The Commission voted 4-0 to approve the creation of the Office of Technology.
The Federal Trade Commission on Friday launched an Office of Technology that the commission says will allow it to keep pace with technological challenges in the digital marketplace.
The Commission voted 4-0 to approve the creation of the Office of Technology.
“For more than a century, the FTC has worked to keep pace with new markets and ever-changing technologies by building internal expertise," FTC Chair Lina M. Khan said in a media release.
"Our office of technology is a natural next step in ensuring we have the in-house skills needed to fully grasp evolving technologies and market trends as we continue to tackle unlawful business practices and protect Americans," she said.
The Office of Technology will have dedicated staff and budget and will be led by Chief Technology Officer Stephanie T. Nguyen.
The new office will:
Strengthen and support law enforcement investigations into business practices and the technologies underlying them.
Advise and engage with staff and the Commission on policy and research, including 6(b) studies, reports, requests for information, policy statements, congressional briefings, and other initiatives.
Highlight market trends and emerging technologies that affect FTC work, meeting with the public and stakeholdersthrough workshops, conferences, and consultations and highlight key trends and best practices.
Khan said the Office of Technology builds on the FTC’s long-term efforts to expand in-house technological expertise, and brings the agency in line with other antitrust and consumer protection enforcers around the world.
The Senate Commerce Committee voiced bipartisan support for a bill to regulate PBMs.
U.S. Senate Commerce Committee members on Thursday vented bipartisan confusion and frustration about the opaque, unregulated, and possibly anticompetitive practices of pharmacy benefits managers and their reputed role in driving up drug costs for consumers.
"I gotta be honest with you, the way I see the situation on PBMs I don't know why the hell they even exist," Sen. John Tester (D-MT) told the committee, which met to discuss Pharmacy Benefit Manager Transparency Act of 2023, a bill that would enhance state and federal oversight of PBMs.
"They were set up for all the right reasons, going to negotiate drug prices, going to pass along benefits to the consumer. But what I see them doing in my state, I don't think the consumer gets much benefit. They're shutting down small businesses on Main Street right and left and those are called our local neighborhood pharmacies."
"As far as holding the big pharmaceutical companies accountable, I don't see it. And the reason I don't see it is because there is no transparency in PBMs. None, zero, nada, kaput, nothing," Tester said. "And quite frankly, when you combine that with anticompetitive tactics, this is a recipe were the only people that win with healthcare costs are the PBMs."
Tester's frustration was shared by Sen. Shelley Moore Capito (R-WV) who said she created a flow chart to understand the complex relationships between stakeholders.
"You've got the researchers, the manufacturing, the distributor, the PBM, the insurer, the doctor or hospital, the pharmacy, and then it gets to the patient," Capito said, "and I guarantee you if we actually had that in front of us, it would be more difficult to read than a flowchart from the Corps of Engineers. It would be ‘if this, that', ‘if this, that' and before you know it total confusion, which is what we have in terms of the lack of transparency with PBMs."
Committee Chair Maria Cantwell (D-WA), the sponsor of SB127, likened the complex, secretive inner workings of PBMs to the arcane practices of the housing and banking sectors before the 2008 crash.
"I'm reminded of a time when we had a similar issue of derivatives and one of our colleagues on the Senate floor said ‘we can't regulate derivatives, we don't understand them.' And then shortly thereafter, our whole U.S. economy blew up," Cantwell said. "So I guarantee you, we can look at this market, and we can understand what's going on. And we certainly can benefit from more transparency."
The committee took no action on the bill Thursday.
Mystery and Margin
Expert witness Erin Trish, PhD, co-director of pharmaceutical and health Economics at USC's Schaeffer Center, told the committee that the opaque dealings of PBMs are intentional and to their benefit.
"Prescription drug markets are complicated, and it takes a lot of boxes and arrows to show you even a simplified version of how the dollars and goods flow," Trish said. "While this complexity keeps health economists like me in business, it still remains a mystery to most Americans. And where there is mystery, there is margin."
