About Covid-19
World Health Organization releases latest set of COVID-19 guidelines “The guidelines include advice on treatments, isolation periods and wearing masks.”
These recommendations are worth reading.
About healthcare quality
High-Volume Orthopedic Surgeons Generate Better Outcomes at Lower Costs Not new qualitative information, but there are some quantitative findings that are interesting. For example, look at the graphics for differences between sites of treatment.
About health insurance/insurers
Record High in U.S. Put Off Medical Care Due to Cost in 2022 “STORY HIGHLIGHTS
38% say they put off treatment, up 12 percentage points from 2021
27% say medical treatment was for a very or somewhat serious condition
Lower-income, younger adults, women most likely to report delaying care
Medicare Advantage enrollment hits record 30 million “Over 30 million people are now enrolled in Medicare Advantage plans, according to CMS data released Jan. 17.
Total enrollment reflects the Jan. 1 payment date, and payments reflect accepted enrollments through Dec. 2, 2022.
The record enrollment marks a significant milestone for the public-private program. In 2022, 28.4 million people were enrolled in MA out of 58.6 million Medicare beneficiaries overall – or 48 percent.”
UnitedHealth Group and Allianz SE Remain Atop AM Best’s Largest Insurer Rankings Measured by net premiums written (NPW), the top three global firms are American healthcare companies.
Medicare Commission Highlights MA’s Efficiencies in Delivering Benefits to Over 30 Million Americans “During a recent public meeting, the Medicare Payment Advisory Commission (MedPAC) reported that Medicare Advantage (MA) plans are far more efficient at delivering basic benefits than original Medicare. For 2023, MedPAC estimates MA plan bids average just 83% of original Medicare costs, down from an average of 96% a decade ago. Furthermore, payments to MA plans, including bonuses for achieving higher quality ratings in the Medicare stars program, continue to be on par with original Medicare spending.”
This announcement comes from AHIP. You should check the entire MedPAC presentation for a more nuanced report.
CMS Announces Increase in 2023 in Organizations and Beneficiaries Benefiting from Coordinated Care in Accountable Care Relationship Yesterday, the Centers for Medicare & Medicaid Services (CMS) announced that three innovative accountable care initiatives will grow and provide higher quality care to more than 13.2 million people with Medicare in 2023. More than 700,000 health care providers and organizations will participate in at least one of the three initiatives – the Medicare Shared Savings Program and two CMS Innovation Center accountable care model tests. This growth furthers achieving the CMS’ goal of having all people with Traditional Medicare in an accountable care relationship with their health care provider by 2030…
announcement includes three CMS accountable care initiatives: the Medicare Shared Savings Program (Shared Savings Program), the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model,and the Kidney Care Choices (KCC) Model.”
About pharma
Florida agency warns pharmacists not to dispense abortion pills “With pharmacies in some states preparing to dispense abortion pills, Florida’s Agency for Healthcare Administration sent a letter Thursday to all state health care providers warning them that to do so in Florida is illegal.
‘The Agency issues this alert to remind providers that they must continue to comply with Florida laws that govern the performance of abortions,’ the Florida agency said via an email.
The warning follows the U.S. Food and Drug Administration’s early January decision allowing retail pharmacies to stock and dispense abortion pills in states that allow the procedure.”
Woman Convicted for Billing Claims as Part of $65 Million Pharmaceutical “Coupon” Fraud “According to court documents and evidence presented at trial, Berro, engaged in a conspiracy to submit fraudulent reimbursement claims to numerous pharmaceutical manufacturer’s co-pay assistance programs. These manufacturer-sponsored “coupon” programs exist to assist real patients with the often-high costs associated with name brand prescription drugs. The evidence showed that Berro, who participated in the scheme for nearly a year, was a biller for multiple pharmacies. In that role, she created fake “prescriptions” for fake “patients” by taking addresses from real estate lists, making up names and birth dates, selecting expensive name brand, and then ultimately pairing them with real doctors’ names and credentials.”
About the public’s health
U.S. birth rates drop as women wait to have babies “American women are having fewer babies, and they're having them later in life, government figures released Tuesday show. Data collected by the National Center for Health Statistics — the Centers for Disease Control and Prevention's statistic arm — showed a sharp decline in fertility rates in recent years, with most women having an average of 1.3 babies and an increasing percentage giving birth at age 35 or older.”
Moderna says RSV vaccine 84% effective at preventing symptoms in older adults “Moderna Inc (MRNA.O) said on Tuesday that its experimental messenger RNA vaccine for respiratory syncytial virus (RSV) was 83.7% effective in a late-stage trial at preventing at least two symptoms, such as cough and fever, in adults aged 60 and older.”
Rates of Follow-up Colonoscopy After a Positive Stool-Based Screening Test Result for Colorectal Cancer Among Health Care Organizations in the US, 2017-2020 “Question What are the overall rates of follow-up colonoscopy (FU-CY) after a positive stool-based test result, and what factors are associated with FU-CY rates, including the early COVID-19 pandemic?
Findings In this cohort study of 32 769 individuals from 39 different health care organizations, the overall FU-CY rate within 1 year of a positive stool-based test result was 56%. Race, ethnicity, insurance type, type of test (fecal immunochemical tests or multitarget stool DNA), health care organization, and the COVID-19 pandemic were significantly associated with these rates.
Meaning Targeted interventions to improve overall FU-CY rates and to cover the backlog of colonoscopies from the peak COVID-19 months (March to June 2020) are necessary to achieve the full clinical benefits from stool-based colorectal cancer screening tests.”
About healthcare IT
New CPT codes added for AI, virtual reality For examples:
— 0740T and 0741 to report AI insulin titration.
— 0764T and 0765T to report AI cardiac function services
About healthcare personnel
Harvard Medical School Withdraws From U.S. News Ranking Are more medical schools going to follow, as happened with law school withdrawals from the rankings?