Today's News and Commentary

About healthcare IT

Federal Trade Commission, Plaintiff, v. Surescripts, LLC: This is the story of the day. Surescripts may be the only truly interoperable functionality in the IT space. It checks patient insurance eligibility and allows physicians to prescribe electronically. The FTC filed this suit claiming Surescripts engaged in anticompetitive behavior (such as predatory pricing) to keep its monopoly. The government is asking for cessation of this behavior and “grant other such equitable relief, including equitable monetary relief, as the Court finds necessary to redress and prevent recurrence of Defendants’ violations.”

Read the brief

Poor Usability of Electronic Health Records Can Lead to Drug Errors, Jeopardizing Pediatric Patients: This report from the Pew Trusts documents the harms to pediatric patients from electronic record dysfunctions. The paper details twelve different area and opportunities for improvement. Examples include: Patient received drug overdose due to entry of wrong weight; Display problems with automatic medication holds caused missed dose: and Hidden medication order settings contributed to a lapse in care.

Read the study

About health insurance

Poll: Majority of Americans want laws protecting them from surprise medical bills: If you ask Americans what they want next from their health insurance, it is lower drug costs and protection from surprise medical bills. ACA repeal and “Medicare for all” got fewer than a third response rate as a high priority.

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Three New Opportunities to Test Innovative Models of Integrated Care for Individuals Dually Eligible for Medicaid and Medicare: CMS Administrator Verma announced federal efforts to reduce costs for those eligible for both Medicare and Medicaid (dual eligibles). According to Verma: “ dually eligible individuals have accounted for 20 percent of Medicare enrollees, yet 34 percent of Medicare spending. The same individuals have accounted for 15 percent of Medicaid enrollees and 33 percent of Medicaid spending.”
Her proposal calls for three types of programs: capitation model, shared fee for service, and state-specific innovations. Of note is that from their earliest days, Medicare HMOs enrolled dual eligibles. Also, the shared fee for service is like the Medicare Shared Savings Plans currently in operation. Further, states have long been able to apply for waivers for Medicaid beneficiaries and others. I do not understand what is new. Why add to the bureaucracy when expansion of current programs would solve the same problems?

Read the CMS announcement

We’re investigating how insurance gaps endanger mothers. This is why.: This article points out the growing maternal mortality rate weeks after delivery, when many mothers lose their Medicaid eligibility. The mortality is due to untreated chronic conditions.

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Moody's: Insurers like Centene, Molina better positioned to weather economic downturn than in 2008: This article summarizes a recent Moody’s report on resilience of the healthcare sector in the event of a recession. A couple sample points: companies like Centene and Molina will be fine because of their positions participating in ACA exchanges where the unemployed would be eligible for subsidized enrollment; hospitals, on the other hand, would see an unfavorable change in payer mix and increase in uncompensated care.

Read the article (The original report requires subscription)

About the public’s health

The Impact of Chronic Underfunding on America’s Public Health System: Trends, Risks, and Recommendations, 2019: This report from the Trust for America’s Health documents underfunding for public health measures. For example, “the CDC’s budget fell by 10 percent over the past decade (FY 2010-19), after adjusting for inflation.” An additional $4.5 billion is required to bring this system to where it needs to be. The study also documents the high degree of public support for more funding.

Read the report

Antibiotic use linked to greater risk of heart attack and stroke in women: Another reason to be cautious about antibiotic use. The “researchers found that women who used antibiotics for periods of two months or longer in late adulthood were 32% more likely to develop cardiovascular disease than women who did not use antibiotics. Women who took antibiotics for longer than two months in middle age had a 28% increased risk compared to women who did not…The most common reasons for antibiotic use were respiratory infections, urinary tract infections and dental problems.”

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The State of the Air 2019: In its 20th annual report, the American Lung association reports that air quality is getting worse. Currently: “More than four in 10 Americans, approximately 43.3 percent of the population, live in counties that have monitored unhealthy ozone and/or particle pollution. The number of people exposed to unhealthy air increased to nearly 141.1 million. “ You can also look up the air quality where you live.
For example, I live near two adjacent counties, both of which got an “F” rating for ozone.

Read the report

About pharma

New PhRMA Report Shows More Than 160 Medicines in Development for Diabetes and Related Conditions:Finally some good news. Pharma companies have been working a lot on medications for rare diseases that can be sold at high prices. This article documents the research for a very common disease.

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Gilead defied a government HIV patent. The Justice Department has opened a review.: Gilead holds the patent for Truvada as a treatment for HIV infection. But the drug can also be used to prevent infection (Truvada for PrEP). The Justice Department claims the patent for the latter use belongs to the federal government because it was developed at the CDC. The issue is that Gilead is not paying the government royalties for its preventive use.

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