Iowa could have no insurers selling on exchanges for 2018 and other regional news
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May 06, 2017 01:00 AM

Iowa could have no insurers selling on exchanges for 2018 and other regional news

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    Baptist Memorial brings 17 hospitals to the merger with Mississippi Baptist.

    MIDWEST:​ Iowa​ could​ have​ no​ insurers​ selling​ on​ exchanges​ for​ 2018

    Medica last week said it may pull out from Iowa's individual insurance marketplace, potentially leaving no alternative insurance option for most residents on the exchanges next year.

    The Minnetonka, Minn.-based insurer, which offers exchange plans for 12,645 members in Iowa, has a relatively small presence in the market but the recent exits of other big insurers-Aetna and Wellmark Blue Cross and Blue Shield-makes Medica just one of two insurers selling plans on the exchanges for 2018.

    In a statement, Medica said its ability to offer marketplace plans in Iowa "is in question at this point" given the uncertainty in the state's exchanges.

    Medica and Gundersen Health Plan are the only two health plans expected to sell individual health plans on the exchanges next year. But Gundersen, which offers plans in just four Iowa counties, is also weighing whether or not to offer plans for next year.

    If both insurers exit, about 51,600 people enrolled in Iowa's insurance marketplace would have no insurance option next year.

    -Maria​ Castellucci

    MIDWEST: Ardent, KU Health join forces to buy St. Francis Health

    The​ University​ of​ Kansas​ Health​ System​ and​ for-profit​ Ardent​ Health​ Services​ are​ creating​ a​ joint​ venture​ company​ to​ purchase​ 378-bed​ St.​ Francis​ Health​ in​ Topeka,​ Kan.

    ​ The deal is the sixth such joint venture that Ardent has announced with a not-for-profit academic medical center. The arrangement allows the partners to share the capital costs of buying and building out the capabilities of targeted hospitals. Ardent also brings business practices and purchasing economies to the acquired hospitals, while KU Health contributes clinical expertise and brand equity to the deals.

    As part of the deal, the Kansas joint venture plans to spend $50 million at St. Francis Health to improve and expand services, the companies said.

    Financial terms were not disclosed.

    Ardent operates 20 hospitals in six states with more than 500 employed physicians and 18,000 employees.

    ​ -Dave​ Barkholz

    NORTHEAST: Hackensack Meridian and JFK Health merger focuses on population health

    Hackensack Meridian Health and JFK Health signed a definitive agreement to merge last week, creating a combined entity with 15 hospitals throughout New Jersey.

    The deal, pending governmental and regulatory review, would combine the Hackensack Meridian system and JFK Health's not-for-profit hospital in an effort to expand patient access and deliver better outcomes by focusing on population health, according to the companies. Financial terms of the deal were not disclosed. Both organizations are based in Edison, N.J.

    The merger will help Hackensack Meridian bolster its ambulatory network that already spans a variety of specialties across 120 centers, which is the "future of healthcare," said John Lloyd, co-CEO of Hackensack Meridian Health. Fewer patients are going to hospitals and instead choosing outpatient facilities where they can get more affordable and efficient treatment, he said.

    Hackensack and JFK executives say the combined share of the companies' ambulatory and home healthcare networks will allow them to reduce costs and improve quality by bundling care.

    The combined entity would employ more than 33,000 team members and 7,000 physicians on staff.

    -Alex​ Kacik​

    NORTHEAST:​ NYC​ Health​ &​ Hospitals​ harnesses​ IT​ to​ boost​ revenue

    NYC​ Health​ &​ Hospitals​ last​ week​ said​ it​ expects​ to​ pull​ in​ an​ additional​ $142​ million​ in​ revenue​ after​ it​ implements​ Epic​ Systems​ Corp.'s​ new​ revenue-cycle​ technology​ across​ its​ 11​ hospitals​ and​ other​ care​ sites.​

    Several large systems, such as Kaiser Permanente and Cleveland Clinic, have similar technologies in place already. For the New York public system, "the result will be a greatly improved user and patient experience," NYC Health & Hospitals interim CEO Stan Brezenoff said in a statement.

    The revenue-cycle announcement comes a year after NYC Health & Hospitals-the largest public healthcare system in the country-began rolling out Epic's electronic health record system. The rollout has been rocky, with one executive resigning over concerns about the system and with delays in implementation, which is supposed to be complete by 2018, the same year the organization will begin putting in place the new revenue-cycle system, itself slated to be completed by 2020 at a cost of $289 million.

    -Rachel​ Z.​ Arndt

    NORTHEAST:​ N.Y.​ hospital​ forges​ clinical​ affiliation​ with​ Northwell

    Northwell​ Health​ has​ entered​ into​ a​ clinical​ partnership​ with​ Crouse​ Health,​ an​ independent​ community​ hospital​ in​ Syracuse,​ N.Y.​

    As part of the agreement, New Hyde Park, N.Y.-based Northwell will help Crouse expand its network and presence in New York. Northwell will offer Crouse assistance with population health, group purchasing, physician recruitment, quality-improvement initiatives and the possible creation of new urgent-care centers.

    Terms of the deal were not disclosed.

    Northwell is the largest provider in New York, operating 21 hospitals and 550 outpatient facilities. The system has made recent efforts to grow its network. In the past few years, Northwell created a new insurance arm and merged with three hospitals.

    -Maria​ Castellucci

    SOUTH:​ Baptist​ Memorial,​ Mississippi​ Baptist​ compete​ merger​ forming​ large​ regional​ system

    Baptist Memorial Health Care and Mississippi Baptist Health Systems completed their merger, the companies announced last week, creating the largest not-for-profit healthcare system in the region.

    The deal, which federal regulators already have approved, combines Memphis, Tenn.-based Baptist Memorial's 17 hospitals across Arkansas, Mississippi and Tennessee with Mississippi Baptist's four hospitals. It will allow the combined organization to expand its reach and improve the level of care, hospital executives said. Terms were not disclosed.

    Baptist, which is scheduled to open a new $300 million hospital in Oxford, Miss., later this year, has been working on the deal with Jackson-based Mississippi Baptist since September. Baptist Memorial and Mississippi Baptist have 100-plus-year histories in their communities. Baptist Memorial was founded in 1912 with one hospital in downtown Memphis while Mississippi Baptist was Jackson's first hospital, built in 1911.

    ​ -Alex Kacik

    WEST:​ Two​ states​ launch​ investigation​ into​ Eli​ Lilly's​ insulin​ pricing

    Two state attorneys general are investigating the pharmaceutical company Eli Lilly & Co.'s insulin pricing, the company said last week.

    The attorneys general of Washington state and New Mexico are looking into the price of the Indianapolis-based company's insulin products as well as its relationship with pharmacy benefit managers. Eli Lilly said in a Securities and Exchange Commission filing that it was cooperating with the investigations.

    The price of insulin has been steadily rising over the last decade-plus. The annual cost for patients has increased from $231 in 2002 to $736 in 2013, according to a 2016 study published in JAMA. Researchers say the price surge is related to the improvement and specialization of the drug as well as looming price competition when more biosimilars are introduced.

    ExpressScripts, a major pharmacy benefit manager based in St. Louis, recently launched an insulin discount program in partnership with Eli Lilly, offering a potential 40% discount off the retail price of most insulin products made by Lilly.

    -Alex Kacik

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