About Covid-19
Covid deaths no longer overwhelmingly among unvaccinated as toll on elderly grows “Unvaccinated people accounted for the overwhelming majority of deaths in the United States throughout much of the coronavirus pandemic. But that has changed in recent months, according to a Washington Post analysis of state and federal data…
The vaccinated made up 42 percent of fatalities in January and February during the highly contagious omicron variant’s surge, compared with 23 percent of the dead in September, the peak of the delta wave, according to nationwide data from the Centers for Disease Control and Prevention…
As a group, the unvaccinated remain far more vulnerable to the worst consequences of infection — and are far more likely to die — than people who are vaccinated, and they are especially more at risk than people who have received a booster shot.”
Comparison of Home Antigen Testing With RT-PCR and Viral Culture During the Course of SARS-CoV-2 Infection “Findings In this prospective cohort study of 225 adults and children with reverse transcription–polymerase chain reaction (RT-PCR)–confirmed SARS-CoV-2 infection, antigen test sensitivity was 64% and 84% when compared with same-day RT-PCR and viral culture, respectively. Antigen test sensitivity peaked 4 days after illness onset (77%); a second test 1 to 2 days later showed improved sensitivity (81%-85%).
Meaning The study results suggest that symptomatic individuals with an initial negative home antigen test result for SARS-CoV-2 infection should test again 1 to 2 days later because test sensitivity seems to peak several days after illness onset.”
Vaccines for young kids could be available in June, FDA official says “The remarks by Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, came in an interview about the agency’s new, but tentative, timeline for handling vaccine issues during the next two months. The FDA announced plans to convene meetings with its outside advisers on June 8, 21 and 22 to consider emergency use authorizations for pediatric coronavirus shots and to hold additional sessions for other pressing vaccine matters.”
About health insurance
Racial and Ethnic Disparities in Insurance Coverage Among US Adults Aged 60 to 64 Years “…the coverage disparity between low-income Hispanic adults and low-income White adults was 11.4 percentage points larger in [Medicaid] nonexpansion states vs expansion states (95% CI, 3.2-19.5 percentage points; P = .007). We did not detect significant Black-White coverage disparities in expansion or nonexpansion states.”
Doctor Sentenced in $12 Million Medicare Fraud and Device Adulteration Scheme “A California doctor was sentenced today to 93 months in prison for defrauding Medicare, re-packaging single-use catheters for re-use on patients, and submitting false declarations in a bankruptcy proceeding.
According to court documents, Donald Woo Lee, 55, of Temecula, recruited Medicare beneficiaries to his clinics, falsely diagnosed the beneficiaries, and provided the beneficiaries with medically unnecessary procedures. Lee billed these unnecessary procedures to Medicare using an inappropriate code in order to obtain a higher reimbursement, a practice known as ‘upcoding.’”
UK healthcare is already being privatised, but not in the way you think Among the findings: “In 1990, out-of-pocket spending by Britons on medical expenses was equivalent to 1 per cent of GDP, while across the Atlantic, uninsured Americans forked out more than twice as much, at 2.2 per cent. Thirty years on, that gap has all but disappeared. Americans’ non-reimbursable spending now stands at 1.9 per cent, and Britons’ has doubled to 1.8 per cent.”
The delays in care from the NHS have forced many to seek fee-for-service private care.
Employers to tackle employee healthcare affordability amid rising costs “The vast majority of U.S. employers (94%) say managing healthcare benefit costs will be their top priority over the next two years, followed by enhancing mental health benefits (87%), according to a new survey by WTW (Willis Towers Watson)…
When asked what their greatest challenges will be to effectively deliver on their healthcare strategy over the next two years, 73% cited increasing healthcare prices due to rising inflation and provider consolidation. More than half (54%) identified lack of employee awareness about where to find programs to support their needs as a key challenge.”
About hospitals and healthcare systems
Association Between Hospital Private Equity Acquisition and Outcomes of Acute Medical Conditions Among Medicare Beneficiaries “In this cross-sectional study of more than 21 million Medicare beneficiaries with 5 different acute medical conditions who were hospitalized at short-term acute care hospitals, PE acquisition was associated with significantly lower inpatient mortality (−1.1 percentage points) and lower 30-day mortality (−1.4 percentage points) among patients admitted with acute myocardial infarction. However, PE acquisition was not associated with significant differences in other dimensions of quality and spending or with differences across other medical conditions.”
