About Covid-19
Kids with COVID shed virus for median of 3 days, supporting school-isolation policies “Children who tested positive for COVID-19 in 2022 were contagious for a median of 3 days, regardless of vaccination status, suggesting that 5-day school isolation policies are sufficient amid Omicron variant predominance, University of Southern California (USC) and Stanford University researchers report… in JAMA Pediatrics.”
About health insurance/insurers/costs
Three quarters of ACOs in direct contracting model earned savings “The Global and Professional Direct Contracting Model for Performance Year 2022 saved the Centers for Medicare and Medicaid Services $371.5 million and saved direct contracting entities $484.1 million, according to the agency's first evaluation report of the model.
This represents an increase from $70.4 million in savings to CMS and $46.5 million in net savings to direct contracting entities (DCEs) in 2021.
Ninety-nine DCEs, compared to 53 in 2021, participated in the program in 2022, the second year of the model. CMS has posted quality and financial results for each model participant.”
Centene boosts guidance on the back of $469M in Q3 profit “Centene Corporation posted $469 million in profit for the third quarter, according to its earnings report released Tuesday morning.
That's down from the $738 million reported in the third quarter of 2022, but it did surpass Wall Street's expectations, according to analysts at Zacks Investment Research. Centene also beat the Street on revenue with $38 billion.”
In a related article: Centene still expects to lose more than 2M members as Medicaid redeterminations reach midway point
11th Circuit upholds $2.7 billion Blue Cross antitrust settlement “An 11th Circuit panel on Wednesday upheld a federal judge's approval of a nearly $2.7 billion subscriber class action settlement in an antitrust action against the Blue Cross Blue Shield association.
The 11th Circuit ruling allows for the settlement to move forward and for benefits to be distributed, over a decade after subscribers who bought health insurance sued Blue Cross. They argued the health insurance giant violated the Sherman Antitrust Act by restricting competition between its 36 insurer companies, creating a hike in prices for customers.”
Obamacare premiums rise for 2024, but subsidies will protect most enrollees “The average monthly premium for the benchmark silver plan in 2024 will rise by 4% in the 32 states participating in the federal exchange, healthcare.gov, according to a Centers for Medicare and Medicaid Services report released Wednesday. That matches the increase for this year, which was preceded by four straight years of premium declines...
Open enrollment launches November 1 and runs through January 15, though folks must sign up by December 15 if they want coverage to begin at the start of the year.”
GNC launches virtual healthcare services Hard to figure out how to categorize this story, but here goes: “Nutrition and wellness company GNC is expanding into healthcare through new membership plans that offer virtual urgent and primary care.
GNC Health is offering three tiers of membership plans to individuals and families. The GNC Health Basic plan is a $34.99 per year offering that provides members with virtual urgent care, virtual lifestyle care and access to more than 100 prescriptions with no copay…
The Health Plus plan costs $9.99 per month for individuals and members gain access to virtual primary care and more than 400 prescriptions with no copay. The company's Health Premier plan costs $39.99 per month for individuals and allows members to access virtual mental healthcare and virtual physical therapy.”
Paying for It: How Health Care Costs and Medical Debt Are Making Americans Sicker and Poorer “Survey Highlights
Large shares of insured working-age adults surveyed said it was very or somewhat difficult to afford their health care: 43 percent of those with employer coverage, 57 percent with marketplace or individual-market plans, 45 percent with Medicaid, and 51 and percent with Medicare.
Many insured adults said they or a family member had delayed or skipped needed health care or prescription drugs because they couldn’t afford it in the past 12 months: 29 percent of those with employer coverage, 37 percent covered by marketplace or individual-market plans, 39 percent enrolled in Medicaid, and 42 percent with Medicare.
Cost-driven delays in getting care or in missed care made people sicker. Fifty-four percent of people with employer coverage who reported delaying or forgoing care because of costs said a health problem of theirs or a family member got worse because of it, as did 61 percent in marketplace or individual-market plans, 60 percent with Medicaid, and 63 percent with Medicare.
Insurance coverage didn’t prevent people from incurring medical debt. Thirty percent of adults with employer coverage were paying off debt from medical or dental care, as were 33 percent of those in marketplace or individual-market plans, 21 percent with Medicaid, and 33 percent with Medicare.
