About Covid-19
U.S. officials say fully vaccinated don't need booster: “U.S. health officials, after meeting with vaccine maker Pfizer, reiterated on Monday that Americans who have been fully vaccinated do not need to get a booster shot, a spokesperson for the Health and Human Services Department said.”
In a related article: WHO: Rich countries should donate vaccines, not use boosters: “Top officials at the World Health Organization say there’s not enough evidence to show that third doses of coronavirus vaccines are needed and appealed Monday for the scarce shots to be shared with poor countries who have yet to immunize their people instead of being used by rich countries as boosters.”
Pfizer-BioNTech and Oxford AstraZeneca COVID-19 vaccine effectiveness and immune response among individuals in clinical risk groups: This article is a preprint of an English study.
”In most clinical risk groups, immune response to vaccination is maintained and high levels of VE [vaccine effectiveness] are seen with both the Pfizer and AstraZeneca vaccines. Reduced antibody response and vaccine effectiveness were seen after one dose of vaccine among the immunosuppressed group, however, after a second dose there is only a small and non-significant reduction in vaccine effectiveness. These findings would support maximising coverage with two doses in immunosuppressed individuals.”
Greece and France join Italy in making Covid-19 shots mandatory for health workers, telling the unvaccinated they won't get paid: Contrast these actions with our piecemeal approach.
”France and Greece both announced new vaccine requirements on Monday, following in the footsteps of Italy, which made vaccinations compulsory for health employees in April.
The UK government, which is pushing ahead with its unlocking plan despite strong warnings from experts, has previously said it will mandate shots for care home staff from October.”
In a related article: Germany won't make COVID-19 vaccination compulsory - Merkel: “Germany will not make vaccination against COVID-19 compulsory, Chancellor Angela Merkel said on Tuesday, adding that ensuring more Germans get vaccinated, sticking to distancing rules and testing should help prevent a fourth wave.”
About health insurance
CMS Proposes Physician Payment Rule to Improve Health Equity, Patient Access: This announcement is CMS’s annual Physician Fee Schedule (PFS) proposed rule, which ranges from telehealth to quality improvement initiatives. The final rule will come after the comment period suggestions are considered. Here are some highlights from MGMA:
—”Setting 2022 Medicare payment rates for physician services. For 2022, CMS is proposing a Conversion Factor of $33.5848 and $21.0442 for Anesthesia (a decrease of -3.75% and -2.39%, respectively, over final 2021 rates);
—Delaying the payment penalty phase of the Appropriate Use Criteria (AUC) program to Jan. 1, 2023 or the Jan. 1 that follows the end of the COVID-19 public health emergency (PHE), whichever is later;
—Allowing audio-only visits for the diagnosis, evaluation, or treatment of mental health disorders furnished to established patients in their homes past the COVID-19 PHE;
—Setting the 2022 MIPS performance threshold at 75 points, and the additional performance threshold for exceptional performance at 89 points; and
—Setting 2023 as the first performance year of the new MIPS Value Pathways (MVPs), with participation options including individual clinicians, single specialty groups, multispecialty groups, subgroups, and APM entities.”
CMS starts process to decide on covering pricey Alzheimer’s drug aducanumab: “The Centers for Medicare & Medicaid Services announced Monday it is opening a National Coverage Determination (NCD) analysis on the drug that will cost patients $56,000 a year. Advocates and experts have called for the agency to move quickly to decide whether to cover the drug.”
Physician sentenced for defrauding 3 insurance companies out of $17 million: “A Florida physician pleaded guilty and was convicted for defrauding Cigna, Blue Cross Blue Shield and Humana out of over $17 million.
Max Louis Citrin was investigated by the Palm Beach County Sober Homes Task Force after allegations that he was improperly prescribing drugs to sober home residents. State Attorney Dave Aronberg said Mr. Citrin copied and pasted patient symptoms to fraudulently bill companies for unnecessary allergy testing and treatment.”
Humana quietly funded 40 Iora primary care clinics: “Health insurer Humana quietly funded 40 of Iora Health's 47 primary care clinics, according to a Securities and Exchange Commission registration statement…
The filing also showed the Humana-funded clinics exclusively served Humana members until July 2020.”
