April 30, 2020 | Post-COVID, teach population health

INDUSTRY NEWS

SCOTUS: Feds owe some ACA insurers $12B

In an 8-1 decision Monday, the U.S. Supreme Court ruled that the federal government must pay the $12 billion it owes insurers that took part in the Affordable Care Act’s temporary “risk corridor” program. Under the program, the government collected payments from insurers with lower-than-expected claims on the health insurance exchanges and made payments to insurers with higher- than-expected claims. Both the Obama and Trump administrations had argued that because Congress had limited payments for the program, the federal government had no obligation to pay. (HealthLeaders Media; Becker's Hospital Review)

HHS to delay rules on interoperability and data blocking

Health and Human Services will delay enforcement of the two recently released rules on interoperability and data blocking. CMS will give providers six extra months to comply with rules to improve data sharing. Meanwhile, the ONC will give vendors an extra three months to comply with its health IT certification program. “[I]n a pandemic of this magnitude, flexibility is paramount for a healthcare system under siege by COVID-19,” CMS Administrator Seema Verma said in a prepared statement. (Modern Healthcare; CMS statement)

CMS provides reopening guidance

CMS is providing a path forward for hospitals to proceed with non-essential medical procedures. It is issuing a series of recommendations on how states or regions with stabilized outbreaks and which meet certain criteria can begin re-instituting elective surgeries. The guidelines are similar to principles issued by the American College of Surgeons. Most facilities have been putting off elective services since mid-March, and they’ve taken a financial hit as a result, Healthcare Dive reports. The fourth coronavirus relief package—currently under discussion in Congress—reportedly contains $75 billion for hospitals. (Healthcare Dive; CDC recommendations; ACS principles)

INNOVATION & TRANSFORMATION

Nash: Post-COVID, teach population health

Medical schools should emphasize population health, writes Dr. David Nash of the Jefferson College of Population Health in Philadelphia. The current health care system gives little thought or resources to improving population health by preventing and managing disease. It’s too late to do more than scramble and “do the best we can with what we’ve got,” during this pandemic, “but education is about the future. What can we do in our healthcare curricula today to make sure we don’t find ourselves in this predicament tomorrow?” He shares his recommendations for reform, based on the tenets of population health. (Modern Healthcare)

Experts: Don’t pin re-opening hopes on antibody testing

Antibody tests are not reliable enough to guide policy on lockdowns and re-openings, warn scientists. Few scientists ever imagined that these tests would become an instrument of public policy—and many are uncomfortable with the idea, the New York Times reports. Antibody tests are often inaccurate, and it remains unclear whether a positive result actually signals immunity to the coronavirus. (New York Times)

CONSUMERS & PROVIDERS

Yet another COVID puzzle: Strokes in the young

Hospitals are reporting young and middle-aged COVID-19 patients are dying from strokes. The numbers of those affected are small but nonetheless remarkable because they challenge how doctors understand the virus. Many researchers suspect these strokes may be a direct consequence of blood problems that are producing clots throughout some people’s bodies. Initially thought to be a pathogen that primarily attacks the lungs, COVID-19 appears to affect nearly every major organ system in the body. (Washington Post)

NEW & NOTED

Atypical COVID symptoms in seniors: Older adults with COVID-19 often present with atypical symptoms. COVID-19 is typically signaled by three symptoms: a fever, an insistent cough and shortness of breath. But older adults may have none of these. They may just “seem off,” perhaps sleeping more than usual, becoming confused, disoriented and/or apathetic. (KHN “What The Health?”) 

Cats contract coronavirus: Two New York cats recently became the first confirmed pet cases of COVID-19 in the U.S. Experts believe the cats, who live in different parts of the state, contracted the virus from people in their household or neighborhood. Authorities say there’s no indication pets are transmitting it to human beings. (AP)

Extended prior authorization: Several health insurers are extending prior authorizations for elective services that have been canceled or deferred because of COVID-19. (Becker's Hospital Review)

MULTI-MEDIA

Briefing: COVID and the life sciences

In this 50-minute briefing, executives from across IQVIA share the data and analytics driving a global perspective on the impact of COVID-19 on life sciences. Areas of focus include the current state of R&D, prescription demand and launch strategies, as well as insights into the realities of a post-COVID-19 world. (IQVIA)

MARKETVOICES...QUOTES WORTH READING

“Our healthcare system gives little thought or resources to improving population health by preventing and managing disease. We spend our treasure on health services, not on social services, which is upside down and backward. Maybe it takes a pandemic to get people to realize, holy mackerel! Population health! I guess that’s kind of important.”—Dr. David Nash, founding dean emeritus and professor of health policy at the Jefferson College of Population Health in Philadelphia, writing in Modern Healthcare.