Issue 37

Upcoming Meeting

Mark your calendar for our EFI Member All-Stakeholder Meeting November 12th, from 1:00 – 5:00pm ET! The Agenda is below and a calendar invite will be sent to members in early October.

1. Welcome and EFI Year in Review
2. Value Based Payments: What is it?
3. Indiana All-Payer Claims Database (APCD) Demonstration
4. Panel Discussion: Improving Access to Maternal and Infant Care
5. Awards / Closing
6. Networking Cocktail Hour

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Vice President Job Opening

The Forum seeks a highly organized Vice President to support our membership, education, and research efforts. The VP will work in tandem with the Forum’s CEO and Director of Business Operations to improve the value received by employers and patients for their health care expenditures. This role reports to the CEO. For more information go here. If interested in the position, please send a resume to Sara Otte at sara@employersforumindiana.org.

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Presentations

In October, Gloria Sachdev was invited to give presentations regarding market and policy ideas to advance transparency, affordability, and competition to the following organizations:

• October 28th: Center on Health Insurance Reforms at Georgetown University
• October 30th: Catalyst for Payment Reform

The 26th KFF Annual Employer Health Benefits Survey was released on October 9, 2024. The survey examines trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices. This year, employers were also asked about their provider networks, abortion coverage, family building benefits, coverage for GLP-1 agonists as well as programs for lower-wage workers. The survey includes 2,142 interviews with non-federal public and private firms. Learn more about the report in these Wall Street Journal and Health Affairs articles.

Investigative journalist George Joseph’s released a report on October 17th revealing troubling insights into Parkview Health System. Despite being headquartered in the nation’s most affordable city, Parkview’s hospital prices rank among the highest in the country. Full report here. A follow up article was then released on October 24th with Hoosier employers, families and lawmakers weighing in on Indiana’s healthcare market. Read the follow up report here.

This report uncovers many of the deep-rooted inefficiencies that exist across the U.S. healthcare system including:

• The harmful effects of health system consolidation;
• aggressive billing practices;
• lack of transparency;
• high and variable pricing;
• cost shifting to commercial payers; and
• inequitable access to care.

When large systems dominate the market, the lack of competition leads to unchecked price hikes, leaving patients and employers without options. To ensure healthcare is affordable and accessible, we need meaningful reform that holds healthcare systems accountable.

National Alliance of Healthcare Purchaser Coalitions

In Person Conference: Manifesting a New Destiny: Employers Creating the Future of Healthcare

Agenda: Link

Date: November 18th – 20th

Registration: Link (EFI has a limited number of free registration codes. If you are an Employer Member of EFI and interested in attending this event, please contact Sara Otte at sara@employersforumindiana.org.)

Overview: The Annual Forum will take place in Arlington, VA, November 18-20, 2024. This event brings hundreds of employers, business coalition leaders, and healthcare stakeholders to discuss successful strategies and emerging trends in healthcare value; health policy; and benefits, wellbeing and health equity.

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Employers:

• Third Annual Conference Tackles the Cost of Hospital Care (City and State NY)
• 32BJ Health Insights 2024 Conference, The Price of Power: Confronting the Hospital Affordability Crisis (32BJ Health Insights)
• Employers Require More Health to Improve Health-Care Affordability (Bloomberg Law)
• Rising Health Care Prices are Driving Unemployment and Job Losses (Yale)
• A Five-Lever Framework For Pres (Benefits Magazine, pg 40)
• ICHRAs vs. Self-Funded Plans: Choosing the Best Health Benefits Solution for Your Employees (The Alliance)

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Hospitals:

• Methodist Hospital to Come Tumbling Down After IU Health Opens New Hospital (IBJ)
• IU Health Breaks Ground on Fort Wayne Hospital (Inside Indiana Business)
• Days of Cash on Hand at 35 Health Systems (Beckers)
• The $37.4 Billion Tilted Playing Field For Nonprofit Hospitals (Forbes)
• Parkview’s Pricing Again Comes Under Scrutiny (Journal Gazette)
• Ascension to Open $200M Indiana Women and Infants Hospital (Beckers)
• IU Health Bloomington Hospital Pays for Some Patients to Transfer to Bedford (IN Public Media)
• Shining a Light on Corporate Hospital Systems’ Role in Driving America’s Healthcare Cost Crisis (Hospital Watch)
• Indiana Hospital Association Names Longtime Health Care Leader as New President (IBJ)

