Friday Factoids

David Ermer–CDC, Congress, COVID-19, Mental health care, Telehealth, U.S. Healthcare–

From Washington, DC,

  • Govexec reports,
    • “Lawmakers on the Senate Appropriations Committee unveiled and unanimously advanced spending legislation Thursday effectively endorsing President Biden’s planned 2% average pay increase for federal workers in January, to the chagrin of federal employee groups and advocates.
    • “The committee moved four of the 12 fiscal 2025 appropriations bills Thursday, including the Energy and Water Development; Defense; Labor, Health and Human Services; and Financial Services and General Government Appropriations acts. That last bill is traditionally the avenue by which lawmakers seek to override a president’s alternative pay plan, and the committee’s draft is silent on most federal workers’ compensation rates, effectively endorsing the White House’s plan.” * * *
    • “With the GOP-controlled House Appropriations Committee’s version of the Financial Services and General Government spending package, advanced by the panel last month on a party-line vote, similarly endorsing the White House proposal, it is unlikely federal employees will see a raise larger than 2% next year.”
  • Bloomberg Law lets us know,
    • “The Biden administration failed to persuade the Fifth Circuit to reinstate rules making median network rates a primary consideration in deciding payment disputes under a law meant to prevent “surprise” medical bills. 
    • “In a Friday ruling, the appeals court upheld a lower court decision in favor of health-care providers that had vacated the regulations implementing the No Surprises Act from the Departments of Health and Human Services, Labor, Treasury, and Office of Personnel Management.
    • “Judge Jeremy Kernodle of the US District Court for the Eastern District of Texas had ruled in 2022 that the agencies didn’t abide by the text of the health-care benefits statute in issuing requirements that arbitrators must follow in payment dispute cases between medical providers and health insurers.
    • “The US Court of Appeals for the Fifth Circuit panel’s decision agreeing that the regulations violate the Administrative Procedure Act creates another significant setback for the government in its attempt to defend the rules governing the arbitration system from a spate of litigation.” * * *
    • “The DOL, HHS, and Treasury Departments did not immediately respond to requests for comment on the decision Friday.”
  • The National Committee for Quality Assurance has released information on its measurement year 2025 HEDIS measures.
    • “For Measurement Year 2025, NCQA added three HEDIS measures, retired four measures and made smaller changes across multiple measures. We also continue the transition to Electronic Clinical Data Systems (ECDS) reporting.”
  • Per BioPharma Dive,
    • “The Food and Drug Administration on Thursday approved a new type of cellular medicine, clearing a therapy developed by the biotechnology company Adaptimmune for a rare soft tissue cancer called synovial sarcoma.
    • “The agency granted Adaptimmune’s therapy, formerly known as afami-cel and to be sold as Tecelra, an accelerated approval for use in some people with metastatic synovial sarcoma who previously received chemotherapy. Those people must have certain immune signatures and tumors expressing a protein, MAGE-A4, that Tecelra is designed to target.
    • “The FDA based its decision on Tecelra’s ability to spur tumor responses in about 43% of people who received it in a clinical trial, with responses lasting a median of about 6 months, according to the therapy’s new labeling. Adaptimmune has to confirm those benefits in an ongoing study to maintain the approval. The company expects to submit those results next year, executives said on a Friday conference call with analysts.”

