About health insurance/insurers
Evaluation of Low-Value Services [LVS] Across Major Medicare Advantage Insurers and Traditional Medicare “In this cross-sectional study of nearly 6 million Medicare beneficiaries, utilization of LVS was on average lower among MA beneficiaries compared with TM beneficiaries, possibly owing to stronger financial incentives in MA to reduce LVS; however, meaningful differences existed across some of the largest MA insurers, suggesting that MA insurers may have variable ability to influence LVS reduction.”
In a related article:
Higher MA enrollment linked to lower Medicare spending: report “Medicare Advantage’s popularity is associated with lower total Medicare spending, a new report from Elevance Health finds.
Medicare spending was $431 billion less from 2010 to 2020 than the Congressional Budget Office predicted, and the overestimations were due to spending per enrollee. More than 32 million people, or 54% of the eligible Medicare population, are enrolled in an MA plan.
This trend is most noticeable geographically in midwestern and southern counties, researchers explained, but a weaker association is evident in northwest and western counties.
A 10% percent higher MA penetration in a county points to a 1.9% decrease in Medicare spending, correlating to a $204 decrease in per person spending. This resulted in up to $144 billion cumulative savings from 2012 to 2021.”
The Curious Persistence of Site-Dependent Payments Worth reading the entire article. “Despite the overwhelming bipartisan vote in the House (the bill passed with 320 votes to 71) and the US Congressional Budget Office’s estimate that site-neutral drug payments would save more than $3.7 billion over 10 years, the bill’s enactment by the US Senate remains uncertain because of aggressive lobbying from hospital interests…
Recent evidence, in fact, illustrates that the nation’s largest purchasers of health care—employers that purchase health insurance on behalf of employees (collectively, 178 million people or 54% of the US population and >80% of the privately insured)—are not exercising their preferences, intelligence, and purchasing power as much as rational models would estimate.”
About hospitals and healthcare systems
CMS' hospital capacity reporting rule takes effect “Beginning Nov. 1, CMS will require hospitals to report admission information related to respiratory illnesses, including capacity, to the CDC. The new rule reinstates some pandemic-era requirements that have been voluntary since May 1.”
About pharma
Using Bayh-Dole Act March-In Rights to Lower US Drug Prices “In this cross-sectional study of drugs approved by the Food and Drug Administration (FDA) with patents listed in the FDA’s Orange Book from 1985 to 2023, the share of drugs where all patents were subject to march-in was 2% for new molecular entities approved between 1985 and 2022, 1% for all new drug applications (NDAs) ever listing a patent in the Orange Book, and 1% for all NDAs on patents in 2023.
Meaning The findings suggest that few drugs have solely march-in–eligible patents, so the overall effect of march-in on removing patent barriers to competition would be limited.”
About the public’s health
Exposure to sugar rationing in the first 1000 days of life protected against chronic disease “We examined the impact of sugar exposure within 1000 days since conception on diabetes and hypertension, leveraging quasi-experimental variation from the end of the United Kingdom’s sugar rationing in September 1953. Rationing restricted sugar intake to levels within current dietary guidelines, yet consumption nearly doubled immediately post-rationing. Using an event study design with UK Biobank data comparing adults conceived just before or after rationing ended, we found that early-life rationing reduced diabetes and hypertension risk by about 35% and 20%, respectively, and delayed disease onset by 4 and 2 years. Protection was evident with in-utero exposure and increased with postnatal sugar restriction, especially after six months when solid foods likely began. In-utero sugar rationing alone accounted for about one third of the risk reduction.”
Extreme heat set records for health perils in 2023 “Heat-related deaths last year in people over age 65 increased by 167% globally above levels seen in the 1990s — nearly three times more than what would have been expected if temperatures had not changed.
People were also exposed to an average of 1,512 hours of high temperatures that posed at least a moderate risk of heat stress when doing light exercise such as walking or cycling — a 27.7% increase on the 1990-1999 yearly average.
Conditions were ripe for the spread of more deadly mosquito-borne infectious diseases, with dengue cases reaching an all-time high of over 5 million infections reported in more than 80 countries and territories in 2023.
On a more positive note, the report found deaths from fossil fuel-derived air pollution fell almost 7% from 2016 to 2021, with most of this decline due to efforts to reduce pollution from coal burning.”
About healthcare technology
Baxter restarts IV solutions manufacturing line at hurricane-hit facility “Medical device maker Baxter International said on Thursday it has restarted the highest-throughput intravenous solutions manufacturing line at its North Carolina facility, which was impacted by hurricane-related flooding.
The North Cove facility was temporarily closed last month due to flooding caused by Hurricane Helene. The plant makes 60% of the United States' supply of IV fluids and peritoneal dialysis (PD) solutions, according to the American Hospital Association.”
AI Colonoscopies: More Benign Lesion Removals, Potentially Higher Costs “Use of artificial intelligence (AI)-assisted colonoscopy led to a greater removal rate of exclusively benign lesions compared with colonoscopies that did not use AI, according to data analyzed from a previous single-center prospective study.
About a third more polypectomies were performed only for benign lesions in the AI-assisted colonoscopy group than in an unassisted historical cohort (12.4% vs 8.4%, P=0.04), reported Tessa Herman, MD, of the University of Minnesota and Minneapolis VA Health Care System, at the annual meeting of the American College of Gastroenterology in Philadelphia.”
About healthcare finance
Francisco Partners plans to buy medical software company AdvancedMD for $1.1B “Private equity firm Francisco Partners plans to buy medical software company AdvancedMD from Global Payments for $1.125 billion dollars, the companies announced Wednesday.
Global Payments, which sells payment technology and software solutions, bought the health tech company from investment firm Marlin Equity Partners in 2018 in a transaction valued at $700 million.
The company reported in a filing with the U.S. Securities and Exchange Commission that the transaction is valued at $1.125 billion and is expected to close this quarter.”