Good morning ... Seems like a good time to catch up on some of the big health care issues that we were ignoring while Affordable Care Act repeal was taking up all of our time. Like making sure medical devices don't get hacked. You could argue that's important.
It's been a few months since the worldwide WannaCry ransomware attacks, and a month and a half since the NotPetya attacks that hit U.S. hospitals and the drug company Merck. The cyberattacks were bad enough to get the attention of the health care industry — and the rest of us — but not bad enough to force the industry to solve the underlying problems.
The bottom line: A cyberattack that takes down multiple hospital systems is "the thing that keeps me up at night," said Richard Staynings, principal and cybersecurity healthcare leader at Cisco. "I have no way of knowing the last time a patient received their medication … It essentially renders hospitals near useless."
You can read the full story here, but here's the brief rundown of what's changed and what still hasn't, according to cybersecurity experts:
Bob Herman has a smart interview this morning with Marc Harrison, a doctor, bladder cancer survivor and CEO of Intermountain Healthcare in Salt Lake City.
No, it wasn't just President Trump seeming to threaten nuclear war with North Korea. That was only part of the briefing. The rest was more or less on topic. The highlights:
No national emergency: Health and Human Services secretary Tom Price rejected the suggestion from Trump's opioids commission that he should declare a national emergency to address the crisis, as Shane Savitsky reported yesterday. Price said national emergencies are usually reserved for "a specific area, a time-limited problem — either an infectious disease or a specific threat to public health."
"Nobody is interested in cutting Medicaid": That was Price's response, stepping back to the podium after trying to end the press conference, after he was asked about the failed GOP health care bill. He repeated his frequent criticisms of Medicaid's current structure, adding that "our focus and our desire is to make sure we have a health care system that works for patients."
Reality check: Medicaid is a major source of substance abuse treatment funds — which is why GOP moderates were uneasy about its cuts.
That's the verdict from a survey of large employers released yesterday by the National Business Group on Health. Roughly one in four believe specialty drugs are the biggest cause of rising health care costs, and eight in 10 say it's in the top three cost drivers.
Why it matters: It means employers are going to get more aggressive about managing their costs, like steering their employees away from having specialty drugs administered in the most expensive settings.
One more thing: The survey also found that the number of employers promoting accountable care organizations, the networks of hospitals and doctors that team up to save money, could double by 2020. That could be wishful thinking, given that ACOs' results so far "have not been a home run" in reducing costs, as Ashish Jha of the Harvard T.H. Chan School of Public Health has noted.
CVS is being sued by a woman who claims she was charged $165.68 for a generic medication that only would have cost $92 if she had paid for it without using insurance. According to Business Insider, the lawsuit targets both CVS and pharmacy benefit managers, claiming that because the PBMs determine which pharmacies are in network, CVS offers them a cut of the drug sales.
The response: CVS says the lawsuit is "built on a false premise" and "completely without merit."
Why it matters: It's part of a growing list of lawsuits against "clawback" practices, where patients pay copayments that are more than the cash cost of the drug, per Bloomberg. The public debate over drug prices tends to focus on legislative fixes, but a successful lawsuit could have a powerful impact on industry practices, too.
We got some feedback from America's Health Insurance Plans, the main health insurance trade group, on our item in yesterday's Vitals about Austin Frakt's analysis of Medicare Advantage. Frakt asked why the program costs so much if it's spending less on medical care than traditional Medicare. AHIP took issue with two points:
Frakt's response: He doesn't think there's much actual conflict with what he wrote. Yes, Medicare Advantage payments have come down under the ACA, and yes, the plans are more efficient — but the payments are still above the costs. "You can make a case that Medicare Advantage is doing some great things," he told me. "But from a taxpayer's point of view, you could make the case that, why are we spending so much money on it?"
What we're watching today: Last day of the National Association of Insurance Commissioners summer meeting in Philadelphia.
What we're watching in September: Senate HELP Committee hearings on bipartisan ACA stabilization bill, week of Sept. 4. Also, Senate Finance Committee hearing on CHIP reauthorization, same week.
Let me know if we screwed something up or missed something big: firstname.lastname@example.org.