Doctors have joined the chorus for more gun restrictions Condolences to the families and friends of the Robb Elementary School victims. Today’s “The Health 202” in The Washington Post has an excellent summery of recent gun control efforts.
Rhetorical question: Why is it that the Republican party opposes gun control legislation and at the same time it claims to be be an advocate of the pro-life agenda?
About Covid-19
US has a new dominant COVID-19 strain “A highly contagious sublineage of the BA.2 omicron subvariant is now the nation's dominant strain, according to the CDC's latest variant proportion estimates.
The sublineage, BA.2.12.1, accounted for 57.9 percent of all U.S. COVID-19 cases in the week ending May 21, CDC data shows. BA.2, which became the nation's dominant strain in mid-March, now accounts for an estimated 39.1 percent of all cases.
BA.2.12.1 is estimated to have a 25 percent growth advantage over BA.2, which is already more transmissible than the original omicron strain.”
Post–COVID Conditions Among Adult COVID-19 Survivors Aged 18–64 and ≥65 Years — United States, March 2020–November 2021 “COVID-19 survivors have twice the risk for developing pulmonary embolism or respiratory conditions; one in five COVID-19 survivors aged 18–64 years and one in four survivors aged ≥65 years experienced at least one incident condition that might be attributable to previous COVID-19.
What are the implications for public health practice?
Implementation of COVID-19 prevention strategies, as well as routine assessment for post-COVID conditions among persons who survive COVID-19, is critical to reducing the incidence and impact of post-COVID conditions, particularly among adults aged ≥65 years.”
About health insurance
SCOTUS should stay out of False Claims Act dispute, says DOJ “The U.S. Supreme Court should not use a whistleblower’s complaint against a for-profit hospice provider to clarify the level of detail required to plead Medicare fraud under the False Claims Act, the Justice Department’s top lawyer has told the court.
U.S. Solicitor General Elizabeth Prelogar said no further clarification of the standard is necessary because there is no true circuit split…”
New Study: No Surprises Act [NSA] Prevented Over Two Million Potential Surprise Bills for Insured Americans “AHIP and Blue Cross Blue Shield Association (BCBSA) released a survey and analysis which found that in the first two months of 2022, the NSA prevented more than two million potential surprise medical bills across all commercially insured patients. The analysis also found that should this trend hold, more than 12 million surprise bills will be avoided in 2022.”
Measuring progress in improving prior authorization[PA] Highlights from an AMA survey:
— “A strong majority (84% and 84%, respectively) of physicians report that the number of PAs required for prescription medications and medical services has increased over the last five years…
—A majority (65% and 62%, respectively) of physicians report that it is difficult to determine whether a prescription medication or medical service requires PA…
—An overwhelming majority (88%) of physicians report that PA interferes with continuity of care.”
Disparities in Health Care Use Among Low-Salary and High-Salary Employees “In this study, we found that lower-salary employees enrolled in an HDHP with an HSA through their employer spent significantly less on outpatient services and prescription fills compared with higher-salary employees. At the same time, low-salary employees spent significantly more on ED care. These results suggest that low-salary employees may be forgoing outpatient services and instead spending more in the ED compared with higher-salary employees when HDHPs are present. This pattern of health care utilization may lead to delayed diagnosis of health conditions and potentially miss the window and benefits of early diagnosis or prevention.”
8 recent payer mergers and acquisitions A good summary of recent activities.
New York attorney general $13.6M to consumers denied mental healthcare coverage by UnitedHealthcare “New York and federal law requires mental health and substance use disorder parity under all health plans. [Attorney general] James sued UnitedHealthcare under those laws, claiming two practices by the company violated behavioral health parity laws by improperly restricting coverage of psychotherapy. According to Ms. James, UnitedHealthcare had reduced reimbursement to members for psychotherapy and set arbitrary thresholds to trigger reviews of psychotherapy treatments, often leading to denials of coverage.”
About hospitals and healthcare systems
Financial updates from 16 health systems A good summary and links to individual results. Many systems had increased revenues but decreased operating margins- due to increased personnel and supply costs.
Advocate Aurora hit with class action alleging anticompetitive behavior in eastern Wisconsin “Advocate Aurora Health has been hit with a class-action antitrust lawsuit alleging the system has used its market strength in eastern Wisconsin to suppress competition and drive ‘unreasonably high prices.’
Filed Tuesday, the case was brought by Uriel Pharmacy, based in Wisconsin, and its self-funded health plan…
Among the anticompetitive strategies plaintiffs alleged the large nonprofit employed were “all-or-nothing” clauses that require commercial health plans to include all Advocate Aurora facilities in their networks.
Advocate Aurora ‘aggressively’ blocks employers and payers from directing patients to competing facilities, according to the complaint, and ‘has gone to extraordinary lengths to suppress innovative insurance products, such as tiered plans, that would reduce costs for employers.’”