From the public health and medical research front,

  • The Centers for Disease Control informs us,
    • Summary
      • Seasonal influenza and RSV activity are low nationally, but COVID-19 activity has increased in most areas.
    • COVID-19
      • Most areas of the country are experiencing consistent increases in COVID-19 activity. COVID-19 test positivity, emergency department visits, and rates of COVID-19–associated hospitalizations remain elevated, particularly among adults 65+. Surges like this are known to occur throughout the year, including during the summer months. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
    • Influenza
    • RSV
      • Nationally, RSV activity remains low.
    • Vaccination
  • Calculated Risk adds, “COVID in wastewater is increasing – especially in the West and South.” 
  • STAT News tells us,
    • “Untreated vision loss and high LDL cholesterol have been added as two new potentially modifiable risk factors for dementia in a report released Wednesday by the Lancet Commission.
    • “These new additions join 12 other risk factors outlined by the commission, affiliated with University College London, in previous reports on dementia prevention, intervention, and care in 2017 and 2020. The other risk factors are lack of education, hypertension, physical inactivity, diabetes, social isolation, excessive alcohol consumption, air pollution, smoking, obesity, traumatic brain injury, and depression.
    • “The commission’s latest findings suggest more ways of preventing dementia than previously known, according to Gill Livingston, a professor of psychiatry at University College London and co-author on the report.
    • “A lot of surveys have asked people of 50 and above what illnesses they most are concerned about, and dementia tends to come up as the highest one,” Livingston said. “And yet there’s really quite a lot that we can do to change the scales and make it less likely.”
  • Per Fierce Healthcare,
    • “CVS Health has launched an environmental health impact program to help vulnerable Americans during extreme weather events.
    • “The program, already live for a few weeks, initially focuses on extreme heat. Using advanced environmental data analytics and patients’ medical and pharmacy data, CVS Health offers timely excessive heat alerts and outreach to at-risk patients up to a week before the event. The initiative will expand to encompass air quality events this fall. It is initially available to members of Aetna with the goal of expanding to pharmacies and MinuteClinics.” * * *
    • “Heat waves and our changing environment is just such a pressing public health threat. I don’t think it’s appreciated nearly as much as it should be,” Dan Knecht, M.D., chief clinical innovation officer for CVS Caremark, told Fierce Healthcare.” * * *
    • “Consulting with experts in climate change and public health, CVS Health determined a wet bulb temperature threshold in the mid-80s Fahrenheit. Ingesting third-party weather data, it determines regions that surpass the limit and uses its own algorithm to stratify Aetna members by their vulnerability to extreme heat. Care managers who are registered nurses then reach out by phone, using an evidence-based framework for navigating the conversations. They provide information on the symptoms of heat stroke, how to minimize heat exhaustion and local resources such as cooling centers. Many Oak Street Health centers, now owned by CVS Health, can be used as a safe space to gather during extreme temperatures, Knecht said.”

From the U.S. healthcare business front,

  • STAT News reports,
    • “Contract disputes between hospitals and health plans have become routine, but they tend to be local, affecting a handful of hospitals and the people in the surrounding communities.
    • “This latest one is different. It involves the country’s biggest private health insurer, UnitedHealthcare, and its biggest hospital chain, HCA Healthcare. If they can’t strike a deal on prices by Sept. 1, 38 hospitals and their affiliated physician groups and surgery centers across four states — Texas, Colorado, South Carolina, and New Hampshire — would become out-of-network for UnitedHealthcare members. * * *
    • “UnitedHealthcare spokesperson Cole Manbeck said in a statement that HCA issued notices to end its contracts in four markets and demanded “significant price hikes that are not affordable or sustainable.” Manbeck said UnitedHealthcare shares the goal of reaching an agreement that ensures continued access to providers. He added that the parties could reach an agreement in one market and not another. “It’s not all or nothing,” he said.”
  • Per Healthcare Dive,
    • “Private equity firms TowerBrook Capital Partners and Clayton, Dubilier and Rice entered into a definitive agreement to acquire R1 RCM for about $8.9 billion and take the company private, the revenue cycle management firm said Thursday. 
    • “TowerBrook currently controls around 36% of the company’s shares, according to a press release. Under the deal, which will take R1 private, TowerBrook and CD&R will buy the rest of the company’s outstanding stock for $14.30 per share.
    • “The acquisition comes months after another private equity firm, New Mountain Capital, offered to buy out other investors for $13.75 a share— a price some analysts thought undervalued R1.” 
  • and
    • “Amwell boosted its adjusted earnings outlook for 2024 as the telehealth vendor works to cut costs and rein in expenses.
    • “The company now expects adjusted earnings before interest, taxes, depreciation and amortization to be a loss between $150 million and $145 million. It previously estimated adjusted EBITDA losses between $160 million and $155 million.
    • “Amwell also narrowed its net loss in the second quarter. The virtual care vendor reported a loss of $49.9 million, compared with $92.5 million during the same period last year.”