Nysha Recent News

Public Health and Policy

By Mendy Hecht

John Hancock to sell only interactive life insurance

Toronto, Ontario — John Hancock, the iconic 156-year-old and now Canadian-owned life insurance company, announced in September that it would no longer sell traditional life insurance plans and will only be selling “interactive” insurance plans that track fitness and health data through wearable devices and smartphones.


Interactive life insurance, pioneered by John Hancock’s partner the Vitality Group, is already well-established in South Africa and Britain and is becoming more widespread in the United States reported Reuters.


Policyholders score discounts for hitting exercise targets tracked on wearable devices, and get gift cards for retail stores and other perks by logging their workouts and healthy food purchases.


In theory, everybody wins, as customers are incentivized to adopt healthy habits and insurance companies collect more premiums and pay less in claims if customers live longer.



Medicaid’s ‘Bundled Payment’ model draws nearly 1,300 providers

Washington, D.C. — Close to 1,300 healthcare providers nationwide have signed up to participate in the first wave of the new voluntary bundled payment program launched by the federal Centers for Medicare and Medicaid Services (CMS) since its January 2018 launch, CMS announced in October.


The Bundled Payment for Care Improvement (BPCI) program is the first new advanced alternative payment model (APM) launched under the current administration.  It essentially reimburses providers for health results achieved, not medical services provided.  Participants include 832 acute care hospitals and 715 physician group practices across 49 states.


The program began on Oct. 1 and will run through Dec. 31, 2023.


U.S. Dept. of Justice clears CVS-Aetna union

Washington, D.C. — On October 11, the U.S. Dept. of Justice (DOJ) announced that it will not challenge the $69 billion merger of CVS and Aetna so long as the two divest Aetna’s Medicare Part D business.  Aetna has already agreed to sell the business to a subsidiary of WellCare. 


According the DOJ, the sale of the Medicare Part D business alleviates competition concerns the department had about the tie-up.


With DOJ approval secured for the megamergers of both CVS-Aetna and Cigna-Express Scripts, a major sector of the healthcare industry is under a seismic shift.


CVS Health and Aetna’s merger pairs together one of the largest U.S. drugstore chains, its pharmacy benefit firm and one of the nation’s largest health plans.  The deal is aimed at simplifying the healthcare experience for consumers demanding change, according to the companies, which have pledged to “remake the consumer health care experience.”


The deal has already secured shareholder approval and is expected to be complete later this year.


Rocky start for Arkansas’ 1st-in-country Medicaid work requirement

Little Rock, Arkansas — Free healthcare for the poor and/or people with disabilities via Medicaid has been a pillar of U.S. public health policy for decades—with debate, and legislation, to reduce, expand or otherwise modify the state/federal healthcare program a pillar of state and national politics for decades, too.


This June, Arkansas became the first U.S. state to implement a Medicaid work requirement.


While intended to incentivize gainful employment with free healthcare, over 4,300 Medicaid members have lost coverage as of September and another 5,000 are at risk, the state reported.


A key reason for the problem is that many Arkansas Medicaid members live in low-employment, low-education rural areas where they remain difficult to contact—in addition to the complexity of signing up and participating in the program, which requires regular submission of work reports.



‘Traditional Chinese Medicine’ included in new global manual

Geneva, Switzerland — The World Health Organization (WHO), the U.N.’s global health watchdog, recently released its 11th edition of the International Classification of Diseases (ICD). 


The ICD assigns a code to each of its thousands of listed diseases, conditions, diagnoses and treatments—driving much of modern medicine, including medical billing, record-keeping and health insurance, for decades.  (The same is true for the U.S.-based Physician’s Desk Reference (PDR) and, of equal importance, the Diagnostic and Statistical Manual (DSM), which covers psychiatry and mental health.)


But in a controversial move, ICD-11 includes a chapter on “Traditional Chinese Medicine.” 


The WHO says that the inclusion “provides guidance to Member States and other stakeholders for regulation and integration of safe and quality assured traditional and complementary medicine products, practices, and practitioners.”  But some critics say it amounts to endorsing non-scientific quackery and superstition; others opine that a push by WHO-member China to globally export Chinese medicine, and import global medical tourism, is behind the addition.


Competition in ACA exchanges has plummeted since 2016

New York, New York — According to a new report in Health Affairs, the number of counties country-wide that have at least three Affordable Care Act (ACA) marketplace payers dropped in 2017 and again in 2018.


Payer participation at the county level stayed mostly stable in 2015 and 2016 as 80% of countries had at least three marketplace payers. That equaled 93% of the population.  The percentage dropped to only 36% of counties and 60% of the population in 2018 as more payers left the exchanges, especially in low-population areas.


However, competition was more common in states with a higher proportion of Hispanic citizens between the ages of 45 and 64 and in states that expanded Medicaid under the health law.