Today's News and Commentary

About pharma

New gene editor harnesses jumping genes for precise DNA integration: Current efforts at gene editing have used CRISPR technology- cutting and replacing genes. This new technology integrates genetic changes without the potential problems due to the imprecision of cutting.

Read the research announcement

How Drug Prices Are Negotiated in Germany: As we look to other countries for pharmaceutical pricing solutions, one option is the German system. It relies on consortium negotiations with pharma companies. It is an interesting model, even if it would face some possible anti-trust issues if adopted here.

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Grassley Calls for Drugmakers to Share Medicare Costs: When spending for Medicare Part D beneficiaries reaches a certain limit, the federal government steps in and covers 80% of the “catastrophic expenses.” Senate Finance Committee Chair Chuck Grassley is calling for pharma companies to share in some of that expense.

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DeSantis signs Florida drug importation bill: Despite not having the required federal approval for such action, Florida now allows importation of pharmaceuticals from Canada and other countries.

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About healthcare IT

Facebook debuts US blood donation tool, its latest public health move: Yesterday, Facebook launched a feature “to help users find places to donate blood in their area and be notified when a nearby blood donation center may be in need.”

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Health systems look to tech to improve efficiency, interoperability: While the subject of the article is not really “new",” one fact is startling: “no more than a third of healthcare organizations surveyed said they currently leverage any single cybersecurity best practice.” Obviously the market for providing these solutions is wide open.

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Why are physicians not sharing patient info? Lack of data sharing, privacy concerns and more: The top reason for not sharing data inside and outside the organization is lack of access to data sharing systems. The solution to that problem is technical. But also scoring high are concerns over data privacy and security. That kind of trust is not so easy to get.

Read the summary article
Read the original research from Phillips (Has a lot more information, like patient preferences for owning their data)

About health insurance

Lawmakers: If industry doesn't solve surprise billing problem, 'we will,' and 'none of you will like it': This article summarizes some rhetoric by lawmakers about their intent to pass the No Surprises Act, which is now in draft form. The Act amends “the Public Health Service Act and title XI of the Social Security Act to protect health care consumers from surprise billing practices, and for other purposes.” Briefly, it says that insurance companies must pay emergency bills for non contracted providers as they would for contracted providers and count patients’ out- of- pocket payments toward deductibles and annual limits. As far as providers of these services, “ if such provider holds such individual [patient] liable for a payment amount for such an item or service furnished by such provider during a visit at such facility that is more than the cost-sharing amount for such item or service (as determined in accordance with section  2719A(e)(1)(A) of the Public Health Service Act), such provider shall be subject, in addition to any other penalties that may be prescribed by law, to a civil money penalty of not more than $[amount to be determined] for each specified claim.” In other words, contracted providers will be required to limit their charges.

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Berwick: Cost concerns over 'Medicare-for-All' overblown: Yesterday, the House Ways and Means Committee hosted a panel of health policy experts and advocates to comment on 'Medicare-for-All.' Donald Berwick, M.D., president emeritus of the Institute for Healthcare Improvement and former administrator of the Centers for Medicare & Medicaid Services expressed his opinion that the reputed costs for such a program are overblown.

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Read more on this hearing

AMA says yes to strengthening ACA, no to ending opposition to 'Medicare-for-All' single-payer reform: The headline says it all. The votes were taken at this week’s annual AMA meeting.

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Impact Of Physicians, Nurse Practitioners [NPs], And Physician Assistants [PAs] On Utilization And Costs For Complex Patients: Insurance companies have looked at payment models for non physicians and worried about increased costs. This study from Duke using 2012-2013 VA data showed that: “Case-mix-adjusted total care costs were 6–7 percent lower for NP and PA patients than for physician patients, driven by more use of emergency and inpatient services by the latter. We found that use of NPs and PAs as primary care providers for complex patients with diabetes was associated with less use of acute care services and lower total costs.”

Read the study (Health Affairs but open access article)

About the public’s health

Canada Is Banning Single-Use Plastics as Early as 2021: Canada is not the only country that has gone down this road. The article includes other examples.

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CDC activates Emergency Operations Center for Congo Ebola outbreak: The outbreak of over 2000 cases in the Democratic Republic of the Congo (DRC) is the second largest ever recorded and has spread to Uganda. The CDC wants to help contain the highly infectious disease before it spread elsewhere.

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Time to End the Manel Tradition: This letter from NIH Director Francis S. Collins, M.D., Ph.D. declares: “it is time to end the tradition in science of all-male speaking panels, sometimes wryly referred to as ‘manels.’ Too often, women and members of other groups underrepresented in science are conspicuously missing in the marquee speaking slots at scientific meetings and other high-level conferences. Starting now, when I consider speaking invitations, I will expect a level playing field, where scientists of all backgrounds are evaluated fairly for speaking opportunities. If that attention to inclusiveness is not evident in the agenda, I will decline to take part. I challenge other scientific leaders across the biomedical enterprise to do the same.”

Read the letter

Barriers to Care Experienced by Women in the United States: Speaking of gender inequalities, this article provides a clear “infographic” of the problems women face from the US healthcare system.

View the graphics

Women in the healthcare industry: This paper by McKinsey & Company is a survey of women’s roles in management in healthcare. The bottom line is that the situation is better than in other industries but still has a long way to go to achieve equity.

Read the report

Cheerios, Nature Valley cereals contain Roundup ingredient, study finds: This story continues the exposure of foods that contain the weed killer Roundup. The EWG (Environmental Working Group) “said the tests found glyphosate levels above what it considers safe for children in all but four of the products.”

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The Worst Patients in the World:This extended article from The Atlantic posits that if we exported our population to other countries, they would have the same cost problems that we have.

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Study Calls for Clarity on SDOH, Related Terminology: This article reviews the different definitions for Social Determinants of Health and calls for more uniformity in the term.

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Clinical Metagenomic Sequencing for Diagnosis of Meningitis and Encephalitis: Despite the complex title, the message is simple. Detection of genomic sequences in the blood of patients with nervous system infections was better than bacterial cultures in making a diagnosis and guiding treatment. This technique could open a whole new methodology for diagnosis.

Read the abstract

Intermountain, Amgen subsidiary launch DNA mapping effort: These two organizations are teaming up for what they contend “is the largest and most comprehensive domestic DNA mapping effort to date from a single population.” The project will map DNA from 500,000 patients of Utah-based Intermountain.

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About hospitals

Hospitals' Top Priorities Swing to Growth over Costs for 2019: This summary of an annual Advisory Board report showed that:

The Top 5 areas of extreme interest to hospital and health system executives are:

1. Improving ambulatory access (57 percent)
2. Minimizing unwarranted clinical variation (53 percent)
3. Strengthening primary care alignment (53 percent)
4. Redesigning health system services for population health (52 percent)
5. Innovative approaches to expense reduction (51 percent)

Read the article (The original report is for Advisory Board members only)