About Covid-19
Most federal covid vaccine mandates to end May 11 “The Biden administration will end its requirements that most international travelers, federal workers and contractors, health-care workers and Head Start educators be vaccinated against the coronavirus effective on May 11 — the same day it terminates the pandemic-related public health emergency.”
About health insurance/insurers
Milliman Retiree Health Cost Index “A healthy 65 year old retiree needs to save between $90,000 and $203,000 for healthcare costs if they retire in 2023.”
Medicare Advantage, Part D Premiums Increased Slightly in 2023 “The average monthly Medicare Advantage premium grew by 50 percent from 2022 to 2023. The average premium in 2023 was $9 per month, compared to $6 in 2022, marking the second year in a row that premiums increased.
However, the average premium was still relatively low due to high enrollment in zero-dollar premium plans.
In 2023, 84 percent of Medicare Advantage plans selected by eHealth consumers had a zero-dollar monthly premium. This figure is down slightly from 87 percent in 2022 but is up significantly from 63 percent in 2018.”
Half of All Eligible Medicare Beneficiaries Are Now Enrolled in Private Medicare Advantage Plans “According to recently released data from the Centers for Medicare & Medicaid Services (CMS), Medicare Advantage now provides Medicare coverage for just over half of eligible beneficiaries. In January 2023, 30.19 million of the 59.82 million people with both Medicare Part A and Part B were enrolled in a private plan.”
CVS closes $10.6B acquisition of Oak Street Health to expand primary care footprint “CVS Health has sealed the deal on its acquisition of Oak Street Health, picking up about 169 medical centers in 21 states.
The acquisition will broaden CVS Health's value-based primary care platform and significantly benefit patients' long-term health by improving outcomes and reducing costs – particularly for those in underserved communities, according to the company in a press release Tuesday.”
Insurer Market Power And Hospital Prices In The US “We found that the market-leading insurer in the least competitive (most concentrated) insurance markets pays 15 percent less to hospitals than the market-leading insurer in the most competitive (least concentrated) markets. We also found the price relationship to be more pronounced for for-profit hospitals than for not-for-profit hospitals. Our results invite the question of whether dominant insurers are passing savings on to employers in the form of lower premiums.”
About hospitals and healthcare systems
How CHS, Tenet, HCA and UHS fared in Q1 FYI
CommonSpirit Health finalizes acquisition of 5 Utah hospitals, 35 medical clinics “CommonSpirit Health officially sealed the deal on picking up five hospitals and 35 medical group clinics from Steward Health Care, the health systems said Monday.
The deal, announced in February, also includes imaging and urgent care centers, other outpatient ventures and a clinically integrated network of providers. Colorado-based Centura Health will manage all the operations.”
About pharma
Pfizer pulls off Q1 surprise with strong sales even as COVID vaccine demand plummets “With analysts expecting a free-fall in sales from COVID products, Pfizer pulled off a surprise Tuesday morning with its first-quarter earnings report.
Revenue for the period came in at $18.3 billion, routing the analyst consensus of $16.6 billion. With the performance, Pfizer reaffirmed its expectations for 2023 revenue to fall between $67 billion and $71 billion.”
J&J refuels CAR-T ambitions with $245M upfront to Cellular Biomedicine for pair of therapies “J&J’s pharma unit Janssen has handed over $245 million in upfront cash and the promise of further milestone payments to Cellular Biomedicine for two autologous CAR-T therapies being investigated in non-Hodgkin lymphoma. In return, Janssen gets the exclusive ex-China rights to the therapies as well as an option on commercializing the drugs in China.”
The Role Of Financial Incentives In Biosimilar Uptake In Medicare: Evidence From The 340B Program “We investigated whether the 340B Drug Pricing Program, which offers eligible hospitals substantial discounts on drug purchases, inhibits biosimilar uptake. Almost one-third of US hospitals participate in the 340B program. Using a regression discontinuity design and two high-volume biologics with biosimilar competitors, filgrastim and infliximab, we estimated that 340B program eligibility was associated with a 22.9-percentage-point reduction in biosimilar adoption. In addition, 340B program eligibility was associated with 13.3 more biologic administrations annually per hospital and $17,919 more biologic revenue per hospital. Our findings suggest that the program inhibited biosimilar uptake, possibly as a result of financial incentives making reference drugs more profitable than biosimilar medications.”
About the public’s health
A new Supreme Court case seeks to make the nine justices even more powerful This case could have serious implications in all fields, but especially in healthcare.