About the public’s health
Heart risk ‘calculators’ overlook increased risk for people of South Asian ancestry: “When compared to individuals of European ancestry, South Asians had a more than two-fold risk of developing heart disease.
Risk calculators used by clinicians to guide decisions about preventing or treating heart disease do not always reflect the increased cardiac risks faced by people of South Asian descent.
To gain a better understanding of heart disease risks for those of South Asian ancestry and have more accurate assessment tools, more people of South Asian ancestry need to be included in research used to develop these tools.”
Human genome editing: recommendations: Guidelines from the WHO.
About healthcare IT
Could Gen Z Free the World From Email?: Not, strictly speaking, a healthcare article, but it has significant implications for the field. The whole article is worth reading but here is the “takeaway”:
”According to a 2020 study from the consulting firm Creative Strategies, there’s a generational gap in primary work tools. The survey found that for those 30 and above, email was among the top tools they used for collaboration. For those under 30, Google Docs was the app workers associated most with collaboration, followed by Zoom and iMessage.”
Bayesian Health Launches with Research-Backed AI Platform Enabling Health Systems to Save Lives: A news release: “Bayesian's AI platform sits within the EMR, analyzing patient data with industry-leading AI/machine learning models. The platform sends accurate and actionable clinical signals within existing workflows when a critical moment is detected, helping physicians and care team members accurately diagnose, intervene, and deliver timely care.
With a research-first foundation of over 21 patents and peer-reviewed research papers, Bayesian's platform is based on technology licensed from the Johns Hopkins University. The platform is configured to scale within health systems, and targets high-priority areas with specific modules such as clinical deterioration, sepsis, pressure injury, and transitions of care.”
Telehealth: A quarter-trillion-dollar post-COVID-19 reality?: McKinsey’s take on telehealth.
Here are the highlights:
Telehealth utilization has stabilized at levels 38X higher than before the pandemic. After an initial spike to more than 32 percent of office and outpatient visits occurring via telehealth in April 2020, utilization levels have largely stabilized, ranging from 13 to 17 percent across all specialties. This utilization reflects more than two-thirds of what we anticipated as visits that could be virtualized.
Similarly, consumer and provider attitudes toward telehealth have improved since the pre-COVID-19 era…
Some regulatory changes that facilitated expanded use of telehealth have been made permanent, for example, the Centers for Medicare & Medicaid Services’ expansion of reimbursable telehealth codes for the 2021 physician fee schedule. But uncertainty still exists as to the fate of other services that may lose their waiver status when the public health emergency ends.
Investment in virtual care and digital health more broadly has skyrocketed, fueling further innovation, with 3X the level of venture capitalist digital health investment in 2020 than it had in 2017.4
Virtual healthcare models and business models are evolving and proliferating, moving from purely ‘virtual urgent care’ to a range of services enabling longitudinal virtual care, integration of telehealth with other virtual health solutions, and hybrid virtual/in-person care models, with the potential to improve consumer experience/convenience, access, outcomes, and affordability.”
About healthcare professionals
These specialties report the most pronounced gender pay gaps: “Gender disparities in both representation and salary are greatest among cardiology and gastroenterology, according to research published July 12 in JAMA Internal Medicine.
Highlights:
1. “Overall, women comprised about 40 percent of total full-time faculty across ranks. At the instructor and assistant levels, female representation was nearly equal at 47 percent and 46 percent, respectively. That figure dropped at higher ranks, sitting at 24 percent at the professor rank.
2. Women were the majority in three specialties: general internal medicine, endocrinology and geriatrics.
3. Women were least represented in procedural specialties such as pulmonology, critical/intensive care, gastroenterology and cardiology, which had the greatest imbalance as only 21 percent were women.
4. The median annual salary across all ranks for women was within $25,000, except for chief. By specialty, women's salaries were at least 90 percent of men's for 10 of 13 internal medicine specialties.
5. For cardiology, gastroenterology, and critical/intensive care, women's median salary did not reach 90 percent of men's. While these specialties paid better overall, they also ‘demonstrated the largest gender disparities in both representation and salary, particularly within the higher ranks of cardiology and gastroenterology.’”