About Covid-19
Biden administration asks court to lift stay of vaccine-or-test rule: “The Biden administration is asking a federal court to lift an order halting its vaccine-or-test mandate for private employers, arguing that delaying the standard could have ‘significant’ impacts outside the workplace….
Attorneys for the administration also said that if the court rejects the request to lift the overall stay, it should allow the government to impose a requirement in the broader mandate that unvaccinated workers wear masks and be routinely tested for Covid-19 while the issue makes its way through the courts.”
Covid-19 cases in children are up 32% from two weeks ago, pediatricians' group says: “Covid-19 cases in children are up 32% from two weeks ago, according to new numbers published Monday by the American Academy of Pediatrics.
For the week ending November 18, there were at least 141,905 new cases among children, with children making up a disproportionate share of the cases, representing more than a quarter of all new Covid-19 cases for the past week. Children account for 22% of the US population. When the virus first became a known problem in the US in early 2020, kids accounted for fewer than 3% of confirmed cases. Since the start of the pandemic, more than 6.8 million children have tested positive for Covid-19.”
Covid vaccine that creates T-cells ‘gives better immune response than current jabs’: “Study findings suggest an experimental vaccine, dubbed CoVac-1, that is designed to specifically create T-cells against COVID-19 produces a better immune response than the alternatives already in use, reported The Telegraph.
‘The induction of SARS-CoV-2 T-cell immunity is a central goal for vaccine development and of particular importance for patients with congenital or acquired B-cell deficiencies,’ researchers wrote in a paper published in Nature.
The Phase I trial involving 36 people who received CoVac-1 early this year showed the vaccine to be safe and capable of producing a robust immune response.
The scientists said the vaccine's T-cell response ‘surpassed those detected after SARS-CoV-2 infection as well as after vaccination with approved vaccines.’
Data suggest that CoVac-1, a single shot in the stomach, produces 3.5 times as many T-cells as the Pfizer/BioNTech vaccine and 20 times as many as the AstraZeneca vaccine.”
About health insurance
Companies are telling unvaccinated workers to pay more for health insurance: “In a September survey, the Society for Human Resource Management found less than 1% of organizations had raised health insurance premiums for unvaccinated workers and 13% have considered doing so.
It was higher among large companies, where nearly 20% were considering the move.”
The higher fees resulted in higher vaccination rates.
Uninsured? You may be among the 10 million who could get help paying for private coverage through the public health marketplace: “In addition to the 10 million who could be eligible financial help with coverage through the public health exchange, 7 million more may qualify for Medicaid or the Children’s Health Insurance Program.
Subsidies for marketplace plans are expanded for 2021 and 2022, due to legislation enacted earlier this year.”
In a related article: Obamacare Open Enrollment Is Here; 1.6 Million Have Already Signed Up: “Open enrollment began on November 1, 2021. Already, more than 1.6 million people in 33 states have newly enrolled or renewed their coverage on the marketplace, according to the Centers for Medicare and Medicaid Services (CMS). Of these, approximately 287,000 were new enrollees, while the majority (more than 1.3 million) renewed their coverage from last year.”
Evidence on Surprise Billing: Protecting Consumers with the No Surprises Act: “Research over the past decade shows that surprise billing is relatively common among privately- insured patients. Studies show that, on average, 18 percent of emergency room visits by people withlargeemployercoverageresultinoneormoreout-of-networkbillsandnearly20percentof patients undergoing in-network elective surgeries or giving birth in a hospital received surprise bills. Surprisebillsinthesestudiesaveragedmorethan$1,200foranesthesia,$2,600forsurgical assistants, and $750 for childbirth. All told, more than half of U.S. consumers report having received an unexpectedly large bill.”