19 Tenet hospitals sue Cigna over alleged low reimbursement rates, denied claims “Tenet Healthcare and 19 of its hospitals are accusing Cigna of reimbursing claims at low rates and wrongfully denying claims for emergency care in a lawsuit…
Nineteen hospitals managed by Tenet across Arizona, Florida, Tennessee, Alabama, South Carolina and Massachusetts allege Cigna engaged in ‘an ongoing pattern of financial misconduct.’
The hospitals allege Cigna created ‘narrow’ networks — which Tenet is not part of — to maximize the discounts it receives from the limited number of hospitals participating in those networks, thereby creating the risk of members seeking care at out-of-network emergency departments that have not agreed to offer discounted rates. The lawsuit claims Cigna forced Tenet hospitals to treat members at artificially low rates by reimbursing the hospitals at rates they did not agree to.
The lawsuit also claims Cigna ‘arbitrarily denied numerous claims for emergency medical services.’”
HCA agrees to acquire urgent care chain “Nashville, Tenn.-based HCA Healthcare signed an agreement to acquire Richmond, Va.-based BetterMed, an urgent care practice with 12 locations, Tim McManus, president of HCA Healthcare Capital Division…
The deal is not final, he added. The HCA Healthcare Capital Division has locations in Indiana, Kentucky, New Hampshire and Virginia…”
SSM Health, Saint Louis University Collaborate to Form the Region’s Leading Fully Integrated Healthcare Delivery Network SLU press release: “Under a new agreement reached in principle, the two organizations will formally bring together the world-class academic medical expertise of SLUCare Physician Group with SSM Health’s high-quality community-based care model to create the region’s leading integrated healthcare network. Ownership of SLUCare Physician Group will transition from Saint Louis University to SSM Health when the transaction closes. The agreement is expected to be finalized later this summer, pending all regulatory and other approvals.”
Memorial Sloan Kettering reports operating loss of $13.5M “New York City-based Memorial Sloan Kettering Cancer Center's operating loss narrowed to $13.5 million in the three months ended March 31, compared to a loss of $33 million in the same period last year, according to its financial results released April 25.
The organization, which has locations in New York and New Jersey, reported a total operating revenue of $1.6 billion in the first quarter of 2022, a 10.3 percent increase from the same period last year at $1.5 billion.
Its expenses reached $1.6 billion for the first quarter of 2022, an 8.7 percent increase year over year from $1.5 billion. Its compensation and fringe benefits also rose by 7.2 percent year over year, from $824 million in the first quarter of 2021, to $882.9 million in the first quarter of 2022.”
Keep in mind that MSK is one of the named cancer hospitals exempt from DRGs and often does not negotiate rates with private payers.
About pharma
Ex-Cerebral executive files lawsuit claiming the startup overprescribed ADHD meds “The lawsuit, filed Wednesday in California state court, alleges that Cerebral planned to increase customer retention by prescribing stimulants to 100% of its ADHD patients.”
See the related story in yesterday’s blog about Walmart and CVS blocking prescriptions from this and other similar companies.
Latest pharma financial reports
Lilly bumps up annual sales guidance as Trulicity revenue climbs 20% in Q1
Merck & Co. raises annual guidance as COVID-19 drug sales top $3 billion in Q1
Gilead's Q1 sales edge past estimates lifted by Biktarvy, Veklury
Novo Nordisk hikes full-year forecast after Q1 sales climb 24%
AstraZeneca backs annual guidance as Farxiga sales reach $1 billion in Q1
About the public’s health
U.S. Case of Human Avian Influenza A(H5) Virus Reported “A person has tested positive for avian influenza A(H5) virus (H5 bird flu) in the U.S., as reported by Colorado and confirmed by CDC. This case occurred in a person who had direct exposure to poultry and was involved in the culling (depopulating) of poultry with presumptive H5N1 bird flu.”
About healthcare IT
Walmart Health rolls out virtual diabetes program as retail giant moves deeper into treating chronic conditions “Building on its acquisition of telehealth provider MeMD last year, Walmart Health is rolling out a virtual care diabetes program for employers and payers.”
About health technology
Baxter's revenue climbs with acquisition of Hillrom “Medical products giant Baxter International reported rising revenue in the first quarter coming on the heels of its acquisition of Hillrom.
Deerfield-based Baxter saw revenue grow 26% to $3.7 billion in the first quarter, the company announced in an earnings call today. U.S. sales totaled $1.76 billion, a nearly 50% increase from the same period a year earlier, with international sales increasing 10% to $1.95 billion. Net income was $71 million.”