About Covid-19
Biden administration announces $600M to produce COVID tests and will reopen website to order them “The Biden administration announced Wednesday that it is providing $600 million in funding to produce new at-home COVID-19 tests and is restarting a website allowing Americans to again order up to four free tests per household — aiming to prevent possible shortages during a rise in coronavirus casesthat has typically come during colder months.
The Department of Health and Human Services says orders can be placed at COVIDTests.gov starting Sept. 25, and that no-cost tests will be delivered for free by the United States Postal Service.
And in a related article: New COVID vaccine campaign off to a bumpy start New billing codes, insurance company funding glitches, and shortages have caused the “bumpy start” of the headline.
COVID-19 admissions up for 9th straight week “More than 20,500 patients with COVID-19 were admitted to U.S. hospitals for the week ending Sept. 9, according to the latest CDC update.
This marks a nearly 8 percent jump from the week prior and the ninth straight week of increase. COVID-19 hospitalizations are rising from record lows, though healthcare officials are watching moving trends as fall begins and activity forother respiratory viruses also ramps up.”
Does the risk of getting long Covid increase each time you get reinfected? “We compared people who have a reinfection to people who have no reinfection — not comparing the severity of infection versus the first. What we found is really undeniable: It’s very clear in our data that reinfection contributes additional risk of long Covid.”
Outpatient Treatment of Confirmed COVID-19: Living, Rapid Practice Points From the American College of Physicians (Version 2) FYI. [nirmatrelvir–ritonavir is Paxlovid].
The Top COVID-19 Hot Spots in the U.S. FYI
Covid Infections Rise as OSHA Health-Care Inspections, Rule Lag “OSHA inspections of health-care facilities dropped by about 84% so far this year, returning to pre-pandemic levels as Covid-19 hospitalizations tripled over the summer and infections quadrupled among nursing-home workers.
From January through August 2023, the Occupational Safety and Health Administration inspected 159 nursing homes and 99 hospitals, according to agency data analyzed by Bloomberg Law. In the same period last year, the agency probed 915 nursing homes and 664 hospitals.”
About health insurance/insurers/Cost
US employers to see biggest healthcare cost jump in a decade in 2024 “Benefit consultants from Mercer, Aon and Willis Towers Watson see employer healthcare costs jumping 5.4% to 8.5% in 2024 due to medical inflation, soaring demand for costly weight-loss drugs and wider availability of high-priced gene therapies.”
CMS: Out-of-network billing arbitration may continue for cases submitted Aug. 3 or earlier “The Centers for Medicare and Medicaid Services (CMS) has instructed certified independent dispute resolution (IDR) entities to resume processing single and bundled disputes submitted on Aug. 3 or earlier, though those after the cutoff will have to wait for future guidance from the agency.
The IDR process has been on hold for a month and a half due to two court decisions handed down on Aug. 3 and Aug. 24 that vacated certain portions of out-of-network billing regulations…”
Tenet, HCA, CHS and UHS ranked by Q2 margins FYI
AMA posts CPT 2024 code set FYI: The American Medical Association released updates Sept. 8 to its Current Procedural Terminology code set for 2024.
The best-rated health plans of 2023, per NCQA “The National Committee for Quality Assurance has named the best-rated health plans of 2023 based on factors that include care quality, patient satisfaction and efforts to keep improving.” And in a related article: The best-rated Medicaid plans of 2023, per NCQA
Traditional Medicare lags behind MA, commercial plans in utilization, efficacy: research “A white paper by Harvard Medical School and Inovalon Harvard Medical School and Inovalon, which provides cloud-based healthcare data aggregation services, looks at enrollment data from 2015 through 2019. Researchers found that MA enrollees have more than 50% fewer inpatient hospital stays than fee-for-service Medicare enrollees.
In addition, MA members visited emergency departments 22% fewer times than those enrolled in traditional Medicare.
While people who enrolled in MA plans saw stable utilization in the first two years, those who enrolled in fee-for-service Medicare instead saw utilization increase by 35%, according to the report.”
Half a million children, others being reinstated after removal from Medicaid “Nearly a half-million children and other individuals in 30 states have been improperly dropped from Medicaid rolls, prompting federal health officials to shut down parts of a massive campaign to figure out who qualifies for the safety-net health insurance in more than half the country.
Leaders of the Centers for Medicare and Medicaid Services (CMS) on Thursday revealed the scope of the trouble, caused by computer systems failing to determine whether individual family members qualify for Medicaid. CMS discovered the problem late last month and ordered every state to report whether it was doing things wrong.
