About pharma
Blues plans invest in new generic drug company: “Eighteen Blue Cross Blue Shield insurers are investing a combined $55 million to build a new generic drug company as a subsidiary of the nonprofit Civica Rx. The firm will focus on manufacturing generics people get at the pharmacy.” In addition to providers, payers are now getting into the pharma space.
Interesting science
Efficacy, immunogenicity, and safety of an oral influenza vaccine: a placebo-controlled and active-controlled phase 2 human challenge study: This promising study shows the efficacy of an oral influenza vaccine. Such technology could revolutionize public health by eliminating temperature restrictions and enhancing portability and ease of administration.
About health insurance
Medicare Surgical Payments Should Be Updated to Reflect Postoperative Care That Is Actually Provided: This research from the RAND corporation and published in the New England Journal of Medicine looks at Medicare payments for post operative services. Post-op care (usually for the first 90 days) is bundled into the payments for the surgical procedure itself. However, many of those visits do not take place. If Medicare (Part B) accounted for those reduced services, it would have saved $2.6 billion in 2018. Recall that the work component of these payments is determined by the AMA committee that sets the RBRVS weights.
Critics: consumers should be wary of short-term health plans: A reminder of the severe pitfalls of choosing a short-term health plan.
Trump 'going to look' at Medicare cuts: This short article summarizes Trump’s statements about Medicare during a wide-ranging interview at Davos with CNBC’s Joe Kernen. No specifics, but entitlement programs were on the budget-cutting table.
About healthcare IT
Humana to allow members to connect hundreds of wearables to Go365 wellness program: “Humana is teaming up with health data company Validic to allow its members to connect a slew of wearable devices to the insurer’s Go365 wellness program.” The article does raise the issue of whether such programs improve health but does not address the security issues when such interoperable software is connected.
2020-2025: Federal Health IT Strategic Plan: This plan from the Office of the National Coordinator lists four overall goals (each with subsections on objectives and strategies):
—Promote Health and Wellness
—Enhance the Delivery and Experience of Care
—Build a Secure, Data-Driven Ecosystem to Accelerate Research and Innovation
—Connect Healthcare and Health Data through an Interoperable Health IT Infrastructure
With regard to the last goal, Epic’s CEO sent a letter to large hospital clients claiming the interoperability requirements would give app makers unauthorized access to patient data. Consumer groups want more interoperability, so one wonders how much of the concern is really over protecting her business.
2019 CAQH INDEX®: Conducting Electronic Business Transactions: Why Greater Harmonization Across the Industry is Needed: CAQH is a consortium of large payers whose mission is: “To accelerate the transformation of business processes in healthcare through collaboration, innovation and a commitment to ensuring value across stakeholders.” This monograph looks at the potential savings of electronic business transactions over manual processes. From a percent improvement standpoint, the greatest potential is in prior authorizations, of which only 13% are being conducted electronically.
About the public’s health
A couple insightful articles about the Chinese corona virus:
Appetite for 'warm meat' drives risk of disease in Hong Kong and China: “For various reasons, the Chinese prefer freshly slaughtered pig, chicken and beef over chilled or frozen meat that has been slaughtered before being shipped.
That desire is at the heart of why diseases such as avian flu in poultry and ASF [African swine fever] been so difficult to eradicate, with huge movements of live animals from all over the country – from farm to slaughterhouse to market – on a daily basis making controlling the spread of disease incredibly difficult.”
The coronavirus outbreak is linked to a market in Wuhan, eastern China where the meat was freshly slaughtered. “Like other respiratory illnesses, the disease was initially transmitted from animal to human, but is now being passed from human to human.” For deep cultural reasons, this habit may be hard to control without strict governmental intervention, not only now (as was quickly done) but in the future.
How China’s slow response aided coronavirus outbreak: This article is a good summary of how the Chinese government reacted to initial cases of the virus. One metric was holding hospital administrators to a “zero infections” target among staff; failure to comply could result in loss of their jobs. Obviously the policy slowed reporting of infections among nurses. This article is from the Financial Times (available by subscription only), so if you can get a copy it is well worth it.