About health insurance
Anthem Waives Cost Share for COVID-19 Treatment: Insurance companies are expanding benefits for covered members beyond testing for coronavirus. This Anthem “expansion covers the waiver of cost share for COVID-19 treatment received through May 31, 2020. Anthem will reimburse health care providers at in-network rates or Medicare rates, as applicable, for Anthem’s affiliated health plan fully insured, Individual, Medicaid and Medicare Advantage members. Anthem is strongly encouraging participation by our self-funded employers and will work with them to ensure their employees’ needs are met.” Note the last sentence. Many insurers are only acting as third party administrators for self-insured businesses; so the choice of benefits is up to the employer. Here is a more complete list of insurers waiving COVID-19 costs. Click on the plan to see the company’s policies.
Blue Cross parent launches special enrollment period: As posted yesterday, the Trump administration withdrew its previous proposal to open up the health exchanges for a special enrollment period. This insurer-based action may act as a model for social action. “Blue Cross & Blue Shield of Illinois parent company Health Care Service Corp. is offering a special sign-up period to increase the number of people with health insurance during COVID-19.
The enrollment period, which runs from today through April 30, applies to people who previously declined group health insurance coverage through their employer, the Chicago-based insurer, which owns Blue Cross plans in five states, announced today. It does not extend to self-insured employer plans, in which employers bear the cost of claims.”
Insurers knew the damage a viral pandemic could wreak on businesses. So they excluded coverage: Not a health insurance issue but important, nevertheless. “The forced closure of businesses nationwide because of the novel coronavirus would seem to be the perfect scenario for filing a ‘business interruption’ insurance claim.
But most companies will probably find it difficult to get an insurance payout because of policy changes made after the 2002-2003 SARS outbreak, according to insurance experts and regulators.
…many insurers added exclusions to standard commercial policies for losses caused by viruses or bacteria. Now, the added policy language will potentially allow insurance companies to avoid hundreds of billions of dollars in business-interruption claims because of the covid-19 pandemic.”
About pharma
White House pressures FDA on unproven Japanese drug: I mentioned this drug in a previous posting. Trials are underway. “Japanese Prime Minister Shinzo Abe has championed the drug, Avigan, as a possible treatment, and clinical trials are now getting underway in Japan. Chinese scientists also have touted the drug, produced by Japan-based Fujifilm, as a potential coronavirus treatment, but global regulators and U.S. researchers have long expressed concern about the drug’s risks, such as birth defects, and have warned that the Chinese data is insufficient.”
Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial: This reference is the article the White House is touting as evidence for the effectiveness of hydroxychloroquine. I posted another Chinese study showing a slight, but statistically insignificant, benefit in the control group. Note that it is a preprint that has not been peer reviewed.
Unlike FDA, European regulators refuse to clear chloroquine for COVID-19 without data: In a related story: “In guidance Wednesday, the European Medicines Agency restricted general use of the drugs—already approved to treat malaria and autoimmune diseases—to patients taking them for approved indications. COVID-19 patients can receive the drugs as part of clinical trials or through national emergency use programs, the EMA said.”
The Role of Combination Antiplatelet and Anticoagulation Therapy in Diabetes and Cardiovascular Disease: Insights from the COMPASS Trial: Yes, there really is non-COVID-19 news. This study could set treatment standards for diabetic patients with cardiovascular disease. “In stable atherosclerosis, the combination of aspirin plus rivaroxaban 2.5 mg twice daily provided a similar relative degree of benefit on coronary, cerebrovascular, and peripheral endpoints in patients with and without diabetes. Given their higher baseline risk, the absolute benefits appeared larger in those with diabetes, including a three-fold greater reduction in all-cause mortality.”
About the public’s health
China Concealed Extent of Virus Outbreak, U.S. Intelligence Says: “China has concealed the extent of the coronavirus outbreak in its country, under-reporting both total cases and deaths it’s suffered from the disease, the U.S. intelligence community concluded in a classified report to the White House, according to three U.S. officials.
The officials asked not to be identified because the report is secret, and they declined to detail its contents. But the thrust, they said, is that China’s public reporting on cases and deaths is intentionally incomplete. Two of the officials said the report concludes that China’s numbers are fake.”
Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020: This study emphasizes the need for mass testing. “Investigation of all 243 cases of COVID-19 reported in Singapore during January 23–March 16 identified seven clusters of cases in which presymptomatic transmission is the most likely explanation for the occurrence of secondary cases.”
‘We have no choice.’ Pandemic forces polio eradication group to halt campaigns: Treatment and prevention of other diseases do not stop because of COVID-19. “The COVID-19 pandemic is imperiling the worldwide, 3-decade drive to wipe out polio. In an unprecedented move, the Global Polio Eradication Initiative (GPEI) has recommended suspending polio vaccination campaigns to help stop the spread of the novel coronavirus.”
BD to offer fingerstick antibody blood test for COVID-19: This method tests for antibodies rather than nucleic acid fragments of the virus. It takes 15 minutes and is done with a finger stick.
Texas 'mom and pop' business flooded with orders for helmet ventilators amid coronavirus crisis: This small Texas- based company’s space-helmet device has been tested in Italy and the US. “ …using them required ventilation 18.2 percent of the time, compared to 61.5 percent for the masks, and had a better 90-day survival rate, according to the study, published in the Journal of the American Medical Association.” The device costs $160. Why is the federal government not funding and ramping up such effective technology?
Medical Device Company’s Israel Division to Provide Ventilator Blueprints for Free: In a related technology story, the “Israel division of the medical device company Medtronic will provide the blueprints for its ventilators for free to companies seeking to manufacture them.”
Governmental Public Health Powers During the COVID-19 Pandemic: The government has certain powers to impose public health measures. This is a very good article that gives the legal basis for governmental actions during such crises.
About healthcare IT
Microsoft warns hospitals of sophisticated ransomware attacks targeting remote workforce: With more people than ever before working remotely, the opportunity for hacking into companies has greatly increased. “As healthcare organizations move their nonessential employees to work remotely during the COVID-19 pandemic, ransomware operators are trying to find vulnerabilities in network devices like gateway and virtual private network (VPN) appliances.”
About hospitals
Hospitals margins fell as COVID-19 pandemic ramped up: “U.S. hospitals were already facing falling margins when the COVID-19 pandemic began to ramp up in the nation.
That’s according to the National Hospital Flash Report from Kaufman Hall, which provided a snapshot of the performance of U.S. hospitals in February 2020. COVID-19 is expected to have a significant impact on hospitals over the coming months, changing the outlook for healthcare providers in the U.S.
EBITDA margins dropped 92.7 basis points year over year in February, while operating margin declined 73.2 basis points. Operating EBITDA margin dropped 162.9 basis points and operating margin fell 206.4 basis points.
Margins fell thanks to lower volumes from January 2020 and higher expenses.”
