About Covid-19
Biden to end covid health emergencies on May 11 “President Biden informed Congress on Monday that he will end the national emergencies to combat the covid outbreak on May 11, a move that will restructure the federal government’s response to the pandemic nearly three years after the virus first arrived in the United States.”
COVID DATA TRACKER WEEKLY REVIEW “As of January 25, 2023, the current 7-day average of weekly new cases (42,163) decreased 11.3% compared with the previous 7-day average (47,515). A total of 102,171,644 COVID-19 cases have been reported in the United States as of January 25, 2023.”
[WHO] Statement on the fourteenth meeting of the International Health Regulations (2005) Emergency Committee regarding the coronavirus disease (COVID-19) pandemic “The WHO Director-General concurs with the advice offered by the Committee regarding the ongoing COVID-19 pandemic and determines that the event continues to constitute a public health emergency of international concern (PHEIC). The Director-General acknowledges the Committee’s views that the COVID-19 pandemic is probably at a transition point and appreciates the advice of the Committee to navigate this transition carefully and mitigate the potential negative consequences.”
About health insurance/insurers
CMS issues final rule on Medicare Advantage risk adjustment The Centers for Medicare and Medicaid Services has finalized risk adjustment policies in a final rule to prevent overpayments to Medicare Advantage Organizations.
Rather than applying extrapolation beginning for payment year 2011 audits as CMS initially proposed, the agency has finalized a policy not to extrapolate RADV [Risk Adjustment Data Validation] audit findings for payment years 2011-2017 and begin extrapolation with the 2018 RADV audit.
As a result, CMS will only collect the non-extrapolated overpayments identified in the CMS RADV audits and OIG audits between payment years 2011 and 2017.
The rule finalizes a proposed policy that CMS will not apply an adjustment factor, known as an Fee-for-Service Adjuster, in RADV audits.”
What Happens After People Lose Medicaid Coverage? “Key findings include:
In the year following a disenrollment from Medicaid/CHIP, roughly two-thirds (65%) of people had a period of uninsurance.
Roughly four in ten (41%) people who disenrolled from Medicaid/CHIP eventually re-enrolled in Medicaid/CHIP within a year …”
About hospitals and healthcare systems
National Hospital Flash Report “Key Takeaways
Hospital margins end year in difficult shape.
Despite modest margin improvements in November and December, suggesting a positive trendline heading into the new year, 2022 was the worst financial year since the start of the pandemic. Approximately half of U.S. hospitals finished the year with a negative margin as growth in expenses outpaced revenue increases.
Financial pressures driven by labor expenses.
Hospitals faced prolonged increases in labor expenses last year. The increases were driven in part by a competitive labor market, as well as hospitals needing to rely on more expensive contract labor to meet staffing demands. Increased lengths of stay due to a decline in discharges also negatively affected hospital margins.
Outpatient settings see increased volume.
The front door of the hospital continues to shift away from the emergency department. Hospitals experienced increased outpatient volumes, including in surgical settings.
Success in 2023 tied to learning lessons of '22.
Expense pressures are unlikely to recede in 2023. Hospitals that embrace better workforce management strategies, secure more stable supply lines, and more effectively negotiate with payers are likely to have better financial years in 2023. Hospitals should also leverage their outpatient footprint and improve relationships with post-acute settings to maximize current patient volume trends.”
Why urgent care centers are popping up everywhere A good review if the status these facilities. One disturbing statistic: “One urgent care industry magazine says, in 2009, 70% of its providers were physicians, but that the percentage had fallen to 16% by last year.”
About pharma
J&J Can’t Use Bankruptcy to End Cancer Suits Over Baby Powder, Court Says “Johnson & Johnson can’t use bankruptcy to resolve more than 40,000 cancer lawsuits over its baby powder, a federal appeals court ruled.
The three-judge panel in Philadelphia sided with cancer victims, who argued that J&J wrongly put its specially created unit, LTL Management, under court protection to block juries around the country from hearing the lawsuits.”
Pharma wins a key round in a court battle with hospitals over a drug discount program “In a victory for the pharmaceutical industry, a federal appeals court ruled drug companies have the right to limit discounts to hospitals that rely on numerous contract pharmacies as they participate in a U.S. government drug discount program.
The decision was made in response to lawsuits that were originally filed by three large drugmakers — Sanofi, Novo Nordisk, and AstraZeneca — that the federal government was unlawfully interpreting key provisions in the controversial 340B drug discount program. The matter is actually not resolved, though, because the same dispute is still being considered in two other appeals courts.”
Simulated Medicare Drug Price Negotiation Under the Inflation Reduction Act of 2022 “In this cross-sectional study using a policy simulation analysis, 40 top-selling drugs that would have been selected for negotiation from 2018 to 2020 were identified; although individual Medicare Part D plans already received substantial discounts for many of these drugs, the statutory ceiling prices for negotiation would have reduced spending by $26.5 billion on these drugs, or 5% of estimated net Medicare drug spending, from 2018 to 2020.”
10 top M&A targets in biotech for 2023 FYI
The top 10 biopharma M&A deals of 2022 FYI
Pharma reputation scores drop to pre-COVID levels as Haleon tops most respected, but it's a huge fall from grace for Pfizer and Moderna “Although trust in pharma spiked during the pandemic, it seems companies' reputations are back to pre-COVID-19 levels—and there’s bad news for the biggest COVID vaccine makers.
That’s according to a new report out by Caliber, which found that in 2022 only four out of 10 people were likely to say something positive about a pharma company…
Before the COVID-19 pandemic, about 32% of the U.S. public had a positive opinion of the pharmaceutical industry, Rob Jekielek, managing director of Harris Poll, said in an interview with Fierce Pharma in late 2021.
That number jumped to 59% of patients rating pharma’s reputation as “excellent” or “good” in the same year. In 2023, it seems the industry is coming down from its peak, and consumers are looking for new ways to affirm their trust.”
CVS, Walmart to Cut Pharmacy Hours as Staffing Squeeze Continues “CVS Health Corp. and Walmart Inc. are cutting pharmacy hours in the midst of a pharmacist shortage that has plagued the nation’s biggest drugstore chains throughout the Covid-19 pandemic.
CVS, the largest U.S. drugstore chain by revenue, plans in March to cut or shift hours at about two-thirds of its roughly 9,000 U.S. locations. Walmart plans to reduce pharmacy hours by closing at 7 p.m. instead of 9 p.m. at most of its roughly 4,600 stores by March.
Walgreens Boots Alliance Inc. previously said it was operating thousands of stores on reduced hours because of staffing shortages. Combined, the three chains operate some 24,000 retail pharmacies across the U.S.”
About healthcare IT
The Potential Impact of Artificial Intelligence on Healthcare Spending “In this paper, we estimate that wider adoption of AI could lead to savings of 5 to 10 percent in US healthcare spending—roughly $200 billion to $360 billion annually in 2019 dollars. These estimates are based on specific AI-enabled use cases that employ today’s technologies, are attainable within the next five years, and would not sacrifice quality or access. These opportunities could also lead to non-financial benefits such as improved healthcare quality, increased access, better patient experience, and greater clinician satisfaction. We further present case studies and discuss how to overcome the challenges to AI deployments. We conclude with a review of recent market trends that may shift the AI adoption trajectory toward a more rapid pace.”