News for Insurers
Top stories summarized by our editors
3/20/2019

The FDA has approved Sage Therapeutics' Zulresso, or brexanolone, as an intravenous treatment for adult women with postpartum depression, making it the first drug targeted specifically for the condition. The drug, which could cost $20,000 or more, is delivered intravenously over 60 hours and can only be administered by a health care provider at certified health care facilities through a restricted program.

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USA Today, CNBC, NBC News
3/20/2019

The "Medicare-for-all" idea backed by some Democrats would increase federal spending by $2.4 trillion in 2022, reduce innovation and lead to health care shortages and extended wait times, according to a report prepared by the White House Council of Economic Advisers. The policy would "be neither more efficient nor cheaper than the current system, and it could adversely affect health," the report said.

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CNN
3/20/2019

The CMS is soliciting comments on a proposed update of the methodology used to calculate penalties issued to Medicare Advantage plans, Medicate Part D plans and other Medicare managed care organizations for the 2019 contract year. Changes would include modifications to the formula for calculating fines, the frequency of adjustments and the way adjustments are publicized.

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Medicare
3/20/2019

The CMS has approved Maryland's request to amend its Medicaid program through 2021. The waiver will allow greater funding for certain family planning services and allow the state to test a substance misuse treatment program, an adult dental pilot program and a diabetes prevention program for adults who have prediabetes or are at risk of type 2 diabetes.

3/20/2019

Older adults with moderate or high fitness levels and three or more cardiovascular risk factors had better survival rates than those with lower fitness levels, according to a study presented at the American College of Cardiology Scientific Session. Dr. Michael Emery of the Indiana University School of Medicine commented the study did not address nutrition, which cannot be ignored in discussions of health and wellness.

3/20/2019

Individuals who reported two or more stressful events were at a 33% higher risk of developing diabetes, with the highest risk seen among those who experienced personal-related stress, compared with those who did not report any stressful events, according to findings in the Journal of Diabetes Investigation. Chinese researchers used a cohort of more than 500,000 adults and found that losing a job or retiring was associated with a significantly high diabetes risk, followed by having a major family conflict, death of a family member and severe injury.

3/20/2019

An analysis of data from 53 studies found people who used sit-stand desks spent less time sitting than those who used regular desks, and users reported feeling more comfortable, researchers reported in the journal Applied Ergonomics. Data did not associate sit-stand desks with weight loss or a significant effect on obesity.

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Medical News Today
3/20/2019

Researchers reviewed data from the 2009 to 2014 National Health and Nutrition Examination Surveys, meta-analyses and published sources involving Medicare and/or Medicaid beneficiaries, between ages 35 and 80, and found that healthy food prescriptions could prevent 120,000 diabetes cases and 3.28 million cardiovascular events and save $100.2 billion in health care costs over a lifetime. Published in PLOS Medicine, findings also showed that a prescription for fruits and vegetables could prevent 1.93 million CV events and save $39.7 billion over a lifetime.

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Reuters
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Medicare, Medicaid
3/20/2019

Lincoln Elementary School this week began serving breakfast in the classroom to increase the number of students getting free breakfast, and middle schools and high schools are looking at how they can increase their breakfast numbers, including encouraging students to pick up food on their way to class. Increasing the number of students eating school meals is a top priority, according to Elaine Reynolds, food service manager for the Schenectady, N.Y., school district.

3/20/2019

Across all payers, more than 1,000 accountable care organizations cover about 33 million US lives, and those numbers have consistently increased since the model's inception, even after the Pathways to Success rule was finalized. Data show that at the end of 2018, hospital-led ACOs and large ACOs of all types had low dropout rates despite a move toward downside risk, and dropout rates were highest among small physician-led ACOs, suggesting a need for program modifications to accommodate encourage their participation.

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Health Affairs Blog
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ACO