From Washington, DC

• Fierce Healthcare tells us
  • “Friday morning, the HHS uploaded a policy statement that is set to be published in the Federal Register on March 3.
  • “Bylined by the secretary, it says the department is no longer required to undergo a public comment period it typically observes following the publication of proposed rulemaking in “matters relating to agency management or personnel or to public property, loans, grants, benefits or contracts.”
• The FEHBlog has often wondered why CMS circulated draft Medicare Advantage call letters for public comment but OPM hasn’t circulated draft FEHB / PSHB call letters. This article explains why, but HHS is doing away with this practice.

• Federal News Network informs us,
  • “SSA will offer employees voluntary separation incentives and early retirement options as part of a major reorganization.
  • “Through these massive reorganizations, offices that perform functions not mandated by statute may be prioritized for reduction-in-force actions that could include abolishment of organizations and positions, directed reassignments and reductions in staffing,” SSA stated in a Feb. 27 release. “The agency may reassign employees from non-mission critical positions to mission critical direct service positions (e.g., field offices, teleservice centers, processing centers). Reassignments may be involuntary and may require retraining for new workloads.”
  • “SSA says it’s looking to shed about 7,000 workers. The latest data from last March says SSA had 56,645 employees, up slightly from 2023 and down from 66,967 in 2010.”

• Govexec maintains a RIF watch.

• Yesterday, OPM reminded FEHB plan carriers,
  • [A]n enrollee whose FEHB enrollment is terminated, other than by cancellation or discontinuance of the plan, is entitled to a 31-day extension of coverage without contributions by the enrollee or the Government. This applies to Self Only, Self Plus One, or Self and Family enrollments.   See 5 CFR 890.401(a)(1).  Carriers must provide the 31-day extension of coverage beyond the coverage end date provided by employing agencies in the SF-2810 action to all terminated enrollments cited in the regulation.”  

• Cardiovascular Business lets us know,
  • “The U.S. Food and Drug Administration (FDA) has announced a new recall for the ablation catheters associated with Johnson & Johnson MedTech’s Varipulse pulsed field ablation (PFA) system. No devices need to be returned or removed from the market. Instead, the FDA is urging all customers to read updated instructions provided by Johnson & Johnson MedTech. 
  • “The recall comes after approximately 3% of patients treated with the device during the early stages of its U.S. rollout experienced a stroke or transient ischemic attack shortly after treatment. The expected stroke rate is closer to 1%, the FDA explained, prompting this action. 
  • “In total, four serious injuries have been linked to this issue.
  • “This is a Class I recall, which means the FDA believes patients face a risk of serious injury or death if they use the devices without reviewing the updated instructions.” 

From the public health and medical research front,

• The Centers for Disease Control and Prevention announced today,
  • “Seasonal influenza activity remains elevated nationally but has decreased for two consecutive weeks. COVID-19 activity is declining nationally but elevated in some areas of the country. RSV activity is declining in most areas of the country.
  • “COVID-19
    • “COVID-19 activity is declining nationally but elevated in some areas of the country. Wastewater levels are moderate, emergency department visits are at low levels, and laboratory percent positivity is stable. Emergency department visits and hospitalizations are highest in older adults and emergency department visits are also elevated in young children.
    • “There is still time to benefit from getting your recommended immunizations to reduce your risk of illness this season, especially severe illness and hospitalization.
    • “CDC expects the 2024-2025 COVID-19 vaccine to work well for currently circulating variants. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
  • “Influenza
    • “Seasonal influenza activity remains elevated nationally but has decreased for two consecutive weeks. Data to date suggests the season has peaked, however, flu-related medical visits, hospitalizations, and deaths remain elevated, and CDC expects several more weeks of flu activity.
    • “Additional information about current influenza activity can be found at: Weekly U.S. Influenza Surveillance Report | CDC
  • “RSV
    • “RSV activity is declining in most areas of the country. Emergency department visits and hospitalizations are highest in children and hospitalizations are elevated among older adults in some areas.
  • “Vaccination
    • “Vaccination coverage with influenza and COVID-19 vaccines is low among U.S. adults and children. Vaccination coverage with RSV vaccines remains low among U.S. adults. Many children and adults lack protection from respiratory virus infections provided by vaccines.

