#26 • A Healthy Dose of Healthcare News • April 23, 2021
200 million more doses of Pfizer and Moderna, Costco's PBM partnership for employer-paid plans, Optum's nationwide telehealth expansion, abortion bills in Oklahoma, and a CMS nomination kerfuffle
I forgot to include my new piece with my colleague Kofi Ampaabeng in last week’s AHDoHN post. We wrote about how young people can make the healthcare system work better for them despite the many obstacles they face to accessing high-value care that matches their health status in the current healthcare environment. Catch it at Fortune.
In this edition, you will read about:
#26.1. Biden’s order of another 200 millions doses from Pfizer and Moderna;
#26.2. Costco’s foray in employer-paid drug plans;
#26.3. Optum’s nationwide telehealth expansion;
#26.4. Three abortion bills on the Oklahoma Governor’s desk; and
#26.5. A roadblock to the nomination of the CMS Secretary.
#26.1. Biden administration orders 200 million more doses of Covid-19 vaccines (NBC News)
April 21st saw the injection of the 200 millionth dose of the COVID-19 vaccine in the US, bringing the number of fully-vaccinated Americans to 85 million. With the distribution of the Johnson & Johnson vaccine still on pause after 6 people out of 6.8 million experienced blood clots, the Administration is moving forward with orders for 100 million additional doses from Pfizer and 100 million from Moderna. The President is not setting a new target for vaccination, however, and wisely so: shots in arms have been decreasing for the past nine days. Now that all adults can get the vaccine and that there is ample supply for all who want it, people’s consciences and choices are about to draw the limits of the vaccination efforts. The frontier should become visible in two to four weeks.
#26.2. Costco Brings Its Low-Price Magic to Employer-Paid Drug Plans (Bloomberg Law)
Costco is partnering with Navitus, a closely-held Wisconsin-based pharmacy benefits manager (PBM), to help employers save on employees’ medical drugs. Navitus offers a fee-based model that passes 100% of the savings it secures from bulk purchasing to the employers it serves. Costco acquired a minority stake in the company in 2020 and is now working to increase the PBM’s clientele. Navitus’ emphasis on transparency is unusual in the industry and may shield it from new legislation coming down the pike in many states as PBMs’ behavior receives increased scrutiny.
#26.3. Optum launches virtual care offering nationwide (Becker’s Hospital Review)
In March, Amazon announced that it was going to offer telehealth services in all 50 states starting this summer. Now, UnitedHealth’s subsidiary OptumHealth is following suit with a system similar to Amazon’s, offering virtual health services with referrals to brick-and-mortar facilities and home-based care if the provider deems it necessary. This decision flows naturally after a highly successful rollout during the pandemic, which has led to an exponential growth in the utilization of telemedicine services. For instance, one in two behavioral health appointments with Optum doctors are now provided virtually. Optum employs 56,000 doctors, i.e. 10,000 more than HCA Healthcare, the largest hospital system in the country. With tech and healthcare giants threatening to take over the telehealth industry, the competition may become too fierce to bear for other players, such as Teladoc.
#26.4. Oklahoma Senate passes bills to restrict abortion (Oklahoma’s News)
Three bills are headed to Governor Kevin Stitt’s desk:
House Bill 2441 bans abortion if an unborn child has a heartbeat, making anyone performing an abortion on a child with a heartbeat guilty of homicide;
House Bill 1102 includes the performance of an abortion in the state’s definition of “unprofessional conduct” for physicians, meaning that physicians’ licenses will be revoked for performing an abortion not deemed necessary to prevent the death of the mother or irreversible harm to her that would increase her risk of death;
House Bill 1904 requires persons performing abortions to be board certified in obstetrics and gynecology.
If signed, the laws will come into effect on November 1st of this year.
#26.5. Cornyn places hold on Biden Medicaid nominee (The Hill)
We saw last week that the US Department of Health and Human Services (HHS) revoked Texas’ Medicaid waiver that allowed it to provide care to underserved communities and reimburse hospitals for care provided to uninsured patients. In reaction to the agency’s action, Sen. John Cornyn (R-TX) is placing a procedural hold on the nomination of Chiquita Brooks-LaSure, whom President Biden has put forward for the role of CMS administrator. He accused HHS of playing “political chicken” and unduly pressuring Texas to expand Medicaid. The position was previously held by Seema Verma.