From Washington, DC

• Congress remains on the campaign trail until the lame duck session begins on November 12.

• Modern Healthcare reports,
  • “Humana Inc. sued U.S. health agencies seeking to reverse a cut to crucial Medicare quality ratings, linked to billions of dollars in revenue, that sent the company’s stock tumbling this month.
  • “The lawsuit argues that the U.S. Medicare program was “arbitrary and capricious” in how it calculated the metrics for Humana’s health plans. The scores, known as star ratings, are linked to billions in bonus payments in future years.
  • “The case was filed Friday in federal court in the Northern District of Texas before Judge Reed O’Connor, who has frequently ruled in favor of plaintiffs challenging government regulations.” 

From the public health and medical research front,

• The Washington Post reports,
  • “The simple difference in the genetic code — two X chromosomes vs. one X chromosome and one Y chromosome — can lead to major differences in heart disease. It turns out that these genetic differences that usually distinguish women from men influence more than just sex organs and sex assigned at birth — they fundamentally alter the way cardiovascular disease develops and presents. * * *
  • “Women are more likely to die after a first heart attack or stroke than men. Women are also more likely to have additional or different heart attack symptoms that go beyond chest pain, such as nausea, jaw pain, dizziness and fatigue. It is often difficult to fully disentangle the influences of sex on cardiovascular disease outcomes vs. the influences of gender.
  • “While women who haven’t entered menopause have a lower risk of cardiovascular disease than men, their cardiovascular risk accelerates dramatically after menopause.
  • In addition, if a woman has Type 2 diabetes, her risk of heart attack accelerates to be equivalent to that of men, even if the woman with diabetes has not yet gone through menopause. Further data is needed to better understand differences in cardiovascular disease risk among nonbinary and transgender patients.
  • “Despite these differences, one key thing is the same: Heart attack, stroke and other forms of cardiovascular disease are the leading cause of death for all people, regardless of sex or gender.”
    
• STAT News lets us know,
  • “Pascal Geldsetzer and his team looked at nearly 300,000 electronic health records gathered randomly from people born between 1925 and 1942, comparing those on either side of the birthday cut-off date. They found that individuals who received the vaccine, called Zostavax, had a 20% lower risk of later developing dementia. The single shot had no impact on a host of other health outcomes common in older people, including heart disease, lung infections, and cancer. When his team began looking at other places with similar vaccine rollouts, including the U.K. and Australia, they kept finding shingles shots were protecting people’s brains. 
  • “Wherever we look, we see this strong signal,” Geldsetzer said. “We’re looking at a causal effect. And it’s specific to dementia. There is something clearly going on here.”
  • “The idea that viral infections can play a role in at least some dementia cases goes back decades. But it’s still controversial in the Alzheimer’s field, where scientists who raised the possibility have faced frustrating, even career-ending obstacles to pursuing their research. In the last decade though, the connections between pathogens and dementia have been slowly strengthening, as more and more researchers and funders begin to take the idea more seriously. 
  • “Like most fields there is an orthodoxy; in Alzheimer’s disease it’s not infectious agents,” said Paul Harrison, a professor of psychiatry at Oxford University. “But I’ve always viewed it as very intriguing.” * * *
  • “For the past few years, a team Harrison leads has been combing through millions of electronic health records to understand how Covid-19 affects the brain. They’ve published several influential studies showing how rates of mood disorders, strokes, and dementia alarmingly increase following infection, risks that stay elevated for years. Harrison realized he could use this same massive medical database to look for a link between a newer version of the shingles vaccine and dementia incidence. 
  • ‘The results of their analysis of health records from 200,000 Americans, published in Nature Medicine in July, showed that Shingrix — the recombinant shingles vaccine approved in the U.S. in 2017 — decreased the risk of developing dementia in the six years following its approval by 17%, compared to people who’d received Zostavax, an older, less effective shingles shot. Compared to people who’d received shots against other infections (like flu and tetanus), Shingrix vaccination cut dementia risks by up to 25%.”
    
• Fortune Well discusses the public health implications of food dyes.

From the U.S. healthcare business front,

• The Wall Street Journal considers why health insurers keep getting slammed with higher costs.
  • “[W]hat seems to have unnerved investors is how, after consecutive quarters of disappointing results, insurers still don’t seem to have a full understanding of what is going on or when it will improve. Many will choose to wait on the sidelines until the fog clears.”

• Modern Healthcare notes,
  • “The HLTH 2024 conference kicked off Sunday, Oct. 20, in Las Vegas at the Venetian Expo Center, where all sorts of innovative companies from the healthcare industry will connect to share strategies, network and discuss their thoughts on the future. Speakers and presenters this year include leaders from Kaiser Permanente, Nvidia, Oracle, Walgreens and many more plus special appearances by Dr. Jill Biden, Halle Berry and Lenny Kravitz.”
    
• Legal Dive tells us,
  • “Expect to spend twice as long preparing a filing under the Hart-Scott-Rodino merger review process under final guidelines released by the Federal Trade Commission and Department of Justice, an analysis says. 
  • “What typically took about 37 hours to comply with will likely take closer to 70 hours, Freshfields attorneys say in a memo on what in-house counsel can look forward to once the guidelines take effect, slated for mid-January. 
  • “The time, cost, and burden on all filing parties will increase significantly,” the attorneys say in their Oct. 16 analysis. “And [the increased burden] almost certainly underestimates the time required for strategic transactions.”

• HR Dive informs us,
  • “As the global workforce continues to evolve, talent acquisition and retention will shift toward personalized employee experiences and expectations rather than typical rewards and physical work locations, according to an Oct. 11 report based on EY’s 2024 Work Reimagined Survey.
  • “For instance, 38% of employees said they’re likely to quit in the next year, which will require company flexibility and a plan for talent flow. This means untethered culture, expanded rewards and agile skill building will become more prevalent, the report found.
  • “Previous iterations of this survey showed the lenses through which employers and employees viewed the working world: employers driven mostly by cyclical concerns and employees fueled by structural transformation of how, where and why they work,” EY experts wrote. “Those lenses appear to be fracturing, as old thinking is shown as too rigid to navigate new terrain.”
  • “Instead, organizational success will rely on five dimensions: talent health and flow; work technology and generative AI; total rewards priorities; learning, skills and career pathways; and culture and workplaces. EY calls the combination a “Talent Advantage.”