From Washington, DC,

• The Washington Post reports,
  • “The White House on Wednesday backed proposals to permanently stiffen penalties on synthetic-drug traffickers, monitor machines used to make fentanyl pills and close a loophole that allows criminal groups to easily ship drugs in packages.
  • “President Biden announced the initiatives as state and federal officials from both political parties grapple with how to curb a drug epidemic that has killed more than 300,000 people during his administration.
  • “The crisis is fueled by fentanyl, the potent synthetic opioid manufactured by Mexican criminal groups and smuggled into the United States. Border security has proved to be a political flash point, with Republicans hammering the White House about the failure to stop fentanyl from entering the country.”

• American Hospital News informs us,
  • “At a Capitol Hill briefing July 31, hospital and health care leaders shared strategies and stories highlighting the importance of passing the Safety from Violence for Healthcare Employees Act (H.R. 2584/S. 2768), bipartisan legislation that would provide federal protections against violence to hospital workers.  
  • “The panel featured: Mark Boucot, president and CEO of Potomac Valley Hospital in Keyser, W.Va., and Garrett Regional Medical Center in Oakland, Md.; Rachel Culpepper, DNP, RN, general medicine service line director at Indiana University Health West Hospital in Avon, Ind.; and James Phillips, M.D., an emergency room physician in Washington, D.C. and chair of disaster medicine at the American College of Emergency Physicians. Sen. Joe Manchin, I-W.Va., author of the Senate bill, also delivered remarks.  
• and
  • “The Centers for Medicare & Medicaid Services July 31 issued a final rule for fiscal year 2025 for the skilled nursing facility prospective payment system, which will increase aggregate Medicare spending by 4.2% or $1.4 billion compared to FY 2024. This reflects a 3% market basket update, a 1.7 percentage-point increase to counter the agency’s market basket error in FY 2023, and a 0.5 percentage point cut for productivity. CMS also revised its regulations regarding its nursing home enforcement authority to allow the agency to impose additional financial penalties on facilities where health and safety deficiencies are identified.”
• and
  • The Centers for Medicare & Medicaid Services July 31 released the fiscal year 2025 final rule for inpatient rehabilitation facilities, which will update IRF payments by an estimated 3% overall (or $300 million) in FY 2025. This includes a 3.5% market basket update, which is reduced by a 0.5 percentage point cut for productivity. However, IRF payments will be further decreased by an estimated 0.2% ($20 million) due to the updated outlier threshold. 
• and
  • “The Centers for Medicare & Medicaid Services July 31 issued the final rule for the inpatient psychiatric facility prospective payment system for fiscal year 2025. CMS will increase IPF payments by a net 2.5%, equivalent to $65 million, in FY 2025. This increase includes a market-basket update of 3.3% minus a productivity adjustment of 0.50 percentage points; it also accounts for an update to the outlier threshold so that estimated outlier payments will remain at 2.0% of total payments, resulting in a 0.3% decrease to aggregate payments.”

• Here are links to the CMS Fac Sheets on the SNF final rule, the IRF final rule, and the IPF final rule.

• Per an HHS press release,
  • “Today, the U.S. Department of Health and Human Services (HHS), through the Health Resources and Services Administration (HRSA), announced more than $68 million in Ryan White HIV/AIDS Program funding to provide family-centered medical care and essential support services for women with low incomes, infants, children, and youth with HIV. This announcement supports and advances the Biden-Harris Administration’s National HIV/AIDs Strategy.” * * *
  • “HRSA’s Ryan White HIV/AIDS Program provides a comprehensive system of HIV primary medical care, medication, and needed support services to more than 560,000 people with HIV who have low incomes. The program focuses on tailoring approaches to best meet people with HIV and their communities where they are and addressing factors, like access to food, childcare, housing, and transportation that directly affect the ability of patients to enter and stay in care.”  

• Govexec informs us,
  • “The Senate Homeland Security and Governmental Affairs Committee on Wednesday unanimously advanced legislation codifying recent changes to the federal hiring process stressing applicants’ skills and experience over educational attainment.” * * *
  • “By a 10-1 vote, the panel [also] moved legislation expanding the list of federal positions in which employees are “further restricted” from partisan political activity under the Hatch Act. Sen. Rand Paul, R-Ky., was the lone dissenter.
  • “The bill (S. 4656), introduced by Sen. Chuck Grassley, R-Iowa, and Committee Chairman Gary Peters, D-Mich., would add employees of agency offices of inspectors general to the Hatch Act’s list of employees with additional guard rails on political activity, alongside other oversight agencies like the Office of Special Counsel and Merit Systems Protection Board and national security organizations like the National Security Agency and FBI.”

