result in significant disruption in the Northeast Wisconsin health insurance market.

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PACE Act Passage Elicits Praise and Frustration

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Earlier this month, President Obama signed the bipartisan PACE Act to stop the Affordable Care Act (ACA) from changing rules that apply to employers with between 51 and 99 employees. This is important both as a rare example of bipartisan cooperation to reform Obamacare, as well as a preservation of the status quo for employers in this mid-market segment. The Act has been praised by insurance brokers and business groups, but has ...

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