About Covid-19
CDC changes approach to covid: Most Americans can go without masks: “The Centers for Disease Control and Prevention eased mask recommendations for the vast majority of the country Friday under a new framework to monitor coronavirus that immediately affects about 70 percent of Americans — a process that state and local officials had already begun amid demands for a return to normalcy…
Under the new approach, many parts of the country that were previously considered to have high or substantial levels of the virus are now reclassified as having low to medium levels of covid-19 disease. CDC recommends mask-wearing for indoor public settings, including schools, only in communities with high levels of disease.”
How many people died believing vaccine misinformation?: “In a just-published nationwide survey of 18,782 people across all 50 states and the District of Columbia, the Covid States Project asked about four vaccine misinformation claims, asking respondents whether they were “true” or “false” or if a respondent was “not sure.” Five percent said they thought that vaccines contained microchips; 7 percent said vaccines used aborted fetal cells; 8 percent said the vaccines could alter human DNA; and 10 percent were concerned that vaccines could cause infertility. Forty-six percent were uncertain about the veracity of at least one of the four false statements…
Misinformation about vaccines has a direct correlation with whether people get immunized. The survey showed that among those who did not believe any of the false statements, 80 percent said they were already vaccinated. In the group that thought multiple false statements were true, 60 percent were hesitant to get the shot.”
Moderna projects $19 billion in Spikevax sales this year: “During its earnings call on Thursday, Moderna said it generated $17.7 billion from its coronavirus vaccine Spikevax in 2021, through sales of 807 million doses worldwide. For this year, the company says it has signed $19 billion worth of orders for its vaccine, up from $18.5 billion announced in January. However, options for 2022 orders were revised downward to $3 billion, roughly $500 million less than what it had previously projected, amid fading pandemic concerns.”
EMA recommends authorisation of booster doses of Comirnaty from 12 years of age: “EMA's human medicines committee (CHMP) has recommended that a booster dose of the COVID-19 vaccine Comirnaty may be given where appropriate to adolescents from 12 years of age. Comirnaty is already authorised in the EU as a 2-dose primary course in adolescents1 (as well as adults and children from 5 years of age) and a booster dose is currently authorised from 18 years of age.
The CHMP opinion follows an evaluation of interim safety and efficacy data from a clinical trial of a booster dose of the vaccine in those aged 16 and over, together with published literature and post authorisation data plus real-world evidence from the use of booster doses in young recipients in Israel.”
Florida governor issues new COVID-19 guidance to 'buck CDC': “Florida Gov. Ron DeSantis and Florida Surgeon General Joseph Ladapo, MD, updated the state's COVID-19 guidance Feb. 24, which shortens isolation periods, advises against masks in community settings and grants healthcare practitioners flexibility to treat patients with emerging and off-label drugs for the virus.”
About health insurance
Medicare Advantage plans gain record hold on the market in 2021, study says: “Medicare Advantage corporations added 2.3 million enrollees in 2021, with 1.3 million of these people switching from conventional, fee-for-service Medicare, in accordance with a report launched on Thursday by The Chartis Group. At least half of the eligible inhabitants in 11 states are actually enrolled in Medicare Advantage plans, up from three states final yr, the report stated…
Forty-five % of all beneficiaries—or 28 million people—are actually enrolled in Medicare Advantage plans.”
CMS overhauls Direct Contracting model to include new requirements on governance, health equity in 2023: “The Centers for Medicare and Medicaid Services announced Thursday that the professional and global Direct Contracting model will transition in 2023 to the Accountable Care Organization Realizing Equity, Access and Community Health (REACH) Model. In addition, the geographic Direct Contracting model on pause since March 2021 will be eliminated immediately.”
The changes are summarized here: CMS gives ACO model a makeover: 7 things to know: “The ACO REACH model has three main principles. The first is to improve health equity and bring the benefits of accountable care to underserved areas. CMS will do this through better support care delivery and will require model participants to create a health equity plan to be implemented in underserved communities.
The second principle is to promote provider leadership and governance, which will make sure doctors and healthcare providers play a vital role in accountable care, according to CMS. At least 75 percent of each ACO is to be controlled by participating providers and their designated representatives; the Global and Professional Direct Contracting model only required 25 percent. It also requires at least two beneficiary advocates on the governing board, with one being a Medicare beneficiary and one a consumer advocate.
The third principle is to protect beneficiaries and the model through more participant vetting, monitoring and transparency. More information on applicants' ownership, leadership and governing board will be required. There will be more up-ront screening of applicants, monitoring of participants and more transparency while the model is implemented. There will also be stricter protections against incorrect coding and risk score growth.”
