CareZone, an online service that delivers prescriptions to people's homes, is suing Express Scripts for allegedly engaging in anticompetitive behavior by locking out mail-order firms.
The bottom line: This dispute shines another light on how pharmacy benefit managers like Express Scripts profit from the drug supply chain — in this case, how it is more beneficial for PBMs to prefer their own mail-order pharmacies over others. Express Scripts denies CareZone's allegations.
Verscend Technologies is buying Cotiviti in a deal worth $4.9 billion, including debt. Verscend analyzes health care data, and Cotiviti audits providers to make sure payments are correct.
Why it matters: Private equity firms back both companies (Veritas Capital for Verscend and Advent International for Cotiviti), showing their desire for Cotiviti's very profitable niche industry. And that industry only exists because of the immense waste within the U.S. health care system.
A group of conservative policy advocates has released another proposal to repeal and replace the Affordable Care Act, which has been in the works now for a few months.
The details: Policy-wise, it’s basically the same as the Graham-Cassidy repeal bill, but without dramatic cuts to traditional Medicaid. It would eliminate most of the ACA’s consumer protections/benefit mandates and convert federal subsidy funding, as well as the law’s Medicaid expansion, into block grants to the states.
Rural counties — particularly in the Midwest and Northeast of the U.S. — are losing people due to higher death rates than birth rates and more people moving away than moving in.
The outlook: The 2020 census is likely to show the extent of this drastic trend. "Barring a significant reversal in the next few years," Richard Fry of the Pew Research Center tells Axios, "the share of the population living in rural counties will be less than it was in 2010 ... Rural clout in Congress and the electoral college will be diminished."
Democrats clearly see a winning 2018 issue in the Trump administration’s approach to pre-existing conditions. They — and vulnerable incumbents in particular — have been hammering away at the Justice Department’s attempts to strike down the Affordable Care Act protections for sick people.
The big picture: Sen. Joe Manchin wrote an op-ed about it. Florida is part of the lawsuit that got all this started, as Sen. Bill Nelson — who’s being challenged by Gov. Rick Scott in November — will remind you.
