About healthcare quality
Malpractice Liability and Health Care Quality: One reason given by advocates for large malpractice awards is that it improves quality by making practitioners more cautious. “In this systematic review, most studies found no association between measures of malpractice liability risk and health care quality and outcomes. Although gaps in the evidence remain, the available findings suggested that greater tort liability, at least in its current form, was not associated with improved quality of care.” Don’t expect the trial lawyers to be persuaded by evidence, though.
How Chaos at Chain Pharmacies Is Putting Patients at Risk: This investigative piece by the NY Times details how pharmacist fatigue at the large chain pharmacies is causing prescription filling errors. Well worth the read.
2019 Update on Pediatric Medical Overuse: This article details the evidence concerning examples of misuse of pediatric medical treatments: “misdiagnosis of ADHD in students who are simply young for their grade, NICU admission and pharmacologic therapy for infants with NAS, antibiotic prophylaxis for UTIs, routine treatment of PDAs, prolonged antibiotic courses for latent TB, and overprescription of opioids.”
4 in 10 patients harmed by medical errors in primary and outpatient settings: “Globally, as many as 4 in 10 patients are harmed in primary and outpatient healthcare settings, with up to 80% of those medical errors preventable, according to a new white paper released today by the nonprofit Foundation for the Innovation and Development of Health Safety.”
About pharma
2020 could be a record year for drug approvals: This quarterly report from OptumRx projects that this year:
“150 new drug approvals. Over 150 new drug approvals, including new molecular entities and other approvals, will be evaluated by the FDA.
64 drugs filed with FDA. Currently, 64 total drugs have been filed with the FDA and have anticipated approval dates in 2020.
11 U.S. blockbusters. 11 are potential blockbusters with expected $1B+ in U.S. sales.”
Oncology is the leading therapeutic category; orphan drugs will continue to play a significant role in healthcare costs (each already costing at least $147,000 a year on average).
The 10 most-anticipated drug launches of 2020: In a related article, read about each of these 10 drugs.
About health insurance
CMS Releases Proposed Notice of Benefit and Payment Parameters Rule for 2021: The big news in this announcement is that CMS is going to more closely scrutinize eligibility for ACA plan subsidies. One way they will do so is by stopping automatic re-enrollment, so beneficiaries will have to document their eligibility each year.
Hospitals clobber Medicaid supplemental payment rule as unworkable cut to program: States have a variety of ways to supplement funds that they use to get federal Medicaid matches. The federal government is proposing to crack down on these other sources, which could cut $50 billion annually. Hospitals are obviously opposing this change.
Out-Of-Network Primary Care Is Associated With Higher Per Beneficiary Spending In Medicare ACOs: Using data from 2012-2015, the authors found that: “While there was no association between out-of-network specialty care and ACO spending, each percentage-point increase in receipt of out-of-network primary care was associated with an increase of $10.79 in quarterly total ACO spending per beneficiary. When we broke down total spending by place of service, we found that out-of-network primary care was associated with higher spending in outpatient, skilled nursing facility, and emergency department settings, but not inpatient settings. Our findings suggest an opportunity for the Medicare program to realize substantial savings, if policy makers developed explicit incentives for beneficiaries to seek more of their primary care within network.” The findings of higher costs are something practitioners have known for a while. The problem is that freedom of choice is built into the ACO model. Medicare Advantage, on the other hand, has the workable structure.
About the public’s health
Flu season continues, with H1N1 diagnoses picking up, CDC says: While the corona virus has garnered almost all of the public health attention, the flu epidemic is much more significant. The CDC estimates more than 19 million cases, 180,000 related hospitalizations and 10,000 deaths. It is not too late to get a flu shot.
Recommended Adult Immunization Schedule, United States, 2020: The figures are an easy-to- understand display of recommended adult immunizations.
Associations of Processed Meat, Unprocessed Red Meat, Poultry, or Fish Intake With Incident Cardiovascular Disease and All-Cause Mortality: “These findings suggest that, among US adults, higher intake of processed meat, unprocessed red meat, or poultry, but not fish, was significantly associated with a small increased risk of incident CVD, whereas higher intake of processed meat or unprocessed red meat, but not poultry or fish, was significantly associated with a small increased risk of all-cause mortality. These findings have important public health implications and should warrant further investigations.”