Medical debt is leading many people to delay or avoid getting care or filling prescriptions: more than one-third (34%) of people with medical debt in employer plans, 39 percent in marketplace or individual-market plans, 31 percent in Medicaid, and 32 percent in Medicare.”
About hospitals and healthcare systems
Lawmakers mull lifting ban on physician-owned hospitals as doc lobbying groups claim major cost savings “A new analysis backed by doctor lobbying groups suggests that physician-owned hospitals could have fueled about $1.1 billion in savings across 20 of Medicare’s most expensive conditions in 2019— though the hospital industry is sticking firm to its stance that the broadly restricted facilities are a detriment to the U.S. healthcare system.
The technical report , commissioned by the Physicians Advocacy Institute and The Physicians Foundation but conducted by researchers from UConn Health and Loyola University Chicago, concluded that the Medicare program and its beneficiaries’ total payments at traditional hospitals would have been 8.6% and 15.2% (depending on the condition) lower if reimbursed at the same rate as a POH.
It also found that patient demographics and comorbidity levels were very often statistically similar among POHs and traditional hospitals in the same hospital referral region—a counter to the hospital industry’s assertions that POHs often selectively treat patients that are healthier and less costly.”
HCA says 2 IT issues could affect future earnings “After reporting $16 billion in third-quarter revenue, Nashville, Tenn.-based HCA Healthcare said that the July data breach and the health system's ability to use its EHR could affect future earnings.
The July data breach affected 11 million patients and 171 hospitals. The health system is now facing at least five lawsuits relating to the incident where a hacker stole data from an external storage location and posted it online.
HCA also said that "our ongoing ability to demonstrate meaningful use of certified electronic health record technology and the impact of interoperability requirements" could determine future financial results.”
HCA joint venture to lose $50M a quarter “Nashville, Tenn.-based HCA Healthcare reported $1.63 billion in third-quarter operating income on revenues of $16.21 billion, but the company's results were ‘unfavorably impacted’ by its Valesco physician staffing joint venture, which ‘performed below expectations,’ CEO Sam Hazen said during an Oct. 24 earnings call.
In April, HCA went from a 50 percent owner to 90 percent owner of Valesco, a joint venture with EmCare, a physician practice management firm affiliated with Envision Healthcare, which filed for Chapter 11 bankruptcy in May. HCA is consolidating operations at Valesco, but the move reduced the health system's consolidated margins by about 30 basis points in the second quarter, according to CFO Bill Rutherford.”
CHS reports $91M net loss in Q3 “Franklin, Tenn.-based Community Health Systems reported a $91 million net loss in the third quarter of 2023, down from a net loss of $42 million over the same period last year, according to the health system's earnings report released Oct. 25.
The 76-hospital system attributed the increase in net loss to unfavorable changes in payer mix, a reduction in pandemic relief funds recognized, higher costs for supplemental reimbursement programs and an increased rates for outsourced medical specialists. These were partially offset by strong inpatient volumes and reduced expense for contract labor.”
UHS reports $167M net income in Q3 “King of Prussia, Pa.-based Universal Health Services, one of the largest for-profit health systems in the country, has reported third-quarter net income of $167 million on revenue of $3.6 billion.
Those figures compared with $182.8 million net income in the same period in 2022 on revenue of $3.3 billion.”
About pharma
5 years in, Civica Rx makes 80 drugs for 1/3 of US hospitals “Since launching in 2018, hospital-owned Civica Rx works with about a third of the nation's hospitals and manufactures 80 drugs facing shortages…”
EU Commission fines pharma companies for price fixing “The European Commission on Thursday said it had fined five pharmaceutical companies for a total of 13.4 million euros ($14.1 million) in a settlement of an antitrust investigation.
The commission fined Alkaloids of Australia, Alkaloids Corporation, Boehringer, Linnea and Transo-Pharm for participating in a cartel aimed at fixing the minimum price of an ingredient to produce the abdominal antispasmodic drug Buscopan and its generic versions.”
Roche agrees $7.1bn deal for Telavant to boost drug pipeline “Roche plans to buy immunology company Telavant from Roivant Sciences and Pfizer for more than $7bn, as the drugmaker’s new chief executive seeks to replenish its drug pipeline. The Swiss company will acquire the rights to develop and manufacture Telavant’s potential drug for inflammatory bowel disease, which affects almost 8mn people worldwide. It will acquire the rights to sell it in the US, where there is a $15bn market for IBD, and in Japan.”
