5 Things Texas: Kevin Denmark, Lessons from Idaho, Maternal Health

This morning’s news that Cigna has acquired ExpressScripts seems like a counter to CVS’s purchase of Aetna, accelerating a trend in health care that may be more disruptive to the system than Amazon’s entry.

We’ll have coverage of the deal later in the day.  Until then, here are 5 Things We’re Watching in Texas health care for March, 2018.

1. Video: Kevin Denmark, Beacon Health Options

Kevin Denmark is the Vice President of Client Partnerships at Beacon Health Options. He joins us in this edition of “What They’re Watching” to talk about disruption in the next five years in health care.

“I generally am looking five years out, six years out and I don’t think anything has really changed in the terms of the path of health care in the United States. You see a lot of distraction from various areas, federal government, state government, these are all distractions. I think ultimately payors are going to look more like providers and providers are going to look more payors. That’s been happening for a while. How we get there is going to be disruptive. And that’s what you’re going to see is continued disruption I think in 2018.”

2.  Lessons from Idaho

What’s happening in Idaho could be very important for Texas health care. The governor is arguing that the ACA requires only that states “substantially enforce” the provisions of the law, which is the language in the statute.  You can read Blue Cross of Idaho’s legal letter to Secretary Azar here in what is a powerful argument.

study out today says the Texas actually has among the lowest net premiums on the Exchange of any state market, but that it faces “catastrophic” premium increases of as much as 90% by 2021, among the worst in the country.

If Idaho can redesign plans to mitigate costs in the individual market while being “substantially” within the ACA regulations, then I’d expect to see that approach in Texas in plan year 2019.

3.  Primary election takeaways

With the Texas primaries over, there is a sense in Texas that the political ground is moving under our feet. It’s not clear that this is enough to turn Texas Blue, however. Moreover, voters are far more Republican in Texas than adults in general. Republicans still far outpace Democrats with about 1.5 million votes compared to approximately 1 million votes from Democrats for the US Senate race. If this trend continues to the general election, we may expect record turnout in November.

Notably, of the nearly 50 women running, more than half won their primary or will be advancing to a runoff. Lupe Valdez, Texas’s first openly gay and first Latina sheriff, led with 42.9 percent of the vote in the Democratic gubernatorial race. Also, with Tuesday’s results, Texas is likely to send the first two Latina members to represent the state in Congress.

4.  Podcast: Addressing maternal health

Texas has the highest maternal mortality rate in the developed world, and the rate has increased in recent years. In 2014, the rate was 35.8 per 100,000 births, up from 18.6 in 2010 according to the journal Obstetrics and Gynecology.

In this podcast, three health care leaders share their experiences with maternal health in Texas and talk through the policies and programs they are working on to address Texas’ maternal health crisis. We hear from Dr. Amy Young, Chair of the Women’s Health Department at Dell Medical School, Amanda Adkins, Vice President of Population Health at Cerner, and Adriana Kohler, Senior Health Policy Associate at Texans Care for Children. Take a listen, and be sure to subscribe!

5.  What opioid addiction looks like, in photos

If you haven’t seen Time’s recent photojournalism showing what the opioid epidemic looks like in America, it’s worth your time. It’s powerful. “If there was a terrorist that showed up… and shot 50 people or 25 or 10 for that matter, this community would be in an uproar. There would be an army here trying to stop it. That’s exactly where we are with opioids.  But who’s showing up to stop it?”

While the US has had a 14% increase of overdose deaths, Texas is below the national average, with an increase of 4.7%. But Texas has also seen a continued increase in opioid-related deaths, up from 966 in 2013 to 1,174 in 2015.