About Covid-19
CDC panel skeptical of fourth Covid shots for broader population, says U.S. needs clear vaccine strategy “The CDC’s panel of independent vaccine experts signaled an unwillingness to endorse fourth Covid shots for the broader U.S. population until the agency adopts a clear strategy.
The group, in a five-hour meeting Wednesday, largely agreed that repeatedly deploying boosters to prevent infection isn’t a realistic goal with the current generation of shots.”
Philly ends mask mandate and nixes response levels; Kenney said SEPTA’s move influenced the decision “Mayor Jim Kenney said the decision to scrap the mandate after just a few days was influenced in part by SEPTA’s announcement on Monday that masks would no longer be required on public transit.
SEPTA lifted its mandate shortly after a federal judge in Florida struck down the CDC’s rule requiring masks on most forms of transit.”
About health insurance
Dozens of Hospitals Sue HHS Over Medicare Billing “On Wednesday a case was filed in the Central District of California by the Cleveland Clinic, Paradise Valley Hospital, and over 125 other hospitals against Xavier Becerra as Secretary of Health and Human Services. The case is regarding the calculation of payments owed under Medicare Part A bills and the Disproportionate Share Hospital (DSH) payment adjustment.
The complaint explained that one of the factors included in the DSH payment adjustment calculation is the number of ‘days entitled to benefits under part A.’
This particular factor comes into play on the “denominator” side of the calculation and on the “numerator” side of the calculation of the disproportionate patient percentage . However, the plaintiffs in the case accuse HHS and Medicare of using different definitions for ‘entitled’ depending on which side of the fraction is being reviewed, resulting in a lower payment to the hospital than would otherwise be calculated.”
KLAS: Hospitals say price transparency remains too confusing and pricey to implement “KLAS spoke with 66 revenue cycle leaders to get a sense of how hospitals feel about the shift towards price transparency and the nuts and bolts of implementing the rule more than a year after its compliance deadline…
Among those surveyed, 52% said that the rule requires a significant number of resources to comply while 40% put resource requirements at a moderate level and 8% at a small number.
Many of the respondents lashed out at two parts of the rule: the requirement that facilities use machine-readable files for the pricing information and that they put online a master list of rates.
Respondents cited problems with ‘software used to publish the pricing information. Some say the published rates mainly benefit payer and provider organizations instead of patients.’”
About hospitals and healthcare systems
Rural hospitals have been particularly challenged during the Covid-19 pandemic. Below are two papers explaining the problems they face:
Pandemic Increases Pressure on Rural Hospitals & Communities and
THE IMPACT OF THE PANDEMIC ON RURAL HOSPITALS
HCA's profit dips to $1.2B as labor costs rise “The 182-hospital system reported revenues of $14.95 billion in the first quarter of this year, up from $13.98 billion in the same period of 2021. The for-profit hospital operator said same-facility admissions, emergency room visits and inpatient and outpatient surgeries increased year over year.
HCA reported higher expenses. Salaries and benefits climbed 10.1 percent year over year to $6.94 billion. Supplies expenses were $2.32 billion, up 4.4 percent from the same quarter of 2021. “
About pharma
Spending on U.S. Medicines Rose 12% in 2021 Due to COVID-19 Vaccines and Therapies, Says IQVIA Institute for Human Data Science “Spending on medicines in the United States, at estimated net manufacturer prices, reached $407 billion in 2021, up 12% over 2020, as COVID-19 vaccines and therapeutics became widely available and added $29 billion in related spending…In the same year, the non-COVID medicines market grew more slowly, at 5%, from the growing impact of biosimilars, which increased significantly, offsetting increased use of branded medicines.
Patient out-of-pocket (OOP) costs in aggregate rose $4 billion, or 5.3%, in 2021 to a total of $79 billion, back to the level seen in 2018 after two years of declining costs. Those OOP costs remain a significant burden for a relatively small part of the population, even as average costs per prescription were flat or slightly declining.”
As US launch falters, Biogen ditches Aduhelm application in Europe “Biogen has scrapped its filing for the Alzheimer’s disease drug in the European Union after talks with regulators made it clear the data provided so far are unlikely to support marketing approval, the company said Friday.”
About the public’s health
What's the State of YOUR Air? Annual American Lung Association report on air quality, by county. Enter your zip code to get local information.
Study finds disparities in improper antibiotic prescribing “The analysis found that 11.3% of visits included a prescription for an oral antibiotic, with patients under 18 years (114.1 prescriptions per 1,000 patient visits), Black patients (122.2/1,000 patient visits), Hispanics (138.6/1,000 patient visits), and women (169.6/1,000 patient visits) having the highest antibiotic prescribing rates.