Trish said that PBMs initially were independent of health plans and effectively reduced prices, encouraged generics, and expanded mail-order services. However, in recent years PBMs have consolidated to the point where three companies -- CVS Health (33%), Cigna (26%) and UnitedHealthcare (21%) -- control 80% of the market.
"The wave of consolidation in the last few years—including health insurers buying up PBMs and PBMs expanding their footprint in pharmacy markets—and other activities have distorted behavior," she said. "Unfortunately, evidence indicates that PBMs are now leveraging their position to extract profits in ways that are detrimental to patients, payers, and the drug innovation system more broadly."
Prof. Casey B. Mulligan, director of The Initiative on Enabling Choice and Competition in Healthcare at the University of Chicago, warned against unintended consequences in the PBM Transparency Act of 2023 and other PBM regulations, which he said "put some of these economic gains (made by PBMs) at risk by constraining the use of benefit-management tools; discouraging investment in the capital assets that help manage utilization, claims, and other activities of drug plans; and creating barriers to further innovation and entry in the PBM business."
"In the likely case that large incumbent PBMs are better able to adapt to the regulations than smaller new PBMs are, the regulations would have the unintended consequence of reducing competition – growing large PBMs at the expense of smaller ones – while they increase the resource costs of managing pharmacy benefits," Mulligan said. "Even if a new regulation eliminated only 10% of the value of benefit management – something like $14 billion annually – it would not pass a cost-benefit test unless it also resulted in a commensurate regulatory benefit."
Sen. Chuck Grassley (R-IA), speaking as a witness before the committee, raised concerns that PBMs push consumers to buy more expensive drugs so the PBMs can collect higher rebates.
"PBMs are blocking a cheaper product," Grassley said. "PBMs will claim they pass on savings to consumers or through lowering premiums, but their spread pricing and clawback tactics prove otherwise."
"When a PBM goes with a higher-price product, consumers may pay more out of pocket before their deductible kicks in or through co-insurance," he said. "The consumer ought to be the point of everything we are trying to accomplish."
The models were authorized under an executive order by President Joe Biden to 'complement' drug cost-savings provisions in the Inflation Reduction Act.
The Biden administration on Tuesday unveiled three drug cost-savings models for Medicare enrollees, including a plan to offer Medicare Part D enrollees about 150 generic drugs for $2 a month.
The models, authorized under an executive order by President Joe Biden, "complement" drug cost-savings provisions in the Inflation Reduction Act, Health and Human Services Secretary Xavier Becerra says.
"HHS is using every tool available to us to lower healthcare costs and increase access to high-quality, affordable health care," Becerra said.
"We are full steam ahead in delivering the cost savings from the President's Inflation Reduction Act of 2022, and people on Medicare are already feeling the benefits. But as President Biden has made clear, we must build on the new prescription drug law with further action, which is why HHS is implementing these new projects to bring down prescription drug costs."
The Medicare $2 Drug List for chronic conditions such as high blood pressure and high cholesterol. Under this model (the Medicare High-Value Drug List Model), CMS says Part D plans would be encouraged to offer a low, fixed co-payment across all cost-sharing phases of the Part D drug benefit for a standardized Medicare list of generic drugs that treat chronic conditions.
The Cell and Gene Therapy Access Model addresses an emerging – but often prohibitively expensive -- area of drug development that can cost upwards of $1 million. Under this model, state Medicaid agencies would ask CMS to administer multi-state, outcomes-based agreements with drugmakers for certain cell and gene therapies.
The Accelerating Clinical Evidence Model would develop payment methods for drugs approved under accelerated approval, in consultation with the Food and Drug Administration and would also reduce Medicare spending on drugs that have no clinical benefit.
Innovation Center Director Liz Fowler said the models "will test strategies to make it easier for Medicare patients to afford and access needed prescriptions at $2 or less, help expand access to cutting-edge cell and gene therapies for people with Medicaid, and help ensure drugs already on the market are safe and effective."
Fowler told reporters at a media availability Tuesday that the models likely would not take effect until at least 2025.
"Realistically, 2023 Open Enrollment, we've already started down that road," Fowler said. "We haven't even started working with the model yet. And for 20224, the Inflation Reduction Act provisions are still going into effect and so we'll need to make sure that the incentive model is operationally feasible in light of those changes."
