January 14, 2021 | Daily COVID deaths > annual homicides
INDUSTRY NEWS
With a majority in the House and control of the Senate, President-elect Joe Biden may be able to enact parts of his health care agenda. FierceHealthcare identified three areas. First, Congress should be able to bolster the Affordable Care Act, including expanding subsidies. It may also remove the “firewall” that prevents low-income people with poor employer-sponsored insurance from getting a premium tax credit. Second, expect progress in lowering high drug prices, an area with bipartisan support. Finally, look for COVID-19 relief. However, the much-discussed public option may not come to fruition anytime soon. (FierceHealthcare)
Kaiser ranked best, Centene worst in Insure.com survey
Consumers ranked Kaiser Permanente the best health insurance for 2021; it came in fourth last year. Rounding out the top five in the Insure.com survey: Blue Shield of California, Humana, Florida Blue and UnitedHealthcare, which saw a tremendous jump—it was number 13 last year. Centene came in last. The survey looked at 15 major US insurers. Cigna came in seventh, CVS Health-owned Aetna was tenth and Anthem was eleventh. (Healthcare Dive; Insure.com)
INNOVATION & TRANSFORMATION
UCLA Health shares telehealth protocols
UCLA Health is developing telehealth-specific triage protocols to ensure patients receive the right care, at the right time, via the right medium, according to a NEJM Catalyst commentary. They discuss the protocols in detail and offer these pearls: First, make virtual care a priority. “Create a multidisciplinary team…to evaluate and implement changes that enhance a health system’s ability to provide high-quality virtual care.” Next, incorporate telehealth into triage protocols. Third, check and refine. “Develop performance metrics and gather regular feedback from physicians, staff, and patients. Use this information in a continuous improvement framework to refine your triage protocols.” (NEJM Catalyst)
CONSUMERS & PROVIDERS
Patients willing to pay for quality
Patients are willing to pay more for physicians and hospitals with high hospital star ratings, according to research published in Health Affairs. An analysis of older adults scheduling arthroplasty total hip or knee replacements found they are willing to pay $2,607 more for each hospital star rating gained and $3,152 more for every physician star rating gained. “Patients appear willing to accept significantly higher copayments for higher quality of care, and surgeon quality seems relatively more important than hospital quality. Further study is needed to understand the value and trust patients place in publicly reported hospital and surgeon quality ratings,” the researchers conclude. (PatientEngagementHIT; Health Affairs)
Delays between cancer diagnosis and treatment deadly
Longer time from diagnosis to definitive treatment after prostate, breast, lung and colon cancer diagnosis correlates to higher mortality, according to research published in JAMA Network Open. Patients with colon and lung cancer had the highest mortality associated with increased time to treatment. "When you consider that cancer screening may have been delayed during the pandemic … timely treatment for cancer has never been more important," lead author Eugene Cone, MD, told Medscape Medical News. (Medscape Medical News; JAMA Network Open)
Defining and distinguishing burnout
Burnout differs in fundamental ways from depression and anxiety; clinician and patient health depend on knowing the difference, according to research published in JAMA Network Open. “[B]urnout and depression are correlated but empirically distinct latent factors and from distinct networks and that emotional exhaustion and depersonalization form the core of the burnout construct, highlighting that the distinctions within the burnout construct might be of clinical importance,” they write. It has consequences for efficient diagnosis and delivery of adequate treatment options, which affect clinician well-being and effectiveness as well as patient outcomes. (JAMA Network Open)
NEW & NOTED
Daily COVID deaths > annual homicides: The number of people dying of Covid-19 in Los Angeles County in a day is now equivalent to the number of homicide deaths the city saw in an entire year, Mayor Eric Garcetti said last Thursday. "Yesterday we had 259 deaths, that's one more than all the homicides in 2019 in L.A. city combined," he said. "In a single day, equal to a year of homicides." (CNN)
CMS adds digital quality metrics: CMS is considering adding 20 quality measures to some of Medicare's quality and value-based payment programs. All but three would have to be collected digitally. The proposed measures are part of CMS's annual rule-making process where the agency selects a list of measures that are reviewed by the National Quality Forum. (Modern Healthcare*)
Most COVID spread by the asymptomatic: People with no symptoms transmit more than half of all cases of the novel coronavirus, according to a model developed by CDC researchers. “The findings of this study suggest that the identification and isolation of persons with symptomatic COVID-19 alone will not control the ongoing spread of SARS-CoV-2,” they conclude. (JAMA Network Open)
MULTI-MEDIA
From spokesperson to whistleblower
Wendell Potter, once a communications chief for a major health insurance company, turned into a whistle blower. “What I used to do for a living was mislead people into thinking that we had the best health care system in the world.” In this episode of An Arm and a Leg, he discusses what spurred his change of heart and talks about the messy process of change in general. (KHN)
MARKETVOICES...QUOTES WORTH READING
“The way in which we practice medicine is changing — and changing fast — in response to the coronavirus pandemic, strong market pressures, and patient preferences. However, the best care is that which is provided at the right time, by the right person, using the right medium. Despite its benefits, telehealth also has limitations. Therefore, we must refine our current triage processes to complement the rapid expansion of telehealth services and thoughtfully reflect the risks and benefits of virtual and in-person care.” —Daniel Croymans, MD, MBA, MS, medical director of quality, Department of Medicine, UCLA Health; and colleagues, in NEJM Catalyst commentary.