Biden's $6.8T budget: 15 healthcare takeaways A good, short summary of the proposals.
See, also, a related article: What Biden's proposed budget means for Medicare Advantage
About healthcare quality
Accounting for Person- vs Neighborhood-Level Social Risk in Quality Measurement A good discussion of the pros and cons of each method. The article is a commentary on another article in the same journal issue.
The crux of the analysis is: “ Ultimately, 3 social risk factors were identified, one of which was a patient-level variable (Medicare-Medicaid dual-enrollment status) and 2 of which were community-level measures of social risk, including low Agency for Healthcare Research and Quality Socioeconomic Status (AHRQ SES) Index (an aggregated score of neighborhood vulnerability based on employment, income, education, and housing) and low physician-specialist density (a marker for reduced access to specialty care).”
About health insurance/insurers
Medicaid Health Plans Try to Protect Members — And Profits — During Unwinding “The plans have a strong financial incentive to keep their members enrolled because states pay them per member, per month: The more people they cover, the more money they get.
The Biden administration estimates that 15 million of the more than 91 million Medicaid enrollees will fall off the rolls, nearly half because their income exceeds program limits and the rest because they fail to complete the reenrollment paperwork.
Of the people losing eligibility, about two-thirds will enroll in a workplace health plan, health insurers predict, and the other third will be evenly divided between ACA plans and being left uninsured…
Investor-owned companies earn pretax profit margins of about 3% on average from Medicaid managed care, slightly below what they make on ACA marketplace business, he said. So moving members to an ACA plan could boost the profits of these companies.”
Industry groups form coalition to avoid coverage lapses as Medicaid redeterminations loom “The Connecting to Coverage Coalition is spearheaded by AHIP, the health insurance industry's largest lobbying group, and its other founding members include the American Cancer Society Cancer Action Network, the Federation of American Hospitals, the Blue Cross Blue Shield Association and the Association for Community Affiliated Plans.
The national effort is seeking to provide a single source for information about the redetermination process and to build solutions that ensure people are able to find the coverage the works best for them and their families, according to an announcement.”
How Obamacare Enabled a Multibillion-Dollar Christian Health Care Cash Grab Ever wonder how the “Health Sharing Ministries” are legally able to operate health plans, despite the negative news about their performances? Their enablement was written into the ACA. This ProPublica article provides a great insight into these plans.
About hospitals and healthcare systems
Providence reports $1.7B operating loss in 2022 “Renton, Wash.-based Providence, a 51-hospital system, has reported a $1.7 billion operating loss for fiscal 2022 amid labor and inflationary pressures as well as delayed reimbursements. Investment losses also further dragged the system's performance down.”
About the public’s health
WHO global report on sodium intake reduction The report can be downloaded from this site. Briefly: “The largest number of diet-related deaths, an estimated 1.89 million each year, is associated with excessive intake of sodium, a well-established cause of raised blood pressure and increased risk of cardiovascular disease. The global average sodium intake is estimated to be 4310 mg/day (10.78 g of salt per day), which far exceeds the physiological requirement and is more than double the World Health Organization (WHO) recommendation of <2000 mg of sodium (equivalent to <5 g of salt) per day in adults.
Reducing sodium intake is one of the most cost-effective ways to improve health and reduce the burden of noncommunicable diseases, as it can avert a large number of cardiovascular events and deaths at very low total programme costs. WHO recommends several sodium-related best buys policies as practical actions that should be undertaken immediately, to prevent cardiovascular disease and its associated costs. These include lowering sodium content in food products; implementing front-of-pack labelling to help consumers select food products
with lower sodium content; conducting mass media campaigns to alter consumer behaviour around sodium; and implementing public food procurement and service policies to reduce sodium content in food served or sold.
All 194 Member States committed to reducing population sodium intake by 30% by 2025, demonstrating strong consensus on sodium reduction as a life-saving strategy.”
FDA mandates breast density information with mammography results “The U.S. Food and Drug Administration said on Thursday all mammography facilities in the country will be required to notify patients about the density of their breast tissues, as that can potentially make detection of tumors more difficult…
The agency recommends patients with dense breasts, a normal and common finding in mammograms, to discuss their individual situation with their respective healthcare providers.”
Comment: While more informed patients is a laudable goal, without clear criteria for making this determination, the number of unnecessary extra tests (and costs) will skyrocket.
Smoking, snuff use in pregnancy raises risk for sudden infant death syndrome “Children of mothers who used snuff or smoked during pregnancy had higher risks for postneonatal mortality, sudden infant death syndrome and sudden unexpected infant death, according to study results published in Pediatric Research.”
Covid backlash hobbles public health and future pandemic response “At least 30 states, nearly all led by Republican legislatures, have passed laws since 2020 that limit public health authority, according to a Washington Post analysis of laws collected by Kaiser Health News and the Associated Press as well as the Association of State and Territorial Health Officials and the Center for Public Health Law Research at Temple University.
Health officials and governors in more than half the country are now restricted from issuing mask mandates, ordering school closures and imposing other protective measures or must seek permission from their state legislatures before renewing emergency orders, the analysis showed.”
Association of Primary Care Visit Length With Potentially Inappropriate Prescribing “In this cross-sectional study of 4 360 445 patients, those who were younger, publicly insured, Hispanic, or non-Hispanic Black had shorter primary care physician visits. Shorter visits were associated with a higher likelihood of inappropriate antibiotic prescribing for patients with upper respiratory tract infections and coprescribing of opioids and benzodiazepines for patients with painful conditions.”
About healthcare IT
Cerner contributes $1.5B to Oracle's Q3 revenue EHR vendor Cerner contributed $1.5 billion to software giant Oracle's $12.4 billion in third-quarter revenue; analysts at FactSet had expected $12.43 billion in revenue.
The company's quarterly revenue was up 18 percent year-over-year. Cloud revenue contributed $4.1 billion to the total third-quarter revenue, according to an Oracle March 9 news release.”
3.2 million patients caught in Cerebral data breach “More than 3 million patients were affected in a data breach involving telemental health company Cerebral, according to a notice to HHS' Office of Civil Rights.
Cerebral, whose clinicians prescribe medications for depression and anxiety via telehealth, started notifying patients March 6 that some of their data may have been sent to social media companies via consumer-tracking pixel tools.”