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Health Costs

Two central Georgia hospitals look to team up

Two hospital systems in Middle Georgia announced Tuesday that they intend to form a partnership, in a move that reflects the constant consolidation of health care organizations.

The deal will not be a merger or acquisition, but it will have some financial aspect to it, said leaders of Milledgeville-based Oconee Regional Health Systems and Macon-based Central Georgia Health System.

Medical Center of Central Georgia

Medical Center of Central Georgia

Ninfa Saunders, CEO of Central Georgia and the Medical Center of Central Georgia, said the partnership’s primary goal is to improve the value of health care for patients, medical providers and insurers.

“This partnership will allow our health system to keep its identity intact while greatly enhancing the patient-focused health care we have provided our local residents for so many years,” Jean Aycock, CEO of Oconee Regional Health Systems and Oconee Regional Medical Center, said in a statement.

The nonprofit Milledgeville hospital, though, recently suffered a credit downgrade from Standard & Poor’s from B to CCC. full story

Georgia still a national leader in health IT

An industry magazine’s list of top U.S. health care IT companies again shows a heavy Georgia presence.

Healthcare Informatics Magazine lists eight Georgia-based companies in its top 100 health IT companies in 2014, based on revenues from the previous year.

logoMcKesson, based in Alpharetta, is again ranked as the No. 1 company in the industry. The company, with $3.4 million in revenues, has topped the magazine’s list for seven straight years.

Others in the top 100 include Alpharetta-based MedAssets, at No. 17; Greenway Health, based in Carrollton, at No. 32; and HealthPort Technologies, based in Alpharetta, at No. 36. full story

Cost is a big question, and here’s an answer

Millions of Americans have no health insurance. Millions of others have health coverage that includes high deductibles.

Both these groups often have to pay upfront for the whole cost of a medical procedure or a visit to a doctor. And these prices can have wide variation, even within a single community.

Healthcare CostYet there’s little if any information publicly available that helps such individuals compare prices.

Three major health insurers are doing something about that. UnitedHealthcare’s parent company, along with Humana and Aetna, are leading an industry initiative
to make medical price information available to consumers on the Internet.

The independent nonprofit Health Care Cost Institute will create and administer this online portal, expected to be available in January.

Separately, a health care website Monday rolled out some price information for people who “self-pay” — or have no insurance — in various markets around the country.

Georgia consumers can find out what the estimated self-pay price is for procedures at facilities run by the hospital chain HCA on clearhealthcosts.com. full story

Hepatitis C: The high cost of a cure

Probably the biggest ethical dilemma now confronting the health care world involves two expensive new drugs to treat hepatitis C.

The issue boils down to a tradeoff between efficacy and cost.

iStock_000017543934SmallOne drug, Sovaldi, has a 90 percent cure rate for newly infected patients – much better than previously available treatments for hepatitis C. It also costs $84,000 for a 12-week treatment – basically $1,000 per day.

The second drug, Olysio, is about $66,000 for a 12-week treatment, but is approved for fewer types of patients.

Some patients face even longer treatment periods – and higher costs.

Georgia Medicaid covers the drugs, though with some restrictions, for its 1.6 million beneficiaries. In March, Georgia’s Drug Utilization Review Board recommended that Medicaid add Sovaldi and Olysio as “non-preferred,” and needing a state approval in each case.

In April, 107 Medicaid patients were taking Sovaldi, at a cost of  roughly $3 million per month to the program, though the state will receive a rebate that will lower that cost.

Still, physicians say the use of these two drugs is a breakthrough. “It really transformed treatment for hepatitis C,’’ Dr. Anjana Pillai, an Emory transplant hepatologist, told GHN on Tuesday. full story

State seeking more choice in 2015 health plan

State officials said Tuesday that they plan to increase the number of insurers and health plan options for state employees and teachers next year.

The State Health Benefit Plan (SHBP) has been a target of fierce criticism since Jan. 1. That’s when changes to its benefit design, plus the use of just one insurer, sparked widespread complaints about a lack of choice of insurance plans and higher health care costs.

Sarah Lesley and her daughters joined a Capitol rally in February against the change in the state health plan.

Sarah Lesley and her daughters joined a Capitol rally in February over the state health plan.

Now, though, the Department of Community Health is asking for proposals for a second statewide insurer to offer a high-deductible health plan, a Medicare Advantage plan for retirees, and a statewide HMO.

The current single insurer for SHBP, Blue Cross and Blue Shield of Georgia, would retain its health reimbursement arrangement plans and Medicare Advantage plans, plus add a statewide HMO option for the 2015 plan year. A third insurer would offer a fully insured in-network-only option for metro Atlanta, under the Community Health plan.

“SHBP is looking to enhance member choice in the 2015 plan year,” said DCH Commissioner Clyde Reese in a statement

The State Health Benefit Plan covers 650,000 state employees, teachers, other school personnel, retirees and dependents. With those numbers, the plan’s members can be a political force in an election year such as this one. When many of them began to complain about this year’s plan, and some began to organize, the state moved swiftly to amend it. full story

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