Sanofi’s shares fall 19% as dropped 2025 target overshadows planned consumer unit split “Sanofi will split off its consumer healthcare division into a separate unit as part of plans to increase R&D investment in its biopharma business. The move – announced Friday - will see the company prioritise its drug-development spending and modernise its approach to commercial delivery.
CEO Paul Hudson said “in this new chapter of our strategy, we are deepening our investment in R&D, taking steps toward becoming a pure play biopharma company and further optimising our cost structure.” Sanofi is targeting savings of up to €2 billion ($2.1 billion) from 2024 to the end of 2025, with the majority to be reinvested in innovation and growth drivers.”
HRSA Policy Change Could Mean Some Outpatient Clinics Lose 340B Discounts “Some hospital outpatient clinics are likely to lose 340B drug discount program eligibility under a policy the Health Resources and Services Administration issued Thursday. Hospitals participating in the drug pricing program now must register offsite clinics with HRSA and list them on Medicare cost reports to qualify for 340B, the agency announced in a Federal Register notice. This reverses a 2020 HRSA policy that aimed to streamline 340B certifications during the height of the COVID-19 pandemic.”
About the public’s health
RSV shots for infants in short supply: CDC “The monoclonal antibody for preventing the respiratory syncytial virus, known as RSV, in infants is in short supply, and federal officials are advising doses be prioritized for those at the highest risk for severe illness, with the drug’s manufacturer saying demand has outpaced expectations.”
EPA proposes banning cancer-causing chemical TCE used in automotive care and other products “The U.S. Environmental Protection Agency on Monday proposed banning the cancer-causing chemical trichloroethylene, which can be found in consumer products including automobile brake cleaners, furniture care and arts and crafts spray coating.
The move would end a nearly four decade battle to ban the chemical known as TCE, which can cause sudden death or kidney cancer if a person is exposed to high levels of it, and other neurological harm even at lower exposure over a long period.
EPA’s recent risk-evaluation studies found that as much as 250 million pounds of TCE are still produced in the United States annually.”
Firearm Homicide Rates, by Race and Ethnicity — United States, 2019–2022 “Although the overall national rate of firearm homicide decreased from 2021 to 2022, the rate remained higher than in 2019. The onset of higher rates has been attributed to a range of factors, including economic and social stressors and disruptions in health and emergency services related to longstanding systemic inequities (such as employment or housing), which were worsened by the COVID-19 pandemic…”
National medication, medical equipment shortages harming patients, ECRI survey finds “Most respondents reported that shortages have compromised patient care. Half said shortages have delayed patient treatments, while a third said they were unable to provide patients with optimally recommended drugs or treatments. A quarter said they were aware of at least one error related to a drug, supply or device shortage…
Six in 10 respondents reported shortages of more than 20 drugs, single-use supplies or other medical devices during the six months prior to the survey. Various specialties have had care quality affected as a result, including in surgery and aesthetics (74%), emergency care (64%), pain management (52%), cardiology (45%), hematology and oncology (44%), infectious disease (39%) and obstetrics and gynecology (37%).”
'Extremely rare' case of mosquito-borne dengue found in California The case was in a patient without a travel history to endemic areas. This case is important, along with those Americans who have malaria , because it is a harbinger of changing infectious disease patterns due to global warming.
The official definition of infertility now includes LGBTQ+ and single people “Last week, the American Society for Reproductive Medicine (ASRM) issued an expanded description of the condition, stating that infertility involves ‘the need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos in order to achieve a successful pregnancy either as an individual or with a partner.’
Before this update, the ASRM officially described infertility as a condition in which heterosexual couples weren’t able to conceive after a year of unprotected intercourse.”
The opioid crisis has gotten much, much worse despite Congress’ efforts to stop it “Even though 105,000 Americans died last year, Congress is showing little urgency about reupping the law since it expired on Sept. 30. That’s not because of partisan division, but a realization that there are no quick fixes a new law could bring to bear.”
About healthcare IT
Clinician EHR Efficiency: Software and Services 2023 FYI from KLAS. School down to check the two charts.