Results from the Institute for Medicaid Innovation’s 2021 Annual Medicaid Health Plan Survey: This monograph is a great overview of Medicaid Health Plans. Among the findings:
“In 2020, 100 percent of health plan respondents provided high-risk care coordination for members, and 95 percent tracked the effectiveness of their efforts by monitoring metrics such as emergency department utilization (HEDIS measure; 95%), inpatient utilization (HEDIS measure; 95%), and patient experience survey results (79%)…
Almost all Medicaid health plan respondents (90%) utilized an alternative payment model (APM) or value-based purchasing (VBP) arrangement in 2020, with 100 percent of medium (i.e., 250,001 to 1 million covered lives) and large (over 1 million covered lives) health plans reporting having an arrangement in place. Other key findings from 2020 included:
Most respondents (73%) implemented VBP arrangements with a majority of primary care providers.
The majority of respondents did not implement VBP arrangements with dentists (89%), nurse-midwives (84%), or orthopedists (84%).
Three-quarters (75%) of respondents were required by the state in which their plan operated to implement a VBP or APM contract with providers.
Eighty-four percent (84%) of respondents used or considered Healthcare
Effectiveness Data and Information Set (HEDIS) measures as part of their
VBP models.
The most frequently used payment strategies were payment incentives
based on performance measures related to access to care (78%), payment incentives for the availability of same-day or after-hours appointments (56%), and enhanced payment rates for hard-to-recruit provider types (56%).
From 2017 to 2020, all external factors impacting the adoption of and innovation in VBP/APMs decreased between 16 (provider readiness and willingness) and 83 (impact of 42 CFR Part 2 on limiting access to behavioral health data) percentage points.”
About hospitals and health systems
Higher penalties for undisclosed prices won't sway all hospitals to comply, consultant says: “While CMS' move to increase the penalty for hospitals that don't publish their prices will make some facilities more likely to comply with that requirement, it may not sway the country's largest health systems, Caroline Znaniec, a managing director at advisory firm CohnReznick…
According to Ms. Znaniec, the new noncompliance fee of up to $2 million per year will likely persuade mid-sized hospitals and health systems to comply with the regulation, but not the larger facilities and health systems.
’For the extremely large health systems, that amount is not really that large of a fine," Ms. Znaniec said. "I'm hearing from some systems that $2 million is nothing to them. They may be weighing the risks.’”
About the public’s health
Trends in Obesity Prevalence Among Adults Aged 18 Through 25 Years, 1976-2018: “This analysis found that from 1976 to 2018, the prevalence of obesity among emerging adults in the US increased significantly. Limitations of this study include the population being limited to non-Hispanic Black and non-Hispanic White individuals, patterns among whom may not be generalizable to other races or ethnicities, as well as a decline in the NHANES response rate over time.”
Don’t Screen for COPD in Asymptomatic Adults, Says USPSTF: “Based on the available evidence, the task force recommends against screening for COPD in asymptomatic adults. This is a “D” recommendation and pertains only to adults who do not recognize or report respiratory symptoms. It does not apply to individuals who present with symptoms such as chronic cough, sputum production, wheezing or difficulty breathing.
The task force also noted that its evidence review did not include people with alpha-1 antitrypsin deficiency, a hereditary genetic disorder that may cause lung damage and thereby increase the risk for COPD.”
Antibiotic accountability: how countries and companies perform: An excellent global review of antibiotic resistance. Who is over-prescribing, who has the most drug-resistant organisms, and who is doing the most research to combat the problem (by country and company).
About pharma
Two very interesting emerging technologies that could lead to the development of successful oncology drugs:
New insights into how cancer cripples immune cells could fuel fresh I-O approaches and
By putting cancer cells to sleep, new drug could prevent tumor metastasis
About healthcare professionals
Medscape Malpractice Report 2021: Among the highlights:
—51% of physicians have been sued at least once.
—Fewer lawsuits took place during the Covid-19 pandemic
—Failure to diagnose and treatment complications were the leading reasons for suits (unchanged from past reports
—Surgeons of any specialty are most likely to be sued
—Premium rates are rising but many physicians do not know what they are because of their employed status
—80-85% of verdicts are in favor of the of the physician, but rates vary nationally
—52% of respondents to the survey were over age 60.