• The University of Minnesota’s CIDRAP adds,
  • “Newly confirmed US Department of Agriculture (USDA) Secretary Brooke Rollins, JD, [on February 26] introduced new steps to battle avian flu in poultry and stabilize the egg supply, which includes $500 million to help poultry producers shore up biosecurity measures.
  • “Earlier this week, Rollins met with egg producers during a tour of an egg-laying facility in Texas, and today she detailed USDA’s strategy in an opinion piece in the Wall Street Journal. The USDA also detailed the plan today on its website.
  • “Since 2022, the H5N1 avian flu virus has led to the loss of more than 166 million poultry, including 19 million over the past 30 days. Outbreaks over the fall and winter have hit poultry farms hard, especially layer facilities in some of the top egg-producing states, such as Ohio.” 

• The Wall Street Journal reports,
  • “Health and Human Services Secretary Robert F. Kennedy Jr. said ending the measles outbreak in Texas is a top priority for him and listed the steps his agency had taken to combat the spread of disease, including supporting the state’s vaccine efforts.
  • “I recognize the serious impact of this outbreak on families, children, and healthcare workers,” Kennedy wrote Friday in a post on X.
  • “There have been at least 155 measles cases linked to the outbreak across West Texas and New Mexico, local health officials said Friday. Twenty patients have been hospitalized, and one school-age child died this past week. Most of those sickened weren’t vaccinated, or their vaccination status wasn’t known. 
  • “Kennedy said HHS had provided lab support to track the virus, offered technical assistance to local public health officials and updated federal advice on doctors offering vitamin A to manage measles cases.
  • “HHS communicated about the disease in Low German to the affected population in Texas’ Gaines County, Kennedy said, where the outbreak was concentrated among Mennonites.”

• Medscape relates,
  • “For decades, physicians had little to offer patients who have heart failure with preserved ejection fraction (HFpEF), which is a growing global health problem with a grim death rate in the 5 years after diagnosis. But that started to change in 2021, when a drug trial showed benefits in preventing hospitalization and death.
  • “And each year since, has brought a new clinical trial that shows the value of yet another drug for HFpEF.
  • “It’s so wonderful,” said Michelle Kittleson, MD, PhD, professor of cardiology at the Smidt Heart Institute at Cedars-Sinai in Los Angeles and chair of the writing committee for the latest American College of Cardiology (ACC) update to the HFpEF management pathway.”

• The Wall Street Journal points out “New Treatments Give Hope to Patients with One of the Deadliest Cancers. Half of all pancreatic cancer patients live less than a year after diagnosis. But researchers say there is potential for change.”

• The American Hospital Association News tells us,
  • “A study published Feb. 26 by JAMA Psychiatry found that female physicians died by suicide at more than 1.5 times the rate of female nonphysicians from 2017-2021. During the same time, male physicians had a lower suicide risk than male nonphysicians. The study also found that physicians who died by suicide had higher odds of depressed mood and mental health, job and legal problems preceding suicide compared to the general population. 
  • “The AHA has a dedicated webpage with resources on preventing suicide in the health care workforce.”

• Per MedPage Today,
  • “Rates of pancreatitis and liver-related complications from alcohol have increased in teens and young adults.
  • “Males were most affected, yet young females had changes in rates that were higher than males.
  • “These findings suggest a need for addiction medicine training in gastroenterology.”
• and
  • “Diabetes prevalence in U.S. adults over the past decade has remained stable, with a small non-significant increase.
  • “HbA1c and rates of glycemic control significantly worsened from 2017-2020 to 2021-2023, with changes concentrated in adults ages 20 to 44.
  • “The changes observed in HbA1c and glycemic control among these younger adults would be expected to increase their lifetime risk of cardiovascular events, according to the researchers.”
• and
  • “To improve mental health, risk factors related to “social determinants” like food insecurity or inadequate housing need to be addressed, according to some health experts. But even doing that doesn’t go far enough upstream, said one psychiatrist here on Thursday.
  • “It’s not enough to intervene at the level of the risk factors — [if you do], you’re actually intervening too late,” said Ruth Shim, MD, MPH, a professor of cultural and clinical psychiatry at the University of California Davis in Sacramento. “So, I started looking into and trying to understand what is actually happening before the risk factor.”
  • “Those upstream factors are sometimes known as the “causes of the causes,” Shim said at an event sponsored by the Johns Hopkins Center for Mental Health and Addiction Policy. “What’s the context that’s going to set you further upstream from the risk factor?”
  • “The answer is that there are two “very fundamental issues,” she noted. “Social norms, or the belief in common society, about who in our society is worthy of value and who is less worthy of such value, who in our society deserves advantage, and who is less deserving of this advantage. And what are the public policies or the laws that we pass that reflect those belief systems? Because those laws that we pass then create unfair and unjust distribution of opportunity, which set into motion the social determinants of mental health, which then lead to the risk factor, which then leads to poor outcomes.”

