About Covid-19
Contralateral second dose improves antibody responses to a two-dose mRNA vaccination regimen “In previously unexposed adults receiving an initial vaccine series with the BNT162b2 mRNA COVID-19 vaccine, contralateral boosting substantially increases antibody magnitude and breadth at times beyond 3 weeks after vaccination. This effect should be considered during arm selection in the context of multi-dose vaccine regimens.”
About health insurance/insurers
Big payers ranked by 2023 profit FYI
and in a related article: Payers ranked by medical loss ratios in 2023
Vermont ACO model ties payer, provider payment to care quality An interesting summary of Vermont’s single payer experiment.
U.S. investigates alleged Medicare fraud scheme estimated at $2 billion “The alleged scheme was uncovered by the National Association of ACOs — known as NAACOS — a health-care nonprofit that represents hundreds of medical groups and hospitals across the nation. The nonprofit’s members concluded that seven companies allegedly operating out of Connecticut, Florida, Kentucky, New York and Texas were behind a surge of bills submitted to Medicare across the last two years for intermittent urinary catheters… While the companies used real patients’ information to submit the bills, NAACOS and its members found no evidence that any of their patients wanted the catheters or even received them.
All seven companies had become accredited with Medicare, allowing them to bill the health insurance program, although in some cases the accreditation was linked to a person who said they no longer worked at the company and had sold it last year.”
Comment: What is also incredible about this story is that over two years the companies committing the fraud went from billing just 14 patients for catheters to nearly 406,000. Who is supposed to monitor such use?
About hospitals and healthcare systems
Accrediting Organization Proposed Rule Fact Sheet “In recent years, CMS has identified several concerns related to AO performance:
Providers and suppliers that have been terminated from the Medicare/Medicaid program but retain accreditation despite significant quality and safety concerns;
AOs provide fee-based consulting services to the providers and suppliers they accredit, potentially affecting the integrity of the onsite survey process and decreasing public trust by creating conflicts of interest;
Inconsistent survey results due to differing AO standards or practices (such as AOs notifying facilities of the date of their onsite surveys in advance contrary to CMS policies).”
In order to address these concerns, CMS issued proposed rules detailed in the document.
Kaiser posts $4.1B net income in 2023 “Oakland, Calif.-based Kaiser Permanente reported $329 million in operating income (0.3% margin) in 2023, a significant improvement on the $1.3 billion operating loss (-1.3% margin) it reported in 2022.
Operating revenue for Kaiser's health plan, hospitals and their respective subsidiaries hit $100.8 billion in 2023, up from $95.4 billion the previous year. Expenses were $100.5 billion, up from $96.7 billion.
After factoring in nonoperating items, which primarily consists of investment returns, Kaiser's net income for 2023 was $4.1 billion, compared to a $4.5 billion net loss in the prior year.”
About pharma
Novo bets big on Catalent deal, Lilly hits $700 billion benchmark, our Leqembi survey says?...and more Last week’s big pharma stories. Some news media are calling for Lilly to replace Tesla in The Magnificent Seven list since its market cap is now greater than the auto manufacturer.
Gilead inks $4.3-billion deal to buy CymaBay “Gilead Sciences agreed to pay $32.50 per share in cash, or around $4.3 billion, to acquire CymaBay Therapeutics, gaining the latter’s primary biliary cholangitis (PBC) drug candidate seladelpar. The oral PPARδ agonist is currently under review by the FDA with a decision expected by August 14.”
The Oncology Market: 2023 Year in Review A good review of coming (and intending) trends. Worth sat least skimming the headings.
Moderna's stock slumps after RSV shot efficacy wanes faster than GSK's Arexvy “The efficacy of Moderna’s investigational respiratory syncytial virus (RSV) vaccine appears to wane faster than GSK’s approved shot Arexvy, a revelation that sent the Big Biotech’s stock slipping.
Phase 3 data shared Thursday showed overall efficacy of 63.3% after 8.6 months in preventing RSV-associated respiratory tract disease with two or more symptoms, dropping from 84% at 3.3 months.”
About the public’s health
US respiratory virus activity remains high, with flu B rising in 2 regions “The nation's respiratory virus activity last week remained elevated, and flu levels rose in some regions of the country, partly due to a slight rise in influenza B activity, which is sometimes seen in the latter half of the flu season.
In its respiratory virus snapshot today, the Centers for Disease Control and Prevention (CDC) said COVID-19 indicators declined last week, with respiratory syncytial virus (RSV) levels continuing to decline in many areas.”
About healthcare IT
HHS rule goes into effect after pushback from Epic, Amazon “Health IT companies that supply artificial intelligence to health systems must meet new federal transparency requirements starting Feb. 8.
ONC's HTI-1 final rule went into effect, requiring that certified health IT developers provide clinical users a "consistent, baseline set of information" about their decision-making algorithms and their ‘fairness, appropriateness, validity, effectiveness, and safety.’ ONC-certified developers support care at over 96% of hospitals and 78% of office-based physicians, according to the HHS division.”
About healthcare personnel
Primary care merger creates 680+ combined clinics “Denver-based Everside Health and Indianapolis-based Marathon Health, both primary care providers, have merged, combining more than 680 health centers across 41 states to serve 2.5 million eligible patients.”
About health technology
Health Resources Priorities and Allocations System (HRPAS) From HHS: “The Department of Health and Human Services (HHS) is issuing a final rule establishing standards and procedures by which it may require acceptance and priority performance of certain contracts or orders to promote the national defense over other contracts or orders with respect to health resources. This final rule also sets new standards and procedures by which HHS may allocate materials, services, and facilities to promote the national defense.”
Investigating the accuracy of blood oxygen saturation measurements in common consumer smartwatches “Using a clinical-grade pulse oximeter as the reference standard, there were statistically significant differences in accuracy between devices, with Apple Watch Series 7 having measurements closest to the reference standard… and the Garmin Venu 2s having measurements farthest from the reference standard…There were also significant differences in measurability across devices, with the highest data presence from the Apple Watch Series 7 (88.9% of attempted measurements were successful) and the highest data missingness from the Withings ScanWatch (only 69.5% of attempted measurements were successful).”
Unlike clinical oximeters, skin tone did not appear to play much of a role in these measurements.
About healthcare finance
INDUSTRY RESEARCH Healthcare Services A really good summary of PE investments for Q4 of 2023. Look, especially, at the graphic on page 8 for a summary of the relative sizes of investments sectors.
Report 10 of the largest US healthcare companies by revenue | 2024 FYI
Biotech bankruptcies hit 10-year peak in 2023 “2023 eclipsed all other years by far, with 18 companies filing for protection compared to eight in 2022, which had previously held the record as the highest bankruptcy year.”