About Covid-19
WHO recommends new COVID shots should target only XBB variants “A World Health Organization (WHO) advisory group on Thursday recommended that this year's COVID-19 booster shots be updated to target one of the currently dominant XBB variants.
New formulations should aim to produce antibody responses to the XBB.1.5 or XBB.1.16 variants, the advisory group said, adding that other formulations or platforms that achieve neutralizing antibody responses against XBB lineages could also be considered.”
About health insurance/insurers
IRS Gives Big Boost to HSA, HDHP Limits in 2024 “Annual HSA contribution limits for 2024 are increasing in one of the biggest jumps in recent years, the IRS announced May 16: The annual limit on HSA contributions for self-only coverage will be $4,150, a 7.8 percent increase from the $3,850 limit in 2023. For family coverage, the HSA contribution limit jumps to $8,300, up 7.1 percent from $7,750 in 2023.
Participants 55 and older can contribute an extra $1,000 to their HSAs. This amount will remain unchanged.
Meanwhile, for 2024, a high-deductible health plan (HDHP) must have a deductible of at least $1,600 for self-only coverage, up from $1,500 in 2023, or $3,200 for family coverage, up from $3,000, the IRS noted. Annual out-of-pocket expense maximums (deductibles, co-payments and other amounts, but not premiums) cannot exceed $8,050 for self-only coverage in 2024, up from $7,500 in 2023, or $16,100 for family coverage, up from $15,000.
The IRS also announced it will raise the maximum amount that employers may contribute to an excepted-benefit health reimbursement arrangement (HRA) in 2024 to $2,100—up from the 2023 amount of $1,950.”
Government stats show number of uninsured declined in 2022, though experts question methodology, conclusion “The number of uninsured individuals dropped slightly in 2022, with 8.4% or 27.6 million people of all ages in the U.S. falling into that category compared to 9.2% or 30 million in 2021, according to initial estimates (PDF) from the National Center for Health Statistics (NCHS).
The data, from surveys of 27,654 adults and 7,464 children taken throughout 2022, also show that 12.2% of adults aged 18 to 64 were uninsured, while 22% in that age group had public coverage, and 67.8% had private health insurance.
Among children from birth to 17 years old, 4.2% were uninsured, 43.7% had public coverage and 54.3% had private health insurance coverage.
The report found that among non-Hispanic white adults aged 18 to 64, the percentage of uninsured people declined from 10.5% in 2019 to 7.4% in 2022. Meanwhile, people under 65 who purchased coverage on the Affordable Care Act (ACA) exchanges rose from 3.7% in 2019 to 4.3% in 2022.”
Engaging Primary Care in Value-Based Payment: New Findings from the 2022 Commonwealth Fund Survey of Primary Care Physicians “While our survey doesn’t reveal what share of a physician’s total payments are value-based, it does reveal that more PCPs are receiving FFS payment than VBP. Seventy-one percent of respondents reported that their practice was receiving any FFS payments, while fewer than half (46%) reported receiving any VBP. Similar rates of primary care practices report receiving two common types of VBP, shared savings or capitation (30% and 32%, respectively). Practices are likely receiving a combination of payments because they are paid differently by different payers.”
Comment: The first sentence is critical. Without substantial percentages of total compensation in VBPs, physician behavior will not change.
2023 EDITION High-cost claims and injectable drug trends analysis More analysis from Sun Life:
Some key insights included in this year’s report are:
—71% of all stop-loss claims came from the top 10 conditions.
—While cancer continues to be the largest driver of high-cost claims, cardiovascular disease rose one spot to the #2 claim condition in 2022, with $142.4M in reimbursements for over 2,300 members.
—11 of the top 20 high-cost injectable drugs are related to the treatment of
cancer. Rylaze, the cancer drug with the highest average cost ($808.7K), is new to the top 20 injectables drug list this year.
—Approximately one in nine employers (11%) experienced a birth-related stop- loss claim in the four-year benefit period of 2018 through 2021. Newborn/ infant care ranks at #5 in 2022, consistent with its previous ranking in the topfive last year and has one of the highest average costs at $371.8K.
—20% of employers had at least one member with over $1M in claims during
the four-year benefit period from 2018 through 2021.
—Million-dollar claims on a per million covered employees basis rose 15% in the
past year and 45% over the past four years.”
About hospitals and healthcare systems
CMS: Hospitals Can Continue to Bill for Remote Outpatient Therapies “In a Frequently Asked Questions (FAQs) document, the Centers for Medicare and Medicaid Services (CMS) stated that hospitals could continue to bill for various outpatient therapies delivered via remote care technologies in patients' homes through the end of calendar year (CY) 2023.”
About the public’s health
Pfizer’s maternal RSV vaccine effective at preventing severe infections in newborns, FDA says, but flags potential risk of preterm birth “Pfizer’s vaccine to protect newborns from respiratory syncytial virus, or RSV, by vaccinating their moms late in pregnancy cuts the risk that infants will need to see a doctor or be admitted to the hospital with a moderate to severe infection before 6 months of age, according to a new analysis by government regulators…
Safety data published in an agency analysis Tuesday also showed a slightly higher proportion of preterm birth in babies whose moms got the experimental RSV vaccine compared with those who got a placebo: 5.7% vs. 4.7%, respectively.
The difference between the groups was not statistically significant, meaning it could have been due to chance.”
About healthcare finance
At request of FTC, Amgen agrees to delay closure of $27.8B Horizon acquisition until September “Amgen has complied with an FTC request for a temporary restraining order, agreeing not to close its proposed $27.8 billion deal to acquire Horizon Therapeutics while the agency's lawsuit plays out.
The move comes in response to the FTC filing an antitrust lawsuit earlier this week which is attempting to block the sale.”