BHI [Blue Health Intelligence] 2020 Year-end data Digest: Worth a look for some year-end trends. Among the findings:
“Men faced several health challenges in 2019, and, in many cases, had significantly higher rates of disease than women. Higher rates of alcohol abuse, opioid abuse, and nicotine dependence were observed in all age groups of men 19 and older.
Obesity increased in both adults and children from 2016-2019. Children ages 2-4 showed the highest annual increase (20.6%). “Childhood obesity puts children at increased risk of cardiac disease, diabetes, breathing difficulties, joint and musculoskeletal discomfort, and gastrointestinal issues,” the report notes. “Being overweight also can result in social and psychological problems such as low self-esteem, anxiety, and depression.”
Skin cancer and melanoma rates differ widely from state to state, and not always in the expected ways. Typically, warmer and sunnier states have higher rates of skin cancer, but in 2019, rates for Maine, Massachusetts, and Pennsylvania were higher than the southern states of Texas and Louisiana. Of note, Hawaii and Alaska – two states at opposite ends of the weather spectrum – shared the lowest rate of melanoma.
HPV played a significant role in the higher rates of certain cancers in men, which are linked to men’s higher use of nicotine and alcohol. On a positive note, BHI found the rate of HPV vaccination rose 7.8 percentage points for males from 2016 through 2019, compared with 5.9 percentage points for females.
Telehealth skyrocketed in the first nine months of 2020. BHI specifically noted a 50-fold increase in the utilization of virtual healthcare services by commercially insured individuals from March 2019 to March 2020 and a 100-fold increase from April 2019 to April 2020.”
About health insurance
Hospitals get ‘raw deal as CMS rejects site-neutral pay cut exemptions: “CMS may claw back millions of dollars in payments after the agency denied reimbursement rate cut exemptions for hospitals' off-campus outpatient facilities. CMS rejected more than 60% of the mid-build exceptions, which would preserve hospitals' higher reimbursement rates if they had the documentation to prove their off-campus outpatient departments were being constructed when the Bipartisan Budget Act was passed in 2015.”
About Covid-19
U.S. handling of American evacuees from Wuhan increased coronavirus risks, watchdog finds: “As the first American evacuees from Wuhan, China, touched down at a California military base a year ago, fleeing the epicenter of the coronavirus outbreak, they were met by U.S. health officials with no virus prevention plan or infection-control training — and who had not even been told to wear masks, according to a federal investigation.
Later, those officials were told to remove protective gear when meeting with the evacuees to avoid ‘bad optics,’ and days after those initial encounters, departed California aboard commercial airline flights to other destinations.”
J&J Vaccine Provides Strong Shield Against Severe Covid: “In a study of more than 43,000 people, the vaccine prevented 66% of moderate to severe cases of Covid-19, according to a company statement Friday. And it was particularly effective at stopping severe disease, preventing 85% of severe infections and 100% of hospitalizations and deaths.” While not as high a prevention rate as Moderna and Pfizer products, it can be produced in very large quantities, only requires a single dose and does not have the same handling (refrigeration) limitations as do the other two vaccines.
Novavax vaccine almost 90 percent effective in trial, but not against South Africa variant: “Efficacy was strong in the U.K. trial, at 89.3 percent, the company said. But in a separate, smaller trial in South Africa, where a more contagious variant of the virus has taken hold, efficacy fell sharply to 49.4 percent, though it was somewhat higher, at 60 percent, among participants who did not have HIV.”
German authorities recommend against use of AstraZeneca's COVID-19 vaccine in over-65s: “The recommendation, which supports use in adults between 18 and 64 years, follows reports earlier in the week from German media outlets that the efficacy of AstraZeneca's vaccine was only 8% effective in people over 65. AstraZeneca called the reports ‘completely incorrect,’ while the German health ministry has also since refuted the claims.”
