About health insurance
Medicare Advantage, Part D plans face uncertain healthcare world under COVID-19 as they develop bids: Part D plan bids are due today and the media is focusing on the uncertainty of costs due to COVID-19. However, I have not seen any evidence that outpatient prescription drug use is increased or costs are higher during the pandemic. The real incremental costs seem to be for inpatient care, paid by
Part A under the DRG scheme.
Insurers Continue to Waive Customer Costs for Virus Tests, Care: “Health insurance companies are extending practices that ensure beneficiaries can receive free Covid-19 testing and treatment during the pandemic.
At least five insurers, including Aetna and Cigna, have decided to lengthen the period for which they would waive out-of-pocket costs related to the coronavirus past the initial June 1 end date, according to America’s Health Insurance Plans, an industry trade group.”
Trends in Insulin Out-of-Pocket Costs and Reimbursement Price Among US Patients With Private Health Insurance, 2006-2017: Health policy makers have said insulin costs are becoming unaffordable for most diabetics taking the medication. In response, CMS has placed a limit on out of pocket payments for Part D plans. But according to this study: “Although the findings in this study contradict the view that insulin cost-sharing is excessive for many privately insured patients, monthly out-of-pocket payments may be burdensome for low-income individuals. Nevertheless, the data suggest that privately insured patients have been relatively shielded from insulin price increases and that commercial health insurers have accommodated higher insulin prices by increasing premiums or deductibles for all members.”
More states moving to operate their own health exchanges: Uninsured rising: “Among the states transitioning to or considering creating their own marketplaces are Maine, New Jersey, New Mexico, Oregon and Pennsylvania.”
Out-Of-Network Spending Mostly Declined In Privately Insured Populations With A Few Notable Exceptions From 2008 To 2016: The bottom line of this research is that patients are increasingly using in-network physicians when they have a choice. The real problem is “surprise” billing for emergencies or when patients go to contracted facilities but employed physicians are not contracted.
The Potential Health Care Costs And Resource Use Associated With COVID-19 In The United States: “A single symptomatic COVID-19 case could incur a median direct medical cost of $3,045 during the course of the infection alone… If 20 percent of the US population were to get infected, there could be a median of 11.2 million hospitalizations, 2.7 million ICU admissions, 1.6 million patients requiring a ventilator, 62.3 million hospital bed days, and $163.4 billion in direct medical costs over the course of the pandemic.”
About the public’s health
Quest Diagnostics' self-collection COVID-19 test kit gets FDA nod for emergency use: “Quest Diagnostics received emergency use authorization for its self-collection COVID-19 test kit from the FDA.
The company intends more than a half-million test kits to be available by end of June, with plans to make additional kits available on an ongoing basis…The test kit was designed for self-collection by individuals, at home, with a consumer-friendly nasal swab approach, the company said.” But how good is the self-collection process?
Coronavirus may never go away, even with a vaccine: As COVID-19 becomes “endemic,” this article discusses what we should be doing to be able to live with it. As Tom Frieden, former director of the Centers for Disease Control and Prevention said: .”The one thing we have to do is to understand that there is not one thing. We need a comprehensive battle strategy, meticulously implemented.”
Concern About COVID-19 at Medical Facilities Drops: From Gallup: “As the national COVID-19 curve has flattened in the U.S., fewer Americans are concerned about being exposed to the virus while receiving necessary medical treatment. Although 64% of Americans are very (22%) or moderately (42%) concerned, this marks a 20-percentage-point drop from late March/early April.”
Despite widespread economic toll, most Americans still favor controlling outbreak over restarting economy, Post-ABC poll finds: This latest poll has many opinions about Trump v. Biden. Question 18 asks: “What do you think is more important – (trying to control the spread of the coronavirus, even if it hurts the economy), or (trying to restart the economy, even if it hurts efforts to control the spread of the virus)? Do you feel that way strongly or somewhat?” 57% said they felt strongly or somewhat that they preferred to control the spread of COVID-19; 37% preferred to restart the economy.
About healthcare quality
Some Regular Surveys and Review Activities Resuming With Extra Safety Considerations in June: This link explains what The Joint Commission will be doing as it resumes accreditation activities this month.
About hospitals
Covenant breaches to rise amid coronavirus but for most, credit quality likely unaffected: From Moody’s: “Covenant violations will likely rise because hospitals' revenues have declined dramatically, by an average of 30%-40%, because of the suspension of elective procedures amid the coronavirus outbreak…A covenant violation, or technical default, means that a borrower has not met required financial covenants, including debt service coverage and days cash on hand, found in borrowing agreements such as Master Trust Indentures (MTIs) and bank agreements, often called Continuing Covenant Agreements. A technical default, which is not a payment default, would pose a risk to bondholders if investors or lenders elect to accelerate debt in the face of the default. “
About pharma
Lilly Begins World's First Study of a Potential COVID-19 Antibody Treatment in Humans:”This investigational medicine, referred to as LY-CoV555, is the first to emerge from the collaboration between Lilly and AbCellera to create antibody therapies for the prevention and treatment of COVID-19. Lilly scientists rapidly developed the antibody in just three months after AbCellera and the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases (NIAID) identified it from a blood sample taken from one of the first U.S. patients who recovered from COVID-19…
The first patients in the study were dosed at major medical centers in the U.S., including NYU Grossman School of Medicine and Cedars-Sinai in Los Angeles.”
Hydroxychloroquine or Chloroquine for Treatment or Prophylaxis of COVID-19: A Living Systematic Review: “There were few controlled studies, and control for confounding was inadequate in observational studies…Evidence on the benefits and harms of using hydroxychloroquine or chloroquine to treat COVID-19 is very weak and conflicting.”
Gilead Announces Results From Phase 3 Trial of Remdesivir in Patients With Moderate COVID-19: Gilead announced: “We now have three randomized, controlled clinical trials demonstrating that remdesivir improved clinical outcomes by several different measures. Today’s results showed that when treating moderate disease, a 5-day course of remdesivir led to greater clinical improvement than standard of care, adding further evidence of remdesivir’s benefit to previously released study results.”
About healthcare IT
Telehealth: A quarter-trillion-dollar post-COVID-19 reality?: “Pre-COVID-19, the total annual revenues of US telehealth players were an estimated $3 billion, with the largest vendors focused in the ‘virtual urgent care’ segment: helping consumers get on-demand instant telehealth visits with physicians (most likely, with a physician they have no relationship with). With the acceleration of consumer and provider adoption of telehealth and extension of telehealth beyond virtual urgent care, up to $250 billion of current US healthcare spend could potentially be virtualized.”