About Covid-19
HHS expected to renew COVID-19 PHE for 11th time “HHS is set to extend the COVID-19 public health emergency by its standing deadline of Oct. 13.
HHS last renewed the PHE July 15 for another increment of 90 days with a pledge to provide states with 60 days' notice if it decided to terminate the declaration or allow it to expire. Aug. 14, the date in which states would have 60 days' notice, came and went without updates or notifications from the agency, suggesting the declaration will extend.
If renewed on the deadline of Oct. 13, the next deadline would be Jan. 11, 2023…
For an overview of the flexibilities tied to the PHE and what occurs when the declaration ends, check out a comprehensive brief from Kaiser Family Foundation here.”
Americans are moving on from COVID-19 despite acknowledged risks Some highlights of the survey:
The share of Americans who report being concerned about COVID-19 (57%) is among the lowest captured throughout the pandemic. Of those who are concerned, a plurality is more concerned about spreading the virus to people who are at higher risk of serious illness (28%) than for themselves, whether it’s developing long COVID (18%), being hospitalized (12%), or dying (11%).
Nearly two in three (65%) say there is a small risk or no risk in returning to their normal, pre-COVID life.
More Americans now say they already have returned to their normal, pre-COVID life (46%) than at any point during the pandemic.
Still, just 11% say there is no risk of them contracting COVID.
The share of Americans that report occasionally or never wearing a mask outside their home has remained consistent since June (around 63%) but is significantly higher than during height of Omicron in mid-January 2022 (27%).
Nearly two in three (65%) support federal, state, and local governments lifting all COVID-19 restrictions.
Despite the program ending earlier this month, 83% support the federal government mailing free at-home COVID-19 tests to anyone who wants one.
Similarly, 87% support the federal government providing COVID-19 vaccines and treatments for free, regardless of health insurance status.”
About health insurance/insurers
Health Insurance Coverage in the United States: 2021-Current Population Reports From the US Census Bureau: Highlights:
--”More people were insured in 2021 than 2020. In 2021, 8.3 percent of people, or 27.2 million, did not have health insurance at any point during the year, representing a decrease in the uninsured rate and number of uninsured from 2020 (8.6 percent or 28.3 million).
--In 2021, private health insurance coverage continued to be more prevalent than public coverage, at 66.0 percent and 35.7 percent, respectively.
--Of the subtypes of health insurance coverage, employer- based insurance was the most common, covering 54.3 percent of the population for some or all of the calendar year, followed by Medicaid (18.9 percent), Medicare (18.4 percent), direct-purchase coverage (10.2 percent), TRICARE (2.5 percent), and VA and CHAMPVA coverage (1.0 per- cent).
--Overall, public coverage increased between 2020 and 2021. In 2021, 35.7 percent of people held public coverage for some or all of the year, marking a 1.2 percentage- point increase from 2020.
--Between 2020 and 2021, the rate of Medicaid coverage increased by 0.9 percentage points to cover 18.9 percent of people.
--The uninsured rate among children under the age of 19 decreased 0.6 percentage points to 5.0 percent between 2020 and 2021, driven in part by an increase in public coverage.
--In 2021, 7.9 percent of full- time, year-round workers had public health insurance, up 1.8 percentage points from 2020. Among less than full- time, year-round workers, the percentage with public coverage increased 1.6 percentage points to 22.6 percent during this period.”
This annual document is a great resource for health insurance information.
How State Surprise Billing Protections Increased ED Visits, 2007-2018: Potential Implications for the No Surprises Act “Results: By analyzing 15 state-level bans, we find that the bans reduced spending per visit by 14% but spurred a demand response, an increase of 3 percentage points in ED visits, which wiped away the cost savings. Based on an ED severity index, these extra ED visits were 9% less urgent than prior to the bans.
Conclusions: We predict that the federal ban will result in $5.1 billion in savings but 3.5 million more ED visits at $4.2 billion in extra spending per year, largely negating expected savings. Health plans must be prepared to manage this spike in ED visits as the No Surprises Act takes effect.”