From the U.S. healthcare business front,

• Healthcare Dive lets us know,
  • “Universal Health Services’ net income soared in 2024, rising to $1.1 billion from $717.8 million in 2023 on strong demand for services, particularly in the operator’s behavioral health division.
  • ‘The Pennsylvania-based hospital operator plans to expand its behavioral health offerings next year to drive revenue growth, with a specific focus on outpatient services, executives said on a Thursday earnings call.
  • “UHS expects to take in between $17 billion and $17.4 billion in net revenue in 2025. However, the company is contending with several possible headwinds, including potential healthcare policy changes in Washington, which could impact the company’s bottom line.”

• Beckers Payer Issues informs us,
  • “Blue Cross Blue Shield of Massachusetts reported a $400 million operating loss in 2024, driven by spending on GLP-1 medications and other rising medical costs. 
  • “The nonprofit insurer reported its financial results for 2024 on Feb. 28. The company posted a -4.3% operating margin in 2024, compared to a 0.4% margin in 2023. 
  • “In a news release, CFO Ruby Kam said medical costs are rising at the fastest rate in more than a decade. Costs are rising across almost every category of services, but GLP-1 drugs have had the single largest impact, she said. GLP-1 drugs accounted for nearly 20% of the insurers’ pharmacy spending in 2024. 
  • “The insurer is repricing its plans to reflect higher costs and cutting administrative spending, including through hiring freezes and eliminating some jobs, according to the release. 
  • “In a statement, CEO Sarah Iselin said the company does not expect the trend to change any time soon.” 

AI News

• Fierce Healthcare reports,
  • “Last week at the ViVE conference in Nashville, two topics seemed to dominate most conversations—artificial intelligence and the impending snowstorm. (Music City got about two inches of snow.)
  • “According to many executives who attended the digital health-focused conference, AI took the main stage at ViVE and discussions about adoption and use of the technology in healthcare has evolved significantly in just the past year.
  • “Many conversations centered around AI agents and sophisticated prompt engineering. Compared to HLTH, where conversations felt more theoretical, vendors and healthcare customers were speaking about concrete use cases. For a while now people healthcare incumbents have had robotic process automation, then intelligent automation and now AI on their roadmaps. It seems we’ve finally arrived at the final destination and most are piloting different AI tech now,” Neil Patel, Redesign Health’s head of ventures told Fierce Healthcare.”

• Per Healthcare Dive,
  • “A private-public partnership formed to create standards for artificial intelligence adoption in healthcare is launching a new registry for hospitals and developers to access and share information on AI tools.
  • “The hub, known as a model card registry, was unveiled by the Coalition for Health AI (CHAI) and health system members of the group, including Providence, Cleveland Clinic and Kaiser Permanente, on Friday. The goal of the registry is to make it easier for healthcare companies to evaluate and shop between validated AI products, CHAI said.
  • “AI companies and other developers can input their tools into the registry regardless of whether they’re a member of CHAI, according to a spokesperson. There’s no cost to upload model cards or access the registry, though it could include paywalled features in the future, they said.”
• and
  • “Cloud-based software company Salesforce is rolling out a library of prebuilt artificial intelligence tools meant to make it easier for providers, payers and other healthcare companies to apply digital labor to time-consuming tasks.
  • “Salesforce’s “Agentforce for Health” relies on agentic AI, which unlike older AI assistants can operate relatively autonomously.
  • “The product includes patient access and services capabilities, including answering questions and checking patient eligibility with insurers; public health capabilities, like helping organizations monitor the spread of infections; and clinical capabilities to accelerate research and development for drugs and medical devices.”