Wisconsin Sen. Tammy Baldwin wants answers on Ascension's private equity investments, executive pay, charity care, staff shortages and 'conflicting priorities'.
U.S. Sen. Tammy Baldwin (D-WI) wants Ascension CEO Joseph Impicciche to detail "Ascension's questionable priorities that appear to go against its non-profit mission."
"As a nonprofit, tax-exempt, health system, Ascension is required to provide charitable benefits to the community and operate solely to serve a public, rather than a private interest," Baldwin writes in her letter this month.
"Despite these requirements, Ascension has significant for-profit investment activities that dwarf what the system provides in annual charity care."
Baldwin cited reports in the Milwaukee Journal Sentineland Milwaukee Magazinehighlighting "disruptions to patient care, long wait times in the emergency department, delayed surgeries and staff concerns about patient safety" at Ascension Columbia St. Mary's, and the closure of a labor and delivery unit on Milwaukee's south side at Ascension St. Francis.
Baldwin notes that Ascension CFO Elizabeth Foshage boasted at this year's J.P. Morgan Healthcare Conference that Ascension held $18 billion in cash and investments.
"According to Ascension, these investments are 'generating capital gains that can be re-invested to support Ascension's Mission to care for those who are poor and vulnerable,' yet there is no indication that the proceeds of Ascension's investment funds are being reinvested in Ascension's Wisconsin hospitals," Baldwin writes.
"In fact, I am concerned that the opposite is occurring—that by operating like a private equity fund, Ascension is squeezing staff, closing facilities, and extracting cash from its member hospitals for dubious 'management fees' all to advance its investment activities and provide compensation to its executives."
Baldwin also raises questions about Ascension Capital, which the health system calls a "strategic investment initiative, generating capital gains that can be re-invested to support Ascension's Mission to care for those who are poor and vulnerable."
Baldwin notes that recent financial statements show that Ascension's investment funds have lost the system nearly $750 million in the most recent financial quarter.
"These losses are roughly $200 million more than the amount that Ascension provided toward charity care over that same span," Baldwin writes. "Such an investment return—even if it is uncharacteristic of the fund's longer-term performance—raises serious questions about how Ascension Capital tangibly subsidizes the health system's charity care. It also suggests that a less volatile, more conservative investment approach might be more appropriately suited to the system's mission."
Ascension issued this statement: "Ascension and its physicians, nurses and caregivers are proud of our mission to provide care for those most vulnerable – especially during the past three years of the COVID pandemic – and we look forward to continuing to work with Senator Baldwin on ways to serve the community."
8 Questions
Baldwin wants Impicciche to provide:
1. A list of investments by all investment funds operating at Ascension, and additional information on Ascension's investment returns as a percentage of its revenue from fiscal years 2015 through 2022.
2. All re-investments made by Ascension Capital into charity care services from fiscal years 2015 through 2022 by location.
3. An explanation of Ascension's relationship with R1 RCM, including a description of R1 RCM's current contracted activities and associated revenue from fiscal years 2017 through 2022. How does R1 RCM assist in Ascension's debt collection practices and are any Wisconsin facilities currently using R1 RCM's services?
4. A description of all management fees, including direct costs retained by the health system, charged to Ascension Columbia St. Mary's and Ascension St. Francis, including the contract between the ministry and the hospitals.
5. A detailed description of how $66 million in Provider Relief Funds was used to address staffing concerns at Ascension Columbia St. Mary and Ascension St. Francis.
6. The community health needs assessments required by the Affordable Care Act completed by Ascension for all its care venues in Wisconsin.
7. A detailed description of approximately $256 million in reported community benefits funded by the health system in the past three months.
8. A description of the compensation packages, including all equity, stock options, restricted stock units, or performance-related metrics for Ascension executives, and provide detailed compensation descriptions for any board activity attributed to roles on Ascension affiliated organizations for Anthony Speranzo, CEO of Ascension Capital and Anthony Tersigni, Chairman of the Board, Ascension Capital.