From the public health and medical research front,

• STAT News lets us know,
  • “Patients with early Alzheimer’s disease treated with a medication developed by Eisai and Biogen for up to three years experienced less cognitive decline than what’s expected of untreated patients based on historical data, according to new study results reported Tuesday. The manufacturers said the data support long-term, continuous use of the drug.
  • “The three-year benefit seen in patients provided Leqembi remains modest — a 31% slowing of cognitive decline, slightly more than a 27% slowing previously seen in an 18-month placebo-controlled trial. It’s still unclear if the new data will convince doctors to use Leqembi continuously, or if the treatment’s benefit is clinically meaningful for patients, experts told STAT. * * *
  • “Eisai’s argument for continuing Leqembi treatment contrasts with Lilly’s approach to its [similar FDA approved] drug Kisunla. Lilly argues that once amyloid is cleared in treated patients, they can stop the therapy, making Kisunla a more convenient option, and potentially less expensive compared to continuous dosing.”

• MPR points out,
  • “The Food and Drug Administration (FDA) has approved Zunveyl (benzgalantamine) for the treatment of mild to moderate dementia of the Alzheimer type in adults.” * * *
  • “The approval of Zunveyl is a pivotal moment in the fight against Alzheimer disease as it is only the second oral AD treatment to be approved in more than a decade,” said Michael McFadden, CEO of Alpha Cognition. “Zunveyl was designed to address a critical need for a tolerable and effective treatment that can potentially enhance patients’ daily lives with improved long-term outcomes.”
  • Zunveyl is supplied as 5mg, 10mg, and 15mg delayed-release tablets. The product is expected to be available in the first quarter of 2025. 

• The National Cancer Institute posted its latest Cancer Information Highlights.

• At this link, Beckers Hospital Reviews points out “eight new shortages to know about, according to drug supply databases from the FDA and the American Society of Health-System Pharmacists”

From the U.S. healthcare business front,

• Per Beckers Payer Issues,
  • “Humana reported $679 million in net income in the second quarter of 2024. 
  • “The company published its second quarter earnings report July 31. In Q2 2023, Humana posted $959 million in net income.
  • “Total revenue in the second quarter was $29.5 billion, up 10.4% year over year. 
  • “Humana’s medical loss ratio was 89% in the second quarter.”

• Modern Healthcare notes,
  • “An unexpected spike in inpatient utilization during the latter half of the quarter, which continued into July, dinged Humana’s finances. Executives cited the effects of the two-midnight rule, which requires insurers to cover inpatient stays when providers expect patients to remain in the hospital for at least two midnights. The company expects this trend to persist through 2024.”
    
• Healthcare Dive adds,
  • “Medicare Advantage giant Humana expects to lose a “few hundred thousand” members in its marquee business next year, after seriously shrinking its benefits and exiting markets for 2025 in a bid to boost profits, the insurer disclosed Wednesday.
  • “It’s the first time Humana has estimated membership losses from culling its plans, and squares with past guesses from market watchers. MA margins should improve as a result, setting Humana on the path to a long-term target of at least 3%, management told investors on a call. Currently, analysts peg Humana’s MA margin as basically flat, as the Kentucky-based payer has been rocked by rising medical costs among seniors in the privately run Medicare plans.
  • “However, Humana also expects to emerge from 2024 stronger from a membership perspective than it previously thought. The insurer now expects to add 225,000 MA members this year, up from its previous forecast of 150,000 new lives.”

• Per Fierce Healthcare,
  • “In its first quarter with new CEO Chuck Divita, national telehealth provider Teladoc Health posted a net loss of $838 million in Q2 that included a nearly $800 million impairment charge attributed to falling expectations for its virtual mental health solution, BetterHelp.
  • “Teladoc is withdrawing its 2024 outlook, and its three-year business outlook based on its Q2 losses. It now expects low single-digit year-over-year revenue growth for 2024. BetterHelp’s revenue in Q2 decreased 9% from Q2 2023, to $265 million.
  • “Amid slowing growth in recent quarters with a saturated telehealth market and the abrupt departure of longtime CEO Jason Gorevic in April, the company’s net loss skyrocketed in Q2 2024 to $837.7 million, or $4.92 per share, compared to a loss of $65 million, or $0.40 per share, during the same quarter a year ago.” * * *
  • “Divita said transitioning BetterHelp to accept insurance is the next logical step for the company. Customers that leave the platform cite high out-of-pocket costs and lack of insurance coverage, he noted.
  • “BetterHelp expects to have the technical capabilities for insurance coverage by year-end and expects insurance contracting to roll out over the course of 2025.”

