About Covid-19
About 300,000 children under 5 have received at least one Covid-19 shot, White House says The headline should probably start with the word “Only.”
COVID-19 hospitalizations hit highest national average since March “COVID-19 hospitalizations have steadily increased to reach the highest national average since early March, with more than 33,000 people in U.S. hospitals with coronavirus on a given day.
Hospitalizations are up 18 percent nationwide over the past 14 days, with a daily average of 37,472 people hospitalized with COVID-19 as of July 11, according to HHS data…”
Covid-19 reinfections may increase the likelihood of new health problems “Repeatedly catching Covid-19 appears to increase the chances that a person will face new and sometimes lasting health problems after their infection, according to the first study on the health risks of reinfection.
The study, which is based on the health records of more than 5.6 million people treated in the VA Health System, found that, compared with those with just one Covid-19 infection, those with two or more documented infections had more than twice the risk of dying and three times the risk of being hospitalized within six months of their last infection. They also had higher risks for lung and heart problems, fatigue, digestive and kidney disorders, diabetes and neurologic problems.”
Repeat Dosing of Evusheld Recommended for Ongoing COVID-19 Protection “The Food and Drug Administration (FDA) has revised the fact sheet for Evusheld™(tixagevimab co-packaged with cilgavimab) to include a recommendation for repeat dosing every 6 months for the preexposure prophylaxis of COVID-19.
Evusheld is a combination of 2 long-acting monoclonal antibodies designed to bind to distinct sites on the SARS-CoV-2 spike protein. The product is authorized for emergency use for individuals who are not currently infected with SARS-CoV-2 and who have not had a known recent exposure to an individual infected with SARS-CoV-2, and:
Who have moderate to severe immune compromise due to a medical condition or receipt of immunosuppressive medications or treatments and may not mount an adequate immune response to COVID-19 vaccination; or
For whom vaccination with any available COVID-19 vaccine, according to the approved or authorized schedule, is not recommended due to a history of severe adverse reaction to a COVID-19 vaccine(s) and/or COVID19 vaccine component(s).”
About health insurance
2023 employer health and benefit strategies focused on affordability and access, Mercer survey “The survey found that 70% of all large employers are planning benefit enhancements for 2023.
While small employers are somewhat less likely to be planning enhancements, still, more than half (53%) say that they are…
When asked whether benefits enhancements would be targeted to specific employee groups, about a fifth of large employers say they are focusing on their hourly and low- wage workers…
While hourly workers are the group most likely to be singled out for special attention across all industries, highly skilled workers are the priority for large health care employers (24%).”
This short report is well worth at least a quick look.
Association Between Self-reported Health-Related Social Needs and Acute Care Utilization Among Older Adults Enrolled in Medicare Advantage “To what extent are self-reported health-related social needs (HRSNs) associated with acute care utilization among older adults enrolled in Medicare Advantage, and are there specific HRSNs that seem to matter more?
Findings In this cross-sectional study of 56 155 older adults enrolled in Medicare Advantage, HRSNs were associated with statistically significantly higher rates of acute care utilization, with the largest association observed for avoidable hospital stays (53.3% increase). Unreliable transportation had the largest association with hospital stays and emergency department visits (marginal effects of 51.2 and 95.5 events per 1000 beneficiaries, respectively).”
UnitedHealth accused of underpaying for telehealth “The lawsuit, filed in federal court in Connecticut on Thursday by a Chicago woman using the pseudonym CP, seeks to represent a class of "at least hundreds and likely thousands" of beneficiaries of UnitedHealth insurance plans covered by the federal Employee Retirement Income Security Act (ERISA).”
The claim is that United paid at a rate based on an old Medicare rate instead of the updated telehealth rate based on parity with in-person visits.
“20% of adults said they or their family have received an unexpected medical bill this year, and 22% of them were charged over $1,000.
45% of adults said they are confident they would know their emergency room bill up front.
63% of adults said they’re confident they would be able to address a surprise bill that they believed to be illegal with a provider or insurer.”
CMS proposes slight doc pay cut in 2023 and several reforms to ACOs, dental service coverage “CMS proposed a 2023 fee schedule conversion factor of $33.08 for each relative unit, which determines how Medicare payments to doctors are calculated. That factor is a slight decline of the 2022 factor of $34.61.
The factor considers a statutory requirement that the conversion factor for 2023 remains flat and the expiration of a 3% bump in fee schedule payments that went away in 2022. The slight bump was installed to help physicians weather the revenue impact from the COVID-19 pandemic.
The fee schedule must also be budget neutral under federal law.
In addition to the payment changes, CMS is proposing to expand the dental services that would get coverage from Medicare. Currently, Medicare only pays for certain treatments such as reconstruction of a jaw after an injury or tooth extraction following cancer care.
