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Why Adverse Selection is Likely on the HIEs: A Simple Model of Enrollment Behavior

We believe it is more likely than not that premiums paid by (or on behalf of) enrollees on the health insurance exchanges (HIEs) will be insufficient to cover both claims costs, and the operating costs of the health insurers participating

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Higher Premiums – and Higher Deductibles: An Analysis of Health Plans on Offer in 2014

In the market for individually purchased coverage, the same amount of insurance (defined as a constant deductible and/or out-of-pocket maximum) costs substantially more in 2014 than in 2013. At average 2013 deductibles, the cost increase is 81 pct for a

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SSR Index of Current-Quarter Healthcare Demand Growth: Initial 4Q13 Estimates

We expect 3.3% (nominal) y/y growth in US health services demand during 4Q13, the product of 2.1% growth in unit demand, and 1.1% price growth. The 2.2% unit growth forecast would be a 20bp improvement over actual 3Q13 growth of

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NVS: Share of Peer Group R&D Spending Exceeds Share of Peer Group Innovation Produced

NVS’ economic returns to R&D spending (yr10 operating income / yr1 R&D) are on par with peers, after recovering over the last decade. This appears to be more a consequence of cost cuts outside the R&D organization than of efficiency

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ACA: Web Problems and Political Drama are Temporary. Ambivalence of the Uninsured is Permanent

HealthCare.gov will be fixed, and the Affordable Care Act (ACA) will survive the associated political turmoil (amplified by policy cancellations) without immediate major modifications. These temporary problems ultimately are irrelevant         Since the ACA was passed, the

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LLY: Whether High R&D/Sales is Defensible – an Empiric Dissent

Over the last 20 years, LLY accounts for roughly 5pct of peer group R&D spending, but only about 2pct of peer group innovation. This disconnect is worsening: LLY’s share of peer group R&D spending recently exceeded 5pct of the peer

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SSR Index of Current-Quarter Healthcare Demand Growth: Inputs Delayed by Shutdown; Early Read Indicates Strong Flu Season

Among the “not exempt” services that were on hiatus during the 16 day federal government shutdown were data publications from the Bureau of Labor Statistics (BLS), Bureau of Economic Analysis (BEA) and the Centers for Disease Control (CDC) BLS did

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DVA / FMS: Generic Epogen Accretive to EPS

Medicare pays for 85 pct of US dialysis treatment; since 1Q2011 Medicare has paid for treatments on a bundled basis, i.e. with a single payment covering all of dialysis providers’ costs including drugs Erythropoiesis stimulating agents (ESA’s) are roughly 1/4th

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A Simple Yardstick for HIE Enrollment: CBO’s Revised Estimate Looks Like an Outer Boun

CBO* estimates that roughly 20 million subsidy-eligible persons will enroll on the individual health insurance exchanges (HIEs) by 2017, and that this level of enrollment will remain roughly stable over the forecast period (2023)   We believe the 20 million

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SSR Index of Current-Quarter Healthcare Demand Growth, Interim 3Q13 Estimate

We expect 3.6% (nominal) y/y growth in US health services demand during 3Q13, the product of 2.1% growth in unit demand, and 1.4% price growth. The 2.1% unit growth forecast is a 30bp retreat from our initial 3Q13 estimate; the

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