Takeda Pharmaceutical gained shareholder approval for a $59 billion takeover of Shire, which would strengthen the manufacturer’s rare disease pipeline, but the deal would be accompanied by massive debt, according to The New York Times
. The deal would push Takeda into the ranks of the world's top 10 drug manufacturers, but would cause Takeda to be one of the most indebted, the article noted. Beyond issuing new shares, Takeda secured $30.9 billion in bank loans, according to the NYT
New star ratings by the Centers for Medicare and Medicaid Services (CMS) could leave hospitals that serve the sickest and poorest of patients at risk, according to Modern Healthcare
. The report noted that hospitals with a high percentage of dual-eligible patients perform worse than other hospitals in the readmissions section of the CMS ratings, which lowers their overall star rating, according to Modern Healthcare
. The article noted that CMS did not risk-adjust hospitals with peer groups based on a dual-eligible population as it does for the Hospital Readmissions Reduction Program.
Health care consolidation has gained the attention of House Democrats, who indicated that these mergers are among their top concerns heading into 2019, according to the Washington Post
. The report found that since 1990 the percentage of metropolitan hospital markets that are highly concentrated increased from 65% to 93%. Furthermore, small, private physician practices are rapidly being absorbed by large hospital networks, with just one-third of physician groups still being independent compared with approximately 60% in 2000, according to the Post
. "When Democrats assume the responsibility of leadership in January, we will get to work immediately to promote competition and address monopoly power in health care markets," Rep. David N. Cicilline (D-RI), who will head the House Judiciary antitrust subcommittee, told the Post