The CMS Fact Sheet is here: Accountable Care Organization (ACO) Realizing Equity, Access, and Community Health (REACH) Model
Trends in Disenrollment and Reenrollment Within US Commercial Health Insurance Plans, 2006-2018: “In this longitudinal cohort study of 3 018 633 individuals, approximately 1 in 5 members disenrolled from a commercial insurer each year; however, among departing enrollees, approximately 1 in 3 returned to the insurer within 5 years.
Meaning The findings of this study suggest that insurers can benefit from investing in members’ long-term health outcomes despite substantial short-term turnover rates.”
Other states keep watchful eye on snags in Washington’s pioneering public-option plan: “Washington state, in its second year of offering the nation’s first public-option health insurance plan, has learned an important lesson: If you want hospitals to participate, you’re probably going to have to force them.
The Washington public option is more of a public-private partnership: The plan was designed by the state but is offered by private insurance companies. Anyone buying their own policy on the state’s health insurance marketplace can sign up for a public-option plan and, depending on their income, may receive significant subsidies from the federal government to lower its cost. But two years in, the plans are available in only 25 of the state’s 39 counties, enrollment numbers have been underwhelming, and state leaders blame hospitals.”
UnitedHealth Unit Pays $5.8M To End Mass. Drug Price Probe: “A UnitedHealth Group subsidiary will pay $5.8 million to settle allegations that it overcharged Massachusetts employees for prescriptions under the state's workers' compensation program, the state's attorney general said Thursday.”
Physician pays over half million to settle allegations concerning ultrasound billing: “A 41-year-old primary care doctor has paid $504,588.40 to resolve allegations that he billed for excessive ultrasounds, announced U.S. Attorney Jennifer B. Lowery.
Dr. Jose Escandon operates in Mission [Texas]. From Aug. 1, 2014, to Oct. 31, 2018, Escandon violated the False Claims Act by causing the submission of claims to Medicare for ultrasounds that were medically unnecessary or unreasonable.
This investigation arose out of a proactive review of claims data showing Escandon was a significant statistical outlier for ultrasound claims.”
About hospitals and healthcare systems
Organ transplants reached their peak in 2021. Here are the busiest hospitals and common donor types: “During the start of the COVID-19 pandemic, organ transplants plummeted by half. Though there was an increase in deceased donors in 2020 from the year before, there were fewer living donors, possibly explained by the postponement of elective surgeries.
In 2021, however, the rate recovered and the U.S. reached a record number of transplants, at more than 41,300, though a significant waitlist for organs remains and may grow; experts expect there may grow a significant demand for kidney transplants in the years to come due to COVID…
California currently has the biggest waitlist for organs, with more than 20,500 candidates listed, of whom most (45%) are Hispanic. Texas has the second-biggest waitlist, with nearly 10,000 candidates, most of whom (43%) are also Hispanic. New York follows with the third-biggest waitlist, with more than 8,400 on the list, most of whom are white (34%) and Black (33%).”
About pharma
Judge Backs J&J Talc Bankruptcy, Keeping Cancer Lawsuits Frozen: “A bankruptcy judge allowed Johnson & Johnson to use chapter 11 to drive a settlement of litigation linking its baby powder to cancer, backing a controversial tactic that has helped profitable companies freeze roughly a quarter of a million injury lawsuits.
Judge Michael Kaplan of the U.S. Bankruptcy Court in Trenton, N.J., ruled Friday against personal-injury lawyers who asked to throw out the chapter 11 filing of a J&J subsidiary created last year to move into bankruptcy about 38,000 pending lawsuits over allegedly dangerous talc-based products.”
Johnson & Johnson, three pharma wholesalers finalize $26 billion opioid crisis settlement: “Johnson & Johnson and three major pharmaceutical wholesalers [AmerisourceBergen, Cardinal Health, and McKesson] have finalized nationwide settlements over their role in the opioid crisis, paving the way to distribute $26 billion to numerous state and local governments across the country.
The settlement is the largest so far among many lawsuits filed by communities seeking compensation for the decades-long expenses of coping with the fallout from addiction to opioid painkillers.”
Lilly, Boehringer's Jardiance gets US nod for wider range of heart failure patients: “The FDA said Thursday that it has approved Eli Lilly and Boehringer Ingelheim's Jardiance (empagliflozin) to reduce the risk of cardiovascular (CV) death and hospitalisation for heart failure (HF) in adults, regardless of ejection fraction.”
About the public’s health
Understanding cervical cancer after the age of routine screening: Characteristics of cases, treatment, and survival in the United States: “Highlights:
•Most women >65 years with cervical cancer were diagnosed at stage II or higher (63%), including 23% at Stage IV.
