Today's News and Commentary

About quality and safety

Claims Data Signals & Solutions to Reduce Risks and Improve Patient Safety: This study (prepared by medical liability insurer Coverys) offers reasons for malpractice suits against primary care physicians. By far the single greatest cause was diagnostic error, accounting for 46% of the claims and 68% of indemnity payments. About half of the diagnostic errors were cancer-related. The study also has suggestions for mitigating these risks.

Read the report

2019 Top 10 Patient Safety Concerns: This report from the ECRI provides a list of top patient safety concerns. Following on the above article, the #1 concern is “Diagnostic Stewardship and Test Result Management Using EHRs.”

Read the report

Patient Outcomes After Hospital Discharge to Home With Home Health Care vs to a Skilled Nursing Facility: All things equal, which is better, discharging to home or a skilled nursing facility? After adjustment for proximity of the two options, the authors of the study found that: “Among Medicare beneficiaries eligible for postacute care at home or in a skilled nursing facility, discharge to home with home health care was associated with higher rates of readmission, no detectable differences in mortality or functional outcomes, and lower Medicare payments.”

Read the research (Subscription required, but abstract is available)

About health insurance

The Impact of Medicare-X Choice on Coverage, Healthcare Use and Hospitals: The American Hospital Association and Federation of American Hospitals issued a report on the effect Medicare buy-in would have on healthcare costs and hospital finances. Among the conclusions: “Nationally, healthcare spending would be reduced by $1.2 trillion (7%) over the 10-year period from 2024 to 2033, with spending for hospital services being cut by $774 billion -accounting for almost two-thirds of the total spending reduction.”

Since Medicare payment rates are a lot lower than commercial plans, and since these rates would affect hospitals the most, the findings are not surprising.

Read the full report

UnitedHealthcare Will Expand a Drug Discount Program Aimed at Lowering Consumer Costs: United’s pharmaceutical benefits management (PBM) subsidiary (OptumRx) announced that it will require all new employer-sponsored plans to pass along drug company rebates to their members. This action is in line with Medicare Part D proposals being floated by CMS.

Read the story (From the NY Times but appears to be open access)

Pharmacy benefit managers next up to testify in US Senate hearings on drug pricing: Speaking of drug prices, on the heels of recent Congressional testimony by big pharma execs, PBMs are set to appear on April 3.

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HHS Secretary Azar defends proposed cuts to Medicare hospital payments: Part of the President’s budget calls for reduction in hospital payments. This article reviews both what Democrats say the budget does and what Secretary Azar says will happen. You can see a recording of his defense and make up your own mind.

Read the article and see his defense

About the public’s health

FDA rolls out vaping policy to make it harder for minors to buy flavored products: Outgoing FDA Commissioner Scott Gottlieb continued his assault on tobacco products- this time issuing proposed rules for controlling flavored tobacco products delivered by electronic devices (vaping). The rules would limit sales of fruity and kid-friendly vaping products to stores that bar minors or have separate adult-only sections; online sellers would have to enhance their age verification processes and cut bulk sales.

Read the article
Read the FDA Draft Guidance

Cardiovascular disease burden from ambient air pollution in Europe reassessed using novel hazard ratio functions: This research concludes that: “The annual excess mortality rate from ambient air pollution in Europe is 790 000…Between 40% and 80% are due to cardiovascular events, which dominate health outcomes… We estimate that air pollution reduces the mean life expectancy in Europe by about 2.2 years with an annual, attributable per capita mortality rate in Europe of 133/100 000 per year.” To put these numbers in perspective, the mortality rates are higher than tobacco use. Seems like air pollution has become the #1 public health problem.

Read the research