About Covid-19
New Covid boosters look a lot like the old ones. Doctors worry that could lead to errors. “As updated Covid booster shots roll out across the nation, many experts are raising an eyebrow — and perhaps squinting at the label. That's because the new doses come in capped vials that look strikingly similar to the old ones.
It's a design decision, experts say, that could result in some people mistakenly receiving the wrong dose.”
COVID-19-Associated Hospitalizations Among Vaccinated and Unvaccinated Adults 18 Years or Older in 13 US States, January 2021 to April 2022 “In this cross-sectional study of US adults hospitalized with COVID-19 during January 2022 to April 2022 (during Omicron variant predominance), COVID-19-associated hospitalization rates were 10.5 times higher in unvaccinated persons and 2.5 times higher in vaccinated persons with no booster dose, respectively, compared with those who had received a booster dose. Compared with unvaccinated hospitalized persons, vaccinated hospitalized persons were more likely to be older and have more underlying medical conditions.”
Covid Rebound Symptoms, Positive Tests After Paxlovid Are Common, Study Says “Resurgence of Covid-19 symptoms in patients treated with Pfizer Inc.’s Paxlovid appeared far more common than has been reported, and rebounding patients still risked spreading the disease, doctors said in a report on a series of cases in a top medical journal.
The article published Wednesday in the New England Journal of Medicine documented 13 fully vaccinated patients whose rapid Covid tests turned strongly positive and symptoms reappeared several days after finishing five-day courses of Paxlovid.”
RADx reloaded: NIH puts out the call for more effective, easier-to-use COVID tests “In the two-and-a-half years of the COVID-19 pandemic, diagnostic test makers have fine-tuned their development and manufacturing processes to quickly roll out countless tests for the virus, many of them helped along by infusions of federal funding specifically set aside for innovative new testing approaches.
And the government isn’t done yet. With its sights set on the endemic stage of the coronavirus, the National Institutes of Health has re-upped its call for new and improved COVID diagnostics, it announced Thursday.
The summons arrives via the Rapid Acceleration of Diagnostics Tech program, or RADx, which launched in the early days of the pandemic with an initial commitment of $1.5 billion and a ‘Shark Tank’-style competition to quickly develop both at-home and point-of-care tests for the virus.”
About health insurance/insurers
Comparison of Low-Value Services Among Medicare Advantage and Traditional Medicare Beneficiaries “Question Do rates of low-value care differ between traditional Medicare (TM) and Medicare Advantage (MA), and, if so, what elements of insurance design are associated with the differences?
Findings In this cross-sectional study of 2 470 199 Medicare beneficiaries, those enrolled in MA received 9.2% fewer low-value services than those in TM (23.1 vs 25.4 total low-value services per 100 beneficiaries). The MA beneficiaries in health maintenance organizations and those in primary care organizations reimbursed within advanced value-based payment models had the lowest rates of low-value care.”
UnitedHealth Deal Is 'Not A Merger To Monopoly,' Judge Says “The D. C. federal judge who will decide the fate of UnitedHealth's $13. 8 billion bid for Change Healthcare challenged the U. S. Department of Justice during closing arguments Thursday on its assertions that the deal will create a monopoly for health insurance claims processing technology, repeatedly noting plans to divest the sole overlapping business unit.”
About hospitals and healthcare systems
Hospitals Divert Primary Care Patients to Health Center ‘Look-Alikes’ to Boost Finances “A growing number of hospitals are outsourcing often-unprofitable outpatient services for their poorest patients by setting up independent, nonprofit organizations to provide primary care.
Medicare and Medicaid pay these clinics, known as federally qualified health center look-alikes, significantly more than they would if the sites were owned by hospitals.
Like the nearly 1,400 federally qualified health centers — which get those additional dollars as well — a clinic designated by the government as a ‘look-alike’ is also eligible for federal programs that could help reduce costs and recruit providers. They allow the clinics to obtain prescription drugs at deep discounts and attract doctors by making them eligible for a government program that helps them pay off their student debt if they work in an area with a shortage of medical providers.
But unlike the community health centers, the look-alikes do not get an annual federal grant to cover operational costs. Nor do the look-alikes get the financial benefit in which the federal government covers their malpractice risks.”
National Alliance Helps Employers Get to Fair Price for Hospital Services “ To support employers and other healthcare purchasers in efforts to stop paying indefensible hospital prices, the National Alliance of Healthcare Purchaser Coalitions (National Alliance) released a new resource for plan sponsors to map out strategies to identify and negotiate fair market prices for hospitals.
Recent data indicates that for most hospitals a “fair price” for patients privately insured by employers is 140%-200% of what Medicare pays for the exact same products, procedures and services at the exact same facilities. Some hospitals charge 250% more for those services, with others even higher at 500% or more over Medicare. A fair price should allow for a reasonable markup from costs and a price that is competitive with peer hospitals…
The playbook, “Beyond Hospital Transparency: Getting to Fair Price,” helps purchasers navigate and understand how to best leverage newly available hospital price and quality transparency data and tools from Sage Transparency which incorporates content from RAND Corporation, the National Academy for State Health Policy(NASHP), and other sources. It also offers guidance on rights and responsibilities as plan sponsor fiduciaries to determine fair prices for hospital services, market- and policy-based strategies, and ways to work individually and through coalitions to achieve fair pricing for hospital services.
