Mouse clicks replace stethoscopes as U.S. web care grows
To cut medical costs and diagnose minor ailments, WellPoint Inc. and Aetna Inc., among other health insurers, are letting millions of patients get seen online first.
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Doctors’ drug money
Indiana physicians and research organizations reaped more than $25 million in payments from 15 pharmaceutical firms in 2012, according to the most recent data made available by the not-for-profit group ProPublica. Lilly was the biggest spender and the IU medical school was the biggest recipient.
NCAA seeks injury reduction with fewer full-contact practices
The recommendation is among a set of guidelines created to “generate a cultural shift within college athletics,” the Indianapolis-based NCAA said Monday.
New Obamacare rule could boost WellPoint
The U.S. Department of Health and Human Services proposed a rule that would automatically re-enroll exchange plan customers each year, which would help companies like WellPoint that sold aggressively on the exchanges in their first year.
Express Scripts cuts payments for customized drugs
The nation's largest pharmacy benefit manager, Express Scripts, is dramatically scaling back its coverage of compounded medications, saying most of the custom-mixed medicines are ineffective or overpriced.
Obamacare generates windfall for insurers
Obamacare’s tax credits are pumping nearly $400 million into the coffers of health insurers in Indiana this year, according to data released by the federal government and the insurance companies.
Autistic children still denied benefits
Imagine your child had a chronic condition requiring on-going treatment, like diabetes, epilepsy or cystic fibrosis, and every six months you had to fight for weeks in order to continue medical treatment, even though your child’s entire clinical team and physicians agree that treatment is medically necessary.
Company news
Hendricks Regional Health is extending its reach farther west via a collaboration with Putnam County Hospital in Greencastle. On July 10, the two hospitals will open a new obstetrics clinic, called Partners in Care, to provide prenatal care for low-income pregnant women. The clinic will be staffed by a Hendricks Regional Health nurse midwife, and two physicians from the Hendricks Regional Health Medical Group. Patients of Partners in Care will receive prenatal services at Putnam County Hospital, while deliveries will take place at Hendricks Regional Health in Danville. The idea of starting a clinic was boosted by a needs assessment conducted by DePauw University in Greencastle, which confirmed a shortage of prenatal care in Putnam County.
The U.S. Supreme Court ruled Monday that closely held corporations can hold religious objections that allow them to opt out of Obamacare’s requirement that they cover contraceptives for women at no charge. According to the Associated Press, the justices' 5-4 decision is the first time the high court has ruled that profit-seeking businesses can hold religious views under federal law. And it means the Obama administration must search for a different way of providing free contraception to women who are covered under objecting companies' health insurance plans. Contraception is among a range of preventive services that must be provided at no extra charge under the health care law that President Barack Obama signed in 2010 and the Supreme Court upheld two years later. Justice Samuel Alito wrote the majority opinion, which stressed that the ruling applies only to corporations that are under the control of just a few people in which there is no essential difference between the business and its owners.
Indiana Gov. Mike Pence hired Carmel psychiatrist Dr. John Wernert to take over the state's Family and Social Services Administration and tapped former FSSA Secretary Michael Gargano to oversee Pence’s Healthy Indiana Plan 2.0. Wernert is the medical director of medical management at Eskenazi Health in Indianapolis and was the medical director for behavioral health integration for the Franciscan Alliance health system. He'll replace outgoing Secretary Debra Minott, who unexpectedly announced her resignation in June; neither Pence nor Minott have explained her sudden departure. Gargano, who led the agency until Pence took office last January, is returning in the new role overseeing Pence's insurance expansion plan. The Pence administration is in the middle of pitching the Centers for Medicare and Medicaid Services on Indiana's proposal to use the state-run Healthy Indiana Plan 2.0 to expand Medicaid. If the application is approved, residents earning up to 138 percent of the federal poverty level would be allowed to enroll in a hybrid-health savings account plan. The state estimates that more than 457,000 low-income residents could enroll in the program by 2020.
