Top of the Funnel | Marco Data, Policy Position Monitor + Earnings
ELV. Elevance had a nice quarter which you would expect with eligibility of redetermination on hold. They are singing the same song as the other MCOs which is that as people roll off of Medicaid beginning in 1Q (the new consensus end of the PHE), they will enroll in ACA plans.
No doubt partially true. However, barring any significant change in unemployment, which might reduce the effects of eligibility redeterminations, a large part of those people determined ineligible already have insurance from another source. As Medicaid is the payer of last resort, the MCOs have been able to collect PMPM payments without an associated benefit cost.
ELV also gave tells us that higher rates drove some attrition in their commercial at-risk book that repriced in July. January’s repricing may bring more.
ISRG. Innovation and automation are the tonic for what ails hospitals and ISRG's report helps point the way. My favorite quote from earnings call, "If hospital staffing is challenged, particularly OR staff, it will limit the procedures they can perform. [Hospital administrations] are paying more to get ORs staffed, recognizing it is important to treat these patients and important to the revenue line"
That is the quiet part said out loud.
HCA. It was not rewarded by the market today but HCA did what you would hope in a tight labor market. Throughput improved based on decline in patients days even as surgical cases increased. HCA hospitals are doing what ISRG has also observed; keep the surgeons happy and staff in order to do so. This approach is made possible by the near continuous operation at full capacity of the ambulatory system even as hospital staffing has suffered under labor constraints.
CONGRESS
Record Retention. There are just 2 ½ weeks until election day and health care is the last thing anyone is thinking about. To make up for that, the GOP is getting ready for a little oversight.
Presumptive House Ways & Means Chairman, Kevin Brady and subcommittee member, Vern Buchanan sent a letter to the Treasury Department asking them to retain all record related to their new view of the “family glitch” in the ACA.
Expect more of that in 2023.
THE WHITE HOUSE.
Shots for Tots. The CDC’s Advisory Committee on Immunization Practices approved adding the mRNA COVID vaccines to the Vaccination for Children program and to the Child vaccine schedule. There was some blowback from the medical and scientific community as well as cable news.
The concern is that once listed in the child vaccine schedule, schools, camps and athletic program will mandate vaccines and boosters. The CDC was quick to point out that they do not mandate anything.
Of course they don’t.
However, a vaccine that is not on the child schedule is never going to be mandated. One that is could be required. The CDC was seizing a technicality that was no doubt repeated around Atlanta headquarters.
Not that it matters. No one, especially parents appear interested in Covid-19 vaccines.
Other Stuff.
PFE Raises Prices. Pfizer is telling the sellside it plans to price its mRNA vaccine in the commercial market at $110-130 per dose. That figure is 2x Medicare pays for a multivalent flu-type vaccination and 4x what the government is now paying PFE. With so much price transparency, the price point is sure to attract some unwanted regulatory attention in the US and abroad.
Recent Events
The Failure of (Federal) Science with Dr. Tracy Beth Hoeg.
mRNA Technology: More Downside Than Upside, a Discussion with Dr. Aditi Bhargava.
Have a great weekend.
Emily Evans
Managing Director – Health Policy
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