About Covid-19
HHS awards $1.4B in grants to develop future COVID-19 tools “The Biden administration on Tuesday announced it is awarding $1.4 billion in grants through its coronavirus initiative to fund the development of “a new generation of tools and technologies to protect against COVID-19 for years to come.”
Through the Administration for Strategic Preparedness and Response (ASPR), the Department of Health and Human Services (HHS) awarded the grants to a collection of pharmaceutical companies, nonprofits and nongovernmental organizations. Part of the funding aims to develop longer-lasting coronavirus vaccines.”
COVID hospitalizations rise for 5th consecutive week but remain 3 times lower than same time last year: CDC “COVID hospitalizations in the U.S. have risen for a fifth consecutive week, with 12,613 new admissions in the week ending Aug. 12 -- an increase of 21.6% from the prior week, according to new data from the Centers for Disease Control and Prevention.
The new admissions are still at the 22nd lowest levels recorded since tracking began in August 2020; only 21 weeks have had lower levels out of nearly 160 weeks of data, the CDC said Monday night.
Current hospitalization numbers are about three times lower than the same time last year and about six times lower than in 2021, according to the CDC.”
About healthcare quality
CQMC Announces Updates to Eight Core Measure Sets “The Core Quality Measures Collaborative (CQMC) announced updates to eight of its core measure sets. The CQMC also updated the implementation guidance that accompanies the core sets to highlight the role of telehealth, changes in endorsement status, and considerations for measure use to facilitate the widescale adoption of the sets.”
About health insurance/insurers
Primary Care Continuity, Frequency, and Regularity Associated With Medicare Savings
“Findings In this cohort study with 504 471 continuously enrolled Medicare fee-for-service beneficiaries who had at least 3 primary care visits from 2016 to 2018, having regularly scheduled visits to the same primary care clinician was associated with higher savings. The greatest savings were associated with higher frequencies as patient complexity increased.
Meaning These findings suggest that having regular primary care visits with the same clinician is strongly associated with Medicare savings, an association that is optimized at greater visit frequencies for patients of higher complexity.”
Medicaid Enrollment and Unwinding Tracker An update from KFF:
"State Medicaid Disenrollment Data
· At least 5,205,000 Medicaid enrollees have been disenrolled as of August 21, 2023, based on the most current data from 45 states and the District of Columbia. Overall, 38% of people with a completed renewal were disenrolled in reporting states while 62%, or 8.3 million enrollees, had their coverage renewed (three of the reporting states do not provide data on renewed enrollees). Because not all states have publicly available data on total disenrollments, the data reported here undercount the actual number of disenrollments.
· There is wide variation in disenrollment rates across reporting states, ranging from 72% in Texas to 8% in Wyoming…
· Across all states with available data, 74% of all people disenrolled had their coverage terminated for procedural reasons…
· Although data are limited, children accounted for one-third (32%) of Medicaid disenrollments in the 14 states reporting age breakouts. As of August 21, 2023, at least 652,000 children had been disenrolled out of 2,035,000 total disenrollments in the fourteen states. The share of children disenrolled ranged from 58% in Kansas to 18% in Massachusetts.”
BLUE SHIELD OF CALIFORNIA UNVEILS FIRST-OF-ITS-KIND MODEL TO TRANSFORM PRESCRIPTION DRUG CARE; SAVE UP TO $500 MILLION ON MEDICATIONS ANNUALLY “To simplify the system and cut unnecessary costs, Blue Shield has selected five companies with like-minded philosophical and technology standards to build a new, innovative model following regulatory approval. Together, Blue Shield will offer an integrated, coordinated, and holistic pharmacy experience to its members.
Amazon Pharmacy will provide fast and free delivery of prescription medications, complete with status updates, as well as upfront pricing and 24/7 access to pharmacists.
Mark Cuban Cost Plus Drug Company will establish a simple, transparent, and more affordable pricing model, reducing surprise drug costs at the pharmacy pick-up counter.
