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Daily Archives: November 10, 2014

Kidney Dialysis Company Expands Into The Hospital Business

Critics of America’s health care system say it’s really a “sick care” system. Doctors and hospitals only get paid for treating people when they’re sick.

But that’s starting to change. Health insurance companies and big government payers like Medicare are starting to reward doctors and hospitals for keeping people healthy.

So, many health care companies are trying to position themselves as organizations that help people stay well.

Nurse Steve Belcher, left, works with patient Antoinette Swearinger at the DaVita Downtown Dialysis Center in Baltimore in 2013. DaVita, spurred by potential growth in the market is expanding into hospital care. (AP Photo/The Daily Record, Maximilian Franz)

Nurse Steve Belcher, left, works with patient Antoinette Swearinger at the DaVita Downtown Dialysis Center in Baltimore in 2013. DaVita, spurred by potential growth in the market is expanding into hospital care. (AP Photo/The Daily Record, Maximilian Franz)

One of the latest is DaVita HealthCare Partners, a provider of kidney dialysis services. The company operates 2,152 dialysis centers in the U.S. and 87 in its fast-growing international buisiness.

DaVita is making a move into primary care, and it just announced a joint venture with a hospital company in Colorado and Kansas.

DaVita CEO Kent Thiry says it’s like changing the company from being an electrician into a general contractor. “And in so doing,” he says, “[We] have a much more comprehensive impact on how the house gets designed, how it gets built, how it gets maintained for the betterment of those who live in the house. That’s the simplest way to characterize the change.”

DaVita’s partner in the new venture is Centura Health, the biggest hospital company in Colorado. Like DaVita, it is also expanding aggressively into primary care and services beyond hospital-based procedures.

Centura CEO Gary Campbell says that in order for his company to keep people healthy, it needs the ability to crunch lots of health data. The idea is to use computer systems to keep track of peoples’ health, and flag health problems before they happen. He says DaVita HealthCare Partners is really good at that.

This story is part of a partnership that includes Montana Public Radio, NPR and Kaiser Health News. It can be republished for free. (details)logo npr

“Our physicians have gone scouring around the country, and believe that Health Care Partners really has the premier analytics.”

So, if DaVita wants to grow substantially beyond the current 168,000 dialysis patients it serves now, it needs to expand beyond just kidney care, says Mark Stephens with Prima Health Analytics. In 2012, the company started buying big doctors practices in several states. It’s hoping that its experience caring for very sick dialysis patients will help it manage family practices, and now, make hospitals more efficient.

Stephens also says DaVita might also be trying to create a model for Medicare to follow. That agency currently picks up the tab for about 85 percent of all Americans getting dialysis. He says Medicare has been offering dialysis companies opportunities to assume responsibility for those patients’ health care beyond dialysis, but that the companies haven’t found the deals attractive so far.

If DaVita’s new joint venture is successful, and it lowers the cost of care for both dialysis patients and those who aren’t as sick, the company may be able to win lots of new business from Medicare and private insurance companies.

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Cigna Agrees To Reduce Costs Of HIV/AIDS Drugs In Florida

The health insurance company Cigna signed a consent order with state regulators Thursday that will make some of its HIV/AIDS drugs more affordable for consumers in Florida signing up for coverage under the Affordable Care Act.

As part of its agreement with the Florida Office of Insurance Regulation, Cigna will cap the amount consumers pay for four popular HIV drugs — Atripla, Complera, Stribild and Fuzeon — at $200 per month. Previously the company asked consumers to pay a co-insurance of 40 to 50 percent of the drugs’ cost.

Cigna will also move generic HIV drugs from its most expensive specialty “tier” to a less expensive tier for generics. And it will no longer require consumers to seek “prior authorization” from the insurer to refill their prescriptions.

Tony Smith, who was diagnosed with HIV in 2008, is worried he may not be able to afford his medication costs under ACA coverage for 2015. Here Smith sorts through insurance papers at his home in Coral Springs on Oct. 22. (Photo by Al Diaz/ Miami Herald)

Tony Smith, who was diagnosed with HIV in 2008, is worried he may not be able to afford his medication costs under ACA coverage for 2015. Here Smith sorts through insurance papers at his home in Coral Springs on Oct. 22. (Photo by Al Diaz/Miami Herald)

The agreement said that Cigna had entered into the consent order, in part, to “avoid litigation.”

In May, two civil rights groups filed a complaint with the federal government accusing Cigna and three other Florida insurers of discriminating against people with HIV.

The complaint, lodged with the U.S. Department of Health and Human Services, said the four companies made lifesaving HIV drugs so expensive that they prevented consumers “from enrolling in those health plans — a practice which unlawfully discriminates on the basis of disability.”

Cigna denied all wrongdoing in the consent order, which also stated that Florida regulators made “no finding” about whether the company’s practices violated state or federal law.

This copyrighted story comes from the Miami Herald, produced in partnership with KHN. All rights reserved.

In October, the Miami Herald wrote about fears among Floridians with HIV that they would not be able to afford prescriptions under plans offered on the federal marketplace for health insurance, which opens Nov. 15.

Carl Schmid, deputy executive director of the AIDS Institute, one of the groups that filed the federal complaint, called the agreement a “good first step,” but said it should have gone further.

“We’re glad that Cigna recognized they had problems with the way they designed their plans and how it affects people with HIV,” Schmid said.

But he added that the cap on out-of-pocket monthly expenses should have been expanded to include more drugs. Schmid also said that Cigna should offer customers a 90-day supply of its medications, rather than the minimum 30-day supply agreed to in the consent order.

Karen Eldred, a spokeswoman for Cigna, wrote in a statement to the Herald that the insurer had voluntarily agreed to the changes in order “to offer customers quality, affordable care.”

HHS is still investigating the issues raised by the federal complaint, spokeswoman Rachel Seeger confirmed.

In the consent order, state regulators said they had been provided with a copy of that complaint, which also named CoventryOne, Humana and Preferred Medical as discriminating against people with HIV.

Amy Bogner, a spokeswoman for the state Office of Insurance Regulation, would not comment on whether it was negotiating consent orders with the other companies or planning to pursue litigation against them.

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Impact of So-Called 'Cadillac' Tax

The tax on high-cost health plans, which are often referred to as Cadillac plans, is expected to impact a considerable share of the plans provided by healthcare organizations for their own employees, as much as ȇ% by 2020. The implications are significant because the excess-benefits tax requires the employer to payń0% on the value of the portion of the plan that exceeds thresholds set by the Patient Protection and Affordable Care Act. Employers also need to consider that the tax is measured as a direct function of plan cost, and not actuarial plan value, and that a number of factors can drive excise-tax exposure.

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Viewpoints: GOP Win Bolsters Health Law Foes; Ill. Cuts Medicaid Costs; CDC’s Ebola Blunders

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Views On Supreme Court Obamacare Case: ‘Contorted Reading’ Of 4 Words; A Test Of Administration’s ‘Rewriting Of Law’

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State Highlights: Ohio Medicaid Costs Lower Than Expected; Fla. Gets $1.2M For Mental Health

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Cigna Cuts HIV Drug Costs To Settle Discrimination Case

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Quarantines Make Health Workers Reassess Overseas Work

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Facing Shortage, Officials Turn To Selling Docs On VA

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Digital Records Pose Time, Security Challenges

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