About Covid-19
Contagious Brazil COVID-19 variant evades immunity, scientists warn: “Out of 100 people in Manaus who had previously recovered from infection with the coronavirus, ‘somewhere between 25 and 61 of them are susceptible to re-infection with P.1,’ said Nuno Faria, a virus expert at Imperial College London, who co-led the research which has not yet been peer reviewed.
The scientists estimated that P.1 was 1.4 to 2.2 times more transmissible than the initial form of the virus.”
Coronavirus crisis unlikely to be over by the end of the year, WHO warns: “Despite the spread of Covid-19 being slowed in some countries due to lockdowns and vaccination programs, it is ‘premature’ and ‘unrealistic’ to the think the pandemic will be over by the end of the year, the World Health Organization’s executive director of emergency services has said.” And in a related article: The Potential Future of the COVID-19 PandemicWill SARS-CoV-2 Become a Recurrent Seasonal Infection?: A good discussion of this possibility.
No Special Risk for Severe COVID in Asthma— Indeed, could it be actually protective?: “Asthma patients with confirmed COVID-19 were no more likely to require hospitalization or mechanical ventilation than patients without asthma, researchers found.
Moreover, the asthma patients were less likely to die from COVID, reported Lacey Robinson, MD, of Massachusetts General Hospital in Boston, at the virtual annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).”
COVID-19 and Obesity: The 2021 Atlas: “This report shows that in countries where less than half the adult population is classified as overweight, the likelihood of death from COVID-19 is a small fraction – around one tenth – of the level seen in countries where more than half the population is classified as overweight. Of the 2.5 million COVID-19 deaths reported by the end of February 2021, 2.2 million were in countries where more than half the population is classified as overweight.” The studies adjusted for co-morbidities.
Graphic: Bats and the origins of outbreaks: Really interesting video. One fact: Bats are hyper- metabolic mammals (because they fly) and thus have high body temperatures. The viruses that successfully infect them are, therefore, used to this elevation. When the virus jumps to humans, our fever response does not kill them like it does with other infections.
Association between antecedent statin use and decreased mortality in hospitalized patients with COVID-19: “Among 1296 patients (648 statin users, 648 non-statin users) identified with 1:1 propensity-score matching, statin use is significantly associated with lower odds of the primary endpoint in the propensity-matched cohort (OR 0.47, 95% CI 0.36–0.62, p < 0.001). We conclude that antecedent statin use in patients hospitalized with COVID-19 is associated with lower inpatient mortality.”
This study makes you think: With all the data mining for associations between Covid-19 and [whatever is being studied], some factors are bound to emerge as highly significant. This problem is why randomized controlled trials are still needed.
About health insurance
Over 200K sign up for ACA plans during Biden special enrollment period: “More than 200,000 people signed up for health coverage on federal ObamaCare exchanges in the first two weeks of a special pandemic enrollment period, according to federal statistics released Wednesday.”
Changes in Medicare Physician Spending During the COVID-19 Pandemic: “… spending in the first six months of 2020 was $9.4 billion (19 percent) less than expected for that period based on the pre-pandemic trend. And although spending declined regardless of service type, setting or specialty, the severity of the impacts varied substantially. Telehealth spending increased dramatically during the study period but was concentrated in a handful of service categories.”
United Healthcare Advances $100 Million Fraudulent Lab Bill Suit: ”United Healthcare Services Inc. is moving forward with part of its lawsuit accusing a group of medical testing labs of running a $100 million fraudulent billing scheme after a Dallas-based federal judge trimmed a handful of the insurer’s claims.
United’s 12-count complaint includes details and examples of the allegedly fraudulent claims, together with showing knowing participation on behalf of several individual defendants, Judge Ada Brown said.”
Usually fraud of this scope involves Medicare or Medicaid. See the next article.
CEO Sentenced to Prison in $150 Million Health Care Fraud, Opioid Distribution, and Money Laundering Scheme: “The chief executive officer of a Michigan and Ohio-based group of pain clinics and other medical providers was sentenced today to 15 years in prison for developing and approving a corporate policy to administer unnecessary back injections to patients in exchange for prescriptions of over 6.6 million doses of medically unnecessary opioids.
Mashiyat Rashid, 40, of West Bloomfield, Michigan, was the CEO of the Tri-County Wellness Group of medical providers in Michigan and Ohio. In addition to the prison sentence, Rashid was also ordered to pay over $51 million in restitution to Medicare, as well as forfeiture to the United States of property traceable to proceeds of the health care fraud scheme, including over $11.5 million, commercial real estate, residential real estate, and a Detroit Pistons season ticket membership.”
