Weekend update

David Ermer

I am an attorney who practices law in Washington DC. My practice has involved the Federal Employees Health Benefits Program since 1983.

Weekend update

David Ermer–Congress, Medical / Rx research, Mental health care, U.S. Healthcare–

From Washington, DC

  • A joint session of Congress will be held tomorrow to counting the votes received from the Electoral College. Thereafter, the House of Representatives and the Senate will resume organizing the 119th Congress.
  • On January 3, the President issued a “Memorandum on the Designation of Officials of the Office of Personnel Management to Act as Director.” Such a memorandum has been issued in advance of Presidential Inauguration Day pursuant to the Federal Vacancies Act of 1998.
  • The FEHBlog understands
    • “The [Presidential] signing ceremony of HR 82, [the Social Security Fairness Act of 2023 which repeals certain laws that reduce Social Security benefits for individuals who receive other benefits, such as a pension from a state or local government, has been moved up to Sunday, January 5 at 4 PM Eastern time.  
    • “We still don’t know whether the ceremony will be broadcast or streamed, but one possible outlet if it is live is https://www.whitehouse.gov/live/
  • The President also signed another raft load of bills into law yesterday.

From the public health and medical research front,

  • Fortune Well explains why it is particularly important for adults and children to receive the flu vaccine. What’s more,
    • “Don’t worry if you missed the unofficial “vaccine before Halloween” memo. We’re in the thick of cold and flu season and any protection you can provide yourself, your loved ones, and your community will benefit public health, says Dr. Robert Hopkins Jr., medical director of the National Foundation for Infectious Diseases.
    • “It’s not too late,” Hopkins told Fortune in December. “It is not a bad time when we’ve got risk in front of us. And I would certainly prefer that people were vaccinated earlier, but I’m not going to make perfection the enemy of the good.”
  • The Washington Post reports,
    • “People who receive physical therapy shortly after suffering concussions have better outcomes than those who wait longer to start rehabilitation programs, a recent analysis suggests.
    • “Published in the Physical Therapy & Rehabilitation Journal, the study reports on a randomized trial of 203 adults diagnosed with a mild traumatic brain injury, or concussion, who were within two to 12 weeks from their injury.
  • NPR Shots shares “nine unexpected things we learned about mental health and our brains in 2024.”
  • A commentator in the Wall Street Journal shares her personal experience with chronic pain. For context, she writes
    • “[W]e do know that relentless chronic pain is destabilizing,” says Dr. Scott Fishman, a pain specialist at the University of California, Davis, who founded its Center for Advancing Pain Relief, a rare center that focuses on both the treatment and prevention of pain. 
    • It would be absurd to say that chronic pain drives sufferers to become murderers; the only people pain patients are at any heightened risk of killing is themselves. Yet Fishman likens the effects of enduring pain to “driving on a slippery road. It puts everyone at risk.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Health tech companies focused on behavioral health are confident that reimbursement trends favor them in 2025.
    • “Payment flexibilities for telehealth, hospital-at-home care and remote prescribing have been temporarily extended until March 31. The changes will prolong COVID-19-era payment for remote care across all specialties.
    • “For many in mental health tech, new reimbursement codes from the Centers for Medicare and Medicaid Services’ November physician payment rule are an even bigger deal.
    • “The codes reimburse providers for using digital mental health treatment applications or devices that have been cleared or granted De Novo authorization by the Food and Drug Administration.
    • “While the codes are narrow in scope, analysts said the move signifies a larger recognition among CMS and commercial insurers that virtual platforms treating mental health should be reimbursed.”

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the retrospection front,

  • Bleeping Computer reflects on the fourteen “biggest cybersecurity and cyberattack stories of 2024.
  • Dark Reading queries “What Security Lessons Did We Learn in 2024?”

From the cybersecurity policy and law enforcement front.