Although the findings raise concerns, the figures for cannabis-related deaths in Florida pale when compared with opioid- and alcohol-related deaths.
Cannabis and synthetic cannabis have been linked to nearly 400 deaths in Florida between 2014 and 2020, a new study shows.
Researchers from Florida Atlantic UniversityChristine E. Lynn College of Nursing, using state law enforcement data, identified 386 people whose deaths were linked to cannabis use. Of these, 258 fatalities were linked to synthetic cannabis, and nearly 65% of these deaths involved synthetic cannabis as the only drug involved.
"Synthetic cannabinoids are part of the new psychoactive substances that are two to 100 times more potent than THC, the main psychoactive compound in marijuana," says study senior author Armiel Suriaga, PhD, an assistant professor at Lynn College. "Synthetic cannabinoids are manufactured chemicals sprayed onto dried, shredded leaves or plant materials that mimic the effect of cannabis, but their actual effects are unpredictable, harmful and deadly."
Although the findings are a cause of concern, the figures for cannabis-related deaths in Florida pale when compared with other drugs and alcohol. For example, the National Center for Drug Abuse Statistics reports that excessive drinking results in 10,655 deaths each year in Florida, and that the five-year average annual rate of excessive alcohol deaths per capita in the Sunshine State increased by 54% from 2015 to 2019. The NCDAS data shows that Florida averages about 3,200 opioids-related deaths each year.
Florida legalized medical cannabis in 2014 and has seen a 1,107% increase in the number of people carrying medical cannabis cards, from about 65,310 cardholders in 2018 to 788,297 as of Jan. 27, the study reports.
The results, published in the Journal of Nursing Scholarship, show that nearly 28% of the dead were ages 45–54 years, compared to 9% ages 8 to 24, demographic disparities that researchers attribute to health conditions in older people, such as cardiovascular diseases.
Among the study's findings:
Nearly 88% of the deaths were among men.
Approximately 65% were non-Hispanic whites.
100% of cannabis-related deaths occurred in urban counties.
In rural counties, 28% of deaths were related to synthetic cannabis, and 40% were African American.
Nearly all (99%) of the deaths were from drug overdoses (84%) and motor vehicular crashes (14%) that caused blunt traumas to the head and body. More crash-related deaths were traced to cannabis use rather than synthetic cannabis use. Four people died from drowning while on cannabis.
"The persistent deaths from cannabis and synthetic cannabis use are a legitimate public health concern," Suriaga says. "The public should remain vigilant of the adverse health outcomes associated with these substances and their unpredictable effects, especially for men who are disproportionately affected, and particularly for people with underlying cardiovascular and respiratory conditions."
Feds want public input on key provisions, including how to impose civil monetary penalties on drugmakers.
The Centers for Medicare & Medicaid Services on Thursday made a plea for public input after unveiling a rough outline and timeframe for implementing the Medicare Prescription Drug Inflation Rebate Program.
The program, a key component of President Joe Biden's 2022 Inflation Reduction Act, slaps civil penalties on drugmakers whose prices for drugs supplied to Medicare Part B and Part D rise faster than inflation in the overall economy, particularly for brand name drugs, which CMS says make up 80% of all prescription drug spending.
The overage collected from drugmakers will be returned to the Medicare Trust Fund.
In a media availability Thursday afternoon, CMS Administrator Chiquita Brooks-LaSure says her agency is "extremely mindful of trying to implement this law, well-knowing we are under a really tight timeframe."
"That's one of the reasons why we really tried to outline where we're going to be asking for comments to give people a real sense of the opportunities for engagement," Brooks-LaSure says.
"The items that we're putting out today, the draft guidance, asking for comments, are just some of the many ways that we are engaging with all interested parties around the implementation of this act."
Brooks-LaSure says CMS will lead monthly technical calls with drugmakers to apprise them of program updates, and will also meet regularly with patient groups, providers, and other stakeholders as the policy takes shape.
"There are a variety of ways in which we are engaging because it's very important to us to hear from all interested parties and really incorporate all of the factors and expertise and experiences as we thoughtfully implement this law," she says.