Abarca will pay prescription drug claims quickly and accurately while continuing to evolve its technology platform, Darwin, to support new, simplified payment models.
Prime Therapeutics will work with Blue Shield to negotiate savings with drug manufacturers to move toward a value-based model that aligns drug prices to patient efficacy and health outcomes.
CVS Caremark will provide specialty pharmacy services for members with complex conditions, including education and high-touch patient support.”
Aon: U.S. Employer Health Care Costs Projected to Increase 8.5 Percent Next Year “Average costs for U.S. employers that pay for their employees' health care will increase 8.5 percent* to more than $15,000 per employee in 2024, according to Aon plc a leading global professional services firm.
The projection increase, which assumes employers do not implement employee cost sharing increases and other cost saving strategies, is nearly double the 4.5 percent increase to health care budgets that employers experienced from 2022 to 2023. On average, the budgeted health care plan cost for clients is $13,906 per employee in 2023. The analysis uses the firm's Health Value Initiative database, which captures information for more than 800 U.S. employers representing approximately 5.6 million employees.”
Feds Say Hospitals That Redistribute Medicaid Money Violate Law “The Biden administration wants to crack down on private arrangements among some hospitals to reimburse themselves for taxes that help fund coverage for low-income people. It contends the practice violates federal law.
Federal regulators say these arrangements ‘appear designed to’ redirect Medicaid dollars away from facilities that treat the poorest patients to those that ‘provide fewer, or even no, Medicaid-covered services,’ according to a proposed enforcement plan released May 3 by the Centers for Medicare & Medicaid Services.
The practice is typically orchestrated by the lobbying groups that represent hospitals in state capitals — and is often kept secret. Not even federal regulators know how widespread it is, although programs operate in at least a few states, including California and Missouri. It’s also the subject of a Texas lawsuit that could block the federal government’s proposal.”
Postacute Care Services Use and Outcomes Among Traditional Medicare and Medicare Advantage Beneficiaries
“Findings In this cohort study of 2357 Medicare beneficiaries who used postacute care services, MA enrollees reported less use of postacute care services and shorter duration of services vs traditional Medicare beneficiaries. Fewer MA enrollees reported functional improvement while using postacute care.
Meaning Findings of this study suggest the importance of understanding differences in postacute care service use and outcomes by enrollment status; self-reported outcomes are especially important as MA and other payment models seek to reduce use of postacute care services.”
About hospitals and healthcare systems
OHSU to absorb struggling Legacy Health, form 10-hospital system “Two of Portland, Oregon’s leading healthcare providers announced plans Wednesday evening to merge and form a 10-hospital, $6.6 billion health system.
Oregon Health & Science University (OHSU) and Legacy Health said their boards have unanimously approved and signed a nonbinding letter of intent to merge.
The deal is expected to close next year pending regulatory approval and other customary closing conditions, per the announcement.
OHSU would become the merger’s surviving entity with Legacy becoming its subsidiary, according to the signed letter.”
Payer mix in the nation's largest for-profit health systems FYI
Select Health, Kroger team on co-branded Medicare Advantage plans “Select Health is teaming up with grocer Kroger to launch new co-branded Medicare Advantage (MA) plans that aim to improve access to healthy food and affordable medications.
The plans will be available beginning Jan. 1 and will offer savings to enrollees on groceries and prescriptions as well as connect members to programs and services that can improve their health and wellness, Select Health said in an announcement.”
Health Systems and Social Services—A Bridge Too Far? An interesting “contrarian view to health systems getting involved in addressing SDOH.
About pharma
Novartis to Spin Off Sandoz in October -- Update “Novartis said the planned spinoff of its Sandoz unit is expected to occur in early October, ending an era for the Swiss pharmaceutical giant in which generic and prescription drugs businesses coexisted under the same roof.”
