August 4, 2021
Newsletter | Tea Leaves

Access & Coverage:

  • The Oklahoma Health Care Authority reported that more than 150,000 Oklahomans have qualified for Medicaid under a voter-approved expansion of the program. Of those, nearly 91,000 live in urban areas and about 63,000 in rural Oklahoma. About half are between 19 and 34 years old. State officials project that about 215,000 residents qualify for expanded Medicaid for a total annual cost of about $1.3 billion. The estimated state share would be about $164 million. (Article here)
  • A study in Health Affairs found that Medicaid expansion is associated with reduced surgical hospitalizations among the uninsured. According to the study, Medicaid expansion was associated with reductions in both the share (6.20 percent) and the population rate (7.85 per 10,000) of uninsured surgical discharges in expansion versus non-expansion states. In 2019 alone, adoption of Medicaid expansion in non-expansion states could have prevented more than 50,000 incidences of catastrophic financial burden resulting from uninsured surgery. (Study here; Article here)

Health IT:

  • The Colorado Regional Health Information Organization and Health Current in Arizona announced they have completed a merger initiated last year. The two health information exchanges will now operate as a combined not-for-profit regional HIE dubbed Contexture, which will serve roughly 1,800 health care organizations in the two states. Contexture will have an innovation team dedicated to developing new data and analytics services, such as creating new tools and services for state programs such as Medicaid and public health agencies. (Article here)                                           

Life Sciences:

  • The FDA is aiming to grant full approval to Pfizer Inc.-BioNTech SE’s COVID-19 vaccine by early September. The move is expected to trigger vaccine mandates from multiple universities and hospitals, the Defense Department, and the city of San Francisco. The FDA said in a statement that it had “taken an all-hands-on-deck approach” to the process. (Articles here, here, and here)
  • CVS Health Corp. administered nearly 17 million COVID-19 vaccines and more than 6 million tests between April and June, which helped grow its total revenue by 11 percent year over year to $72.62 billion. CVS said revenue also rose by 11 percent in its health insurance business in the second quarter, though it had to pay out more in claims for patients who sought medical services after deferring care earlier in the pandemic. (Article here)


  • A new study found that drug utilization management such as prior authorization and stricter formularies cost the health care industry $93 billion annually. Patients bear the brunt of the cost – $35.8 billion a year – in cost-sharing. Researchers estimate that physicians spend $26.7 billion to deal with cost management tools like prior authorization, drug makers spend nearly $25 billion annually on administrative support programs such as direct financial support and donations, and payers spend $6 billion a year to administer drug prior authorizations. (Study here; Article here)


  • Kaufman Hall’s latest monthly flash report indicates that hospital margins were still tight in June as rising expenses offset rebounding volumes and revenues. In June, the median Kaufman Hall hospital operating margin index was 2.8 percent excluding relief funds and 4.3 percent including relief funds. Operating margin jumped 89.5 percent year to date compared to the first six months of 2020 excluding relief funds; with relief funds the margin jumped 48.7 percent. Compared to the first half of 2019, operating margin was down 10.3 percent year to date without relief funds, though rose 3.7 percent when including the funds. (Report here; Article here)

Public Health/Prevention:

  • The CDC has issued a fresh stop to certain evictions, saying that evicting people could be detrimental to public health and interfere with efforts to slow the pandemic. The new ban applies to parts of the country with high or substantial transmission of COVID-19 and will last until October 3. It comes after President Biden and his administration called on Congress to extend the prior one. (Articles here, here, here, here, and here)