About health insurance
Drivers of 2022 Health Insurance Premium Changes: This monograph from the American Academy of Actuaries is a very thoughtful consideration of the complex factors that could influence healthcare costs (and hence premiums) in the next year. At minimum, read the Summary, which explains these potential factors.
Centene to consolidate its Medicare Advantage plan branding under Wellcare: “Centene is consolidating all of its Medicare Advantage (MA) brands under the Wellcare name, the government insurance giant announcedThursday.
Centene closed its acquisition of Wellcare Health Plans in January 2020, which led to a slew of disparate MA brands across 33 states, the company said. The $17 billion deal created one of country's largest sponsors of government insurance.”
MedPAC considers one-time funding boosts for Medicare in 2023 due to COVID-19 confusion: “A key Medicare advisory panel is debating one-time funding boosts to providers for 2023 due to questions on how COVID-19 has permanently impacted the healthcare industry.”
However, as previously reported in the past few days: Tens of billions of dollars in pandemic aid for hospitals and nursing homes not distributed and FAH calls for Congress to delay $36B in Medicare cuts set to go into effect in October. Is anyone in charge to coordinate these activities?
Florida Blue parent GuideWell to acquire Puerto Rico-based Triple-S Management: “GuideWell, the parent company of Blue Cross and Blue Shield of Florida, will acquire Triple-S Management, a health services firm based in Puerto Rico.
Once the deal is finalized, Triple-S will operate as a GuideWell subsidiary under its current branding, according to an announcement.”
United States Files Suit Against UPMC, Its Physician Practice Group, and the Chair of Its Department of Cardiothoracic Surgery for Violating the False Claims Act: “More specifically, the complaint alleges that Dr. Luketich – the longtime chair of UPMC’s Department of Cardiothoracic Surgery – regularly performs as many as three, complex surgical procedures at the same time, fails to participate in all of the “key and critical” portions of his surgeries, and forces his patients to endure hours of medically unnecessary anesthesia time, as he moves between operating rooms and attends to other patients or matters. According to the United States’ complaint, these practices violate the statutes and regulations governing the defendants, including those that prohibit “teaching physicians” (like Dr. Luketich) from performing and billing the United States for “concurrent surgeries.” As importantly, the United States’ complaint alleges that Dr. Luketich’s practices violate the standard of care and the patients’ trust, and heighten the risk of serious complications.”
Association of Cost Sharing With Delayed and Complicated Presentation of Acute Appendicitis or Diverticulitis: Out-of-pocket payments decrease utilization of health services.
However, they also discourage needed care. How much should these payments be and for what conditions?
We still do not have an answer. “In this cohort study of 151 852 patients, higher patient cost sharing was associated with lower odds of presenting with early, uncomplicated disease, receiving optimal surgical care, and receiving minimally invasive surgery.”
About Covid-19
The impact of coronavirus disease 2019 (COVID-19) on healthcare-associated infections [HAIs] in 2020: A summary of data reported to the National Healthcare Safety Network: “This report provides a national view of the increases in HAI incidence in 2020. These data highlight the need to return to conventional infection prevention and control practices and build resiliency in these programs to withstand future pandemics.”
White House Announces $2.7 Billion to Boost Vaccine Production: “The U.S. government will allocate $2.7 billion to expand vaccine manufacturing, though it’s not yet clear which companies will receive the funds, President Joe Biden’s Covid response team announced Thursday.
The money will be used to increase production of ingredients and supplies used to make vaccines. It will support the manufacturing of raw materials, vials and syringes, as well as the bottling process known as fill-finish, according to an official familiar with the plan.”
Rapid measurement of SARS-CoV-2 spike T cells in whole blood from vaccinated and naturally infected individuals: This study is extremely important in understanding Covid-19 immunity:
”Using this test, we observed a similar mean magnitude of T cell responses between the vaccinees and SARS-CoV-2 convalescents 3 months after vaccination or virus priming. However, a wide heterogeneity of the magnitude of spike-specific T cell responses characterized the individual responses, irrespective of the time of analysis. The magnitude of these spike-specific T cell responses cannot be predicted from the neutralizing antibody levels. Hence, both humoral and cellular spike–specific immunity should be tested after vaccination to define the correlates of protection necessary to evaluate current vaccine strategies.”[Emphasis added]
About the public’s health
Projected Association of Human Papillomavirus Vaccination With Oropharynx Cancer Incidence in the US, 2020-2045: “These results suggest that it will take more than 25 additional years to slow an increasing incidence of OPC by current HPV vaccination rates because most disease will be among older individuals who have not yet been vaccinated.”
Characteristics of Registered Clinical Trials Evaluating the Role of e-Cigarettes in Cessation or Reduction of Cigarette Smoking: “We identified 66 completed and ongoing registered trials examining the effects of e-cigarettes on smoking cessation or reduction. Completed and ongoing trials had similar characteristics, with modest sample sizes and duration, most lacking behavioral support to quit, and very few testing newer e-cigarette devices that are designed to deliver nicotine more similarly to cigarettes. Moreover, ongoing trials were less likely to evaluate outcomes at 6 months, which is a standard outcome used in meta-analyses. These findings support previously identified limitations of e-cigarette trials and highlight how ongoing studies may not address critical evidence gaps.”
Antibiotics Use and Subsequent Risk of Colorectal Cancer: A Swedish Nationwide Population-Based Study: This link is to the academic paper results summarized yesterday.
”This register-based study covering the entire population of Sweden found a robust association between antibiotics use and higher risk of proximal colon cancer and an inverse association with rectal cancer in women. This study strengthens the evidence from previous investigations and adds important insight into site-specific colorectal carcinogenesis.”
Cardiovascular Benefit of Lowering LDL Cholesterol Below 40 mg/dl: A lower limit target for LDL has been controversial. This prepublication article concluded that “these data support the ESC/EAS [European Society of Cardiology/European Atherosclerosis Society] recommendations and suggest that lowering LDL-C well below 40 mg/dl in a wider range of patients with ASCVD would further lower cardiovascular risk.”
Nomura bans smoking even for those working from home: “Nomura, Japan’s biggest brokerage, has split from the rest of the finance sector by asking its local staff to give up smoking during the working day, although Japan Tobacco said the move would not push it to change its longstanding business ties. The initiative has been privately described by some Nomura employees as ‘intrusive’ even though it has been imposed without a formal monitoring system or punishments for rule-breakers. It applies both to office staff and to the more than 50 per cent of staff in Japan working from home.”
Wonder how the company will enforce the at-home smoking ban.
About pharma
Sobi receives $8.1-billion buyout offer: “Swedish Orphan Biovitrum (Sobi) said Thursday that it received a takeover offer from private equity firm Advent International and Aurora Investment of SEK 235 ($27.40) per share in cash, valuing the drugmaker at approximately SEK 69.4 billion ($8.1 billion). Sobi added that its board unanimously recommended that shareholders accept the bid, which represents a premium of around 34.5% to its closing share price on August 25…
However, Handelsbanken analyst Mattias Haggblom said the proposal from Advent and Aurora was low, with shares in Sobi climbing above the offer price on Thursday to around SEK 244 ($28.35), spurring speculation that another bidder could emerge.”