While there isn’t a one-size-fits-all approach as available data and market conditions vary among regions and states, the methodology and action steps in the playbook to help plan sponsors determine and achieve a fair price include:
Identify breakeven costs – Uncover what hospitals need to charge commercial customers to break even considering all other incomes and expenses plus a reasonable margin.
Compare costs among peer hospital systems – Determine how hospital charges compare to other hospitals with similar services and quality.
Determine a fair market price – Use data from Sage Transparency to negotiate fees based on a reasonable markup of hospital costs.”
Nursing facilities and debt collectors “The Consumer Financial Protection Bureau (CFPB) and the Centers for Medicare & Medicaid Services (CMS) remind you of your responsibilities under the Nursing Home Reform Act (NHRA), Fair Debt Collections Practices Act (FDCPA), and Fair Credit Reporting Act (FCRA).
The NHRA prohibits nursing facilities from requesting or requiring that a third party personally guarantee payment to the facility as a condition of a resident’s admission or continued stay in the facility. Contract terms that conflict with the NHRA are unlawful, and alleged debts resulting from such unlawful contract terms are invalid and unenforceable. Some nursing facilities have attempted to evade this prohibition by creating admission contracts that attempt to hold third parties liable for a resident’s debt. When a nursing facility claims that a non-resident is personally financially responsible for a resident’s bill and engages a third-party debt collector to collect the debt, the debt collector may violate the FDCPA by attempting to collect debts that are invalid under the NHRA. They may also violate the FCRA by furnishing information regarding such invalid debts to consumer reporting agencies.”
About pharma
US Food and Drug Administration Accelerated Approval Program for Nononcology Drug Indications Between 1992 and 2018 “In this cohort study, the FDA granted accelerated approval of 48 drugs for 57 nononcology indications from 1992 to 2018 with a median time to regular approval of 53.1 (95% CI, 38.7-70.2) months. Nine postapproval confirmatory trials failed to verify clinical efficacy, but only 1 indication was withdrawn due to a failed confirmatory trial 136 months after approval.”
About the public’s health
DHS unwinds Trump-era 'public charge' rule for immigrants “The Department of Homeland Security on Thursday finalized a regulation rolling back a policy instituted under former President Donald Trump that sought to limit immigration benefits for those likely to rely on government aid.
The new law unravels the Trump-era public-charge rule, under which immigrants could be denied permanent resident status if they had received or were expected to receive food assistance, Medicaid, housing assistance, or other public benefits.”
Artificial sweeteners and risk of cardiovascular diseases: results from the prospective NutriNet-Santé cohort “The findings from this large scale prospective cohort study suggest a potential direct association between higher artificial sweetener consumption (especially aspartame, acesulfame potassium, and sucralose) and increased cardiovascular disease risk. Artificial sweeteners are present in thousands of food and beverage brands worldwide, however they remain a controversial topic and are currently being re-evaluated by the European Food Safety Authority, the World Health Organization, and other health agencies.”
About healthcare IT
Medical breaches accounted for 342 million leaked records from 2009 to 2022 The entire report is worth reading.
”Key findings:
4,746 medical breaches recorded from 2009 to June 2022
342,017,215 individual records were affected as a result of these breaches
2020 was the biggest year for medical breaches with 803 reported (the second-highest was 2021 with 711)
2015 saw the highest number of records affected with over 112 million in total
In 2021 and 2022 (so far), specialist clinics (clinics that specialize in a certain field of medicine–e.g. cardiology or radiology, etc.) account for the most data breaches (15 percent) with 130 breached entities in total, but hospital networks account for the most breached records with 8.8 million affected in total (16 percent of the overall records affected)
In 2021 and 2022 (so far), hacking was the most common type of breach, accounting for 40 percent of breaches (353 out of 862)”
Cyber Insecurity in Healthcare “According to the research, 89 percent of organizations in this research experienced cyberattacks in the past 12 months. For organizations in that group, the average number of attacks was 43. We asked respondents to estimate the single most expensive cyberattack in the past 12 months from a range of less than $10,000 to more than $25 million. Based on the responses, the average total cost for the most expensive cyberattack experienced was $4.4 million. This included all direct cash outlays, direct labor expenditures, indirect labor costs, overhead costs and lost business opportunities.
At an average cost of $1.1 million, lost productivity was the most significant financial consequence from the cyberattack. However, despite the connection between cyberattacks and patient safety, the least amount of cost following a cyberattack was the time required to ensure the impact on patient care was corrected ($664,350).”
This study is also worth reading in its entirety.
About healthcare personnel
More DOs Join Physician Ranks as Osteopathic Pipeline Heats Up “The number of doctors of osteopathic medicine (DOs) is enjoying a significant growth pattern. This year alone, 7300 osteopathic physicians are entering the workforce, and they make up more than 25% of the medical student population. The pipeline of future DOs is at an all-time high of 36,500 students, according to the American Osteopathic Association (AOA).”
About healthcare finance
Alphabet's Verily Raises $1 Billion and Shakes Up Leadership Team “Verily, the Alphabet Inc. life sciences unit that experimented with diabetes-detecting contact lenses and launched Covid-19 testing programs, said it raised $1 billion in new investments led by its parent company, padding its war chest as the health-tech market heats up.”