About health insurance/insurers
Estimated Costs of Intervening in Health-Related Social Needs Detected in Primary Care “Findings In this decision analytical model with a simulated sample based on data of 19 225 noninstitutionalized children and adults of all ages seen in primary care practices, the cost of providing evidence-based interventions for social needs averaged $60 per member per month.
Meaning The findings of this study suggest that substantial resources would be needed to implement a comprehensive approach to addressing social needs that falls largely outside of existing federal financing mechanisms.”
Comment: This article draws a distinction between social insurance and health insurance, despite the obvious link between health and social determinants of disease. $60 per member per month would be an expensive addition to a health insurance policy and would result in fewer people being insured. We need to find a political and financial solution to to funding these needs.
For a thoughtful editorial, see: Addressing Health-Related Social Needs—Costs and Optimism
About hospitals and healthcare systems
MAY 2023 National Hospital Flash Report
“Key Takeaways
Hospitals broke even in April.
The median operating margin for hospitals was 0% in April, leaving most hospitals with little to no financial wiggle room.
Volumes dropped while lengths of stay increased.
Hospital volumes dropped across the board—including inpatient and outpatient. Emergency department volumes were the least affected.
Effects of Medicaid disenrollment could be materializing.
Hospitals experienced increases in bad debt and charity care in April. Combined with anemic patient volumes, experts note this data could illustrate the effects of the start of widespread disenrollment from Medicaid following the end of the COVID-19 public health emergency.
Inflation continued to throttle hospital finances.
Labor costs jumped in April and the costs of goods and services continued to be well above pre-pandemic levels. Though expenses generally fell in April, revenues declined at a faster rate.”
Advocate Health reports 0.1% operating margin, $579M net gain for its first post-merger quarter “Advocate Health, the newly formed marriage of major nonprofits Advocate Aurora Health and Atrium Health, reported a $10.4 million operating income (0.1% operating margin) and $578.7 million net gain in its first-ever first-quarter earnings report released Tuesday.
The 67-hospital entity tallied more than $7.54 billion in total revenue during the three months ended March 1 thanks to year-over-year increases across each of its major divisions—Advocate Aurora Health, Atrium Health’s Charlotte-Mecklenburg Hospital Authority and Atrium Health Wake Forest Baptist.”
About pharma
FDA proposes revamping medication guides that come with prescriptions “The US Food and Drug Administration proposed Tuesday to add to what you get with your prescription drugs.
The proposed rule would require the prescriptions you get to come with a new kind of single-page medication guide with an easy-to-use set of directions and easy-to-understand safety information, a goal the FDA has been working toward for years.”
This panel will decide whose medicine to make more affordable. Its choice will be tricky An excellent review of state-initiated pharma cost controls. Some of the questions that must be answered are: “Do they tackle drugs with extremely high costs taken by only a handful of patients, or drugs with merely very high costs taken by a larger group? Should they consider only out-of-pocket costs paid by consumers…, or the total cost of the drug to the health system? Will they weigh only drug prices, or will they try to right social wrongs with their choices?”
About healthcare IT
AI Improves Stroke Recognition in Emergency Calls “The model was trained using data on 1.5 million calls to the emergency services between 2015 and 2020, of which 7370 turned out to be actual stroke cases. It was then tested on 2021 data on 344,000 calls of which 750 were stroke cases.
Results showed that the AI model correctly identified 63% of patients who were having a stroke, a better result than the human emergency call dispatchers who recognized just 52.7% of stroke cases.”