3 key health policies in the Senate's $1T infrastructure package:
“Providers got a win in the package when lawmakers agreed to not raid unallocated COVID-19 Provider Relief Fund monies. However, the legislation does deal a blow to the industry’s efforts to halt a 2% cut to Medicare payments from resuming.
Requiring drugmakers to refund Medicare for any discarded drugs
The requirement applies to drugs dispensed under Medicare Part B, which reimburses for drugs administered in a doctor’s office such as chemotherapy. The requirement applies to single-dose containers or single-use package drugs.The legislation demands that any federal contract to buy PPE must be for two years and go to a domestic manufacturer. The two-year time frame will give the domestic PPE maker enough financial security to stay in the market.”
2021's Best & Worst States for Health Care: WalletHub’s annual ranking based on Cost, Access and Outcomes. [The classic triad of cost/quality/access]. Massachusetts, RI and Minnesota are the top 3; Arkansas, Louisiana and Alabama [lowest] are at the bottom. The various measures are worth a look.
About devices
FDA Regulation and Approval of Medical Devices: 1976-2020: A good review of the topic, highlighted by a concise timeline of regulatory actions.
About Covid-19
Press Briefing by White House COVID-19 Response Team and Public Health Officials: Transcript of yesterday’s press conference. A great summary of what is happening with Covid-19.
Don’t Want a Vaccine? Be Prepared to Pay More for Insurance.: The Federal government requires waiver of out of pocket expenses for Covid-19 testing and vaccination, but not treatment. This policy raises the question of who pays for treatment if the vast majority (97%) of hospitalizations are non-vaccinated persons. Will/should health plans charge higher premiums and fees to those who refuse the vaccine? Can it apply to anyone who is unvaccinated for other diseases- like influenza, pertussis, and pneumococcal vaccines?
US hits 70% vaccination rate -- a month late, amid a surge: “The U.S. on Monday finally reached President Joe Biden’s goal of getting at least one COVID-19 shot into 70% of American adults -- a month late and amid a fierce surge by the delta variant that is swamping hospitals and leading to new mask rules and mandatory vaccinations around the country.”
NYC Becomes Largest U.S. City To Require Proof Of Vaccination For Indoor Activities: “New York City will require workers and patrons at indoor businesses to show proof of vaccination starting on Sept. 13, becoming the first major U.S. city to take such action amid a surge of new cases nationwide driven by the highly transmissible delta variant.
The new mandate announced Tuesday, dubbed the ‘Key to NYC Pass,’ will apply to indoor dining, gyms and entertainment venues.”
Rates of SARS-CoV-2 transmission and vaccination impact the fate of vaccine-resistant strains: The conclusion of this simulation was that masking must be done with aggressive vaccination. The reason is that viral transmission from vaccinated persons gives the virus a chance to mutate.
11 bans on vaccine mandates — What states have them & which might soon: A good summary.
Germany Will Offer Vaccine Booster Shots Starting in September: “As concerns grow over the highly contagious Delta variant of the coronavirus, Germany on Monday became the biggest Western country yet to announce that it will offer vaccine booster shots to a wide range of people considered potentially vulnerable, adding to growing momentum in rich nations to give additional shots to fully vaccinated people.
The move by Germany came even as a top European Union official criticized the bloc as falling far short of its promises to donate vaccine doses to Africa and Latin America. And with a limited global vaccine supply, health experts say the top priorities should be distributing doses to poor countries that lag far behind in inoculations, and persuading vaccine-resistant people in wealthy countries to get their first shots.”
Insurer filings suggest COVID-19 pandemic will not drive health spending in 2022: “Of the 75 insurer filings submitted in these states [13 states and DC], only 13 say the COVID-19 pandemic will have an upward effect on their costs, with most of those stating that the impact would be less than 1%. This includes seven plans in New York, three plans in Connecticut, one plan in Tennessee, one plan in Michigan, and one plan in Vermont. Three insurer filings said the pandemic would have a downward impact on their costs. About half (37 insurers) say the pandemic will have no net impact on their 2022 costs. The remaining insurers either did not specify a COVID-19 cost impact or redacted it.
Among the 13 plans that specified cost increases due to COVID, reasons included costs related to ongoing COVID-19 testing, treatment, and vaccinations (8 insurer filings), and anticipated vaccination boosters (7 insurer filings).”
Eli Lilly's COVID-19 antibody sales crater as variants, vaccines take a toll: “Lilly’s COVID-19 antibodies raked in $148.9 million during the quarter, an 82% drop from the $810.1 million the drugs generated during the first quarter this year. That includes sales of bamlanivimab, plus Lilly’s combo treatment that pairs that drug with etesevimab.
Neither of Lilly’s treatments, however, are being deployed in the U.S. amid the rapid rise of variants. In early April, the FDA revoked its authorization for bamlanivimab alone after the mutations proved resistant to the solo treatment.”
About healthcare IT
4.5 million affected by data breaches in July: 10 hospitals hit: Why people don’t trust the healthcare system to keep records safe: “In July, 4,584,411 patients and employees across 39 healthcare organizations were hit by data breaches.”
A COVID-19 Telehealth Impact Study—Exploring One Year of Telehealth Experimentation: A good of telehealth utilization, reasons for use and satisfaction through December 2020. The standout is use of behavioral health.
Modernizing Public Health Data SystemsLessons From the Health Information Technology for Economic and Clinical Health (HITECH) Act: Some recommendations from Google- worth a quick read.
About hospitals and health systems
CMS finalizes $2.3B pay bump for hospitals in federal fiscal 2022: “The Biden administration has finalized a rule that gives hospitals an overall $2.3 billion for the 2022 fiscal year that begins in October and scraps a proposal for hospitals to disclose Medicare Advantage rates.
The final Hospital Inpatient Prospective Payment Services rule, released Monday by the Centers for Medicare & Medicaid Services (CMS), also includes a 1.1% hike for long-term care hospitals. The regulation also extends an add-on payment for new COVID-19 treatments through the end of the fiscal year where the public health emergency ends and requires hospitals to submit data on several public health measures to identify emerging outbreaks.”
Three notices of system sales:
HCA sells 4 hospitals to Piedmont
Ascension sells 7 Wisconsin hospitals, 21 clinics
Tenet sells 5 Florida hospitals
National Hospital Flash Report: Monthly report from KauffmanHall. Read the repot for details. Overall: “While overall metrics indicate continued recovery for hospitals and health systems nationwide, the uptick in COVID-19 cases could hinder progress in the coming months.”
About pharma
Quantifying The Economic Burden Of Drug Utilization Management On Payers, Manufacturers, Physicians, And Patients: “Based on a compilation and analysis of the existing peer-reviewed and professional literature, this article estimates that payers, manufacturers, physicians, and patients together incur approximately $93.3 billion in costs annually on implementing, contesting, and navigating utilization management. Payers spend approximately $6.0 billion annually administering drug utilization management, and manufacturers spend approximately $24.8 billion supporting patient access in response. Physicians devote approximately $26.7 billion in time spent navigating utilization management, whereas patients spend approximately $35.8 billion annually in drug cost sharing, even after taking advantage of manufacturer and philanthropic sources of financial support.”
Sanofi to buy partner Translate Bio for $3.2bn in mRNA push: “French pharmaceutical group Sanofi will acquire its partner Translate Bio for $3.2bn, as it makes a big bet on the future of messenger RNA as a transformative technology for vaccines and therapeutics.”