Payer Roundup—Walmart-Humana talks spark early concerns; insurers take aim at curbing opioid use

Prescription and pills
States and the private insurance industry is busy while Congress is out of session. (Getty/Gti337)

Another insurer takes aim at opioid use

One of North Carolina's biggest payers is taking a major step to cut down on the overuse of opioids. 

Blue Cross and Blue Shield of North Carolina said March 29 it will: limit first-time prescription of short-acting opioids to a seven-day maximum supply and require prior authorization before a member receives a first-time prescription for extended-release opioids, among other changes. 

“Every day, opioid addiction destroys lives and tears apart families in North Carolina—and throughout our nation,” Dr. Rahul Rajkumar, Senior Vice President and Chief Medical Officer at Blue Cross NC, said in the statement. “This is a national public health emergency.  Everyone who is in a position to address this epidemic must do so.

The company's new policies follows Cigna's recent announcement that Bloomfield-headquartered insurer cut customers' opioid use by 25% over two years. (Announcement)

Walmart-Humana talks raise concern from hospitals

Whispers of a possible Walmart-Humana merger has already led to concern about greater consolidation in the healthcare industry, and hospitals are worried the retail giant's move into healthcare will cut into their bottom line. 

The financial concerns could come in several forms: Either by pulling patients away from outpatient clinics traditionally overseen by hospitals and health systems, or by building employer plans with narrow networks that leave hospitals out in the cold. 

Late last week the Wall Street Journal reported that the big-box store has discussed a possible deal with Humana in early March, which could follow in the footsteps of planned mergers between CVS and Aetna, and Cigna and Express Scripts. An industry source, however, said a Walmart deal is much more dangerous for competition. (FierceHealthcare)

Ascension, Providence St. Joseph end merger talks

The two hospital systems have halted talks as Ascension embarks on a new strategic direction, according to an article from The Wall Street Journal. 

The WSJ reported in December that the two were discussing a potential merger, which, if approved, would create the largest hospital operator in the U.S. The joint system would have included 191 hospitals across 21 states and a combined annual revenue of $44.8 billion. 

Ascension will now focus on stimulating financial growth and improving productivity in response to new competition from nontraditional sites of care and pressure from payers that want to lower reimbursements. (FierceHealthcare)

Minnesota's Medicaid work requirements is a "dead-bill-walking"

Legislation that includes work requirements for some able-bodied Medicaid patients could soon be coming to the Minnesota senate floor, following passage by the body's health and humans services committee last week, according to Inforum.

Mark Dayton, the state's Democratic governor, however, has said he strongly opposes the bill and a veto would be expected if it reaches his desk. 

The state senate's actions follow a string of Medicaid work requirement approvals in traditionally red states (Arkansas, Indiana and Kentucky.) Minnesota would be the first blue-leaning state to be approved for such requirements. (Inforum News)