About Covid-19
The pandemic cost 7 million lives, but talks to prevent a repeat stall “In late 2021, as the world reeled from the arrival of the highly contagious omicron variant of the coronavirus, representatives of almost 200 countries met — some online, some in-person in Geneva — hoping to forestall a future worldwide outbreak by developing the first-ever global pandemic accord.
The deadline for a deal? May 2024…
Even as negotiators wrestle over those points, the venture is being roiled by misinformation on social media, including hostility toward the WHO and assertions that any international agreement would threaten the sovereignty of nations — claims that WHO Director General Tedros Adhanom Ghebreyesus has condemned as ‘utterly, completely, categorically false.’ The final agreement, Tedros said in early April, won’t give the WHO power to impose lockdowns or mask mandates in individual countries.”
About healthcare safety
WHO launches first ever Patient Safety Rights Charter “WHO launched a Patient Safety Rights Charter at the Global Ministerial Summit on Patient Safety. It is the first Charter to outline patients’ rights in the context of safety, and will support stakeholders in formulating the legislation, policies and guidelines needed to ensure patient safety…
he 10 fundamental patient safety rights outlined in the Charter are the right to:
Timely, effective and appropriate care;
Safe health care processes and practices;
Qualified and competent health workers;
Safe medical products and their safe and rational use;
Safe and secure health care facilities;
Dignity, respect, non-discrimination, privacy and confidentiality;
Information, education and supported decision making
Access medical records;
To be heard and fair resolution;
Patient and family engagement.”
About health insurance/insurers
Medicare Accountable Care Organizations: Past Performance and Future Directions From the CBO: “Providers participate in Medicare ACO programs voluntarily. CBO found the following:
• Certain types of ACOs are associated with greater savings. They include ACOs led by independent physician groups, ACOs with a larger proportion of primary care providers (PCPs), and ACOs whose initial baseline spending was higher than the regional average. (An ACO’s baseline spending is generally the average spending per person in the Medicare fee-for- service, or FFS, program among beneficiaries that would have been assigned to the ACO over several calendar years before the start of the ACO’s contract period.)
•Some factors limit the savings from Medicare ACOs. Those factors include weak incentives for ACOs to reduce spending, a lack of the resources necessary for providers to participate in ACO models, and providers’ ability to selectively enter and exit the program on the basis of the financial benefits or losses they anticipate from participating.”
Maryland, Vermont Apply for CMS’ State-Level Total Cost of Care Model “Both Maryland and Vermont have applied to participate in the Centers for Medicare and Medicaid Services’ States Advancing All-Payer Health Equity Approaches and Development (AHEAD) model.
AHEAD is a state-level total cost of care (TCOC) model that seeks to drive state and regional healthcare transformation and multi-payer alignment.
The model would be in place for up to nine performance years, through 2034. The intent is to allow adequate time for changes in care delivery to be designed and implemented and for those changes to impact outcomes for the state’s residents.
Under a TCOC approach, a participating state uses its authority to assume responsibility for managing healthcare quality and costs across all payers, including Medicare, Medicaid, and private coverage. States also assume responsibility for ensuring health providers in their state deliver high-quality care, improve population health, offer greater care coordination, and advance health equity by supporting underserved patients.”
Note: Maryland has had an all-payer system for the past 36 years.
CMS to Test Mandatory 5-Year Episode-Based Alternative Payment Model “The mandatory Transforming Episode Accountability Model (TEAM) would aim to improve the patient experience from surgery through recovery by supporting the coordination and transition of care between providers and promoting a successful recovery that can reduce avoidable hospital readmissions and emergency department use. TEAM episodes would begin with lower extremity joint replacement, surgical hip femur fracture treatment, spinal fusion, coronary artery bypass graft, and major bowel procedures.
Under the proposed model, selected acute-care hospitals would coordinate care for people with Traditional Medicare who undergo one of the surgical procedures included in the model and assume responsibility for the cost and quality of care from surgery through the first 30 days after the Medicare beneficiary leaves the hospital.
All hospitals selected to participate in TEAM would be required to refer patients to primary care services to support patient continuity of care and positive long-term health outcomes.”
