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ROC Weekly News Bites
Increase in Overdoses Despite Drop in Rx, End of Free Insurance, and Growing Insurance Consolidation
Here is a recap of some of the top industry-related news stories of the week:
44% drop in opioid Rx since 2011, but overdoses spike. Here’s why.
Despite the increased the use of prescription drug-monitoring programs (PDMPs), opioid-related overdoses and deaths are increasing, according to an American Medical Association report.
While PDMPs are useful, more people need to be involved to help patients access evidence-based care to address the opioid epidemic. AMA listed the following actions to be among the actions needed to help overcome the opioid epidemic:
Stop prior authorization for medications to treat opioid-use disorder.
Ensure access to affordable, evidence-based care for patients with pain, including opioid therapy when indicated.
Better support harm-reduction services such as naloxone and needle and syringe-exchange services. These proven harm-reduction strategies save lives, but are often stigmatized.
Collect adequate, standardized data to identify and treat at-risk populations, and better understand the issues facing communities.
Free health insurance for jobless workers ends this week. What you need to know
The federal government’s six-month health insurance subsidy for jobless workers through the Consolidated Omnibus Budget Reconciliation Act, or COBRA, ended on September 30. COBRA was part of the American Rescue Plan, and offered the unemployed free health insurance coverage from April 1 to September 30, 2021. Some estimates believe that 16 million people lost their employer-sponsored health insurance during the pandemic.
Through the plan, people who had become jobless were still qualified to stay on their employer’s insurance plan, though it was typically very expensive.
Those that no longer qualify for coverage from COBRA as of September 30 will receive a notice, along with the amount they are required to pay to maintain their coverage.
Those that are unable to afford the new premium are entitled to a special 60-day enrollment period in the Affordable Care Act’s marketplace. Those approved for unemployment benefits for a week or more at any point in 2021 may qualify for a plan with a $0 monthly premium.
Health Insurance Industry Consolidation Grew from 2014 to 2020
An American Medical Association report argues that as health insurance consolidation increases, consumers’ options for coverage are more restricted.
As Gerald E. Harmon, MD, president of the AMA stated in a press release, “As merger rumors involving health insurers swirl, the prospect of future consolidation in the health insurance industry should be more closely scrutinized given the low levels of competition in most health insurance markets.”
It was found that over 90% of markets had one insurer holding 30% or more of the market share, and almost half of the markets (46%) had one insurer holding 50% or more of the market share.
The AMA also found that the rate of consolidation was increasing for about 60% of markets. Over a quarter of the markets moved from being considered unconcentrated in 2014 to being considered highly concentrated in 2020. For those that were highly concentrated in 2014, 54% became even more concentrated by 2020.
The highest market shares were held by UnitedHealth Group (15%), Anthem (12%), Aetna (11%), and Cigna (10%).
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