Teladoc Health Reports Third Quarter 2023 Results Summary:
“Third quarter 2023 revenue grows 8% year-over-year to $660.2 million
Third quarter 2023 operating cash flow of $105.6 million ; free cash flow of $68.0 million
Third quarter 2023 net loss of $57.1 million , or $0.35 per share
Third quarter 2023 adjusted EBITDA of $88.8 million , up 73% year-over-year”
NCC Group Monthly Threat Pulse - September 2023 “In September, Industrials continued to experience the highest volume of attacks 40% (19), followed by Consumer Cyclicals with 21% (10) and Healthcare 15% (7). The continued targeting of Industrials is unsurprising given that the theft of Personally Identifiable Information (PII) and Intellectual Property (IP) remain attractive motivators for threat actors.
The Healthcare sector experienced a significant increase in ransomware attacks. It witnessed 18 attacks, marking an 86% month-on-month increase from August. However, the increase is in line with trends in earlier months this year, suggesting that the dip in August was an anomaly to the overall trend. Healthcare continues to be an attractive target for threat actors because of the financial impact that a ransomware attack on companies in the pharmaceutical industry can have.”
And in a related article: Since 2016, ransomware attacks on healthcare organizations have cost the US economy $77.5bn in downtime alone “Since 2016, 539 ransomware attacks on healthcare organizations in the US have been confirmed. These attacks impacted more than 52 million patient records and have had an often devastating impact on 10,000 separate facilities.
In total, we estimate the cost of these attacks to be around US$77.5 billion in downtime alone.”
Patient Comfort with Social Needs Data Sharing “For the first time in 2022, the Health Information National Trends Survey (HINTS 6) asked about individuals’ comfort with social needs data sharing for three social needs data types: food, housing, and transportation. Here, we show results that reflect individuals’ comfort with each type of social needs data sharing. Overall, about 6 in 10 Americans reported being comfortable with their health care provider sharing information about their social needs with other providers for treatment purposes in 2022.”
About healthcare personnel
Burnout, harassment driving mental health crisis in health care workers “Overall, about 46 percent of health care workers reported feeling burnout often or very often in 2022, compared with 32 percent in 2018. Nearly half of those in the field also reported they were likely or very likely to apply for a new job — in contrast to other worker groups who reported a decrease in job turnover intention.
Harassment also spiked during the pandemic, CDC found. More than double the number of health workers reported harassment at work in 2022 than in 2018 — 13.4 percent in 2022, up from 6.4 percent in 2018.”
About health technology
US trade tribunal issues potential Apple Watch import ban in Masimo patent fight “The U.S. International Trade Commission (ITC) on Thursday issued an order that could bar Apple from importing its Apple Watches after finding the devices violate medical technology company Masimo's patent rights.
The full commission upheld a judge's ruling from January that Apple violated Masimo's rights in light-based technology for reading blood-oxygen levels.
The decision will not have an immediate effect since it now faces presidential review and possible appeals.”
Medtronic claims FDA approval for defibrillator implant routed outside the heart and veins “Medtronic has secured an FDA green light for a new type of implantable cardioverter-defibrillator that the medtech giant describes as the first of its kind.
Unlike other ICDs that are wired into beating hearts through the body’s veins, the Aurora’s electrical leads can be placed outside of the cardiac muscle and blood vessels to help reduce the risks of long-term complications.”
The Way You Speak Can Reveal Whether You Have Type 2 Diabetes “The team asked 267 participants – some with type 2 diabetes, and some without – to record a fixed phrase six times a day into a phone app, for a period of two weeks. A total of 18,465 recordings were then processed to extract 14 different characteristics from the vocals, including pitch and intensity.
The researchers used a set of these recordings to train the AI on what a person's voice sounds like, based on factors like their sex, age, BMI, and whether they had type 2 diabetes or not. They used the remaining samples to test what the AI had 'learnt'.
Factoring in considerations like age and sex, the model was able to spot type 2 diabetes to an accuracy level of 89 percent for women and 86 percent for men.”
About healthcare finance
Healthcare investor raises $4.3B “Healthcare-focused investment firm OrbiMed has raised over $4.3 billion in its three latest funds, The Wall Street Journal reported Oct. 24.
The firm raised more than $1.86 billion for its ninth venture capital vehicle. OrbiMed partner Carl Gordon said that the firm plans to use the venture fund to invest in 40 to 45 companies. Halfway through 2023, healthcare venture capital funds had raised $13.7 billion, according to Silicon Valley Bank.”