About quality and safety
Safety in healthcare 2024 From PressGaney: “Key safety takeaways for 2024:
The gap in patient perceptions of safety in inpatient and outpatient settings is now 2.5x wider than pre-pandemic. While patients in medical practices and ambulatory settings felt substantially safer in 2023 (81.9%) compared to pre-pandemic levels (78.1%), perceptions of safety in hospitals fell 5.1%.
Following record lows in 2021, workplace safety culture is increasing. Employee views of safety within their organization have risen 1.2% over the last two years, but nearly half still report low perceptions of safety culture.
Reported assaults against nursing personnel jumped 5% YOY. In 2023, the rate of reported assaults against nurses increased to 2.71 per 100 nursing personnel, from 2.59 the previous year.
Safety outcomes show continued momentum. The biggest improvement was seen in catheter-associated urinary tract infection (CAUTI) rates, which are now better than pre-pandemic levels.”
About health insurance/insurers
In Battle Over Health Care Costs, Private Equity Plays Both Sides An excellent article worth reading in its entirety. An excerpt:
”Insurance companies have long blamed private-equity-owned hospitals and physician groups for exorbitant billing that drives up health care costs. But a tool backed by private equity is helping insurers make billions of dollars and shift costs to patients.
The tool, Data iSight, is the premier offering of a cost-containment firm called MultiPlan that has attracted round after round of private equity investment since positioning itself as a central player in the lucrative medical payments field. Today Hellman & Friedman, the California-based private equity giant, and the Saudi Arabian government’s sovereign wealth fund are among the firm’s largest investors.
The evolution of Data iSight, which recommends how much of each medical bill should be paid, is an untold chapter in the story of private equity’s influence on American health care.”
See, also: Insurers Reap Hidden Fees by Slashing Payments. You May Get the Bill.
Contract Year 2025 Medicare Advantage and Part D Final Rule (CMS-4205-F) From CMS. Well-wroth skimming the major points.
Medicare billing forms are running out of space for growing health care prices “CMS last month said it was adding two digits to the Medicare claims processing system for hospital and doctor office charges, called the Fiscal Intermediary Shared System, so that it can now accommodate prices just a penny shy of $100 million.”
Healthcare services ranked by Medicare Advantage utilization increases “Medicare Advantage plans saw utilization rates rise 8.1% in the fourth quarter of 2023, primarily driven by outpatient and emergency room services, according to an AHIP survey.”
The article details specific service changes.
About hospitals and healthcare systems
HHS pitches rewards for hospitals with drug shortage solutions “Every year, U.S. hospitals spend at least $600 million to mitigate drug shortages, according to HHS. On April 2, the department proposed financial incentives for hospitals with resilient drug supplies.
In an 18-page policy recommendation, HHS recommended a Manufacturer Resiliency Assessment Program and a Hospital Resilient Supply Program. The programs, which HHS defined as long-term solutions, would assess and rank drug manufacturers based on their reliability.
Hospitals would then be rewarded for buying drugs from diverse and reliable suppliers.”
See, also:Policy Considerations to Prevent Drug Shortages and Mitigate Supply Chain Vulnerabilities in the United States
From -6.8% to 12.2%: 42 health systems ranked by operating margins FYI
March 2024 National Hospital Flash Report “Key Takeaways
1. Margins this month were at 3.96%, continuing a strong start to 2024. However, data this month do not reflect the full impact of the Change Healthcare outage, which began February 21st.
2. Gross revenue continues to rise at a faster rate than net revenue, highlighting payer mix changes. Bad debt and charity care have also risen over the last few years.
3. Revenue growth is primarily being driven from the outpatient setting. There continues to be a decline in inpatient revenue and increase in outpatient revenue.”
About pharma
Sanofi agrees to settle thousands of Zantac cancer claims “Sanofi confirmed to FirstWord on Friday that it reached a deal in principle to settle approximately 4000 personal injury lawsuits accusing the company of selling the now-discontinued heartburn medicine Zantac (ranitidine) without warning patients that it could potentially cause cancer.
The settlement, which marks the first major resolution of cases related to the product, will apply to litigation pending in courts in US states other than Delaware, where the company is still facing some 20,000 lawsuits.”
Healthy Returns: Weight loss, diabetes drug ad spending tops $1 billion “Companies spent more than $1 billion on ads for weight loss and diabetes medicines in 2023, up 51% from the prior year, according to new data from advertising analytics firm MediaRadar. That’s nearly 15% of drugmakers’ $7.6 billion in ad spending for prescription drugs last year.
Diabetes treatments accounted for nearly $790 million in ad spending in 2023, while weight loss drugs made up almost $264 million.”
Clinical Benefit and Regulatory Outcomes of Cancer Drugs Receiving Accelerated Approval “Question What is the clinical benefit of cancer drugs granted accelerated approval, and on what basis are they converted to regular approval?
Findings In this cohort study of cancer drugs granted accelerated approval from 2013 to 2017, 41% (19/46) did not improve overall survival or quality of life in confirmatory trials after more than 5 years of follow-up, with results not yet available for another 15% (7/46). Among drugs converted to regular approval, 60% (29/48) of conversions relied on surrogate measures.”
Patient Out-of-Pocket [OOP] Costs for Biologic Drugs After Biosimilar Competition “In this cohort study of 190 364 outpatients with 1.7 million claims for 7 biologics between 2009 and 2022, annual OOP spending did not decrease after the start of biosimilar competition, and OOP costs were similar for biosimilars and their reference biologics.”
See, also: Revisiting Expectations of US Biosimilars—Panacea or One Piece of the Puzzle?
About healthcare finance
Johnson & Johnson adds Shockwave Medical to its cardiovascular collection with $13.1B deal “J&J MedTech sees Shockwave’s pioneering portfolio of intravascular lithotripsy catheters—minimally invasive devices that use acoustic energy to shatter the hard, calcified blockages found deep within coronary and peripheral arteries—as the ticket to its 13th priority platform: one that will join its pantheon of products that each claim more than $1 billion in annual sales.
The deal follows up on 2023’s integration of the miniature heart pump maker Abiomed, a $16.6 billion buy, as well as J&J’s $400 million purchase of cardiac implant developer Laminar, aimed at reducing a person’s long-term risk of stroke linked to atrial fibrillation.”