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Providers & Physicians:

• Marathon Health Expands Network to 720 Locations (IBJ)
• Draft for Public Review and Comment: Principals for Alternative Payment Models (CPR)
• Health Care Administrators: A Call for Equal Transparency and Accountability (KevinMD)
• 11 Providers Being Acquired by Payers (Beckers)

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Conglomerates:

• Exclusive: CVS Explores Options Including Potential Break-Up, Sources Say (Reuters)
• CVS Lays Off 400+ at Aetna Headquarters (Beckers)
• UnitedHealth Posts $6.1B Profit in Q3 (Beckers)
• Meet UnitedHealth’s Executive Team (Beckers)
• Elevance Health to Make $11.9M Expansion in Indianapolis, Add 230 Jobs (IBJ)
• Elevance Posts $1B Profit in Q3, Lowers Earnings Forecast (Beckers)
• Kroger Sells Specialty Pharmacy Unit to Elevance (Beckers)

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Insurance:

• Patient Safety Experts Want Progress on Quality Measure Alignment (Modern Healthcare)
• Aetna Launches Deductible-Free Plan: 5 Notes (Beckers)
• Biden Administration Proposes a Rule to Make Over-The-Counter Birth Control Free (NPR)
• “Not Medically Necessary”: Inside the Company Helping America’s Biggest Health Insurers Deny Coverage for Care (ProPublica)
• Labor Department, UnitedHealth Settle Alleged Emergency Claims Issues (Beckers)

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Pharmacy:

• Why Your Pharmacy Experience Is Miserable (Time)
• State Insulin Copay Caps (American Diabetes Association)
• What Went Wrong at CVS? (The Week)
• How Would Authorizing Medicare to Cover Anti-Obesity Medications Affect the Federal Budget? (CBO)
• Cell and Gene Therapy Approvals Drive Paradigm Change in Manufacturing (Pharmaceutical Technology)
• A Free Drug Experiment Bypasses the US Health System’s Secret Fees (Bloomberg)
• Walgreens to Close 1,200 Locations as Retail Sales Decline (Washington Post)
• Walmart Plans to Deliver Prescriptions Nationwide in as Little as 30 Minutes (CBS News)
• A Report in Response to the Executive Order on Lowering Prescription Drug Costs for Americans (CMS)
• FDA Authorizes Marketing of First Home Flu and COVID-19 Combination Test Outside of Emergency Use Authorities (FDA)

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Policy:

• Feds Back Healthcare Workers in Noncompete Lawsuit (Modern Healthcare)
• Lawmakers Scrutinize “Black Box of State PBM Spending” (ICC)
• How State Policy Makers Can Tackle Medical Debt: Lessons From North Carolina (Health Affairs)
• FTC Objection to Proposed Terre Haute Hospital Merger Centers on Controversial State Law (Indiana Lawyer)
• Key Committee to Vote on Maryland Drug Affordability Board Plan (WYPR)

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Public Health

• In Landmark Move, EPA Requires Removal of All U.S. Lead Pipes in a Decade (Washington Post)
• 2024 Health of Women and Children Report (America’s Health Rankings)

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Other Healthcare News

• Medicare Plans Are Making Big Changes for 2025. Here’s How to Navigate Them. (WSJ)
• Healthcare Executive Pay Jumps 4.6%: 5 Notes (Beckers)
• An Epic Dystopia: How a Near-Monopoly Gained Control of Most of the Nation’s Electronic Medical Records, to the Detriment of Medical Practice and Doctor Morale (The American Prospect)
• The Incursion of Profit-Enhancing Middlemen In US Health Care (Health Affairs)