Oct 10, 2018

Axios Vitals

By Caitlin Owens
Caitlin Owens

Good morning ... Situational awareness: The Trump administration has formally threatened to veto Senate Democrats' measure disapproving of the expansion of "short-term" health plans. No big surprise there.

We still need a new and more accurate name for those plans, by the way.

1 big thing: Venture capital loves health care

Health care companies have already raked in more than $23 billion in venture capital funding this year — more than they collected in all of 2017, according to the latest figures from Pitchbook, which tracks VC investments.

Winners: Pharmaceuticals and biotechnology make up the lion’s share of those investments, with more than $14 billion. That’s more than they’ve collected in any previous year.

The big picture: Health care — biotechnology in particular — is attracting just as much cash as the buzziest sectors of the tech industry.

  • The life sciences sector attracted more early-stage VC funding in the third quarter than the burgeoning artificial intelligence industry.
  • Two of the four biggest early-stage deals of the quarter were for biotech companies. The other two were for software for autonomous vehicles.
2. Venture capital also loves Juul

Juul, the dominant e-cigarette manufacturer, reached a $10 billion valuation just seven months after its first VC investment. That's four times faster than Facebook reached the $10 billion mark, according to Yahoo Finance.

Yes, but: Juul's value could take a significant hit if and when the Food and Drug Administration cracks down on flavored vaping products and/or online sales.

  • High schoolers' use of e-cigarettes has jumped by 75% in the last year, according to preliminary data from the Centers for Disease Control and Prevention.
  • As the dominant e-cigarette manufacturer, Juul is profiting from at least some of that increase.
3. California's unusual Medicaid waivers

While red states are using the Medicaid waiver process to curtail their programs, California is using waivers to push the traditional limits of what Medicaid covers, Axios' Caitlin Owens reports.

The goal is to address social determinants of health, mental health and preventative care.

  • One initiative, referred to as Whole Person Care, uses Medicaid money for nontraditional services like housing, in order to better serve populations like the mentally ill and homeless.
  • There's also a program that repurposes payments that go to hospitals for uncompensated care. That money is allocated for outpatient care and other services that keep patients out of the emergency room.
4. No, Medicaid isn't fueling the opioid crisis

A new study pours even more cold water — and there's already been a lot of cold water here — on the idea that the Medicaid expansion has fueled the opioid epidemic.

Details: The study, from the University of Pennsylvania’s Leonard Davis Institute of Health Economics, shows that the rate of overdose deaths in Medicaid expansion states is lower, not higher, than in non-expansion states.

  • It looks at three states that expanded Medicaid before the Affordable Care Act: Arizona, Maine and New York. (The authors say that’s because the opioid epidemic was already underway when the ACA’s Medicaid expansion began.)
  • It found that opioid deaths rose more slowly in those states than in nearby states that didn’t expand Medicaid, as well as in all non-expansion states.

The bottom line: A lot of the “Medicaid is bad for opioids” argument is built on the idea that Medicaid expansion gives people more access to opioids. But multiple studies have questioned that theory, and Medicaid expansion is also a critical avenue to expand treatment for addiction.

5. The costs of a big merger

$37 million — that’s the amount Baylor Health Care System and Scott & White Healthcare spent on “merger costs” a few years ago to become what today is Baylor Scott & White Health, according to my colleague Bob Herman’s reviews of old financial records.

  • Now, the hospital organization wants to merge with Memorial Hermann to create a new mega-system in Texas.

Between the lines: It’s a minuscule percentage of the system’s expenses, but it’s also $37 million going to law firms, banks and consultants instead of patient care. Baylor Scott & White and Memorial Hermann spokespeople could not give an estimate of how much they expect to spend on their merger.

Caitlin Owens