About the public’s health
Cases of Covid-19 in children on rise, with highest 1-week spike yet: ”There were 61,000 new cases in children during the last week of October, ‘which is larger than any previous week in the pandemic,’ the AAP [American Academy of Pediatrics] said in a statement. From the onset of the pandemic through October 29, more than 853,000 children have tested positive for Covid-19, the AAP said, including nearly 200,000 new cases during the month of October…
(E)arly research has suggested children may not get fever, cough or shortness of breath as often as adults. Fever and cough was found in 56% and 54% of children in one study, compared to 71% and 80% of adults, according to the CDC. Shortness of breath was found in only 13% of pediatric patients, compared to 43% of adults. Sore throat, headache, muscle pain, fatigue and diarrhea were also less commonly reported in children.”
Top Trump adviser bluntly contradicts president on covid-19 threat, urging all-out response: “‘We are entering the most concerning and most deadly phase of this pandemic … leading to increasing mortality,’ said the Nov. 2 report from Deborah Birx, coordinator of the White House coronavirus task force. ‘This is not about lockdowns — it hasn’t been about lockdowns since March or April. It’s about an aggressive balanced approach that is not being implemented.’
Birx’s internal report, shared with top White House and agency officials, contradicts Trump on numerous points…”
A Health Opportunity Cost Threshold for Cost-Effectiveness Analysis in the United States: “Cost-effectiveness analysis is an important tool for informing treatment coverage and pricing decisions, yet no consensus exists about what threshold for the incremental cost-effectiveness ratio (ICER) in dollars per quality-adjusted life-year (QALY) gained indicates whether treatments are likely to be cost-effective in the United States…
Given available evidence, there is about 14% probability that the threshold exceeds $150 000 per QALY and about 48% probability that it lies below $100 000 per QALY…
Given current evidence, treatments with ICERs above the range $100 000 to $150 000 per QALY are unlikely to be cost-effective in the United States.”
Health agencies resist Trump civil service executive order: “President Donald Trump’s executive order making it easier to fire federal employees is meeting fierce resistance within the Food and Drug Administration, amid fears the White House is planning a purge of senior health officials it views as disloyal.
The order — which Trump issued on Oct. 21 — would strip certain civil service and due process protections from career federal employees who make policy.
FDA officials see it as laying the groundwork for an across-the-board effort to replace longtime career scientists with political allies in a second Trump term.”
HHS Appeals LGBTQ-Friendly Decision in Obamacare Regulation Row: “The Health and Human Services Department is appealing a September federal district court decision barring it from enforcing a rule that would allow certain religious organizations to discriminate against LGBTQ people in connection with health care.
The agency filed its notice of appeal Oct. 31 in a case brought by Whitman-Walker Clinic Inc., health-care providers, and advocates for LGBTQ people. The plaintiffs challenged HHS’s rewrite of a rule implementing the Affordable Care Act’s anti-discrimination provision, Section 1557.”
About health insurance
Georgia’s latest 1332 proposal continues to violate the ACA: This article from USC-Brookings is an excellent analysis of the Georgia ACA waiver reported yesterday.
Geographic Variation In Medicare Per Capita Spending Narrowed From 2007 To 2017: “The difference in Medicare price- and risk-adjusted per capita spending between hospital referral regions (HRRs) in the top decile and those in the bottom decile decreased from $3,388 in 2007 to $2,916 in 2017—a reduction of $472, or 14 percent. The spending convergence occurred almost entirely between 2009 and 2014, during the early years of the Affordable Care Act (ACA). The highest-spending HRRs in 2007 had the lowest annual growth rates from 2007 to 2017, and the lowest-spending HRRs in 2007 had the highest annual growth rates. We also found that a greater supply of postacute care providers, especially hospice providers, significantly predicted lower spending growth across HRRs after the implementation of the ACA.”
California health system pays $31.5M to settle drug overbilling case: “From December 2016 to May 2019, Memorial Health Services submitted claims to Medi-Cal for outpatient prescription drug reimbursements that were higher than the actual cost the system paid for the drugs. The health system disclosed the overcharges to the Office of the Inspector General in October 2019.
…FY 2020 EPS guidance, now anticipating GAAP EPS to be in a range of $24.70 to $24.95and Adjusted EPS in a range of $18.50 to $18.75.
FY 2020 EPS guidance reflects fourth quarter 2020 losses of approximately $2.55 per share on a GAAP basis, approximately $2.40 per share on an Adjusted basis.
As previously noted, Humana anticipates fourth quarter losses to reflect the continued support for its constituents, along with the impact of increasing utilization, and COVID-19 testing and treatment costs
Increases full year expected individual Medicare Advantage membership growth to approximately 375,000 members from the previous range of 330,000 to 360,000 members, representing expected year-over-year growth of approximately 10 percent.”