• Per BioPharma Dive,
  • “GSK on Wednesday lowered its forecast for vaccine sales this year, citing inventory changes and shifting retail prioritization in the U.S. for its shingles shot Shingrix.
  • “The British pharmaceutical company now expect sales from its vaccines division to increase by low to mid-single digit percentages, down from the high single digit to low double-digit growth it predicted in May.
  • “Shingrix, now one of GSK’s top products, earned 832 million pounds, or about $1.1 billion, in the second quarter, down from the first three months of the year but up year to date. Sales of Arexvy, the company’s new vaccine for respiratory syncytial virus, totaled 62 million pounds as demand eased along expected seasonal patterns.”

• Per MedTech Dive,
  • “Stryker set another record in the second quarter for installations of its Mako orthopedic robot, ahead of two planned launches of spine and shoulder features later this year.  
  • “As you’ve seen, quarter after quarter, our Mako installations are very high. That leads to future strong demand for hips and knees,” Stryker CEO Kevin Lobo told investors on Tuesday. 
  • “This is the third quarter in a row where management has noted record installations, BTIG analyst Ryan Zimmerman said in a research note. 
  • “The results drove more than 14% sales growth in Stryker’s “other orthopedics” segment to $136 million.”

• This link provides an explanation of how the Mayo Clinic uses the Mako orthopedic robot in hip and knee replacement surgeries.

• Per MedPage Today,
  • “Trust in physicians and hospitals decreased sharply during the COVID-19 pandemic, and higher levels of trust were tied to greater odds of getting vaccinated for COVID-19 or influenza, according to a survey study of U.S. adults.
  • “Among over 400,000 unique respondents, the proportion of adults who agreed they had “a lot of trust” in physicians and hospitals declined from 71.5% in April 2020 to 40.1% in January 2024, reported Roy Perlis, MD, MSc, of Massachusetts General Hospital in Boston, and colleagues in JAMA Network Open. * * *
  • In regression models, factors associated with lower trust as of the spring and summer of 2023 included being 25 to 64 years of age, female gender, lower educational level, lower income, Black race, and living in a rural setting. Even when the researchers controlled for partisanship, these associations persisted. * * *
  • “We as physicians and public health officials can talk until we’re blue in the face about things like vaccination and other public health behaviors,” Perlis commented. “But if people don’t trust us, it doesn’t matter — we’re talking to ourselves.” * * *
  • “Perlis and his team also gathered information about why respondents had low levels of trust. Participants with the two lowest levels of trust identified the following reasons: financial motives over patient care (35%), poor quality of care and negligence (27.5%), influence of external entities and agendas (13.5%), and discrimination and bias (4.5%).”
• FEHBlog observation: Wow.

• The Society for Human Resource Management tells us,
  • “After an unexpected surge in pay and benefits in the first quarter, labor costs have slowed down in the second quarter but still remains robust.
  • “The Employment Cost Index (ECI) increased 0.9% in the second quarter of the year, new data finds, after rising 1.2% last quarter, according to Bureau of Labor Statistics data released July 31. Wages and salaries increased 0.9% and benefit costs increased 1% from March 2024. Many economists forecasted that the ECI would rise 1%.
  • “Year over year, compensation costs in the U.S. for civilian workers—including pay and benefits—rose 4.1%, down slightly from the 4.2% year-over-year rise in the first quarter of 2024. Meanwhile, compensation for state and local government workers is up 4.9%.
  • “Wages and salaries grew 4.2% for the 12-month period ending in June 2024 and rose 4.6% for the 12-month period ending in June 2023, according to the BLS. Benefit costs grew 3.8% over the year and rose 4.2% for the 12-month period ending in June 2023.” * * *
  • “Although wage growth appears to be slowing, it’s still robust, said Sydney Ross, junior economic researcher at SHRM.
  • “As shown in the recent JOLTS report, employers are still dealing with a tight labor market and persistent talent shortages across key industries,” she said. “This means there will be more competition between employers for skilled talent, especially for those in specialized industries.”