The officials said Thursday that states are in the process of reinstating everyone who should not have been cut off from Medicaid.”
About hospitals and healthcare systems
100 hospital financial benchmarks | 2023 FYI
55 health systems with strong finances FYI
CommonSpirit posts $1.4B operating loss Aside from the specific organization, the general principles behind this loss indicates widespread industry conditions.
What Share of Nursing Facilities Might Meet Proposed New Requirements for Nursing Staff Hours? “On September 1, 2023, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule that would create new requirements for nurse staffing levels in nursing facilities, settings that provide medical and personal care services for nearly 1.2 million Americans. The adequacy of staffing in nursing homes has been a longstanding issue…
Key takeaways include:
Among all nursing facilities, fewer than 1 in 5 could currently meet the required number of hours for registered nurses and nurse aides, which means over 80% of facilities would need to hire nursing staff.
90% of for-profit facilities would need to hire additional nursing staff compared with 60% of non-profit and government facilities.
The percentage of nursing facilities that would meet the requirements in the proposed rule varies from all in Alaska (100%) to nearly none in Louisiana (1%).
CMS is seeking comment on several alternatives to the proposed rule, one of which would require facilities to comply with requirements that were adjusted to reflect the health and frailty of nursing facility residents. Assuming this alternative was implemented using CMS’ existing approach for adjusting staff hours for resident health and frailty, virtually all facilities would need to hire new staff to meet the requirements.”
Comparison of Hospital Online Price and Telephone Price for Shoppable Services “Findings In this cross-sectional study of 60 US hospitals, online and phone cash prices were poorly correlated within a given hospital for vaginal childbirth (Pearson correlation coefficient [r] = 0.118) and brain magnetic resonance imaging (Pearson r = −0.169).
Meaning These findings suggest that at US hospitals, price estimates for shoppable services posted online correlate poorly with prices obtained via phone; these findings suggest that patients will continue to face barriers to comparison shopping.”
And in a related article: Hospital price transparency fines in 10 numbers Specifics about the hospitals that have been fined since July.
About pharma
After FDA experts smack down ineffective decongestant, class-action lawsuits fly After the FDA’s determination that phenylephrine was not effective, it was only a matter of time before law suits were filed against the companies marketing the preparations.
MedImpact, GoodRx team on new prescription savings program “Pharmacy benefit manager MedImpact is teaming up with GoodRx on a new program that offers drug discounts "seamlessly" at the pharmacy counter.
Under the initiative, when a MedImpact member gets a prescription filled, the cost under the benefit will automatically be compared to GoodRx's price, with the lower option automatically applied, according to an announcement. What the member pays will apply to their deductible, the companies said.”
Ranitidine Use and Incident Cancer in a Multinational Cohort “Question Is use of ranitidine associated with higher risk for incident cancer compared with other histamine-2 (H2) receptor antagonists (H2RAs)?
Findings In this cohort study including 1 183 999 individuals from 11 large databases across Europe, North America, and Asia, risk of cancer among ranitidine users did not differ from users of other H2RAs. Ranitidine use was not associated with an increased risk of esophageal, stomach, or colorectal cancer, or 13 other subtypes of cancer.
Meaning These findings suggest that a history of ranitidine use is not associated with an increased risk of cancer compared with use of other H2 receptor antagonists, but further research is needed on the long-term effects of ranitidine on cancer development.”
Medicare’s Historic Prescription Drug Price Negotiations A really good review of the legal dimensions of this program.
About the public’s health
Estimated Lifetime Gained With Cancer Screening TestsA Meta-Analysis of Randomized Clinical Trials “In this systematic review and meta-analysis of 18 long-term randomized clinical trials involving 2.1 million individuals, colorectal cancer screening with sigmoidoscopy prolonged lifetime by 110 days, while fecal testing and mammography screening did not prolong life. An extension of 37 days was noted for prostate cancer screening with prostate-specific antigen testing and 107 days with lung cancer screening using computed tomography, but estimates are uncertain.”
Associations of Dietary Sugar Types with Coronary Heart Disease Risk: A Prospective Cohort Study “Sugar and carbohydrate intake, including total fructose equivalents (TFE, from fructose monosaccharides and sucrose), total glucose equivalents (TGE, from glucose monosaccharides, disaccharides, and starch), and other sugar types, was measured every 2-4 years by semiquantitative food frequency questionnaire…
Intakes of TGE, total sugar, added sugar, and fructose from added sugar and juice were associated with higher CHD risk, but TFE and fructose from fruits and vegetables were not.”