Now, CMS proposed to also pay for a dental exam and treatment preceding an organ transplant as well as several other services. The agency also wants comments on what else Medicare should reimburse for dental services…
CMS also proposed several major changes to the Medicare Shared Savings Program (MSSP) that oversees ACOs. Chief among them is a proposal to install a health equity adjustment of up to 10 bonus points to the ACO’s Merit-based Incentive Payment System (MIPS) quality performance score. The equity adjustment would only positively impact an ACO but not penalize them, CMS said in a release…
CMS is proposing that an organization new to MSSP which is not renewing or reentering as an ACO and qualifies as low revenue can get a one-time payment of $250,000 and quarterly payments for the first two years of a five-year period.”
About pharma
Amid drug pricing debate, feds reveal plan to crack down on 'incremental' patents “Watch out, pharma—the federal government has its eye on add-on drug patents that can lead to higher prices. In a new effort, the FDA and the U.S. Patent and Trademark Office (PTO) are teaming up to take a close look at patenting procedures… [T]he PTO said it plans to crack down on patenting of “incremental, obvious changes to existing drugs that do not qualify" for new protections.”
Certain discarded drugs will soon cost pharma companies “According to an infrastructure bill passed last year, drug manufacturers must refund Medicare for unused drugs in single-dose vials beginning in 2023. Medicare also included the update in its latest proposed rule…
Back in 2020, Medicare paid nearly $720 million for discarded drugs paid under Part B, the agency said in its proposal. That’s on par with prior years dating back to 2017, when Medicare shelled out between $700 million and $750 million per year for discarded drugs.
A large portion of those unused drugs were ones dosed based on a patient’s body weight or surface area. When a patient’s dose is drawn from more than one vial, any remaining drug must be discarded.
The mandate applies only to single-dose vials or single-use packaged drugs — not to radiopharmaceutical or imaging agents, certain drugs that require filtration, or ‘certain new drugs,’ according to Medicare. And the amount of discarded drugs must be higher than 10% to get a refund.”
Newsom announces California will produce its own ‘low cost’ insulin “Newsom said that the state budget he recently signed includes $100 million for California to ‘contract and make [its] own insulin at a cheaper price, close to at cost, and to make it available to all.’
He said $50 million of that budget will go to the development of the low cost insulin, while the additional $50 million will go toward a California-based manufacturing facility for the drug, which Newsom claims ‘will provide new, high-paying jobs and a stronger supply chain.’
Newsom also noted in his announcement that he had signed an executive order his first day in office to put California on the path to creating its own prescription drugs, touting that ‘now it’s happening.’”
About the public’s health
Childhood Obesity Rate in the U.S. Higher Now Than 12 Years Prior “The researchers noted a 4.5 percent relative increase in the cumulative incidence of new obesity cases by the end of fifth grade across cohorts among children who did not have obesity at kindergarten entry (15.5 versus 16.2 percent), although no substantial change was seen in annual incidence. For children who had a normal body mass index at kindergarten entry, the risk for incident obesity stayed the same, while the risk for incident obesity increased slightly among overweight kindergarteners. There was an expansion of social disparities in obesity incidence: A 29 percent increase was seen in the incidence of new cases during primary school among non-Hispanic Black children, while the risk stayed stable or decreased for other race-ethnic groups. A 15 percent higher cumulative incidence was seen across primary schools in 2010 versus 1998 for children from the most socioeconomically disadvantaged households.”
Monkeypox cases rise 77% in UN agency's latest weekly count
The World Health Organization (WHO) on Thursday reported a 77% weekly increase in the number of lab-confirmed monkeypox cases, to more than 6000 worldwide, as well as two more deaths in parts of Africa…
Most of the cases were reported in Europe and Africa. The agency said the outbreak continues to mainly affect men who have had sex with men, and that other population groups showed no signs of sustained transmission.
The WHO said it counted 6027 laboratory-confirmed cases of monkeypox from 59 countries as of Monday, an increase of 2614 cases since its last count for the week that ended June 27. It added that three people have now died in connection with the outbreak, all in Africa.
It noted that nine additional nations had reported cases, while 10 countries had not reported any new cases for more than three weeks, which is the maximum incubation period.
WHO Director-General Tedros Adhanom Ghebreyesus said he remained ‘concerned by the scale and spread of the virus,’ noting that more than 80% of the cases turned up in Europe. He said he plans to convene the next meeting of a WHO expert panel that is monitoring the outbreak for no later than the week of July 18.”
Biden signs order on abortion access after Supreme Court ruling “Biden formalized instructions to the Departments of Justice and Health and Human Services to push back on efforts to limit the ability of women to access federally approved abortion medication or to travel across state lines to access clinical abortion services.”
About healthcare IT
Teladoc adds medication delivery, in-home phlebotomy to primary care service Primary360 “Primary360 will now provide care coordination support and health plan in-network referrals alongside free same-day medication delivery from Capsule and in-home, on-demand phlebotomy services backed by Scarlet Health, according to an announcement Wednesday from Teladoc.”