About health insurance
Comparing Private Payer and Medicare Payment Rates for Select Inpatient Hospital Services: Among the findings of this Kaiser Family Foundation study: “Private insurance payment rates were between 1.6 and 2.5 times higher than Medicare rates, with some variation among the ten DRGs included in our analysis…Private insurance paid at least $10,000 more than Medicare rates on average for four of the seven other diagnoses we analyzed.” A perfect example of cost-shifting.
Exchanges May Add More than 1 Million New Enrollees due to COVID-19:The latest projections from Avalere.
Accountable Care Organizations and Patient-Centered Medical Homes: Health Expenditures and Health Services: Researchers compared “total health expenditures and health services utilization of patients receiving care in stand-alone accountable care organization (ACO only), stand-alone patient-centered medical home (PCMH only), hybrid (ACO + PCMH), and standard (neither ACO nor PCMH) facilities.” The study concluded that care “received in ACO and PCMH facilities is associated with lower total health care costs compared with standard care. However, hybrid models are associated with slightly higher total health care costs compared with stand-alone models. Integrating innovations in health care delivery and health care reimbursement warrants further evaluation.” The last sentence is noteworthy- higher costs are perhaps due to lack of coordination in the hybrid model.
About the public’s health
The next two articles have a common theme- making healthcare information understandable
How to Read Covid-19 Research (and Actually Understand It): A really good explanation of this topic with examples like hydroxychloroquine effectiveness evaluations. When you finished with this article, read: U.K. megatrial outshines other drug studies.
Americans Are Bewildered by Patchwork of Social-Distancing Rules: “A growing number of public health experts agree that there needs to be more nuanced guidelines for Americans that allow some liberties. Public-health non-profit Vital Strategies has suggested color-coded alerts that communicate to the public how severe the virus is in a given region so that people can adjust their activities appropriately on any given day. (Vital Strategies has received funding from Bloomberg Philanthropies, the charitable foundation of Michael Bloomberg, the founder and majority owner of Bloomberg News’s parent company.) The Texas Medical Association has an activity guide citing camping, tennis and take-out as low-risk, while movie theaters and gyms are high.”
Preschooler's Month of Birth Influences Odds of Becoming Ill With the Flu: “Preschoolers have a higher risk of being diagnosed with the flu if they are born before September, an analysis of insurance claims from more than 1.1 million children has concluded.
The reason: children with birthdays in July and August are less likely to receive the annual influenza vaccine when they are 2 to 5 years old because they often have their annual checkup close to their birthday, before the seasonal vaccine is available.”
Want to defeat COVID-19? Deliver a 70% effective vaccine—and get 70% of people to take it, FDA official says: “To eradicate SARS-CoV-2, the virus that causes COVID-19 illness, we'll need a vaccine that's 70% effective—and 70% of the population will need to receive it, an FDA vaccine official said Wednesday.
That's a higher bar than the FDA set last week. To pass muster at the agency, a COVID-19 vaccine will need to be at least 50% more effective than placebo, according to new FDA guidelines.”
Oxford researchers develop portable COVID-19 test costing less than $25:”The University of Oxford and its research center in China are launching a new company to develop a rapid COVID-19 test that could cost no more than £20, or about $25 U.S.”
Independent evaluation of global COVID-19 response announced: Amid criticisms over its slow response, the WHO Director-General “announced the initiation of the Independent Panel for Pandemic Preparedness and Response (IPPR) to evaluate the world’s response to the COVID-19 pandemic.”
New WHO guidance calls for more evidence on airborne transmission: “The World Health Organization on Thursday released new guidelines on the transmission of the novel coronavirus that acknowledge some reports of airborne transmission of the virus that causes COVID-19, but stopped short of confirming that the virus spreads through the air…
The report follows an open letter from scientists who specialize in the spread of disease in the air - so-called aerobiologists - that urged the global body to update its guidance on how the respiratory disease spreads to include aerosol transmission.”
About healthcare IT
Telemedicine is booming during the pandemic. But it’s leaving people behind.:”Unless health-care systems commit to deploying video technology that is explicitly designed to provide care for our most vulnerable patients, telehealth will further entrench health disparities.” The article provides examples of care disparities created by usual telehealth systems.
Most physicians predict fewer than 10% of their visits will be virtual by next year :The article provides some details of projected telemedicine use by specialty.
Doctor on Demand lands $75M to invest in virtual primary care, behavioral health: “Doctor On Demand wasn't planning to raise capital this year, but the company has seen demand for virtual visits surge during the COVID-19 pandemic.
The venture-backed telemedicine company raised $75 million in series D financing led by General Atlantic, a global growth equity firm, with participation from existing investors.”
See the above story about projected lower use of telemedicine.
Teladoc sued due to robocalls: “April Hale and Len Cline filed suit on July 8 in the Southern District of New York after receiving multiple unsolicited robocalls, attempting to sell its $29.99 membership package. Teladoc contracted with Health Insurance Innovations to place the calls, which the defendants claim violates the Telephone Consumer Protection Act. Both companies would share in the profit from sales, according to the lawsuit.”
The tradeoffs between safety and alert fatigue: Data from a national evaluation of hospital medication-related clinical decision support: “Although hospitals improved overall from 2017 to 2018, there is still important room for improvement for both fatal and nuisance orders. Hospitals that incorrectly alerted on one or more nuisance orders had slightly higher overall performance, suggesting that some hospitals may be achieving higher scores at the cost of overalerting, which has the potential to cause clinician burnout and even worsen safety.”
A new AI tool to fight the coronavirus: “Members of the newly formed Collective and Augmented Intelligence Against COVID-19 (CAIAC) announced today include the Future Society, a non-profit think tank from the Harvard Kennedy School of Government, as well as the Stanford Institute for Human-Centered Artificial Intelligence and representatives from UN agencies.
Within six to eight weeks, CAIAC's platform will produce a decision-making tool that will initially focus on digital contact tracing of coronavirus infections, ferreting out misinformation about the pandemic and identifying second and third-order effects of COVID-19 that go beyond illness and death.”
About pharma
Drug Giants Create Fund to Bolster Struggling Antibiotic Start-Ups: “Twenty of the world’s largest pharmaceutical companies on Thursday announced the creation of a $1 billion fund to buoy financially strapped biotech start-ups that are developing new antibiotics to treat the mounting number of drug-resistant infections responsible for hundreds of thousands of deaths each year.
The fund, created in partnership with the World Health Organization and financed by drug behemoths that include Roche, Merck, and Johnson & Johnson, will offer a short-term but desperately needed lifeline for some of the three dozen small antibiotic companies, many of them based in the United States, that have been struggling to draw investment amid a collapsing antibiotics industry.”
Trump will sign three executive orders on lowering drug prices: chief of staff: “President Donald Trump will sign three executive orders on lowering prescription drug prices, White House Chief of Staff Mark Meadows said on Thursday.” No details were given.
FDA Approves Mylan and Fujifilm’s Humira Biosimilar: Further competition will lower prices for this often-used specialty medication.
About hospitals
Tenet hospital agrees to $72.3M settlement with DOJ over kickback suit: “The Department of Justice (DOJ) announced this week that the Oklahoma Center for Orthopaedic and Multi-Specialty Surgery (OCOM)—as well as its part-owner management company, which includes USP OKC and USP OKC Manager (USPI), Southwest Orthopaedic Specialists (SOS) and two SOS physicians—agreed to the settlement to resolve of false claims. Tenet owns 95% of USPI.
The DOJ alleged improper relationships between OCOM and SOS resulted in the submission of false claims to the Medicare, Medicaid and TRICARE programs.”