Top 10 Accountable Care Organizations by Medicare Shared Savings FYI
AMA, 2 state medical societies join class-action suit against Cigna “The American Medical Association (AMA) has joined a class-action lawsuit against Cigna, alleging the insurer underpaid for claims filed by providers in the contracted MultiPlan network.
MultiPlan is the country's largest third-party network, and Cigna contracts with it to access providers. According to the lawsuit, which was initially filed in June, Cigna reimbursed for claims from providers in MultiPlan's network at its non-participating providers rate rather than at the rate expected for a MultiPlan contract.
As such, the insurer ‘significantly underpaid claims, and put patients at risk of balance billing,’ the plaintiffs claim.”
The number of Americans with past-due medical bills is unchanged since 2015 “The report explores the relationship between past-due medical bills and demographics. Among the key findings:
Since 2015, the percentage of Americans who reported past-due medical bills has remained in the low 20% range, down from 26% in 2012.
Compared with other sources of debt, Americans were less likely to report that they had past-due medical bills.
Women were slightly more likely than men to report that they had past-due medical bills.
The likelihood of having past-due medical bills increased with age for younger adults but decreased with age for older adults.
Black adults were more likely than other race and ethnicity groups to report that they had past-due medical bills.
Adults with a high school degree or less were more likely than those with a college or graduate degree to report that they had past-due medical bills.
As income increased, the odds of having past-due medical bills decreased.
Health insurance and living in a Medicaid expansion state reduced the percentage of individuals reporting that they had past-due medical bills.
Past-due medical bills were highly correlated with a lower level of use of health care services.
Individuals with past-due medical bills were more likely than those without them to report several other financial challenges.”
About hospitals and healthcare systems
Illinois delays Atrium, Advocate Aurora merger “The Illinois Health Facilities and Services Review Board voted Sept. 13 to postpone a vote on the change of ownership for 10 Advocate Aurora facilities in the state covered by the system's plan to merge with Charlotte, N.C.-based Atrium Health.
Atrium and Advocate Aurora, dually headquartered in Milwaukee and Downers Grove, Ill., announced plans to merge into a 67-hospital system with upward of $27 billion in revenue in May.”
About pharma
Rebate walls may thwart biosimilar savings: Biosimilars of AbbVie's Humira are expected to reduce annual pharmaceutical expenditures by $5 billion, but they may be delayed by rebate strategies. “Several biosimilars for the world’s top-selling drug are slated to hit the market next year, but the potential billions of dollars in savings may not materialize until at least 2024.
Humira, the rheumatoid arthritis and anti-inflammatory biologic that has netted AbbVie nearly $200 billion in sales, has benefited from nearly two decades of exclusivity, allowing the manufacturer to hike the price 470% since the drug was introduced. The monopoly will end with the introduction of several Food and Drug Administration-approved copycat versions slated to hit the market in 2023, and more are on the way.
Humira’s biosimilars will save the healthcare system an estimated $5 billion or so a year, cutting costs for providers and patients. Biosimilars will likely be about half the price of Humira, which is $84,000 for a year of treatment.
But AbbVie may manipulate the rebates associated with Humira to limit competition and the potential savings from lower-cost biosimilars.”
About healthcare IT
Increased Mortality Rates Linked to Cyber-Attacks Against Healthcare Organizations “Cyber–attacks against healthcare organizations cause more than 20% to experience increased mortality rates, suggests new research by Proofpoint’s Ponemon Institute.
The report, which surveyed 641 healthcare IT and security practitioners, also found that 89% of them experienced an average of 43 attacks in the past 12 months, with more than 20% suffering one of the following types of attacks: cloud compromise, ransomware, supply chain, and phishing….
he most common consequences of these attacks were delayed procedures that resulted in poor patient outcomes for 57% of the healthcare providers and increased complications from medical procedures for roughly half of them.