The Affordable Care Act’s Insurance Marketplace Subsidies Were Associated With Reduced Financial Burden For US Adults: “Among low-income adults, Marketplace subsidy implementation was associated with 17 percent lower out-of-pocket spending and 30 percent lower probability of catastrophic health expenditures. In contrast, middle-income adults did not experience reduced financial burden by either measure. These findings highlight the successes and limitations of Marketplace subsidies as debate continues over the ACA’s future.”
Big Gap Between Physician Payments for Offices vs Hospitals, Study Shows: “Medicare payments for physician services were, on average, $114,000 per doctor per year higher when billed by a hospital than when billed by an independent physician practice, found a study of Medicare claims data from 2010-2016 in Health Services Research .
According to the study by Brady Post, PhD, Edward C. Norton, PhD, and colleagues, Medicare revenue for outpatient services billed by physician offices would have been 80% higher if they had been billed by a hospital outpatient department (HOPD). The average bundle of Medicare services performed annually by ‘unintegrated’physicians (ie, those not employed directly or indirectly by a hospital) was worth $141,000 if billed by an office and $240,000 if billed by an HOPD.
The payment differential between HOPDs and private medical offices varied markedly by specialty. The payment gap was $63,000 for primary care physicians, $178,000 for medical specialists, and $150,000 for surgeons.”
Industry Voices—Price transparency alone won't solve the healthcare cost crisis: I love this analogy: “Think about it this way: If travel booking platforms like Kayak or Google Flights only shared price information—not the brand, route, fees, or amenities—many customers would end up on Spirit Airlines flights routed through Denver with a 10-hour layover. And many wouldn’t be happy about it. Price is important, but it isn’t everything—especially when you’re choosing a heart surgeon instead of an airline.”
About healthcare IT
More Competition for Docs as Insurers Boost New Telehealth Plans?: Good review of what insurers are doing and with whom they are partnering.
MITRE launches ransomware support hub for hospitals and health systems: “Its Ransomware Resource Center offers free tools to help healthcare IT pros "better prepare for, respond to, and recover from ransomware attacks."
Use of Certified Health IT and Methods to Enable Interoperability by U.S. Non-Federal Acute Care Hospitals, 2019: Despite the date, data was gathered in 2020. Some highlights:
—About 70 percent of hospitals reported integrating data into their EHR – a nearly 15 percent increase from 2018.
— A majority of hospitals used a mix of electronic and non-electronic methods to exchange summary of care records, however use of electronic third party methods Health Information Service Providers (HISPs), HIEs, andvendor networks increased in 2019.
—The proportion of hospitals that used a national network to find (or query) patient health information increased by nearly 40 percent between 2018 and 2019.
—11% of hospitals plan to change EHR vendor by 2022
The last one was most surprising, considering the time and cost of such changes.
Common HIPAA violations physicians should guard against: “According to the OCR, they are:
Impermissible uses and disclosures of protected health information.
Lack of safeguards of protected health information.
Lack of patient access to their protected health information.
Lack of administrative safeguards of electronic protected health information.
Use or disclosure of more than the minimum necessary protected health information.”
About pharma
Drug industry pushes FDA to solve growing inspection backlog: “The Food and Drug Administration is under increasing pressure from the pharmaceutical industry to address the growing backlog of drug inspections — nearly a year after Covid-19 prompted the agency to halt most plant visits.
From March through September, FDA inspected just three plants outside the U.S., well below the 600-plus it visited in each of the prior two years, the Government Accountability Office said last month. FDA has also struggled to keep up with inspections within U.S. borders, conducting just 52 during the same seven-month period last year, compared with roughly 400 each in 2019 and 2018.”
About hospitals and healthcare systems
The World’s Best Hospitals 2021: FYI.
About devices
Boston Scientific to Purchase Lumenis for $1 Billion: “Boston Scientific has announced that it has agreed to acquire Lumenis, a developer of energy-based medical technology, for $1.07 billion.
The deal will earn Boston Scientific the acquired company’s laser systems, fibers and accessories designed for use in urology and otolaryngology procedures, including its MOSES laser technology, which has shown viability in managing kidney stones.”
FDA Clears Neurolief’s Noninvasive Migraine Headset: “The FDA has granted 510(k) clearance for Neurolief’s Relivion system, a noninvasive brain neuromodulation device for treating acute migraine.
The device can be used at home and is worn as a headset to deliver personalized treatment to patients who experience acute migraines. It delivers stimulation to six branches of the occipital and trigeminal nerves, using three output channels.
According to the company, the system is the first and only neuromodulation technology that has shown statistically significant efficacy in eliminating migraine symptoms within two hours after treatment.”
Fascinating technology.
10 recent drug, device approvals: An update FYI.