Global report on hypertension: the race against a silent killer An extensive report from the WHO. In addition to the prevalence data, the following statement is also disturbing: “Currently, among adults aged 30–79 years with hypertension, only 54% have been diagnosed with the condition, 42% are being treated for their hypertension, and 21% are considered to have their hypertension controlled.”
US Supply Shortages Create Adverse Health Impacts for Millions Three years after the worst of Covid-era supply-chain disruptions, about one in six Americans adults are experiencing shortages of medications or other critical medical equipment, based on a Census Bureau survey.
That’s equivalent to more than 45 million people who couldn’t get hold of prescribed drugs, over-the-counter medication, home medical equipment or other critical goods in the previous 30 days. About half of them faced mental distress or had negative health impacts as a result, according the survey, conducted Aug. 23 to Sept. 4.”
CDC Awards to Establish National Infectious Disease Forecasting Network “The CDC’s Center for Forecasting and Outbreak Analytics has awarded over $260 million to 13 infectious disease forecasting and analytics centers.”
About healthcare IT
Commercial Payer Coverage for Digital Medicine Codes A great summary of the topic from the AMA. Worth reading the entire monograph. In summary: “This research surfaced the following findings, related to commercial coverage of digital medicine CPT codes:
There is a lack of alignment across commercial, Medicare and Medicaid plans regarding coverage of digital medicine CPT codes. This lack of alignment makes it difficult for physicians to reliably provide digital services and for the consumer to know what services are accessible to them.
Within the commercial market, there is inconsistent adoption of new digital medicine CPT codes.
The level of transparency regarding coverage of digital medicine services is highly variable across
commercial health plans.
There are varying processes and timelines for adopting new CPT codes across health plans.
There is limited widespread utilization of most new digital health CPT codes, and health plans are eager for research on the impact and quality of digital medicine services.
Health plans often partner with health tech companies directly to provide digital health services to members, but these directly-contracted services are often disconnected from a patient’s medical home.”
Oracle Cerner adds generative AI to its EHR platforms “The multimodal voice and screen-based tool ‘participates in the appointment,’ according to Oracle, to automate note taking and propose ‘context-aware next actions,’ such as ordering medications or scheduling labs and follow-ups.
Providers can use the tool – which will be available in the next 12 months, the company says – to verbally access elements of a patient's EHR record during an appointment, avoiding the need for ‘multi-menu, multi-step’ interactions with the software.”
About healthcare personnel
The cost of physician turnover The Association for Advancing Physician and Provider Recruitment's report on physician and provider retention and turnover in 2022 showed around 76 percent of physician exits in organizations with the most and least providers were due to retirement. Physicians finding a new role elsewhere was also a top response…
[For example]:Losing a physician means hospitals won't receive the revenue associated with those cases until the physician is replaced. Physicians also typically have a ramp-up period for to build a patient base. On average, physicians generate $2.4 million for affiliated hospitals each year, according to Merritt Hawkins. The highest revenue generating physicians being interventional cardiologists who generate $3.48 million per year and then orthopedic surgeons who generate $3.29 million per year.”
Provision of evaluation and management visits by nurse practitioners and physician assistants in the USA from 2013 to 2019: cross-sectional time series study “The proportion of visits delivered by nurse practitioners and physician assistants in the USA is increasing rapidly and now accounts for a quarter of all healthcare visits.”
FTC sues private-equity backed anesthesia staffing firm, saying it tried to corner the market and drive up prices “The Federal Trade Commission sued U.S. Anesthesia Partners Inc., one of the country’s top anesthesia staffing companies, and its private-equity backer, Welsh, Carson, Anderson & Stowe, on Thursday, accusing both entities of scheming over a decade to acquire anesthesia practices in Texas, monopolize the market, drive up prices for patients and generate profits.”
About healthcare finance
Novo Holdings closes $462 mln acquisition of Paratek Pharmaceuticals “Novo Holdings, the controlling shareholder in drugmaker Novo Nordisk, on Thursday said it had closed its acquisition of biopharmaceutical company Paratek Pharmaceuticals in a deal valued at $462 million.
The acquisition of Paratek Pharmaceuticals, which was announced in early June, is Novo Holdings' largest individual investment in antimicrobial resistance therapies to date, it said in a statement.”