  • Beckers Hospital Review highlights
    • “six things the proposed changes to HIPAA would require of [HIPAA covered entities and business associates:
      • 1. “Encrypt electronic protected health information “with limited exceptions.”
      • 2. “Implement multifactor authentication “with limited exceptions.”
      • 3. “Deploy antimalware software.
      • 4. “Establish written procedures to restore EHR systems and data within 72 hours of a cyberattack.
      • 5. “Notify certain regulators within 24 hours when an employee’s electronic access to EHR data or systems is changed or terminated.
      • 6. “Develop and revise an inventory and network map that illustrates the movement of EHR data through the organization’s systems at least once every 12 months.”
  • Dark Reading summarizes themes of the proposed HIPAA Security Rule amendments (some of which are overkill in the FEHBlog’s opinion) and notes
    • “The changes to the security rule will cost approximately $9 billion in the first year and $6 billion for years two to five, said Anne Neuberger, deputy national security adviser for cyber and emerging technology, during a Dec. 27 press briefing.
    • “The cost of not acting is not only high, it also endangers critical infrastructure and patient safety, and it carries other harmful consequences,” Neuberger said.
    • “Stakeholders have 60 days after the nearly 400-page proposal is published to submit comments (early March 2025). HHS will issue the final version of the rule afterward, although a specific date has not yet been set, followed by a compliance date of 180 days. It is also not clear whether work on the changes will continue under the new presidential administration. Even so, healthcare organizations should review proposed requirements and evaluate their existing security programs to prepare.”
  • Another Dark Reading article goes into more detail about proposed rule which is fitting for a “nearly 400-page proposal.”
  • Dark Reading also reports,
    • “A US Army soldier was reportedly arrested Dec. 20 in Texas and charged with two counts of unlawful transfer of confidential phone records.  
    • “Cameron John Wagenius, 20, is suspected of leaking presidential call logs belonging to AT&T and Verizon under an online alias of “Kiberphant0m.”

From the cybersecurity breaches and vulnerabilities front,

  • The Wall Street Journal reports,
    • “The Treasury Department told lawmakers Monday [December 30, 2024] that a state-sponsored actor in China hacked its systems, accessing several user workstations and certain unclassified documents.
    • “The Treasury was informed on Dec. 8 by a third-party software service provider, BeyondTrust, that a threat actor used a stolen key to remotely access certain workstations and unclassified documents, according to a letter reviewed by The Wall Street Journal.
    • “Once alerted, the department said it immediately contacted the Cybersecurity and Infrastructure Security Agency and has since worked with law enforcement partners across the government to assess the incident.
    • “The compromised BeyondTrust service has been taken offline and there is no evidence indicating the threat actor has continued access to Treasury systems or information,” a spokesperson said.
    • “In response, the Chinese embassy in Washington, D.C., denied the Treasury Department’s allegations, and said that its government opposes what it described as U.S. smear tactics without any factual basis.”
  • Per Cybersecurity Dive,
    • “Weeks after BeyondTrust disclosed an attack spree against a limited number of customers, more than 8,600 instances of the company’s Privileged Remote Access and Remote Support products remain exposed, according to a blog post released Thursday [January 2, 2025] by Censys. 
    • “BeyondTrust in December warned that an attacker gained access to a limited number of Remote Support SaaS instances utilizing a compromised API key. This week, the U.S. Department of Treasury said a suspected state-linked attacker gained access to a number of workstations and stole unclassified information using a BeyondTrust key.
    • “Censys researchers, in the Thursday [January 2, 2025] blog, indicated that not all of the exposed instances are considered vulnerable, because the firm does not have access to the versions involved.”
  • The Cybersecurity and Infrastructure Security Agency added one known exploited vulnerability its catalog this week.
  • Palo Alto Network offers details on this CVS at this link.
  • An ISACA commentator cautions “Overreliance on Automated Tooling is A Big Cybersecurity Mistake.”
  • A Dark Reading commentator warns,
    • “Despite never-ending data breaches and ransomware attacks, too many companies still rely on the outdated “trust but verify” cybersecurity strategy. This approach assumes that any user or device inside a company’s network can be trusted once it has been verified. The approach has clear weaknesses: Many businesses are putting themselves at additional risk by verifying once, then trusting forever.
    • “There was a time when “trust but verify” made sense, namely when networks were self-contained and well-defined. But at some point, perhaps due to the overwhelming volume of devices on a network, the number of patches needing to be applied, user demands, and resource constraints in the cybersecurity team, things began to slip. Initial verification meant the asset was trusted, but no additional verification ever took place.”

