June 25, 2020 | Can you hear me now?
INDUSTRY NEWS
Implicit racism in decision-making tools
The algorithms physicians use to guide patient care are racially biased; as a result, Black—and occasionally Latinx—people receive inferior care, according to research published in the New England Journal of Medicine. The study looks at more specialties than previous studies of race and algorithm-driven care. “These algorithms are woven into the fabric of medicine,” senior author Dr. David Jones tells the New York Times. “Despite mounting evidence that race is not a reliable proxy for genetic difference, the belief that it is has become embedded, sometimes insidiously, within medical practice.” (STAT News; New York Times; NEJM)
Epic and five Blues roll out information exchange
EHR provider Epic and Blue Cross and Blue Shield plans in five states are rolling out a new, two-way information exchange, according to Health Care Service, which operates BCBS plans in Illinois, Montana, New Mexico, Oklahoma and Texas. This secure “Payer Platform” will allow the plans and the providers who use Epic to review patient data; streamline administrative processes (e.g., prior authorizations); and “facilitate a care management strategy and identify gaps in care, helping patients make smart care choices that will help reduce personal health care costs.” This will “create a secure, interconnected and efficient health system and information exchange between insurers, providers, and patients.” (Forbes; announcement)
INNOVATION & TRANSFORMATION
Value-based pricing on the table
Last week, CMS released a proposed rule that will make it easier for drugmakers and insurers to enter value-based payment arrangements without violating Medicaid “best price” rules. These deals, tied to clinical outcomes, could ultimately expand access to new, high-cost therapeutics, such as gene therapies. There’s a 30-day comment period, and thousands of responses are expected, Politico reports. Don’t expect any action before the November election, Cowen analyst Rick Weissenstein tells the publication. (Politico)
Is it time for a new EHR model?
EHRs are overdue for an overhaul, writes John Glaser, former CIO of Partners Healthcare and former CEO of Siemens Health Services. He’s not just talking about interoperability: “We must reimagine the EHR not as a document but as a system that supports the generation and tracking of multiple documents, events and processes.” Among his recommendations: a data-driven master plan that would combine appropriate algorithms for treating—as an example—a patient’s asthma, arthritis, depression and obesity, automatically resolving conflicts and redundancies. (Harvard Business Review)
CONSUMERS & PROVIDERS
Americans aren’t using the best tools at their disposal to prevent the spread of COVID-19, CDC Director Robert Redfield recently told the House appropriations subcommittee. He’s particularly concerned about the attitude toward masks. “We continue to try to figure out how to penetrate the message with different groups. We’re going to encourage people who have the ability to request or require masks when they are in their environment to continue to do that. We think it’s an important public health tool and are trying to get more people to embrace it.” (Fierce Healthcare)
What we have here is a failure to communicate
Medicare Advantage plans are doing a poor job of communicating with beneficiaries—and it’s become worse during the pandemic, according to a new study from J.D. Power. All plans had problems; those with the least: Highmark, followed by Kaiser and Humana. “Despite the significant positive effect on member satisfaction, just 15% of MA plans deliver all three information and communication performance indicators,” the study said. In fact, consumers are 3.3 times more likely to receive a helpful communication from their bank than from their health plan. (Fierce Healthcare; J.D. Power announcement)
NEW & NOTED
MedPAC says: Medicare Advantage plans and ACOs could do a better job driving value-based payment reform. “Progress toward value-based payment throughout the Medicare program needs to accelerate and more of the program needs to be detached from straight fee-for-service payment,” MedPAC Executive Director Jim Matthews told reporters. (Healthcare Dive; report)
Reopen with care: Analysis from the Kaiser Family Foundation highlights the challenges of reopening. It finds that 24% of workers (roughly 37.7 million) are considered at high risk of serious illness if they contract COVID-19. Of these, 10 million are 65+, and 27.7 million have pre-existing medical conditions that the CDC says places them at higher risk for severe illness from COVID-19. (Kaiser Family Foundation)
What happened at the nursing homes?: MITRE announced the 25 members of its Coronavirus Commission for Safety and Quality in Nursing Homes. Members include infectious disease experts, nursing home administrators, clinicians, a medical ethicist and a nursing home resident. Their task: Do a comprehensive assessment of the nursing home response to the COVID-19 pandemic. (MITRE announcement)
MULTI-MEDIA
Polling, politics and health during COVID-19
In this edition of Ethics Talk, Audiey Kao, MD, PhD, editor-in-chief of the AMA Journal of Ethics, talks with Mollyann Brodie, PhD, about the science of polling, public opinions on COVID-19 and politically divergent views on policy options to achieve universal health care coverage. Brodie is executive vice president and chief operating officer at the Henry J. Kaiser Family Foundation. (AMA Journal of Ethics podcast)
MARKETVOICES...QUOTES WORTH READING
“As an employer, I know that employers are largely on their own to develop policies to reopen safely. These data suggest employers should take into account the higher risk some workers will face, allowing them to work at home where possible, to be tested and to minimize their risks if they return to work.”—Kaiser Family Foundation President and CEO Drew Altman on an analysis that finds nearly a quarter of U.S. workers are considered at high risk of serious illness if they contract COVID-19