Cleveland Clinic creates insurance joint venture with Oscar Health
Cleveland Clinic is launching a joint venture health insurance company with Oscar Health (NY). The JV will offer individuals coverage on and off the Affordable Care Act’s exchanges at a time when most other insurers are jumping ship because of financial losses and regulatory uncertainty perpetuated by the Trump administration and Republican-controlled Congress. One of Oscar’s founders Joshua Kushner is the younger brother of Jared and brother-in-law of Ivanka Trump. Oscar Health, which has struggled with financial losses in the past few years, gets to align itself will a well-known system that it hopes will attract enrollment. Starting January 2018, Cleveland Clinic and Oscar will together offer individual coverage in five northeast Ohio counties. The 50-50 joint venture takes some risk of the move away from Cleveland Clinic, because the companies will share equally in the losses and profits. The Cleveland Clinic will handle care delivery and Oscar will provide the tech platform and insurance operations expertise. Oscar now covers about 105,000 people, and expects a few thousand to enroll in Ohio in the first year. According to a Modern Healthcare article, Oscar has struggled with losses despite raising millions in venture capital. This year, it sold coverage on exchanges in New York, California, and San Antonio. It lost more than $200 million on plans in 2016 and $120 million in 2015. Oscar previously pulled out of exchanges in Dallas and New Jersey, and recently filed requests with New York regulators to raise its individual rates in the state by 11% on average.
Premier Inc survey finds healthcare leaders expanding use of generics, educating physicians on therapeutic alternatives in order to control drug spending
A new Premier Inc (Charlotte, NC) survey finds drug spending has increased among healthcare leaders. Premier expects the trend to continue over the next five years. To counteract this significant drain on hospital budgets, health system leaders are employing various methods and strategies to ease the burden. The survey found that 96% of respondents said their hospital or health system’s overall pharmacy spend has somewhat or significantly increased for their inpatient population. Additionally, drug prices and use of specialty drugs are culprits of rising pharmaceutical spend: 95% report increased drug prices and 91% said increased use of expensive specialty drugs have contributed the most to their organization’s inpatient pharmaceutical spend. The survey found that 95% of respondents estimate drug expenses to increase by at least 10% over the next five years, with 16% of respondents estimating drug prices will climb by 30% or more.
Vanderbilt Medical Center launches network of recovery ICU clinics
Vanderbilt Medical Center (Nashville, TN) launched the first network of recovery ICU clinics in the U.S. to help ensure patients receive the care they need post-intensive care. The network will consist of 11 clinics in the U.S. and U.K. in the first year.