Input Sought
CMS says it is seeking input from stakeholders in a number of areas, including: the process to determine the number of drug units for rebatable drugs; reduction of rebate amounts for certain Part B and Part D rebatable drugs in shortage and in cases of severe supply chain disruptions; the process to impose civil monetary penalties on manufacturers of Part D rebatable drugs that fail to pay rebates; and assuring accuracy of the inflation rebate payments. The deadline for public comments is March 11.
"Public feedback is critical to successful implementation of the new drug law," says Meena Seshamani, MD, PhD, CMS deputy administrator and director of the Center for Medicare. "Technical expertise and feedback from a wide range of interested parties is crucial for our ability to strike the right balance in implementing the law, ensuring access to affordable and innovative therapies."
A spokesperson for the Pharmaceutical Research and Manufacturers of America (PhRMA) says the drug lobby is reviewing the rough draft and is not yet ready to comment.
Senate Finance Committee Chairman Ron Wyden, D-OR, who earlier this month sent a letter to Brooks-LaSure asking for a public "when and how" update on the program, says Thursday he is "pleased to see CMS beginning this transformational Medicare policy to protect seniors from price gouging by drug companies."
"It's long past time that seniors stop footing the bill for rip offs that pad Big Pharma's profits," Wyden says. "There have never been price gouging penalties in Medicare before, and I am confident that these policies are going to deliver real savings for Americans."
"Critically, price hike rebates in Medicare Part B, which pays for drugs administered in the doctor’s office, will go straight to lowering seniors' coinsurance later this spring."
Timeline
The law took effect for Part B drugs at the start of the federal fiscal year on October 1, 2022, and for Part D drugs on January 1, 2023.
* On April 1, Medicare and Medicare Advantage enrollees may pay a lower coinsurance for some Part B drugs with prices that outstrip inflation.
* In Q4 2023 – CMS will issue revised guidance for the implementation, with timing adjusted if necessary.
* On September 30, 2025, CMS will bill drug companies for the Part B inflation rebates they owe Medicare for calendar quarters in 2023 and 2024.
* On December 31, 2025, CMS will bill drugmakers for Part D inflation rebates they owe Medicare for the 12-months between October 1, 2022 and October 1, 2023.
CMS noted that if the prescription drug law had been in effect between July 2021 to July 2022, more than 1,200 prescription drugs would have been subject to the inflation rebates.
"There is no reason Americans should have to pay two to three times more for the same drugs than people in other countries," Health and Human Services Secretary Xavier Becerra says.
"We are fighting to rein in the excessive cost of skyrocketing prescription drug prices, and now drug companies that increase their prices faster than the rate of inflation will have to pay rebates back to the Medicare Trust Fund."
Centene admits no wrongdoing in the settlement, but will pay back twice the value of its inflated price reporting.
Centene Corp. will pay $215 million to resolve California False Claims Act allegations that two of its managed care subsidiaries inflated drug costs to extract money from Medi-Cal.
It's the latest settlement for St. Louis-based Centene, which manages benefits for nearly 16 million Medicaid recipients nationwide.
California Healthline reports that Centene and its subsidiaries are being investigated in more than 20 states for similar allegations of prescription drug overcharges and have so far paid back about $939 million to 17 states.
"Medi-Cal is a lifeline that provides access to free or affordable healthcare services for millions of Californians," California Attorney General Rob Bonta said Wednesday.
"When companies overcharge the Medi-Cal system, it drains valuable resources from the people who rely on this care. Today's settlement is a win — it brings resources directly back to our state."
Centene issued a statement saying: "This no-fault agreement reflects the significance we place on addressing their concerns and our ongoing commitment to making the delivery of healthcare local, simple and transparent."
The Centene subsidiaries -- California Health & Wellness and Health Net -- manage Medi-Cal services for beneficiaries in more than 20 California counties.
An investigation by the California Department of Justice found that between in 2017 and 2018 the two managed care subsidiaries reported inflated figures for the costs they incurred in providing prescription drugs.
Investigators said Centene leveraged advantages in its pharmacy benefit manager contracts to save its managed care plans $2.70 per prescription drug claim over the two-years.
