Dear Forum Friends,
Hope everyone is having a wonderful start to the holiday season! 2023 has been an exciting and busy year at the Forum. We look forward to collaborating with everyone in 2024. Wishing you and yours a lovely holiday season!
Gloria Sachdev
President and CEO, Employers’ Forum of Indiana
Inside the Forum
Mark Your Calendar – 2024 Forum Meeting Schedule
Mark your calendars for these upcoming All-Stakeholder meetings! Meetings details will be distributed a month prior to each meeting.
- January 29th
- April 18th
- September TBD
- November 7th
If interested in reviewing past meeting materials, click here.
Presentations
In November, Gloria Sachdev was invited to give two presentations regarding market and policy ideas to advance transparency, affordability, and competition to the following organizations:
- November 14: National Alliance of Healthcare Purchaser Coalitions in DC
- November 17: Massachusetts Associations of Health Plans in Boston
Thank you for the opportunity to present!
National Academy for State Health Policy (NASHP) Hospital Cost Tool Update
NASHP Hospital Cost Tool 3.0 Release!
On December 15th, NASHP released an update to their Hospital Cost Tool. The dashboard reports on a range of measures for hospital revenue, costs, profitability, and break-even points across over 5,000 hospitals nationwide for the period from 2011 through 2022.
Users gain insights on hospital financial performance using hospitals’ annual Medicare Cost Reports submitted to the Centers for Medicare and Medicaid Services. In addition to including 2022 data, the updated tool includes additional metrics on labor costs, capital related expenses, and other features that are responsive to state policymakers’ questions. Enjoy diving into the data!
Register for the Jan 9th webinar hosted by NASHP to learn more.
Peterson-Milbank Memorial Fund: Health Care Cost and Affordability
Leveraging Health Care Costs and Affordability Data: A Suite of Analytic Resources
The Peterson-Milbank Program for Sustainable Health Care Costs, in partnership with Manatt Health and Burness, has developed a suite of analytic resources on health care cost and affordability data to provide states with direction on how to access, integrate, and analyze health care data resources. Such analyses can strengthen market insight and support policy action. Check out this free resource noting links to publicly available healthcare quality, price and cost transparency.
The data analytic resources include:
EFI Award Spotlights
2023 EFI Healthcare Innovation Award
Candace Shaffer, M.S., CWPM
Associate Vice President, Benefits & Payroll Human Resources – Purdue University
Candace is known across the state and country for being a leader in the healthcare industry. Under her leadership at Purdue, she worked to flatten Purdue’s overall healthcare trend by leading the market as one of the first employers to open an employee clinic, implement tiered networks within their medical plan, and work on direct contracting with local providers to ensure access to quality care at a reasonable cost. Because of these efforts, Purdue and its employees have saved millions on healthcare costs.
Candace not only serves her campus, but because of her knowledge, acts as a mentor to many employers around the state who have taken notice of her work at Purdue and are interested in doing the same.
Congratulations to Candace on this well-deserved award. Boiler Up!
2023 Dave Kelleher Leadership Award
Donna Schaibley
Indiana State Representative, HD 24
Rep Donna Schaibley has been fiercely advocating for Hoosiers at the Statehouse since 2014. Her leadership and dedication helped shape pivotal legislation, which most recently set the groundwork for lowering healthcare prices in Indiana. Rep Schaibley is a member of and leads important legislative committees aimed at improving the lives of Hoosiers. By focusing on and using unbiased, evidenced based data, Rep Schaibley has set the precedent on how to use data to inform policy decisions.
Congratulations to Rep Donna Schaibley for her fearless leadership and long lasting impact in the Hoosier state!
Hospital Price Files Finder: A New Hospital Price Transparency Tool
Hospital Price Files Finder Tool
On December 11th, PatentRightsAdvocate.org publicly made available an online Hospital Price Files Finder tool.
The federal hospital price transparency rule requires hospitals to publish their prices for all items and services on their own website in a machine-readable file(MRF) for all negotiated rates by payer and plan, including discounted cash prices.
However, it can be challenging to find these price files and many of them are not easily readable. PatientRightsAdvocate.org has cleaned up the files for 6,000 U.S hospitals and made them available in one location. Download the price files of the hospitals you are most interested in!
Read the Bloomberg Law article highlighting the new tool and Sage Transparency.