About the public’s health
Preexposure Prophylaxis to Prevent Acquisition of HIVUS Preventive Services Task Force Recommendation Statement “The USPSTF recommends that clinicians prescribe preexposure prophylaxis using effective antiretroviral therapy to persons at increased risk of HIV acquisition to decrease the risk of acquiring HIV. (A recommendation)”
KFF Health Misinformation Tracking Poll Pilot “Overall, health misinformation is widely prevalent in the U.S. with 96% of adults saying they have heard at least one of the ten items of health-related misinformation asked about in the survey. The most widespread misinformation items included in the survey were related to COVID-19 and vaccines, including that the COVID-19 vaccines have caused thousands of deaths in otherwise healthy people (65% say they have heard or read this) and that the MMR vaccines have been proven to cause autism in children (65%).
Regardless of whether they have heard or read specific items of misinformation, the survey also asked people whether they think each claim is definitely true, probably true, probably false, or definitely false. For most of the misinformation items included in the survey, between one-fifth and one-third of the public say they are “definitely” or “probably true.” While the most frequently heard claims are related to COVID-19 and vaccines, the most frequently believed claims were related to guns, including that armed school police guards have been proven to prevent school shootings (60% say this is probably or definitely true), that most gun homicides in the U.S. are gang-related (43%), and that people who have firearms at home are less likely to be killed by a gun than those who do not (42%).
Combining these measures, the share of the public who both have heard each false claim and believe it is probably or definitely true ranges from 14% (for the claim that “more people have died from the COVID-19 vaccine than from the virus”) to 35% (“armed school police guards have been proven to prevent school shootings”).
U.S. Cigarette Smoking Rate Steady Near Historical Low
“STORY HIGHLIGHTS
12% of U.S. adults smoke cigarettes, similar to 11% measured in 2022
Smoking rates were 20% or higher from 1944 through 2012
8% of U.S. adults smoke e-cigarettes”
Firearms killed a record number of children in 2021, study finds “Gun-related deaths among children in the U.S. reached a distressing peak in 2021, claiming 4,752 young lives and surpassing the record total seen during the first year of the pandemic, a new analysis of Centers for Disease Control and Prevention data found.
The alarming statistic clearly indicated that America’s gun violence epidemic has gotten worse, experts say.
More than 80% of the gun deaths were among males 19 and younger. Black male children were more likely to die from homicide. White males 19 and younger were more likely to kill themselves with guns.”
FDA approves Pfizer's RSV vaccine Abrysvo to protect infants “Pfizer announced on Monday that the FDA has approved its respiratory syncytial virus (RSV) vaccine Abrysvo for use in pregnancy, making it the first maternal vaccine cleared in the US to help protect infants at birth through six months from lower respiratory tract disease (LRTD) and severe LRTD due to RSV. The decision comes on the heels of the FDA approving the shot for adults aged 60 and older back in May.”
About healthcare IT
Employers' enthusiasm for virtual care is on the decline: Business Group “In 2019, just over half (52%) of large employers said they believed virtual services would have major impacts on care delivery. Thanks to the pandemic, that jumped to 80% in 2020 and 85% in 2021.
The number then declined to 74% in 2022 and further to 65% this year, according to the survey.”
About healthcare personnel
All 50 states now allow collaborative pharmacy work “Every state in the U.S. now recognizes collaborative practice agreements between pharmacists and physicians.
Delaware was the 50th state to pass legislation that allows pharmacists and physicians to enter into collaborative practice agreements in which ‘one or more pharmacists [can provide] patient care and drug therapy management services not otherwise permitted to be performed by a pharmacist,’ according to the new state law.”
About health technology
Financial Conflicts of Interest in Public Comments on Medicare National Coverage Determinations [NCD] of Medical Devices “For CMS NCDs of medical devices, nearly all physicians, teaching hospitals, and organizations that submitted public comments supported expanding coverage. More than three-quarters of these public commenters had financial COIs [Conflict of Interests] with device manufacturer(s) potentially affected by the NCD that would benefit from coverage, and although industry has a legitimate interest in engaging in CMS’ public comment solicitation process, these financial COIs were rarely disclosed.”