A ranking of the healthiest states in the country, details on Cignas’a acquisition of Express Scripts, and more.

1. Cigna acquires Express Scripts

Cigna’s $67 billion deal to buy Express Scripts is final. The U.S. Justice Department approved the purchase back in September, but both companies still needed state insurance agencies to approve. New Jersey gave its final approval on Dec. 18, making the acquisition a done deal by Dec. 20. Cigna joins the ranks of healthcare giants by combining its insurance brand with a prescription company that negotiates drug prices for 85 million customers.

2. America’s healthiest (and least healthy) states

Hawaii is the nation’s healthiest state, according to a new United Health Foundation report titled “America’s Health Rankings.” Massachusetts, Connecticut, Vermont and Utah rounded out the top five. “A rank means that you overall are healthier than the states below you in the rank and are overall less healthy than the states above you in the rank,” said Rhonda Randall, MD, chief medical officer of UnitedHealthcare National Markets and a senior adviser to the report.

The report, published annually for the past 29 years, provides insights into the changes in each state’s population. “The states that are in the top five on the list have areas where they could improve. The states that are in the bottom five have areas that they have done well,” Randall said. “So every state has some areas where they’re challenged and some areas where they have some really strong measures around their health.” The bottom five states were Arkansas, Oklahoma, Alabama, Mississippi and Louisiana.

3. Medicaid needs value-based care to address SDOH

 The Association for Community Affiliated Plans (ACAP) and the Center for Health Care Strategies (CHCS) has released a report after studying the key themes across Medicaid-managed contracts in 40 states.

“The report’s state-by-state comparison shows that states are taking myriad approaches to addressing social determinants,” said Tricia McGinnis, MPP, MPH, senior vice president, CHCS. “What’s really exciting is taking an inventory of these efforts from across the country — and identifying the key trends, including emerging areas of innovation.”

To improve health outcomes and address social determinants of health (SDOH), CHCS recommended the Centers for Medicare & Medicaid Services (CMS) consider doing the following:

  • Improve care coordination, access to healthcare and long-term member engagement.
  • Collaborate across community, state and federal agencies.
  • Offer guidance to each state’s Medicaid-managed programs on how to address SDOH.
  • Approve funding for states to test SDOH interventions.
  • Support state organizations for making value-based payments over those that pay for actual services.

4. Mental health issues and chronic disease on the rise

United Health Foundation’s latest population health report discovered increases in two critical areas: mental health and chronic disease. The chronic illnesses with the highest mortality rates include obesity-related diseases such as cardiovascular disease (CVD), diabetes and cancer.

“Deaths from these chronic diseases and others contribute to the nation’s premature death rate — the number of years lost before an individual reaches age 75,” the report stated. “This rate increased for the fourth straight year, driven by suicide and drug deaths with 7,432 years lost per 100,000 people this year.” Drug-related deaths have risen by 25 percent in the past three years and the rate of suicides has jumped 16 percent since 2012.

5. Sock sensors monitor diabetic neuropathy

Socks with special sensors can monitor the foot temperature of patients with diabetic neuropathy, according to a study published in the Journal of Medical Internet Research. The washable and reusable socks made by Siren can report foot temperature within .2 degrees Celsius of the reference standard.

“The temperature studies conducted show that the sensors used in the socks are reliable and accurate at detecting temperature and the findings matched clinical observations,” the study noted. “Continuous temperature monitoring is a promising approach as an early warning system for foot ulcers, Charcot foot, and re-ulceration.”

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