About Covid-19
FDA authorizes a coronavirus booster shot for children as young as 5 “Federal regulators authorized a coronavirus booster shot Tuesday for school-age children, making a third shot of the Pfizer-BioNTech vaccine available to 5-to-11-year-olds as cases rise nationally.
The Food and Drug Administration cleared the booster for use at least five months after children are fully vaccinated with the two-shot primary series.”
US Set to Extend Covid-19 Public Health Emergency Past July “The US government will extend the Covid-19 public-health emergency past mid-July, continuing pandemic-era policies as the nearly 2 1/2-year outbreak drags on…
An HHS spokesperson said the public-health emergency remains in effect, and the department will continue to provide a 60-day notice to states before any possible termination or expiration.”
300,000 US COVID deaths could have been averted through vaccination, analysis finds “Although the national average indicated that approximately 50% of deaths were preventable, researchers said there were large differences among states -- ranging from 25% to 74% vaccine-preventable deaths.”
States Have Yet to Spend Hundreds of Millions of Federal Dollars to Tackle Covid Health Disparities “The Biden administration in March 2021 announced it was investing $2.25 billion to address covid health disparities, the largest federal funding initiative designed specifically to help underserved communities hardest hit by the virus.
Two months later, the Centers for Disease Control and Prevention awarded grants to every state health department and 58 large city and county health agencies. The money is intended to help limit the spread of covid-19 among those most at risk in rural areas and within racial and ethnic minority groups, as well as improve their health…
A year later — with covid having killed 1 million people in the U.S. since the start of the pandemic and hospitalizing millions more — little of the money has been used, according to a KHN review of about a dozen state and county agencies’ grants”
About health insurance
Most Office-Based Physicians Accept New Patients, Including Patients With Medicare and Private Insurance The entire study is worth a read. Characteristics vary by specialty, geography, physician age and practice setting (such as group or solo practice). With that caveat, overall: “Across almost every dimension we examine, the share of physicians accepting new Medicare patients is similar to the share accepting new patients with private insurance, with the only exception being the share of obstetricians and gynecologists accepting new Medicare patients (93%) is somewhat lower than the share accepting new privately-insured patients (99%).”
Private Health Plans During 2020 Paid Hospitals 224 Percent of What Medicare Would Pay From RAND: “The analysis includes facility and professional claims for inpatient and outpatient services provided by both Medicare-certified short-stay hospitals and other facility types. For the first time, the analysis also includes more than 4,000 ambulatory surgical centers, which are free-standing facilities that perform outpatient surgical services.
Data sources include $78.8 billion in spending on hospital-based care and $2.0 billion in spending on care in ambulatory surgery centers…
The study found that the percentages remained relatively stable over the study period. Private insurers paid 222 percent of Medicare prices in 2018 and 235 percent in 2019. In 2020, relative prices for hospital facility–only services averaged 224 percent, while associated professional services such as physician fees averaged 163 percent of what Medicare would have paid for the same services.”
UNLESS CONGRESS ACTS, HEALTH CARE COSTS WILL SOON SKYROCKET FOR PEOPLE WHO BUY THEIR OWN INSURANCE “Overall, 10.3 million people in 33 states use healthcare.gov to buy their own insurance. The Centers for Medicare & Medicaid Services (CMS) has calculated what will happen if ARPA’s improvements to advance premium tax credits disappear in those states. On average, premiums will shoot up by 53%, jumping from $13.7 billion to $20.9 billion – a $7.3 billion hit to family budgets…”
See the chart for a state-by-state breakdown.
Fidelity Releases 2022 Retiree Health Care Cost Estimate: 65-Year-Old Couple Retiring Today Will Need an Average of $315,000 for Medical Expenses “Americans Will Need 7x More Than They Expect to Pay for Health Care Costs in Retirement.
Nearly Half of Health Savings Account (HSA) Owners Feel Prepared for Health Care Expenses in Retirement, Compared to just 27% of Those Without an HSA…
The 2022 estimate for single retirees is $150,000 for men and $165,000 for women. Fidelity’s estimate assumes both members of the couple are enrolled in traditional Medicare, which between Medicare Part A and Part B covers expenses such as hospital stays, doctor visits and services, physical therapy, lab tests and more, and in Medicare Part D…
This year’s estimate is up 5% from 2021 ($300,000) and has nearly doubled from its original $160,000 in 2002.”
Kemp OKs expanded Medicaid coverage for new moms, rejects coverage for HIV An illustration of the dichotomy in healthcare coverage in a Republican-run state: “Low-income moms will be eligible for a year of Medicaid coverage under a bill Gov. Brian Kemp just quietly signed into law.
But the governor caught advocates by surprise when he rejected language and funding in next year’s budget that would have started the process of expanding Medicaid eligibility to cover low-income Georgians living with HIV.”
Justices want solicitor general to weigh in on Medicare 'upcoding' ruling “The U.S. Supreme Court on Monday signaled continued interest in a whistleblower suit involving allegations of systemic exaggeration of Medicare patients’ ailments, asking Solicitor General Elizabeth Prelogar to weigh in on the level of detail required to plead fraud “with particularity” under the False Claims Act.”
Sanders reintroduces single-payer Medicare bill “Sen. Bernie Sanders and 14 other senators introduced the Medicare for All Act of 2022… to create a federally-administered single-payer healthcare system.
Under the bill, the program would be implemented over a four-year period.”
See the article for and copy of the Act for more details. When Congress won’t pass requested Covid-19 funding, is now the time to revisit this issue? It is a best an unneeded distraction.
And in a related article from the CBO: Budgetary Effects of a Policy That Would Lower the Age of Eligibility for Medicare to 60 “CBO and JCT [ Joint Committee on Taxation] that lowering the age of Medicare eligibility to 60 would increase federal budget deficits by $155 billion over the 2026–2031 period through the effects of that policy on federal revenues and mandatory spending.” Read the article and links for more details.
