About healthcare quality
Safety of inpatient care in surgical settings: cohort study “Adverse events were identified in more than one third of patients admitted to hospital for surgery, with nearly half of the events classified as major and most potentially preventable. These findings emphasize the critical need for ongoing improvement in patient safety, involving all health professionals, throughout perioperative care.”
At least 1 in 5 of these complications is the result of medical errors.
About health insurance/insurers
TV personality and surgeon Dr. Oz nominated to run Medicare, Medicaid Another payback: “In 2022, he ran for the Senate in Pennsylvania as a [Trump-endorsed] Republican against then-Lieutenant Governor John Fetterman. Though he beat now-Senator-elect Dave McCormick in the primary, he lost to Fetterman in the general election.”
Change Healthcare restores claims clearinghouse: 5 things to know A good update.
States rush Medicaid requests before Trump return “States are racing to have their Medicaid requests approved before the Trump administration takes power.
The new administration is expected to have a very different view of Medicaid than the Biden administration, and GOP lawmakers in Congress are eyeing major changes. Some states want waivers that will impact their states’ budgets, but others seek to allow Medicaid to pay for social services, a Biden administration innovation that links health to social well-being…”
Medicare Improperly Paid Acute-Care Hospitals an Estimated $190 Million Over 5 Years for Outpatient Services Provided to Hospice Enrollees From HHS OIG: “For 30 of 100 sample items, payments to acute-care hospitals for outpatient services provided to hospice enrollees complied with Medicare requirements. For the remaining 70 sample items, however, payments did not comply with the requirements. Specifically, our medical reviewer found that Medicare paid acute-care hospitals for outpatient services that palliated or managed hospice enrollees’ terminal illnesses and related conditions. These services were already covered as part of the hospices’ per diem payments and should have been provided directly by the hospices or under arrangements between the hospices and acute-care hospitals.”
About pharma
Antidiabetic Medication and Asthma Attacks “In this self-controlled case series and population-based cohort study of 12 702 patients with asthma, metformin was associated with a lowered risk of asthma attacks by approximately 30%, and adding glucagon-like peptide-1 receptor agonists were associated with an additional lowered risk of approximately 40%. Associations were found regardless of glycemic control, weight, or asthma phenotype.”
Semaglutide Eligibility Across All Current Indications for US Adults “A total of nearly 137 million adults, representing more than half of all US adults, are eligible for semaglutide therapy. This exceeds the number of adults eligible for statins (approximately 82 million), currently the most prescribed pharmaceuticals among US adults.6 Although most of these individuals are eligible for semaglutide based on the weight-management indication that is not universally covered by payers, we estimate that more than 39 million adults qualify for indications other than weight management alone, a substantial increase over the estimated 15 million currently taking a glucagon-like peptide-1 (GLP-1) receptor agonist.”
About the public’s health
The many legal fronts of RFK Jr.’s fight against vaccines “Robert F. Kennedy Jr. took leave as chairman of Children’s Health Defense, a nonprofit known for spreading doubt about vaccines, to run for president last year. But he is still fighting in court alongside the group, putting him in an unusual position for someone nominated as Secretary of Health and Human Services.
If confirmed by the Senate, Kennedy will have power to guide the agencies he oversees toward his priorities. The legal fights he and his group pursue offer a glimpse of his policy interests and the tools he’s used to further them — as well as the scrutiny they could face in court.”
The US Preventive Services Task Force in Legal Jeopardy An excellent summary of recent court decisions on the legal ability of the USPTF to set policies (especially preventive care coverage for the ACA).
Childhood Vaccination Rates Continue to Decline as Trump Heads for a Second Term For example: “The share of kindergarten children up to date on their vaccinations continues to decline.
Over three-quarters (39) of states had MMR vaccination rates below the “target” rate of 95% for the 2023-2024 school year, an increase from 28 states during the 2019-2020 (pre-pandemic) school year.”
About healthcare IT
A strategy for cost-effective large language model use at health system-scale “Large language models (LLMs) can optimize clinical workflows; however, the economic and computational challenges of their utilization at the health system scale are underexplored. We evaluated how concatenating queries with multiple clinical notes and tasks simultaneously affects model performance under increasing computational loads…Performance deteriorated as the number of questions and notes increased. High-capacity models, like Llama-3–70b, had low failure rates and high accuracies. GPT-4-turbo-128k was similarly resilient across task burdens, but performance deteriorated after 50 tasks at large prompt sizes. [Emphasis aded]After addressing mitigable failures, these two models can concatenate up to 50 simultaneous tasks effectively, with validation on a public medical question-answering dataset. An economic analysis demonstrated up to a 17-fold cost reduction at 50 tasks using concatenation. [Emphasis added] These results identify the limits of LLMs for effective utilization and highlight avenues for cost-efficiency at the enterprise scale.”
Consolidation Looms in Ambient Voice A good graphic summary of the consolidation in the voice transcription space.