In the News
Employers:
- Indiana Immunization Coalition Employer Vaccination Toolkit (IIC)
- Walmart: Friend or Foe to Hospitals? (Beckers)
- Foot Locker, Teamsters Show Their Drug-Benefit Managers the Door (WSJ)
- Health Benefits In 2023: Premiums Increase With Inflation And Employer Coverage In The Wake Of Dobbs (Health Affairs)
- Small Employer Coverage Is No Longer Affordable for Families (KFF)
- Podcast: The Financialization of Health Benefits for Boards of Directors and C-Suites of Self-Insured Employers, With Andreas Mang (Relentless Health Value)
- Centene to Offer ICHRAs to Indiana Employers (Beckers)
- Walmart Hires 2 Health System Executives (Beckers)
- Indiana Chamber of Commerce’s Indiana Prosperity 2035 Report Card (Indiana Chamber)
- Indiana ranked 49th for health care premium costs & 47th for health care expenditures
Policy:
- List of Federal Healthcare Bills (Georgetown University)
- PBM Bills Drove Lobbying Spending In 2023 (Modern Healthcare)
Hospitals
- Hospitals Due $9B Under 340B Final Rule (Modern Healthcare)
- Community Health Sets Aside $75M In ‘Potential Settlement Agreement’ With Feds, Whistleblower (IBJ)
- Community With High Medical Debt Questions Its Hospitals’ Charity Spending (KFF)
- States With The Most Rural Hospital Closures (Beckers)
- Could Sanford Health’s Rural Hospital-At-Home Program Be A Model? (Modern Healthcare)
- Northwest Health Closing Two Clinics (HomeTown)
- Ascension Nurses Begin Strikes (Beckers)
- Community Health Expands MD Anderson Partnership (Inside Indiana Business)
- Community Invited to Preview Parkview Kosciusko Hospital During Dec 16 Open House (Parkview Health)
- “It’s Not a Done Deal”; Where the Union Health Acquisition of Regional Hospital Stands (Wabash Valley)
- Community Health Ages to Pay $345M to Settle “False Claims” Lawsuit (IBJ)
Insurance
- Appeals Court Upholds $2.67B Blue Cross Settlement (Modern Healthcare)
- UnitedHealth, Cigna Face Lawsuits Over Alleged Automated Claims Denials (Beckers)
- UnitedHealth Group Now Employs Or Is Affiliated With 10% Of All Physicians In The U.S. (STAT)
- Lilly Launches Obesity Drug, But Insurers Balk Over Price (IBJ)
Providers & Physicians
- Indiana’s Rural Health Care Gaps are Complicating Patient Outcomes (IBJ)
- There Are Riches, Risks When Private-Equity Firms Acquire Medical Practices (IBJ)
- Providers Skeptical of Insurer Plans to Reduce Prior Authorizations (Modern Healthcare)
- FTC Chief Gears Up for a Showdown With Private Equity (KFF)
- Walgreens Closes Medical Clinics In Indiana, Causing Headaches For Patients And Doctors (IBJ)
Pharmacy
- Why Your Neighborhood Pharmacy Isn’t So Friendly Anymore (WSJ)
- FDA Approves Lilly’s Diabetes Drug For Weight Management (IBJ)
- Upstart PBMs Aim to Shake Up the Market (Modern Healthcare)
- Next in Gene Therapy: 2024 Roundup (CVS Caremark)
- Confronting High Costs And Clinical Uncertainty: Innovative Payment Models For Gene Therapies (Health Affairs)
- Novo Nordisk Finds Compounded Wegovy Up To 33% Impure, Sues Florida Pharmacies (Reuters)
- CVS’s New Drug Payment Plan Won’t Lower Patients’ Prices, Experts Warn (STAT)
- Targeting Costly Meds, Biden Admin Asserts Authority To Seize Certain Drug Patents (Politico)
- Video: CVS to Change PBM Pharmacy Pricing (Eric Bricker)
- The Future of CRISPR is Now (AAMC)
Other Healthcare News
- U.S. Health Care From a Global Perspective, 2022: Accelerating Spending, Worsening Outcomes (Commonwealth Fund)
- 7 Optum-Owned Clinics Shuttered in Florida, Minnesota (Beckers)
- Instacart Pushing Into Food-As-Medicine Movement With Partnerships (Modern Healthcare)
- Facing Financial Ruin as Costs Soar for Elder Care (NYT)
- Most Black and Hispanic Adults Expect to Get the New COVID-19 Vaccine, Though Most White Adults Don’t (KFF)
- Studies Of Prescription Digital Therapeutics Often Lack Rigor And Inclusivity (Health Affairs)
- Driving Public Health Goals: A Look at Successful Innovative Vaccination Initiatives (AJMC)
- Pay Thousands to Quit Your Job? Some Employers Say So (NYT)
Do you have a suggestion or contribution for our next newsletter? Contact us.