Today's News and Commentary

About health insurance

House votes to get rid of ACA's controversial 'Cadillac' tax on high-cost plans: As predicted a few days ago, the House voted to repeal the tax on costly health plans. Now large firms will be able to provide rich health benefits that are fully tax deductible for them and tax exempt for employees. I expect the Senate to vote to pass the measure.

House lawmakers add arbitration to surprise billing measure: The House Energy and Commerce Committee “unanimously advanced the No Surprises Act as part of a major package that reauthorizes funding for community health centers and delays implementation of cuts to disproportionate share hospitals. The legislation, which now heads to the full House, bans balance billing and requires insurers to pay the median in-network rate for out-of-network surprise bills.” A last minute addition was an arbitration provision if the provider does not accept the insurance company payment.

Health Care Spending, Utilization, and Quality 8 Years into Global Payment: A pilot project of Blue Cross in Massachusetts set spending goals for physicians through population-based global budgets and . quality payments. “During the first 8 years after its introduction, the BCBS population-based payment model was associated with slower growth in medical spending on claims, resulting in savings that over time began to exceed incentive payments. Unadjusted measures of quality under this model were higher than or similar to average regional and national quality measures.” While these results were just published today, the trial ended in 2016. Further, there is nothing new in these findings, as similar results have long been known for capitated arrangements.

About healthcare quality and safety

Today, the Leapfrog Group released: Safety In Numbers: The Leapfrog Group’s Report on High-Risk Surgeries Performed at American Hospitals. Of the eight high-risk procedures assessed, “open abdominal aortic aneurysm repair and esophageal resection for cancer are the two procedures where the fewest hospitals met the volume standard for patient safety (less than 3% fully meeting for each). The procedure for which hospitals were most likely to meet the safety standard was bariatric surgery for weight loss (38%).”

About healthcare professionals

Medscape Residents Salary & Debt Report 2019: Some major findings:
—Over the past 2 years, average resident salaries have increase 3% to $61,200.
—Medical genetics topped the list at $67,500 and at the bottom was family medicine ($10,000 lower). Of course salaries increase each year and are greatest in the longest residencies.
—41% of residents said future earnings were extremely or very important to their specialty choice, while only 8% said it had no influence.
—22% had no debt while 24% had more than $300,000 in debt.

About healthcare IT

Exploring the Digital Divide: Age and Race Disparities in Use of an Inpatient Portal: This research found that there was “lower use of the inpatient portal among African American and older patients, relative to White and younger patients, respectively.” Authors concluded the “findings suggest that the availability of the technology alone may be insufficient to overcome barriers to use and that additional intervention may be needed to close the digital divide.”

About the public’s health

Disease X: Which Plague Is Coming Next?: Ebola, SARS, MERS, Zika…These are infections diseases which have sprung up relatively recently. What is next? This article is a nice summary of the answer to this question.

Association of Genetic and Environmental Factors With Autism in a 5-Country Cohort: Many environmental causes (including, erroneously, vaccinations) have been hypothesized as the cause of autism. This multi-country study shows that the heritability of autism is 80%, “indicating that the variation…is mostly owing to inherited genetic influences…”

Provisional Drug Overdose Death Counts: According to CDC provisional data, about 68,500 Americans died of a drug overdose in 2018, a 5% drop from the previous year. The decrease is the first time the number has fallen since 1999.

Latin America’s war on obesity could be a model for U.S.: Obesity is a major problem in Latin America. Countries in the region face the same obstacles as the U.S. in addressing this problem- including hard lobbying by business groups that would be affected by public health laws. This article is a nice summary of their successful efforts. For example, in" “July 2012, the Chilean Senate approved the law of food labeling and advertising, which went into effect in 2016 with comprehensive food-regulation policy in three, increasingly stringent phases. Spearheaded by Guido Girardi, a physician and senator, the law included front-of-package warnings, restrictions on marketing unhealthful foods directly to children, and limits on what foods could be sold in schools and day-care facilities.”

About healthcare technology

CVS Health Announces Start of Clinical Trial for New Home Hemodialysis Device: CVS announced it will initiate a clinical trial on up to 70 patients to test the safety and effectiveness of the at-home HemoCare Hemodialysis System. Because typical hemodialysis is accomplished during regular, scheduled hours in a facility, times are limited. CVS hopes that this home system will not only make treatment more convenient for patients but also allow them to have longer (or more frequent) sessions- thus improving clearance of blood toxins.