INPATIENT PROSPECTIVE PAYMENT SYSTEM DASHBOARD From McDermott + Consulting: “What is the cost of a knee implant in the inpatient setting? How much does Medicare pay for different types of cardiac valve procedures? How has Medicare inpatient volumes changed over time for inpatient hip and femur procedures?
This dashboard shows the actual costs to hospitals for providing care to Medicare fee-for-service inpatients based on data published by the Centers for Medicare & Medicaid Services (CMS) as part of its rulemaking cycle.”
Clinically Implausible Rates are Getting the Boot “About 60% of rates are clinically implausible, and often even impossible (something along the lines of a rate for a psychiatrist performing a knee replacement). We talk about that more in-depth here. You may have heard about these rates before, and they’re usually given cute names, like zombie rates…
How these rates even came into existence in the first place is a good place to start. There are a few underlying reasons:
Stock contract templates: Payers have boilerplate templates that vary from simply a single fee schedule to as complex as an inpatient hospital agreement with numerous rate types. When providers go in-network with a payer, they often sign a contract that includes rates for all billable services, even though they may bill only a subset of them.
Schema Design: In the current CMS mandated schema, payers associate rates with all providers at a facility, which leads to physicians being associated with services they may not be associated with….
Errors in the Data: Due to the sheer magnitude of posting all items and services, it’s inevitable that payers make mistakes in the processes of gathering and preparing their MRFs [Machine-Readable Files].”
Elevance Health and Clayton, Dubilier & Rice Sign Agreement to Launch Strategic Partnership to Advance Primary Care Delivery “Elevance Health, Inc. and Clayton, Dubilier & Rice (CD&R) announced an agreement to form a strategic partnership to accelerate innovation in primary care delivery, enhance the healthcare experience, and improve health outcomes. This effort, which will operate across multiple regions of the United States, will bring together certain care delivery and enablement assets of Elevance Health’s Carelon Health and CD&R portfolio companies, apree health and Millennium Physician Group (MPG).”
About pharma
Associations Between Surrogate Markers and Clinical Outcomes for Nononcologic Chronic Disease Treatments “Most surrogate markers used as primary end points in clinical trials to support FDA approval of drugs treating nononcologic chronic diseases lacked high-strength evidence of associations with clinical outcomes from published meta-analyses.”
Boehringer signs $1.3B deal with RNA biotech Ochre Bio to team up against MASH “Boehringer Ingelheim is making yet another bet that RNA therapies hold the key to treating metabolic-associated steatohepatitis (MASH).
The German drugmaker is paying British biotech Ochre Bio $35 million in upfront and near-term research-based milestone payments to investigate “multiple targets” for chronic liver disease. Top of the list of indications will be MASH, previously known as nonalcoholic steatohepatitis (NASH).”
About the public’s health
Pesticides pose a significant risk in 20% of fruits and vegetables, Consumer Reports finds “An examination of 59 common fruits and vegetables found pesticides posed significant risks in 20% of them, from bell peppers, blueberries and green beans to potatoes and strawberries, according to findings published Thursday by the nonprofit consumer advocacy group…
Imported produce, especially from Mexico, was particularly likely to carry risky levels of pesticide residues, CR found…
The good news? There's no need to worry about pesticides in almost two-thirds of produce, including nearly all of the organic fruits and vegetables examined.
The analysis found broccoli to be a safe bet, for instance, not because the vegetable did not contain pesticide residues but because higher-risk chemicals were at low levels and on only a few samples.”
USDA releases H5N1 bird flu genetic data eagerly awaited by scientists “The U.S. Department of Agriculture, which has been under pressure from scientists both at home and abroad to share more data on the H5N1 bird flu outbreaks in dairy cows, uploaded a large number of genetic sequences of the pathogen late Sunday.
Access to the 239 genetic sequences will help scientists assess whether the dangerous virus has acquired mutations that might make it easier for it to spread to and among mammals, and whether additional changes have been seen as it moves from cow to cow and herd to herd. In addition to virus sequences from cattle, the trove includes sequences of viruses retrieved from cats, chickens, a skunk, a raccoon, a grackle, a blackbird, and a goose, the agency said.”