When the researchers broke down the data on inappropriate prescribing, they found that nearly three quarters of the antibiotic prescriptions (73.9%) written for patients 65 and older were inappropriate. They also found high rates of inappropriate antibiotic prescribing for Black patients (63.8%), Hispanic patients (57.5%), and men (57.7%).
The most common reasons for inappropriate antibiotic prescriptions were non-bacterial skin conditions, viral respiratory tract infections, and bronchitis.”
Effects of mango and mint pod-based e-cigarette aerosol inhalation on inflammatory states of the brain, lung, heart, and colon in mice “Our findings suggest that daily e-cigarette use may cause neuroinflammation, which may contribute to behavioral changes and mood disorders. In addition, e-cigarette use may cause gut inflammation, which has been tied to poor systemic health, and cardiac inflammation, which leads to cardiovascular disease.”
Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons New draft recommendation: “The USPSTF recommends against the use of combined estrogen and progestin for the primary prevention of chronic conditions in postmenopausal persons.” and
”The USPSTF recommends against the use of estrogen alone for the primary prevention of chronic conditions in postmenopausal persons who have had a hysterectomy.”
This document is available for Public Comments until May 16, 2022.
How Discrimination in Health Care Affects Older Americans, and What Health Systems and Providers Can Do From The Commonwealth Fund:
Highlights
“Older adults in the United States are more likely to report racial and ethnic discrimination in the health system exists, compared with their peers in 10 other high-income countries.
In the U.S., one in four Black and Latinx/Hispanic adults age 60 and older reported that they have been treated unfairly or have felt that their health concerns were not taken seriously by health professionals because of their racial or ethnic background.
More than a quarter of U.S. older adults said they did not get the care or treatment they felt they needed because of discrimination.
U.S. older adults who have experienced discrimination in a health care setting were more likely to have worse health status, face economic hardships, and be more dissatisfied with their care than those who did not experience discrimination.”
About healthcare IT
RCM company suffers 3rd-largest health data breach of 2022 “Adaptive Health Integrations, a Williston, N.D.-based company providing healthcare billing services, suffered a breach in October that exposed510,574 individuals' data.
The incident is the third-largest healthcare data breach to occur in 2022, according to HHS' reporting portal.”
Physician Indicted in $10 Million Telemedicine Health Care Fraud Scheme “According to the indictment, Dr. Raffai purported to practice telemedicine with the AffordADoc Network and other telemedicine companies that paid the defendant for each consultation with a beneficiary. Between July 2016 and June 2017, Dr. Raffai allegedly participated in a health care fraud scheme in which he signed prescriptions and order forms via purported telemedicine services for durable medical equipment (DME), including orthotic braces, that were not medically necessary. Dr. Raffai caused the submission of these claims based solely on a short telephone conversation for beneficiaries he had not physically examined and evaluated, and that were induced, in part, by the payments of bribes and kickbacks. Dr. Raffai was paid by telemedicine companies approximately $25 or $30 per patient consultation. The indictment further alleges that Dr. Raffai, together with others, submitted or caused the submission of approximately $10 million in false and fraudulent claims to Medicare for DME on behalf of beneficiaries who were residents of the Eastern District of New York, and Medicare paid more than $4 million on those claims.”
About healthcare personnel
PAI-Avalere Health Report on Trends in Physician Employment and Acquisitions of Medical Practices: 2019-2021 Key Findings:
“Nearly 3 of 4 physicians are now employed by hospitals, health systems and other corporate entities such as private equity firms and health insurers.
More than one hundred thousand (108,700) physicians shifted to employment since January 2019. This growth split nearly evenly between hospital employees (58,200 additional physician employees) and other corporate entities (50,500 additional physician employees).
Of those, 83,000 physicians (76%) became employees since the pandemic began.
2021 alone saw a marked increase in employed physicians, growing by 19%, from 69.3% to 73.9% of all physicians.”
About health technology
Intuitive Surgical pulls off 15% revenue growth despite ongoing COVID, supply chain challenges “…Intuitive Surgical was able to kick off the year with a modest win, putting up first-quarter revenues of $1.49 billion—a 15% jump compared to the $1.29 billion it earned in the same period of last year, but a minor slip from the $1.55 billion it raked in during the prior quarter, the final three months of 2021.
The year-over-year growth stemmed from a 19% surge in the number of procedures performed around the world using Intuitive’s da Vinci robotic surgery system. Those additional uses were led by ‘bariatric procedures, cholecystectomy, hernia repair and rectal surgery”’in the U.S., CEO Gary Guthart said during a call with investors on Thursday.”