Diabetes, sleep and one really big deal

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Tuesday, January 23, 2018

It was one of the last stories we published in 2017, but a potential merger of giants topped the list of most read specialty stories for the year.

The No. 1 story, “CVS-Aetna deal casts chilling shadow over pharmacy landscape,” about CVS’s plan to pay approximately $69 billion for the health insurer, deals with the potential negative impact on privately-owned pharmacies. It’s easy to see how this latest news of consolidation within the healthcare industry would strike a note with the majority of our readers, who are seeing similar trends across the HME sector.

As an almost direct counterpoint to the CVS deal, the No. 2 most read story, “Mail-order market for diabetes on precipice of disaster,” offers a cautionary tale of what happens when one company corners an outsized share of a market and then fails, as Arriva Medical did when it lost its Medicare billing privileges. Where do those patients go? Oh, right, CVS.

With the mail-order diabetes market teetering on the edge, the fight against Medicare’s competitive bidding program goes on. In August, a group of lawmakers asked CMS to hold off implementing a pilot to bundle CPAP payments in the next round, citing concerns that it could result in inferior products and lower quality of care in “House questions CPAP bundling program,” the No. 3 most read story.

CMS itself backed away from a plan that would have required licensure for any practitioner or supplier who provides custom orthotics in “CMS rescinds proposed orthotics rule,” the No. 5 most read story. The agency cited concerns that it would create financial and administrative burdens for providers, even though stakeholders supported it, saying that Medicare’s own rules require providers to be licensed. A related bill, introduced in May in both the Senate and the House of Representatives, is just one of many pieces of Medicare-related legislation back on the table in 2018.

And finally, it’s not all bad news, at least from Dan Greenleaf’s seat. The president and CEO of BioScrip, who was brought onboard in 2016 to turn the large home infusion provider around, says he’s optimistic that the company is on the right track in the No. 4 most read story, “Clear mission, says Greenleaf.” That’s in line, he says, with the future of the industry as technology makes it easier to care for patients in the home—the direction in which health care is shifting.

Will BioScrip further its turnaround? Will federal regulators approve the CVS-Aetna deal? Will Congress or CMS actually get anything done in 2018? Stay tuned.