January 9, 2020 | Policy vs pain: Opioid control and sickle cell
INDUSTRY NEWS
NEJM: Mergers don’t improve outcomes
Hospital mergers don’t improve the quality of patient care and sometimes lead to poorer care. That’s the conclusion of research published in the New England Journal of Medicine. “[A]cquisition by another hospital or hospital system was associated with modestly worse patient experiences and no significant changes in readmission or mortality rates,” researchers concluded. The study didn’t look at costs, but MedCity News reports other studies have shown that both mergers of hospital systems and practice acquisitions are correlated with higher health care costs. (MedCity News; NEJM)
Fortune-KHN investigation: EHR vendors “gamed the system”
EHR vendors have consistently exaggerated EHRs’ abilities in order to receive millions in government subsidies, according to an investigation by Fortune and Kaiser Health News. Dozens of lawsuits filed by whistleblowers, doctors and hospitals have alleged some EHR software has “hidden flaws that may pose a danger to patients—and that a substantial chunk of the $38 billion in federal subsidies went to companies that deceived the government about the quality of their products,” according to their report. It alleges “software makers allegedly gamed the system, repeatedly.” (Fortune)
Appeals court upholds risk-adjustment payments
Payers and the Department of Health and Human services got a big win last week: A federal appeals court, overturning a lower court ruling, upheld the formula used to calculate billions in risk adjustment payments under the Affordable Care Act. The upshot: The ruling provides more certainty for insurers that rely on the funding. Healthcare Dive explains that the risk-adjustment payments were intended to entice insurers to offer plans to the individual and small group markets. (Healthcare Dive)
INNOVATION & TRANSFORMATION
Study: AI adoption to increase; benefits include less burnout
Nearly 80% of health care providers in the U.S. and the U.K. plan to invest more in artificial intelligence over the next two years, according to a study by MIT Technology Review Insights and GE Healthcare. Respondents at institutions with robust AI deployments indicated they spend nearly 66% percent less time writing reports than their counterparts, and 45% say AI has allowed them to increase time for patient care. Altogether, 78% of respondents said it already created workflow improvements. AI has also helped alleviate burnout, with 80% indicating AI has been instrumental in helping to remove barriers and reduce worker burnout. (announcement; HealthCare Business News)
CONSUMERS & PROVIDERS
Remember all the handwringing over drug prices? All the public and congressional scrutiny of drug makers? Well, drug prices have increased this year by, according to some sources, 5.8%. “The more things change, the more they stay the same,” Piper Jaffray analyst Christopher Raymond wrote in a note to investors, pointing out that the timing and impact are “literally identical to the increases taken last year.” Kaiser Health News has a roundup of the coverage. (Kaiser Health News)
National Academies provides opioid framework
A new report from the National Academies of Sciences, Engineering, and Medicine provides a framework for prescribers and others to develop their own plans for acute pain. It calls on any group drafting prescribing guidelines to consider an array of factors, including the evidence for using opioids vs. alternatives for a specific condition or procedure. Such a framework could inform the development of opioid prescribing guidelines and ensure systematic and standardized methods for evaluating evidence, translating knowledge and formulating recommendations for practice, according to the report. (STAT; report)
NEW & NOTED
OIG’s MA report: Health insurers selling Medicare Advantage plans to seniors and the disabled received an estimated $6.7 billion in 2017—after adding diagnoses to patients' files that were not supported by their medical records, according to the Health and Human Services Inspector General’s Office. This exacerbates ongoing concerns that insurers are receiving billions in improper payments, Reuters reports. (Reuters)
One-on-one with Verma: Seema Verma, administrator for the Centers for Medicare & Medicaid Services, sat down for a one-on-one interview with Kaiser Health News. Topics included Medicare for All, Medicaid and the Affordable Care Act’s future. (KHN)
What to watch in DC: Will Congress move major health care legislation this year? Last year began with momentum around drug prices and surprise medical bills but ended with no legislation and a judicial threat to the Affordable Care Act. Expect these issues, among others, to win headlines in 2020. The Hill offers an overview of five health care fights to watch. (The Hill)
MULTI-MEDIA
Policy vs pain: Opioid control and sickle cell
When her local hospital emergency department changed its opioid policy, India Hardy and her brother Rico suffered. Because of their sickle cell disease, they endure regular bouts of severe pain. They aren’t alone. Researchers say the opioid epidemic has made it harder for patients with sickle cell to get the pain medication they need. (NPR)
MARKETVOICES...QUOTES WORTH READING
People with sickle cell disease aren't fueling the opioid problem. “If anything, individuals with sickle cell disease in our country have really been caught in the crossfire when it comes to this opioid epidemic.”—Dr. Biree Andemariam, chief medical officer of the Sickle Cell Disease Association of America, on NPR