Indianapolis-based Eli Lilly and Co. received European backing for a biosimilar version of Lantus insulin, a mega-blockbuster made by France-based Sanofi that has never faced generic competition. According to Bloomberg News, Lilly’s Abasria insulin was recommended by the European Medicines Agency’s Committee for Medicinal Products for Human Use for the treatment of diabetes. The European Commission, the EU’s executive arm, usually follows the panel’s recommendation. Lantus, which garnered $7.8 billion in sales for Paris-based Sanofi in 2013, loses patent protection in Europe in May next year. The U.S. patent on Lantus expires in February, but generic competition there may be delayed after Sanofi in January said it was suing Indianapolis-based Lilly over its plans to introduce a version in the U.S. Sales of the drug in Europe were less than 15 percent of the total in 2013, because the price of the drug is far lower than in the United States, which accounted for almost two-thirds of total Lantus sales, said Mark Clark, an analyst at Deutsche Bank AG in London. That may limit the erosion of Lantus sales in Europe, he said. Lilly is also trying to introduce a brand-name drug that would compete with Lantus. Last month, it released study results suggesting its once-a-day insulin injection, Peglispro, was better than Lantus in controlling patients’ blood sugar. Lilly has said it will file for U.S. approval to sell that drug in the first quarter of next year.
There will be blood
A new study found that common blood tests performed by hospital-owned facilities in the Indianapolis area were six to nine times more expensive than the same tests at independent lab facilities. Ouch!
Reimbursement snag trips up local DNA testing firm
Strand Diagnostics LLC’s Know Error test uses DNA analysis to make sure a tissue sample that has been declared cancerous does, indeed, belong to the patient doctors think it does. But Strand is having trouble convincing Medicare that the test is medically necessary.
Why hospitals leave the inner city, in one chart
Since hospitals lose money on just about every patient except those with private insurance, they have been closing inner-city facilities and opening new facilities in the suburbs for the past four decades.
GUNDERMAN; MUTZ: We’re now worshipping numbers
“You can’t manage what you can’t measure.” It is difficult to think of an adage more universally endorsed in business, government, not-for-profits and throughout our culture. Every enterprise wants to demonstrate its success through measurable outcomes—whether reduced wait times in the Veterans Administration health system, increased student test scores in the Atlanta public school system, or profits in a business.
The worries of a hospital CEO
In a video presentation to his employees, Community Health CEO Bryan Mills discusses the threats hospitals face from retail clinics and employers—and how Community briefly discussed laying off 1,000 workers last year.
Lilly, IU expect $25M plan to create new model for drug R&D
A new research consortium spearheaded by the Indiana University School of Medicine and Eli Lilly and Co. could bring in $25 million to $50 million over five years to create a new approach for developing drugs that provide more precise treatment for small groups of patients.
People
Kelli Burress, a nurse practitioner, has joined St. Vincent Medical Group in Greencastle. Burress earned an associate’s degree from Ivy Tech State College in Indianapolis and a bachelor’s degree in nursing from Indiana Wesleyan University in Indianapolis.
Dr. Mohammed Tarrabain, a family physician, has joined St. Vincent Medical Group in Carmel. Tarrabain earned his medical degree from The American University of Beirut in Lebanon.
Dr. Tim Franson has joined Indianapolis-based YourEncore as chief medical officer. Franson was vice president of global regulatory affairs at Eli Lilly and Co. and since then has worked as a consultant, on his own and at FaegreBD Consulting. Franson holds a bachelor’s degree from the University of Iowa and a medical degree from the University of Illinois College of Medicine.
Insurance changes put state’s autism industry on edge
Indiana’s autism therapists say their prospects are cloudy after the state’s largest health insurer, Anthem Blue Cross and Blue Shield, cut payments 40 percent and took a harder line on paying for therapy for school-age children.
Why Obamacare is likely to fail in Indiana (and most other states, too)
New data show eight out of 10 Hoosiers with private health insurance are covered by employer plans that are exempt from most Obamacare rules. So, rather than being an invasive train wreck, Obamacare may fail because it doesn’t affect enough people.
Former Riley Hospital CEO Pescovitz to join Eli Lilly
Dr. Ora Pescovitz is returning to Indianapolis after spending the past five years as CEO of the University of Michigan Health System.