“The Supreme Court announced on Monday that it will reconsider one of its modern foundational decisions, Chevron v. National Resources Defense Council (1984), which for decades defined the balance of power between the federal judiciary and the executive branch of government.
Chevron established that courts ordinarily should defer to policymaking decisions made by federal agencies, such as the Environmental Protection Agency or the Department of Labor, for two reasons: Agencies typically have far greater expertise in the areas they regulate than judges, and thus are more likely to make wise policy decisions. And, while federal judges are largely immune from democratic accountability, federal agencies typically are run by officials who serve at the pleasure of an elected president — and thus have far more democratic legitimacy to make policy choices.
Nevertheless, next term the Court will hear a case, Loper Bright Enterprises v. Raimondo, which explicitly asks ‘whether the court should overrule Chevron.’ In the reasonably likely event that the Court does overrule this seminal decision, that would mean the death of one of the most cited decisions in the federal judiciary — according to the legal database Lexis Nexis, federal courts have cited Chevron in over 19,000 different judicial opinions.”
Study: Ingredient found in salad bowls and burger wrappers less safe than previously thought “Acompostable salad bowl seems like an Earth-friendly way to enjoy a healthy lunch. But the toxic chemicals used in containers like molded-fiber salad bowls, sandwich wrappers, and French fry pouches may be leaching into food despite efforts to make those materials safer, according to the results of a study published in March in the journal Environmental Science and Technology.
The presence of “forever chemicals” in materials used to contain or carry food is far from new. Various formulations of compounds called per- and polyfluoroalkyl substances, or PFAS, are used in materials like pizza boxes, popcorn bags, and paper straws because they’re both water-proof and oil-proof. That means they’re perfect for keeping fake butter or salad dressing from seeping out of microwave popcorn packets and takeout salad bowls, as well as for maintaining structural integrity while protecting a steaming, cheesy pizza.
But PFAS are also toxic. They’ve been linked to testicular and kidney cancers, ulcerative colitis, low birth weights, and even decreased immune response to vaccines.”
Feds: Hospitals that denied emergency abortion broke the law “Two hospitals that refused to provide an emergency abortion to a pregnant woman who was experiencing premature labor put her life in jeopardy and violated federal law, a first-of-its-kind investigation by the federal government has found…
The federal agency’s investigation centers on two hospitals — Freeman Health System in Joplin, Missouri, and University of Kansas Health System in Kansas City, Kansas — that in August refused to provide an abortion to a Missouri woman whose water broke early at 17 weeks of pregnancy. Doctors at both hospitals told Mylissa Farmer that her fetus would not survive, that her amniotic fluid had emptied and that she was at risk for serious infection or losing her uterus, but they would not terminate the pregnancy because a fetal heartbeat was still detectable.
Ultimately, Farmer had to travel to an abortion clinic in Illinois.”
US News State rankings: Health Care FYI
About healthcare IT
Merck entitled to $1.4B in cyberattack case after court rejects insurers' 'warlike action' claim “A New Jersey appellate court on Monday ruled that a group of insurers can’t use war as an argument to deny Merck coverage from the notorious cyberattack that afflicted the company and others back in 2017.
Upholding a prior ruling, the appeals court said in an opinion (PDF) that the ‘hostile/warlike action’ exclusion clause shouldn’t be applied to a cyberattack on a non-military company—even if it originated from a government or sovereign power. In this case, the hack was tied to Russia as part of its aggression against Ukraine, according to U.S. officials.”
Are mental health apps better or worse at privacy in 2023? See the article for improved and worsened sites as well as a comparison chart.
About healthcare personnel
Hospital-Physician Integration Is Associated With Greater Use Of Cardiac Catheterization And Angioplasty “We used Medicare claims data from the period 2013–20 to identify patients who received a new diagnosis of stable angina, a common cardiovascular condition that entails clinical discretion in treatment choice. Using linear probability models and an instrumental variables model, we found that patients whose care was managed by a hospital-integrated cardiologist were no more likely to receive stress tests (an office-based procedure) than those whose care was managed by an independent cardiologist. However, these patients were much more likely to receive high-intensity, hospital-based coronary interventions.”
About health technology
Dual CRISPR therapy plus long-acting ART eliminates HIV in mice “In a study published May 1 in Proceedings of the National Academy of Sciences, a research team led by scientists from the Lewis Katz School of Medicine at Temple University and the University of Nebraska Medical Center (UNMC) described how they used CRISPR to inactivate or snip out two different genes in HIV-infected humanized mice. By combining this approach with a long-acting form of antiretroviral therapy, the researchers were able to eliminate the virus in around 60% of the models—a big boost from the 29% they reported back in 2019.”