DOJ alleges that Centene and its PBM failed to disclose or pass on these discounted fees to Medi-Cal, which inflated fees and drug costs reported to California.
The $215.4 million settlement recovers twice the value of Centene's inflated price reporting.
President raps 'record profits' from insulin sales; pushes $35 universal cap.
President Joe Biden on Tuesday night used his State of the Union address to scold "Big Pharma" for reaping "record profits" from insulin sales, and urged Congress to support a universal $35-a-month cap on the price of the life-sustaining diabetes drug.
Noting that Americans "pay more for prescription drugs than any major country on Earth," Biden used the occasion to single-out drugmakers for many of the financial woes plaguing healthcare consumers, Medicare and Medicaid.
He cited insulin costs as a prime example of drugmakers' greed.
"Every day, millions need insulin to control their diabetes so they can stay alive," Biden told Congress. "Insulin has been around for 100 years. The guy who invented it didn't even patent it because he wanted everyone to have it. It costs drug companies just $10 a vial to make. But, Big Pharma has been unfairly charging people hundreds of dollars – and making record profits."
However, the Inflation Reduction Act on Jan. 1 capped at $35-a-month the out-of-pocket costs Medicare enrollees pay for insulin, saving them – and the federal government -- billions of dollars. Biden said the price cap should be available to everyone.
"There are millions of other Americans who are not on Medicare, including 200,000 young people with Type I diabetes who need insulin to save their lives," Biden said. "Let's finish the job this time. Let's cap the cost of insulin at $35 a month for every American who needs it."
The IRA also gives – for the first time -- the Department of Health and Human Services the power to negotiate what it will pay for Medicare's drugs, and caps out-of-pocket drug costs for Medicare enrollees at $2,000 a year. In addition, drugmakers whose prices increase faster than the rate of inflation are also required to refund the overage to Medicare.
"Bringing down prescription drug costs doesn't just save seniors money," Biden said. "It will cut the federal deficit, saving taxpayers hundreds of billions of dollars on the prescription drugs the government buys for Medicare. Why wouldn't we want to do that?"
PHRMA Responds
Stephen J. Ubl, president / CEO of the Pharmaceutical Research and Manufacturers of America (PhRMA), said in a media release that drugmakers "are eager to work with the president on these important priorities."
The PhRMA chief noted that Biden also used his SOTU address to renew his call for a "Cancer Moonshot," and to prepare for future disease epidemics, both of which would rely heavily upon drugmakers' research and manufacturing.
"Unfortunately, the (IRA) also put in place policies that are already impacting the research and development we need to achieve some of the goals President Biden laid out," Ubl said.
"The government price setting provisions in the law are forcing companies to make difficult choices," Ubl says, "including shifting focus away from certain types of medicines and discouraging the research that takes place after medicines are first approved – threatening the very research that remains critical to improving outcomes for cancer and other diseases."
Ubl said the IRA also falls short "in the broader healthcare system that drive up people's costs at the pharmacy."
"Capping the costs of insulin helps some patients – especially those who aren't benefiting from the average 84% discount insurers and their middlemen get for insulin – but it leaves behind many others," Ubl says. "It's a band-aid on a broken system that's forcing people to pay more for medicines than health insurers and pharmacy benefit managers pay."
Justice officials note that the withdrawn guidance hasn't kept pace with the rapidly changing healthcare landscape.
The U.S. Justice Department has withdrawn three, decades-old antitrust policy statements affecting healthcare markets, calling the guidance "outdated" and their removal "long overdue."
"The healthcare industry has changed a lot since 1993, and the withdrawal of that era's out of date guidance is long overdue," Assistant AG Jonathan Kanter of DOJ's Antitrust Division says in a media release. "The Antitrust Division will continue to work to ensure that its enforcement efforts reflect modern market realities."
DOJ says the "withdrawal of the three statements is the best course of action for promoting competition and transparency."
"Over the past three decades since this guidance was first released, the healthcare landscape has changed significantly," DOJ says. "As a result, the statements are overly permissive on certain subjects, such as information sharing, and no longer serve their intended purposes of providing encompassing guidance to the public on relevant healthcare competition issues in today's environment."
