About health insurance
Supreme Court sides with Trump administration on rules to create more exemptions to ACA birth control mandate: “The Supreme Court ruled Wednesday that the U.S. Department of Health and Human Services has the ability to create a religious and moral exemption to the Affordable Care Act’s birth control mandate.”
98% of physicians avoid MIPS penalties: 5 things to know: CMS released results of the 2018 MIPS performance, which determines 2020 payments. Among the results:
” Most clinicians in MIPS — 98 percent — avoided a negative payment adjustment in 2018. A year earlier, 5 percent of clinicians received a negative payment adjustment.
Most clinicians — 84 percent — earned an "exceptional performance" designation, resulting in positive payment adjustments ranging from 0.2 percent to 1.68 percent.”
California surgeon charged in $600M billing fraud scheme: “Randy Rosen, MD, his girlfriend and four others were allegedly involved in a fraud scheme that involved hiring body brokers to pay patients at sober living homes to undergo medically unnecessary surgeries. He is also accused of requiring patients to undergo unnecessary drug tests which he sent to a laboratory owned by his girlfriend.”
About pharma
Startup PBM Capital Rx, Walmart partner to shed light on specialty, mail-order drug prices: Walmart is teaming up with a pharmacy benefits manager (PBM) . The alleged reason is increased transparency but it is obvious Walmart wants to get into the pharmacy benefits business to service payers or corporations that are self-insured.
Walgreens Boots Alliance invests $1B in VillageMD to open 500+ medical clinics, expand telehealth: 6 details: “Clinics will accept several health insurance options and offer telehealth 24/7 as well as at-home visits. VillageMD and Walgreens already made telehealth available to providers on Walgreens Find Care, an online platform that connects patients with virtual services.”
Sandoz to supply Civica Rx with 6 injectable drugs: Civica Rx is expanding its source for pharmaceuticals.
About healthcare IT
Digital behavioral health startups scored $588M in funding amid COVID-19 pandemic: “Digital health is on pace to have its largest funding year ever thanks to the rising demand for virtual care and disease monitoring.
U.S. digital health companies raised $5.4 billion in venture funding across the first six months of 2020. The first half of 2020 saw more funding than any previous first half of the year from 2011 to 2019 and beat the prior record of $4.2 billion set in the first half of 2019…”
VA panel proposes $1.1B more for $16B Cerner EHR upgrade: “The House Military Construction, Veterans Affairs and Related Agencies Appropriations Subcommittee proposed a $104.8 billion discretionary budget for the VA, according to the July 6 report. The budget proposal is $12.3 billion more than the fiscal year 2020 budget and would approve $4.9 billion for IT modernization, up 12 percent from last year's budget.”
About the public’s health
Fauci favors mandatory mask orders:”Fauci, director of the National Institute of Allergy and Diseases, says the United States is in a resurgence of new coronavirus cases, with daily cases nearly double the country’s previously high baseline. Infection rates have been rising in the South and West…’What is alarming is the slope of the curve,’ Fauci said of cases in Alabama. He added, ‘the signal should be wear a mask, period.’”
Health panel may open lung cancer screening to more smokers: In a draft statement, the US Preventive Task Force said “it’s time to expand screening to those who’ve smoked less -- 20 pack-years -- and to start a little sooner, at age 50. The proposed change comes after a newer study found those people are about as likely to benefit as the heavier, older smokers.
If finalized, the new recommendations would make about 15 million Americans eligible for screening, nearly double today’s number…
Importantly, more women and African Americans would qualify…”
.Trump to launch short-term 'surge' COVID-19 testing in hot spot cities:”The Trump administration is launching new "surge" coronavirus testing sites in some of the hardest-hit communities in Florida, Texas and Louisiana.
The Department of Health and Human Services (HHS) said the free COVID-19 testing sites will be located in Jacksonville, Fla., Baton Rouge, La., and Edinburg, Texas, beginning Tuesday.
The surge will last between five and 12 days, and the sites will be able to conduct 5,000 tests per day in each city. It should take between three and five days for someone who is tested to get their results.”
Study: ‘Silent’ Transmission the Top Driver of COVID Outbreaks:”Just over half of new coronavirus infections are tied to people who don't have symptoms, according to a new study from infectious disease modelers.
People sick with COVID-19 can be infectious before they start to show symptoms, while some don't show symptoms at all. The study, published this week in the scientific journal Proceedings of the National Academy of Sciences, estimates that these presymptomatic and asymptomatic cases account for 48% and 3.4% of virus transmissions, respectively – meaning ‘silent disease transmission’ can fuel outbreaks even if everyone who has symptoms is immediately isolated.”
UN chief reviewing whether US has met conditions for WHO withdrawal: “The official withdrawal would take effect on July 6, 2021, due to a one-year notification period required by WHO’s constitution.” However, will will have to see if the President ignores this requirement.
Protective gear for medical workers begins to run low again:The headline speaks for itself.
Volunteers can now sign up for large coronavirus vaccine studies: “The Covid-19 Prevention Trials Network, which knits together the existing federal clinical trial infrastructure developed largely to test HIV vaccines and treatments, launched with a website for volunteers to sign up to be considered when the first trials begin later this month.”
Association of Exposure to Court-Ordered Tobacco Industry Antismoking Advertisements With Intentions and Attempts to Quit Smoking Among US Adults: “Industry-sponsored antismoking advertisements were associated with increased intentions to quit smoking; however, they have not been effective in stimulating attempts to quit among current smokers.”
Association of a Public Health Campaign About Coronavirus Disease 2019 Promoted by News Media and a Social Influencer With Self-reported Personal Hygiene and Physical Distancing in the Netherlands: The researchers “leveraged the power of social norms by having an influencer and a newspaper model appropriate behavior to their audiences. By exposing individuals from the target group to our public health campaign through personalized messaging about their gaps in behavior, we aimed to bridge their intention-behavior gap, which usually results in greater behavioral change.” They found that this campaign “was associated with an approximately 2-fold increase in the odds of washing of all required hand areas and longer duration of handwashing.” Applicability to the US needs to be determined, but it is still an interesting approach.
About hospitals
Introducing the Best Hospitals for America: Here is a different ranking methodology and list hospitals, based on “institutions that save lives, save money, and serve social justice.” In a related article: US News updates hospital ranking methodology: 5 things to know.
Industry Voices—Hospitals will face a new labor shortage after the pandemic: Before the COVID-19 pandemic, there were shortages of many professionals staffing hospitals. With an anticipated rebound in service volume caused by pent-up demand, the shortages may look even worse.
Hospital Merger and Acquisition Activity Withstands COVID-19 Slum: The headline speaks for itself.
Hospital Concentration Index: Interesting analysis by the Healthcare Cost Institute that looked for concentration as a causet of healthcare cost increases. “While metro areas varied in their levels of concentration, by 2017, the majority of metros would be categorized as highly concentrated markets. This reflects the fact that most metros became increasingly concentrated over time.”