About healthcare quality
The Safety of Outpatient Health Care: Review of Electronic Health Records “Overall, 7.0% (95% CI, 4.6% to 9.3%) of patients had at least 1 AE [adverse event] (8.6 events per 100 patients annually). Adverse drug events were the most common AE (63.8%), followed by health care–associated infections (14.8%) and surgical or procedural events (14.2%). Severity was serious in 17.4% of AEs, life-threatening in 2.1%, and never fatal. Overall, 23.2% of AEs were preventable. Having at least 1 AE was less often associated with ages 18 to 44 years than with ages 65 to 84 years (standardized risk difference, −0.05 [CI, −0.09 to −0.02]) and more often associated with Black race than with Asian race (standardized risk difference, 0.09 [CI, 0.01 to 0.17]). Across study sites, 1.8% to 23.6% of patients had at least 1 AE and clinical category of AEs varied substantially.”
About health insurance/insurers
US Social Security, Medicare get slight boost from strong economy “The Medicare Hospital Insurance Trust Fund's reserves are now expected to be depleted in 2036, five years later than was forecast in last year's report, Treasury said. After that date, the program that provides healthcare to seniors and some people who are disabled would be able to pay only 89% of total scheduled benefits, based on annual tax collections.”
See also:Fact Sheet: 2024 Social Security and Medicare Trustees Reports and
Strong Economy, Low Unemployment, and Higher Job and Wage Growth Extend Social Security Trust Funds to 2035
Medicare Advantage Health Risk Assessments [HRAs]Contribute Up To $12 Billion Per Year To Risk-Adjusted Payments “In this study, we evaluated the impact of HRAs on Hierarchical Condition Categories (HCC) risk scores, variation in this impact across contracts, and the aggregate payment impact of HRAs, using 2019 MA encounter data. We found that 44.4 percent of MA beneficiaries had at least one HRA. Among those with at least one HRA, HCC scores increased by 12.8 percent, on average, as a result of HRAs. More than one in five enrollees had at least one additional HRA-captured diagnosis, which raised their HCC score. Potential scenarios restricting the risk-score impact of HRAs correspond with $4.5–$12.3 billion in reduced Medicare spending in 2020. Addressing increased coding intensity due to HRAs will improve the value of Medicare spending and ensure appropriate payment in the MA program.”
Oscar Health Announces Results for First Quarter 2024 First profitable quarter due to 43% increase in membership and lower than expected costs. However, insurance companies are almost always profitable after rapid growth. The revenue is high but the Incurred But Not Reported (IBNR) claims are not yet realized. Before breaking out the champagne, let’s see what happens over the next year.
About hospitals and healthcare systems
Hospital operator Steward Health Care files for bankruptcy protection “Hospital operator Steward Health Care filed for bankruptcy protection early Monday morning, but pledged to maintain the eight hospitals it operates in Massachusetts…
Steward said it is finalizing the terms of ‘debtor-in-possession financing’ from its landlord Medical Properties Trust for initial funding of $75 million and ‘up to an additional $225 million upon the satisfaction of certain conditions.’”
The company’s debt is more than $9B.
About pharma
As drug shortages reach record highs, regulators weigh next steps “Drug shortages hit a new high in the first quarter of 2024, forcing patients and doctors to scramble to secure ADHD medications, cancer treatments and other needed drugs. While shortages have been rising for some time, the persisting struggle to get them under control has spurred new calls for action…
Manufacturing quality issues often contribute to shortages, as do production delays and problems with the flow of needed raw materials or components. Companies can also spark shortages when they decide to abandon low-priced generic drugs that are no longer worth their time to manufacture and distribute.”
About healthcare personnel
Physician Flash Report “Key Takeaways
1. Investment/subsidy per provider is up 2% since Q1 2023. Overall labor expenses continue to rise, and Q1 2024 data show that labor represented 84% of total expenses.
2. Revenue and expenses remain on an upward trajectory. Net Patient Revenue per Provider FTE is up 4% from Q1 2023, while Total Direct Expense per Provider FTE is up 3% in the same time frame.
3. Provider productivity as measured by unit of work (wRVUs) per FTE rose 4% from Q1 2023. However, the ratio of support staff per 10,000 provider wRVUs is not keeping pace, and has decreased by 6% since Q1 2023.”
About health technology
First Patient Begins Newly Approved Sickle Cell Gene Therapy “…Kendric Cromer, a 12-year-old boy from a suburb of Washington, became the first person in the world with sickle cell disease to begin a commercially approved gene therapy that may cure the condition….
[Manufacturer] bluebird bio [the firm does not use caps in its name] says the cost is $3.1million.”
Although 20,000 patients are thought to be eligible for the treatment, bluebird can only handle treatments for 85 to 105 patients each year.
In a related article: Young boy dies in trial for Pfizer Duchenne gene therapy “Pfizer said the boy died of cardiac arrest, but that researchers had not yet determined precisely what happened or whether the death was linked to the treatment.”
FDA approves ColoSense stool RNA test to detect colorectal cancer in average-risk adults “The FDA has approved Geneoscopy Inc.’s ColoSense multitarget stool RNA test for adults aged 45 years or older at average-risk for developing colorectal cancer, according to a company press release.
Previously granted FDA breakthrough device designation in January 2020, ColoSense is the ‘first noninvasive colorectal cancer screening test to provide a dynamic view of disease activity by using RNA biomarkers,’ Geneoscopy noted…”
About healthcare finance
Healthcare Dealmakers—Kaiser wraps Geisinger buy; Advocate Health sells off MobileHelp and more FYI