The attack type most likely to negatively impact patient care was ransomware, leading to procedure or test delays in 64% of cases and longer patient stays (59%).”
Doximity expands access to telehealth service free of charge to thousands of clinics “Doximity, a digital platform for medical professionals, is expanding access to its telehealth service, Dialer Pro, to free medical clinics across the U.S. at no cost.
The telehealth platform is accessible to the purported 1,007 free clinics that offer medical care at zero cost to the patient. Such patients are estimated to total 1.8 million nationwide. The platform’s pilot program was utilized by 48 clinics and roughly 1,000 clinicians in various communities throughout the country.”
The question now is: Do these clinics’ patients have access to the hardware and software to access telemedicine?
About healthcare personnel
2022 Survey of Physician Appointment Wait Times and Medicare and Medicaid Acceptance Rates “Average physician appointment wait times have increased significantly since the survey was last conducted in 2017 and first conducted in 2004. The average wait time for a physician appointment for the 15 large metro markets surveyed in 2022 is 26.0 days, up from is 24.1 days in 2017, an 8% increase, and up from 20.9 days in 2004, a 24% increase….
The average rate of physician Medicare acceptance is 82.4% for all 15 metropolitan areas, down from 84.5% in 2017, a decrease of 4%.
The average rate of physician Medicaid acceptance is 54.1% in all 15 metropolitan areas, up from 53% in 2017, an increase of 2%.”
See the study for specialty and location-specific data.
About health technology
Estimated Cost of Developing a Therapeutic Complex Medical Device in the US “In this economic evaluation study using data from public and proprietary sources, an analytical cost model found that the estimated mean expected capitalized development cost per therapeutic complex medical device was $522 million. The nonclinical development stage accounted for 85% of this cost, whereas the US Food and Drug Administration submission, review, and approval stage comprised 0.5%.”
Baxter reportedly considering shedding dialysis businesses: Bloomberg “Following its blockbuster buy of medtech manufacturer Hillrom late last year, Baxter may now be preparing to trim some of the fat from its newly expanded product portfolio.
The devicemaker is said to be considering a sale of two units within its kidney care division, Bloomberg reports. Unnamed sources familiar with the considerations told the outlet that Baxter is working with advisers to explore the potential sale of its renal care services and hemodialysis divisions.”
Sony dives into nascent over-the-counter hearing aid market with WS Audiology partnership “The consumer electronics giant said it plans to provide a device that users can buy, fit and program themselves, without requiring a visit to a hearing specialist. Sony will work with the Denmark-based WS Audiology, and the development of their first product under the Sony brand is already underway, the companies disclosed in their announcement.
The FDA finalized its long-awaited regulatory rule in August to allow adults with mild to moderate hearing loss to purchase certain types of hearing aids online and in retail stores without a prescription—specifically air-conduction amplifiers that don’t require a surgical implant and can be worn in or behind the ear. The rule takes full effect in mid-October.”
“Human vs Machine” Validation of a Deep Learning Algorithm for Pediatric Middle Ear Infection Diagnosis “We compared the diagnostic performance of human clinicians with that of a neural network algorithm developed using a library of tympanic membrane images derived from children taken to the operating room with the intent of performing myringotomy and possible tube placement for recurrent acute otitis media (AOM) or otitis media with effusion (OME)…
Our model achieved a mean prediction accuracy of 80.8% (95% CI, 77.0%-84.6%). The Google model achieved a prediction accuracy of 85.4%. In a validation survey of 39 clinicians analyzing a sample of 22 endoscopic ear images, the average diagnostic accuracy was 65.0%. On the same data set, our model achieved an accuracy of 95.5%.
Conclusion
Our model outperformed certain groups of human clinicians in assessing images of tympanic membranes for effusions in children. Reduced diagnostic error rates using machine learning models may have implications in reducing rates of misdiagnosis, potentially leading to fewer missed diagnoses, unnecessary antibiotic prescriptions, and surgical procedures.”
Think about the implications for home diagnostics.
