The fight between payers and anesthesiologists isn’t over, despite Anthem Blue Cross Blue Shield (BCBS) reversing plans for a policy that would put time limits on commercial claims for anesthesia coverage.

The policy would have set a time limit for claims by procedure, with the exception of maternity and pediatric care, in New York, Connecticut, and Missouri starting next year. It called for providers “requiring more time than set or recommended by these standards” to undergo the insurance company’s claim dispute process in order to get paid, according to a statement Anthem provided to FOX61 in November.

The plan received backlash from everyone, from anesthesiologists to New York Governor Kathy Hochul.

Anthem retracted the policy on December 5 as a result of what the company called a “misinterpretation” in a statement on its website.

This scuffle highlights a bigger issue, however: a longstanding debate between providers and payers about how much pay anesthesiologists deserve.

Keep reading here.—CC

The online review platform Yelp is an excellent resource to see how restaurants or other local businesses are rated, but new research shows how it can also provide insights on essential public health services.

Researchers from the University of Pennsylvania pulled a decade’s worth of Yelp reviews from 2014 to 2023 on essential healthcare organizations in the US. These are organizations such as urgent care centers, doctor’s offices, diagnostic facilities, and hospitals that provide services health insurance plans must cover under the Affordable Care Act.

The total tally was 1,445,706 online reviews from 151,307 facilities nationwide, which were then sorted by zip code. The researchers’ findings were published on November 22 in the journal JAMA.

Dropping customer satisfaction. In general, the researchers observed a sharp decrease in positive online reviews (four or five stars)—from 54.3% to 47.9%—correlated with the start of the Covid-19 pandemic.

Keep reading here.—CH

One in three retail pharmacies closed between 2010 and 2021, and patients of color may be feeling the effects of the trend more, according to a new study published on December 3 in medical journal Health Affairs.

The research out of University of California (UC) Berkeley, Johns Hopkins University, and the University of Southern California (USC) found in particular one notable trend: Unlike 2010 to 2018, when the number of openings was consistently higher than closures, more pharmacies closed than opened from 2018 to 2021, representing a 2.1% decline and suggesting an influx of retail pharmacies shuttering across the US.

In fact, 2018 was the start of declines in retail pharmacy. Between 2018 and 2021, pharmacy numbers declined in 41 states, with about one-third of counties (32.1%, or 1,009) reporting a net drop, impacting 91.6 million consumers. Meanwhile, retail pharmacy chains got $7.5+ billion in government funding for doling out vaccines during the Covid-19 pandemic, biotech research firm Drug Channels Institute reported in 2022.

The researchers used data from the National Council for Prescription Drug Programs’s dataQ database and the US Census Bureau to analyze 88,930 pharmacies across the US.

Keep reading here.—CM

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