•Nearly 15% of patients weren't treated, which was associated with age > 80, comorbidity scores ≥3, and stage IV disease.
•5-year cancer-specific survival was 50% overall and treatment was associated with higher cancer-specific survival.
•Increasing age and stage at diagnosis were associated with lower cancer-specific survival….
These findings, coupled with the fact that women >65 constitute an increasing proportion of the population, highlight the need to re-evaluate screening and treatment practices in this population to detect cervical cancer at earlier stages and increase survival.”
Strategies to Reduce Low-Value Cardiovascular Care: A Scientific Statement From the American Heart Association: An excellent review of the headline’s topic, but also a great overview of how to approach eliminating low-value care in general. While the entire article is worth reading, a quick read can focus on Tables 1 and 2.
Integrative Prioritization of Causal Genes for Coronary Artery Disease [CAD]: This study highlights the genetic complexity of CAD: “We identified 162 unique candidate causal CAD genes, which exerted their effect from between one and up to 7 disease-relevant tissues/cell types, including the arterial wall, blood, liver, skeletal muscle, adipose, foam cells, and macrophages. When their causal effect was ranked, the top candidate causal CAD genes were CDKN2B (associated with the 9p21.3 risk locus) and PHACTR1; both exerting their causal effect in the arterial wall. A majority of candidate causal genes were represented in cross-tissue gene regulatory co-expression networks that are involved with CAD, with 22/162 being key drivers in those networks.”
Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants: “In conclusion, this study found that being a low meat-eater, fish-eater, or vegetarian was associated with a lower risk of all cancer, which may be a result of dietary factors and/or non-dietary differences in lifestyle such as smoking. Low meat-eaters had a lower risk of colorectal cancer, vegetarian women had a lower risk of postmenopausal breast cancer, and men who were vegetarians or fish-eaters had a lower risk of prostate cancer. BMI was found to potentially mediate or confound the association between vegetarian diets and postmenopausal breast cancer. It is not clear if the other associations are causal or a result of differences in detection between diet groups or unmeasured and residual confounding. Future research assessing cancer risk in cohorts with large number of vegetarians is needed to provide more precise estimates of the associations and to explore other possible mechanisms or explanations for the observed differences.”
About healthcare IT
Hims & Hers 2021 revenue jumps 83% as company expands retail collaborations: Announcements such as this one almost always lead with the rosy revenue data : “Hims & Hers grew its subscriptions by 95% in 2021, reaching 609,000 members as it significantly expanded into new categories and conditions over the past year.
The consumer telehealth and wellness brand's full-year revenue jumped 83% year over year to $272 million compared to $149 million in 2020.”
Then, way down in the article, you get a more meaningful assessment: “The digital health company's losses grew during the fourth quarter to a loss of $31 million compared to a loss $5.2 million a year ago. Hims & Hers' adjusted EBITDA for the quarter was a loss of $7.1 million compared to a loss of $3.1 million for the fourth quarter 2020…
For 2021, the company's adjusted EBITDA was a loss of $30 million compared to a loss of $8 million in 2020. The company had been expecting a loss in the range of $35 million to $37 million.”
Are these announcements honest reporting?
About healthcare personnel
17 'overpaid' healthcare CEOs: You decide: “Despite many CEOs cutting their base salaries last year due to the pandemic, those moves had little effect on overall CEO pay, according to an annual report from the nonprofit shareholder advocacy group As You Sow.”
About health technology
Top 10 Health Technology Hazards for 2022: The annual list from EBRI. FYI, go to its website and check past lists for the evolution of changes in top hazards.
”1. Cybersecurity Attacks Can Disrupt Healthcare Delivery, Impacting Patient Safety
2.Supply Chain Shortfalls Pose Risks to Patient Care
3.Damaged Infusion Pumps Can Cause Medication Errors
4.Inadequate Emergency Stockpiles Could Disrupt Patient Care during a Public Health Emergency
5.Telehealth Workflow and Human Factors Shortcomings Can Cause Poor Outcomes
6.Failure to Adhere to Syringe Pump Best Practices Can Lead to Dangerous Medication Delivery Errors
7.AI-Based Reconstruction Can Distort Images, Threatening Diagnostic Outcomes
8.Poor Duodenoscope Reprocessing Ergonomics and Workflows Put Healthcare Workers and Patients at Risk
9.Disposable Gowns with Insufficient Barrier Protection Put Wearers at Risk
10.Wi-Fi Dropouts and Dead Zones Can Lead to Patient Care Delays, Injuries, and Deaths”