AstraZeneca's COVID-19 shot scores European authorization as production holdups linger: “The vaccine, the result of AZ's collaboration with Oxford University, is conditionally approved across Europe in people ages 18 and older. A broad rollout in EU member countries will follow, but in recent days, a reduction in first-quarter supply has dominated headlines.”
About pharma
In a win for PBMs, Biden administration delays rebate rule: “The Department of Health and Human Services has pushed back the start date for the rule, which was set to take effect on Friday, to March 22. The regulation, revived by President Donald Trump's HHS late last year, would replace protections for drug rebates in Medicare Part D with protections for discounts provided directly to consumers.”
Merck’s Keytruda Nabs EU Approval for Colorectal Cancers: “The approval is for first-line treatment of adult patients with metastatic microsatellite instability-high or mismatch repair-deficient colorectal cancer.”
McKinsey in advanced talks with US states to settle opioid claims: “McKinsey is in advanced discussions with several US states’ attorneys-general to pay hundreds of millions of dollars to settle civil claims about its role in advising drug companies held responsible for the country’s opioid epidemic…
The consultancy firm has previously apologised for its role in trying to boost sales of OxyContin. Last year, it said its work with Purdue was designed to support legal prescription of opioids for patients with ‘legitimate medical needs.’”
About healthcare quality
Patient Safety Watchdog The Leapfrog Group Funded for National Initiative on Preventing Harm from Diagnostic Error: “The Leapfrog Group, a national watchdog organization of employers and other purchasers focused on patient safety and quality, today announced Recognizing Excellence in Diagnosis, a new national initiative to publicly report and recognize hospitals for preventing patient harm due to diagnostic errors. Developed in collaboration with The Society to Improve Diagnosis in Medicine (SIDM) and key experts, the project is funded with a two-year grant of $1.2 million by the Gordon and Betty Moore Foundation.” Disclosure: I am on SIDM’s finance committee.
Hospitals agree to follow higher quality standards to get more money from Medicaid, which covers 1/3 of state's population: “With up to 28 rural Kentucky hospitals vulnerable to closure if their finance don't improve, Tuesday's announcement of a new payment model to increase the amount Kentucky's hospitals are paid for Medicaid patients is cause for their celebration…
In order to receive these funds, hospitals will have to abide by higher quality standards that are still being decided by KHA [Kentucky Hospital Association] and the Cabinet for Health and Family Services. Quality standards include things like hospital-acquired infections, medication errors and readmission rates.”
Association of Graduate Medical Education [GME] With Hospital Performance and Patient Outcomes: “This study found a negative linear correlation between GME funding and patient mortality and a positive correlation between GME funding and resident BCE [Board Certification Examination] pass rates in adjusted regression models. The findings also suggest that hospitals that receive more GME funding are not more financially stable.”
Allocation of National Institutes of Health Funding by Disease Category in 2008 and 2019: “In this study, NIH spending for most diseases seemed to be based primarily on the level of NIH spending more than 10 years earlier, despite changes in burden of disease. Congress and the NIH should examine the allocation process to ensure NIH investments are responsive to changes in the health of the population.”
About healthcare IT
Florida Medicaid website hacked for 7 years, hundreds of thousands affected: “Tallahassee-based children Medicaid health plan Florida Healthy Kids Corp. began notifying members Jan. 27 of a 7-year data breach that exposed the personal information of hundreds of thousands of health plan applicants.
The health plan was notified Dec. 9 of the security breach and launched an investigation, which found there had been "significant vulnerabilities" since 2013 on its website and databases that support the online children health insurance application. The vulnerabilities lasted from November 2013 to December 2020, when the health plan temporarily shut down its website.
The health plan said it discovered that several thousand applicants' information was inappropriately accessed and tampered with as a result of the breach. Information of applicants and enrollees that was exposed included Social Security numbers, dates of birth, names, addresses and financial information.”
22 Million U.S. Seniors Lack Broadband Internet Access; First Time Study Quantifies Digital Isolation of Older Americans as Pandemic Continues to Ravage Nation: The headline speaks for itself. More details, including the full report are in the article.