About hospitals and healthcare systems
HOSPITAL OVERUSE DURING COVID-How many older adults were put at risk for unnecessary procedures? From the Lown Institute, hospital-specific lists.
”KEY TAKEAWAYS
From March-December 2020, hospitals delivered more than 100,000 low-value procedures to Medicare beneficiaries; that’s one every four minutes on average.
Of the 100,000 procedures, 45,000 were unnecessary coronary stents and 30,000 were unnecessary back surgeries.
From June to December 2020, with no vaccines available to vulnerable older adults, hospitals delivered low-value services to Medicare patients at rates similar to 2019.
All of the hospitals on the US News Honor Roll ranking had rates of coronary stent overuse higher than the national average in 2020, and four had rates at least twice that.”
COVID-19 and Hospital Financial Viability in the US “The results of this cross-sectional study suggest that although hospitals experienced a sizeable reduction in operating margins in 2020, their overall profit margins remained similar to those in prior years, suggesting that the COVID-19 relief fund effectively offset the financial losses for hospitals during the COVID-19 pandemic. Government, rural, and smaller hospitals, which were supported by some targeted fund allocations, generated higher overall profit margins during 2020 than in prior years.”
Advocate Aurora Health reports $253M net loss, 0.3% operating margin in Q1 2022 “The most recent quarter’s total revenue was a 9.1% increase over the prior year while expenses rose 11% year over year.
The increase in revenue was largely due to a 10.1% bump in patient service revenue, which the system attributed to increased outpatient (6.3%) and physician (6.7%) visits compared to the previous year’s opening quarter.
Total expenses, on the other hand, were dragged by a 13.4% year-over-year rise in salaries, wages and benefits expenses and an 8.4% increase in supplies, purchased services and other expenses.”
About pharma
GlaxoSmithKline is no more: Meet the scaled down 'GSK' “More than two decades ago, Glaxo Wellcome and SmithKline Beecham combined to become GlaxoSmithKline. But as the British Big Pharma looks to slim down its organization with its consumer demerger, its longstanding name is getting the same treatment.
Out with the GlaxoSmithKline moniker and in with the three-letter acronym: GSK. On Monday, the company made the three letters—which have regularly been used by journalists and in conversation to refer to the company—its official name.
This comes as the pharma is looking to spin out its consumer business, to be known as Haleon, which will be the largest London listing of a company in more than 10 years.”
24 states support federal government in 340B drugmaker lawsuit “A collection of 24 states is throwing its support to the federal government in a legal fight with several drugmakers over access to drugs discounted under the 340B program.
The states and the District of Columbia announced in legal filings Monday that the drugmakers’ moves to cut off sales of 340B drugs to contract pharmacies are unlawful…
The states blasted the moves of six drugmakers—Sanofi, United Therapeutics, Eli Lilly, Novartis, Novo Nordisk and AstraZeneca—that started in 2020. The drugmakers cut off sales of 340B drugs to contract pharmacies, which are third parties that dispense drugs on behalf of the 340B-covered entities.”
About the public’s health
America’s Health Rankings From the United Health Foundation, this report presents the healthiest and least health states for seniors. At the top is Utah and at the bottom (by far) is Mississippi.
”The America’s Health Rankings model… includes four drivers, or determinants of health: social and economic factors, physical environment, clinical care and behaviors, all of which influence the fifth model category, health outcomes.”
Look here for an executive summary.
Biden signs law banning infant sleep products blamed for 200 deaths “President Joe Biden on Monday signed into law legislation that prohibits the manufacture and sale of crib bumpers or inclined sleepers blamed for more than 200 infant deaths”
FDA comes to agreement with baby formula factory to resume production “Abbott Nutrition, the maker of Similac and other popular baby formulas, said Monday it has come to an agreement with the Food and Drug Administration to fix safety issues at a Sturgis, Mich., factory that has been shuttered for more than three months, contributing to a nationwide formula shortage.
The agreement represents a first step toward resolving a problem that has sent parents scrambling from store to store to find sustenance for their infants. But questions remain about what precisely the FDA will require of Abbott and the Sturgis facility operations before reopening is approved.”
And in a related story: Nestlé is flying baby formula into America as shortage continues
About healthcare IT
At 10.8% CAGR, Healthcare Information System Market Size to hit USD 579.56 Billion in 2028, Says Brandessence Market Research “The Global Healthcare Information System Market size was Valued at USD 282.70 Billion in 2021…
Services segments will be accounting for the biggest share in the market as there is a lack of knowledge with regard to the IT applications in the professionals of healthcare.”
AI recognition of patient race in medical imaging: a modelling study Fascinating!
”In our study, we show that standard AI deep learning models can be trained to predict race from medical images with high performance across multiple imaging modalities, which was sustained under external validation conditions (x-ray imaging [area under the receiver operating characteristics curve (AUC) range 0·91–0·99], CT chest imaging [0·87–0·96], and mammography [0·81]). We also showed that this detection is not due to proxies or imaging-related surrogate covariates for race (eg, performance of possible confounders: body-mass index [AUC 0·55], disease distribution [0·61], and breast density [0·61]). Finally, we provide evidence to show that the ability of AI deep learning models persisted over all anatomical regions and frequency spectrums of the images, suggesting the efforts to control this behaviour when it is undesirable will be challenging and demand further study.”
About health technology
FDA Authorizes First DTC Covid-19, Flu, RSV Combination Test “The FDA said it has authorized Labcorp’s combination Covid-19, flu, and RSV test for direct-to-consumer use, the first such test to be accessible without a prescription.”