May 14, 2020 | Winter is coming…
INDUSTRY NEWS
The U.S. economy is crashing, and almost half of the economic devastation comes from the health care sector. This 18-minute episode of the Kaiser Health News podcast “An Arm and a Leg” explores downturn and how health care is fueling the recession. It includes interviews with struggling pediatricians and reveals that even emergency medicine docs fighting COVID-19 aren’t immune to the economic downturn. (KHN)
CMS issues final rule on exchanges
Insurers received a one-week extension to finalize 2021 exchange plan applications, allowing them to factor in COVID-19’s impact as they set premiums. That was one of many provisions of a final CMS rule issued last week. In addition, insurers don’t have to count copay assistance from drug companies toward deductibles or other out-of-pocket spending. Patient advocates warn this will increase patient costs. The rule also gives a boost to value-based care—such as “high-value services like blood pressure monitoring or cardiac rehabilitation with zero cost-sharing.” (Fierce Healthcare; Healthcare Finance News)
Executives of large commercial health insurers don’t seem worried about the impact of COVID-19 on their bottom lines, Healthcare Dive reports. All reaffirmed their earnings outlook for the full year. The main reason: Fewer Americans are seeking care. Lower utilization is better for insurers. “The vast majority of the country’s hospitals are less full today than what they would normally be, and the costs to the insurer for the cases that are in those hospitals are lower,” David Windley, an analyst with Jefferies, told Healthcare Dive. (Healthcare Dive)
INNOVATION & TRANSFORMATION
NEJM paper: Include social factors in VBP models
Social, behavioral and environmental factors need to be incorporated into value-based payment models according to a New England Journal of Medicine paper co-authored by William Shrank, MD, CMO of Humana, and Shantanu Agrawal, MD, president and CEO of National Quality Forum. “Growing evidence indicates that socially disadvantaged people have comparatively worse health outcomes suggesting that clinical and social risk are related,” Agrawal said in a prepared statement. “[W]e must consider this growing body of evidence as part of a comprehensive, 21st century approach to risk adjustment.” (Becker’s Hospital Review; NEJM)
Winter is coming…and she’s armed with antibodies
Llamas may have antibodies that can neutralize the new coronavirus, according to research published in Cell. Well, at least one llama, named Winter, has. Researchers studied the llama's antibodies and found that Winter had separate antibodies that could neutralize SARS and MERS. They were already writing up their findings when the new coronavirus hit the U.S. in January, the New York Times reports. They tested the llama's antibodies and discovered they can neutralize SARS and inhibit the new coronavirus in cell cultures. (The New York Times; Cell)
CONSUMERS & PROVIDERS
Roughly 75,000 Americans could die by suicide, drugs or alcohol abuse—“deaths of despair”—because of the COVID-19 pandemic, according to a report from the Well Being Trust (WBT) and the Robert Graham Center. Without action, it could be worse “If nothing happens and nothing improves—i.e., the worst-case scenario—we could be looking at an additional 150,000 people who died who didn't have to,” Benjamin Miller, PsyD, WBT chief strategy officer, tells Medscape Medical News. (Medscape Medical News; report)
NEW & NOTED
Routine vaccines down: The COVID-19 pandemic appears to have led to a dramatic decline in the routine vaccination of children in the U.S., according to a study the CDC published last week. Researchers compared orders for the period from Jan. 7 through April 21 this year to the same period last year. (STAT News; CDC Morbidity and Mortality Weekly Report)
Rebound coming? The latest projections by Columbia University Mailman School of Public Health scientists suggest a late May COVID-19 rebound. By June 1, one scenario gives median estimates of 43,353 cases per day and 1,841 deaths per day in the U.S. A second scenario, based on looser restrictions, estimates 63,330 cases and 2,443 deaths per day by June 1. (Mailman)
Pandemic highlights interoperability failings: The pandemic is revealing just how far away we are from interoperability. “I’m stunned at EHR vendors’ inability to consistently pull data from their systems,” says Dale Sanders, chief technology officer of Health Catalyst, a data analytics company. “It’s absolutely hampering our ability to understand and react to COVID.” (KHN; Fortune)
MULTI-MEDIA
Listen to this virtual briefing on COVID-19 with the U.S. Centers for Disease Control and Prevention, Johns Hopkins Medicine, U.C. Davis Health and organizations representing the chronic disease community. Learn from experts about why the COVID-19 virus can put people with chronic conditions/diseases at higher risk for complications. (Chronic Care Alliance)
MARKETVOICES...QUOTES WORTH READING
“This means bringing mental health fully into all facets of our healthcare system, of our community. It will take robust investment in creating new mechanisms for care—-those that are team-based, create a new type of workforce to deliver that care, and one that is seamless across clinical and community settings.”—Benjamin Miller, PsyD, WBT chief strategy officer, quoted in Medscape Medical News, talking about “deaths of despair” related to the coronavirus.