Obesity Breakthrough: A landmark trial found that Novo’s obesity drug Wegovy lowers cardiovascular risk by 20%. This has massive implications, mainly for senior populations, in gaining wider coverage access for patients. (Link)

PBM Disruption? In likely the biggest news headline of the week, Blue Shield of CA and its 4.8 million member footprint announced its intention to ditch CVS and is replacing that 3-letter void with an ‘unbundled’ consortium of vendors – Amazon Pharmacy for at-home drug delivery, Mark Cuban Cost Plus Drugs for benefit design and medication access, Prime Therapeutics, and Abarca to fill other existing drug benefit functions. Notably, CVS is still retaining the specialty drug book of business, which contains half of the spend. CVS also issued an 8-K on the matter, notably unconcerned about the loss of business especially given the specialty moat.

MSSP Results: The Medicare Shared Savings Program saved Medicare $1.8 billion in 2022 (0.24% savings), marking the sixth consecutive year of overall savings. Low-revenue ACOs, mainly composed of physicians and serving rural areas, earned more shared savings and led high-revenue ACOs in net savings per capita. (Link)

Amazon launches AWS Tools HealthScribe and HealthImaging: Amazon Web Services (AWS) announced the launch of a new HIPAA-eligible service called HealthScribe that healthcare software providers can use to build their own generative AI documentation & other solutions. HealthScribe is launching in general medicine and orthopedics first, and those building in the space can leverage AWS to manage the underlying infrastructure and healthcare-specific LLMs rather than needing to do so on their own. Stated differently, the AWS offering is a lego set for AI offerings. It’s enabling healthcare software providers to build solutions across generative AI use cases in healthcare. Related to the above was Amazon’s announcement in the imaging space, launching AWS HealthImaging. From the press release, HealthImaging will serve a similar function as HealthScribe in supporting the infrastructure and providing lego bricks needed to store, analyze, and share mass amounts of medical imaging data.

Amazon Clinic Growth: Amazon Clinic is expanding its services nationwide, operating as a platform connecting several telehealth providers with patients for low-acuity conditions.

Demise of Cano Health: After a long and beleaguered journey to this point, including a lengthy board fight, going concern…concerns, a $150M loan at a 14% interest rate for a year-long lifeline, and a rescheduled Q2 earnings conference call, Cano Health posted dismal results on its Q2 earnings release. The Medicare Advantage-focused senior clinic care platform reported a 103.5% medical loss ratio, meaning that for every premium dollar earned, Cano paid out 103.5% in medical costs. The narrative is familiar if you’ve heard my post-mortem of Babylon – Cano Health went public via SPAC at an over-exuberant valuation (I’ve heard anecdotally that the winning bid was several multiple turns above any other PE offer)

Medicare Advantage 2023: KFF highlighted several important trends in the Medicare Advantage space, including that 51% of enrollees are now on Medicare Advantage plans, and UnitedHealthcare and Humana nowcomprise about half of all MA enrollees. Very cool article and visualizations on trends throughout the Medicare Advantage landscape. (Link)

Kroger and Intermountain’s Select Health introduced a co-branded Medicare Advantage plan. The co-branded plan will be offered in Colorado, Idaho, Nevada, and Utah. Remember that SelectHealth is Intermountain’s MA subsidiary with over a million members. Meanwhile I’m just waiting for someone to partner with HEB down in Texas! Kroger has previously partnered with Elevance and Priority Health and there are several other co-branded plans out there in the wild. (Link)