"Recent enforcement actions and competition advocacy in healthcare provide guidance to the public, and a case-by-case enforcement approach will allow the Division to better evaluate mergers and conduct in healthcare markets that may harm competition."
Guidance documents are non-binding and do not create legal rights or obligations.
What This Means
HealthLeaders swapped emails with Zachary M. Johns, an antitrust law expert and partner at Morgan Lewis, and asked him for a quick breakdown what transpired at DOJ.
HL: Why were the policies withdrawn?
Johns: This development is not entirely unexpected as it follows the trendline of the antitrust agencies' statements in other contexts that they will be more critical of health care transaction and information exchanges going forward.
A DOJ representative publicly commented that the DOJ's understanding of healthcare economics has evolved and that healthcare, as a data-intensive industry, relies on machine learning, artificial intelligence, and other advanced tools to deliver products or services. Given these changes, almost all of which are technology drive, the DOJ felt that the statements no longer reflected market realities.
HL: How will the withdrawal of these policies affect healthcare M&A?
Johns: While the withdrawal of the guidance does not change the law, it does signal an increased interest in enforcement in this area, which is unsurprising given DOJ's public statements over the past year. This move may also create some uncertainty for provider networks more generally as the policy statements addressed how those networks could minimize antitrust risk.
It is unclear how much of a risk this actually is, though, as the FTC and DOJ have not (yet) withdrawn their respective guidance on clinical integration and financial risk sharing that is embodied in their advisory opinions and business review letters (in addition to the now-withdrawn policy statements).
HL: Are further policies likely to be amended or withdrawn?
Johns: It is yet to be determined if the agencies take further steps to withdraw past guidance over the coming weeks. If they do, it could signal a more significant change in enforcement on those issues.
HL: Anything else?
Johns: The DOJ seems primarily focused on the impact that advanced technologies, such as AI and algorithmic pricing, are having across health care and other industries to which the guidance has more broadly been applied. It is also clear that the DOJ thinks the safe harbors for benchmarking activities are no longer adequate to guard against potential anticompetitive harms.
The supermarket chain is the latest mega-retailer to enter the digital healthcare space.
Albertsons Companies, Inc. has launched a digital health and wellness platform that the Boise-based grocery chain says will incentivize customers to take better care of themselves.
"Sincerely Health" is now available on the retailer's 16 "banner" grocery apps and websites, including Albertsons, Safeway, Vons, Shaw's, Star Market, Jewel-Osco, Acme, and Tom Thumb.
Omer Gajial, chief digital officer and EVP health at Albertsons Cos., says the platform is designed to help improve lives by connecting, educating, encouraging and rewarding customers so they can make informed choices about food, physical activity, sleep and mindfulness.
"We are introducing Sincerely Health with a singular intention to improve lives," Gajial says. "As a grocery and pharmacy retailer committed to the health and wellness of our communities, we are empowering customers to have a connected and personalized view of their health across food, nutrition, activity, mental well-being and pharmacy services, enabling them to make more informed choices."
The platform is a collaboration with payers, providers, and technology organizations, relies on insights from more 10,000 customers and associates, and will continually evolve based on customer feedback, new features, collaborations, and other enhancements, Gajial says.
Consumers who sign up for the platform will be given a brief questionnaire that creates a health score based on "seven dimensions of well-being," the company says. The scores are calculated using actuarially based lifestyle factors such as age, gender, nutrition, lifestyle choices and mental health.
Consumers can to link activity trackers such as Apple Health, Fitbit and Google Fit, and log their vitals and medications and set goals to improve their health scores, track their progress, and get rewards for attaining goals.
Sincerely Health also manages prescriptions, scheduling vaccine appointments and connecting users with general practitioners via telehealth.
Customers who use the platform will get up to $25 off a future grocery purchase, and they can earn additional points as the reach more health goals.
Albertsons Companies operate 24 "banner" stores in 34 states and the District of Columbia, including 2,270 retail food and drug stores with 1,720 pharmacies.