For example: “A colonoscopy with biopsy at Advocate Aurora Health would run employer health plans $10,700 compared to roughly $4,700 at Froedtert & the Medical College of Wisconsin, ‘a facility that is about 15 minutes away and has generally higher quality and safety ratings,’ plaintiffs wrote in a complaint filed Tuesday.”
Top critical access hospitals announced “The 20 highest-ranked critical access hospitals (CAHs) in the country, as determined by the Chartis Center for Rural Health, were recently announced by the National Rural Health Association (NRHA)…
The determining factors for the top 20 CAHs are based on the results of the Chartis Rural Hospital Performance INDEX and its eight indices of performance: inpatient market share, outpatient market share, quality, outcomes, patient perspective, cost, charge, and finance.”
About pharma
Pfizer to provide all patented drugs, vaccines to poor countries on no-profit basis “Pfizer announced Wednesday that it will provide all of its current and future patent-protected medicines and vaccines that are available in the US or Europe on a not-for-profit basis to 45 lower-income countries. The company noted that Rwanda, Ghana, Malawi, Senegal and Uganda have committed to join the programme and will help identify and resolve hurdles to inform the roll out in other countries.”
CVS Will Stop Filling Controlled-Substance Prescriptions for Cerebral, Done “CVS’s move is the most sweeping action by a major pharmacy chain on prescriptions by the telehealth companies in the wake of scrutiny of their prescription practices for attention-deficit hyperactivity disorder medication. Concern over those practices has also prompted an investigation by federal prosecutors, who subpoenaed Cerebral earlier this month and led Cerebral last week to replace its chief executive.
Cerebral and Done between them treat tens of thousands of patients for ADHD, prescribing stimulants such as Adderall.”
FDA Approves Dermavant’s VTAMA® (tapinarof) cream, 1% for the Treatment of Plaque Psoriasis in Adults: First Topical Novel Chemical Entity Launched for Psoriasis in the U.S. in 25 Years The headline is the story.
Teva, Allergan Strike $161M Deal With W.Va. AG In Opioid Case The headline is the story.
About the public’s health
E-Cigarette use costs US $15 billion per year, reports UCSF in first study of its kind “Use of electronic cigarettes costs the United States $15 billion annually in health care expenditures — more than $2,000 per person a year — according to a study by researchers at the UC San Francisco School of Nursing.
The study, published on May 23, 2022 in Tobacco Control, is the first to look at the health care costs of e-cigarette use among adults 18 and older.”
And in a related story: Use Patterns, Flavors, Brands, and Ingredients of Nonnicotine e-Cigarettes Among Adolescents, Young Adults, and Adults in the United States “This cross-sectional study of 6131 US residents aged 13 to 40 years found that 25.9% had ever used a nonnicotine e-cigarette, 16.7% had used one in the past 30 days, and 12.4% had used one in the past 7 days; 18.8% had ever co-used nonnicotine and nicotine e-cigarettes. The most-used flavors were sweet, dessert, or candy flavors; fruit flavors; and mint or menthol flavors; most common ingredients were tetrahydrocannabinol, cannabidiol, melatonin, caffeine, and essential oils.
Meaning These findings suggest that a significant proportion of US residents are using nonnicotine flavored e-cigarettes marketed with unsupported health claims, which warrants further research, regulation, and prevention.”
Tedros Adhanom Ghebreyesus re-elected as director-general of World Health Organization The
re-election extends his tenure for another five years.
About healthcare IT
CISA Adds 20 Known Exploited Vulnerabilities to Catalog “CISA has added 20 new vulnerabilities to its Known Exploited Vulnerabilities Catalog, based on evidence of active exploitation. These types of vulnerabilities are a frequent attack vector for malicious cyber actors and pose significant risk to the federal enterprise.”
Why Isn’t New Technology Making Us More Productive? “The growth in productivity since the pandemic hit now stands at about 1 percent annually, in line with the meager rate since 2010 — and far below the last stretch of robust improvement, from 1996 to 2004, when productivity grew more than 3 percent a year…
Seemingly small percentage gains in productivity can make a big difference in a country’s wealth and living standards over time. Even an additional 1 percent annual increase in productivity over a few years, to 2024, would generate an extra $3,500 in per-capita income for Americans, McKinsey & Company estimated in a report last year. The 3.8 percent average annual gain from 1948 to 1972 was the engine of the nation’s postwar prosperity.”
The article has many good examples, including Anthem (Elevance Health).
2022 ANNUAL CONSUMER SENTIMENT BENCHMARK REPORT Lots of good information in this report, ranging from patient: 1)satisfaction about transparency to 2) trust in healthcare professionals and institutions to 3)sources of trusted information and more.