July 30, 2020 | Fewer preemies. Why?
INDUSTRY NEWS
Medicare insolvency looms larger
The pandemic is accelerating Medicare’s impending insolvency. With record numbers of Americans out of work, fewer payroll taxes are rolling in to fund Medicare spending, the number of beneficiaries is rising and Congress dipped into Medicare’s reserves to help fund the COVID-19 relief efforts this spring. The Medicare trust fund can get into trouble two ways, explains Kaiser Health News: Either the money flowing in is too little, or the payments going out for care are too much. Most of those who watch Medicare finances agree that the larger problem right now is how little money is being collected; those funds largely come from the 1.45% payroll tax. With so many people out of work, cash flowing in has dropped dramatically. (Kaiser Health News)
Many more COVID cases than we thought?
Serological tests—which screen for antibodies to the virus and determine whether someone was previously infected—indicate the actual number of coronavirus cases in the U.S. could be anywhere from six to 24 times higher than the confirmed number of cases, depending on location. The findings, published in JAMA, “may reflect the number of persons who had mild or no illness or who did not seek medical care or undergo testing but who still may have contributed to ongoing virus transmission in the population,” according to researchers. Overall, an estimated 1% of people in the San Francisco Bay Area have had Covid-19, while 6.9% of people in New York City have. Researchers stress that the vast majority of Americans, however, are still vulnerable to Covid-19. (STAT News; JAMA)
INNOVATION & TRANSFORMATION
Employers give plans a C+ in promoting value
Employers give health plans an overall 2.57 GPA in how effectively they're directing employees to high-value care, according to a Leapfrog employer survey. Respondents gave Cigna the highest marks for its efforts towards driving for value. Respondents gave UnitedHealthcare the lowest ratings, with the most room for improvement in value, reducing costs and improving quality. Aetna led for putting a focus on quality. “But no health plan is earning an ‘A’ from their employer clients for improving health care, and that is disappointing,” Leah Binder, president and CEO of The Leapfrog Group said in a prepared statement. (Fierce Healthcare; Leapfrog)
When patients access the notes about their visits, they mostly understand and agree with them. Overall, 93% of respondents said the notes accurately described the visit; only 6% reported that something important was missing, according to the results of a survey published in The Journal of General Internal Medicine. “Patients overwhelmingly report understanding their visit notes and usually find them accurate, with few disparities according to sociodemographic or health characteristics. They have many suggestions for improving their quality, and if they understand a note poorly or find inaccuracies, they often have less confidence in their clinicians,” the authors conclude. Effective Nov. 2, 2020, all U.S. physicians must provide access to notes. (Medscape; Journal of General Internal Medicine)
CONSUMERS & PROVIDERS
ED visits still down; most are high-acuity patients
Hospital visit volumes continued to slowly recover at the end of June with emergency department visits down only 25% compared to pre-COVID-19, according to research from TransUnion Healthcare. Of note, patients with high-acuity medical issues (e.g., chest pain) were returning to EDs faster than those with low-acuity issues. In addition, pediatric ED visits remain significantly below pre-COVID-19 volumes and are down 59%. (Becker’s Hospital Review; TransUnion Healthcare)
Why problem lists are a problem
Rates of EHR problem list completeness and duplication vary widely, and disease severity seems to be a factor, according to research published in the Journal of Informatics in Health and Biomedicine. Duplication may be the result of more systemic complications and the fact that these patients have multiple providers. Providers have trouble maintaining complete problem lists for patients with less severe and less symptomatic disease “likely because these patients have fewer providers and fewer visits…” (Becker’s Hospital Review; Journal of Informatics in Health and Biomedicine)
NEW & NOTED
Fewer preemies. Why? Hospitals in several countries saw dips in premature births, which could be a starting point for future research. They don’t know what caused the drop in premature births and can only speculate as to the factors in lockdown that might have contributed. But further research might help doctors, scientists and parents-to-be understand the causes of premature birth and ways to prevent it, which have been elusive until now. (NY Times)
Telehealth continues dramatic growth: Telehealth claim lines among the privately insured increased 8,336% nationally, from 0.15% of medical claim lines in April 2019 to 13.00% in April 2020, according to new data from FAIR Health’s Monthly Telehealth Regional Tracker. (AJMC; FAIR Monthly Telehealth Regional Tracker)
Vaccine trial begins: The world’s biggest COVID-19 vaccine study began Monday with the first of 30,000 planned volunteers helping to test shots created by the U.S. government—one of several candidates in the final stretch of the global vaccine race. This vaccine is the one developed by the National Institutes of Health and Moderna, Inc. (AP)
MULTI-MEDIA
Meeting patients’ needs during a crisis
During the coronavirus pandemic, Kaiser Permanente’s pharmacies saw a dramatic increase in services. How did it meet rising demand? And what can other health care organizations learn? In this episode of Voices of Change Amy Gutierrez, PharmD, talks about the lessons learned—and lessons still being learned—from the pandemic. (Voices of Change)
MARKETVOICES...QUOTES WORTH READING
“These [COVID-19 vaccine] trials need to be multigenerational, they need to be multiethnic, they need to reflect the diversity of the United States population.”—Dr. Larry Corey, a virologist with the Fred Hutchinson Cancer Research Institute in Seattle, who helps oversee the COVID-19 vaccine study sites, quoted by AP.