From the ransomware front,

  • Cybersecurity Dive lets us know,
    • “Rhode Island officials said a ransomware group has begun to leak stolen information from a state social services database following a December attack. 
    • “In a Monday [December 30, 2024] press conference, Rhode Island Gov. Daniel McKee said the state was informed by Deloitte, which manages the RIBridges program, that hackers had begun to release data on a dark web leak site. 
    • “The contents of those files are still being analyzed by experts,” McKeetold reporters during the briefing. “Identifying what is in those files is a complex process, but they’re working right now to make those identifications.”
    • “RIBridges is a state program that administers several social services programs, including Medicaid, Temporary Assistance for Needy Families and other programs.”  * * *
    • “A threat group called Brain Cipher previously claimed credit for the attack, which was disclosed Dec. 5. The group has been active since June 2024 and leverages the LockBit 3.0 payload for their ransomware payloads, SentinelOne previously told Cybersecurity Dive.
    • “The group often uses phishing campaigns to gain initial access to targeted organizations, thus tricking users into downloading malicious files, according to Jon Miller, co-founder and CEO of Halcyon. 
    • “Once inside, they leverage tools and exploits to move laterally across networks, frequently targeting Windows domain administrator credentials to maximize their reach,” Miller said via email.
    • “Researchers from Sophos confirmed Brain Cipher posted detailed information on a leak site claiming credit for the RIBridges database incident.”
  • Per Security Week,
    • “The Richmond University Medical Center in New York has been investigating a ransomware attack since May 2023 and it recently determined that the incident resulted in a data breach affecting more than 670,000 people. 
    • “The healthcare facility, which serves residents in Staten Island, New York, suffered significant disruptions in May 2023 after being targeted in a ransomware attack. It took the organization several weeks to restore impacted services.
    • “An initial forensic investigation showed that the hospital’s electronic health record systems were not compromised, but it was later determined that other files may have been accessed or exfiltrated from Richmond University Medical Center’s network in early May. 
    • “Once the investigation determined what files may have been accessed or removed from our network, we located a copy of each file and then undertook a manual review process of those files to determine whether they contained any sensitive personal information or personal health information,” the hospital said in a security incident notice.”
  • Healthcare IT News adds,
    • “Ransomware attacks are having a severe impact on U.S. healthcare organizations, with an alarming escalation in incidents and their consequences, according to a Comparitech report.
    • “The study found that, since 2018, 654 ransomware attacks have targeted healthcare providers, with 2023 standing out as a record-breaking year, logging 143 incidents.
    • “These attacks compromised over 88.7 million patient records during this period, with more than 26.2 million breached in 2023 alone.
    • “Each day of downtime due to ransomware costs healthcare organizations an average of $1.9 million, culminating in an estimated $21.9 billion in downtime losses over six years.
    • “On average, medical organizations experienced 17 days of downtime per incident, with the highest disruptions reported in 2022, averaging 27 days.”

From the cybersecurity defenses front,

  • A Dark Reading commentator explains how to get the most out of your cybersecurity insurance policy.
    • “As cyber threats continue to evolve, so must our approach to mitigating them. Bolster your cybersecurity posture in a holistic manner — self-assessing your risk profile, addressing vulnerabilities, and striving for continuous improvement — and you can better safeguard your organization against threats and control your cyber-insurance costs.
    • “Prepare for increasingly rigorous risk assessments from [insurance] providers moving forward. Underwriters now have access to extensive data about cyber threats and protections. Expect them to ask more granular questions and do deeper inspections into the efficacy of controls, especially those around identity-related risks, such as privileged access and credential theft. Anticipate their questions, and be prepared with comprehensive, up-to-date answers.
    • “Cyber insurance should augment your cybersecurity strategy, not replace it. Prioritize implementing robust, ongoing cyber practices that protect your organization.”
  • Cybersecurity Dive informs us,
    • “Most cyber leaders are bullish on generative AI despite governance concerns, according to a CrowdStrike survey published in December. Nearly two-thirds say their organization would overhaul tooling in order to leverage better generative AI capabilities. 
    • “Leaders expect generative AI adoption to bring ROI through cost optimization, easier tool management, reduced incidents and shorter training cycles, according to the survey of more than 1,000 cybersecurity leaders and practitioners. 
    • “Respondents said the leading concern when weighing a generative AI purchase is how applications or services integrate with current tools. Around 70% intend to purchase access to the technology in the next year.”
  • Dark Reading discusses “6 AI-Related Security Trends to Watch in 2025. AI tools will enable significant productivity and efficiency benefits for organizations in the coming year, but they also will exacerbate privacy, governance, and security risks.”
  • Here is a link to Dark Reading’s CISO Corner.

Friday Report

David Ermer–CDC, Congress, COVID-19, FDA, Medical / Rx research, NIH, Rx coverage, U.S. Healthcare–
Photo by Josh Mills on Unsplash

Public service notice — January 3 is the statute of limitations for wishing another person Happy New Year, according to Larry David.

From Washington, DC,

  • The Wall Street Journal reports,
    • “Incumbent Mike Johnson won re-election as speaker of the House on the first ballot, after President-elect Donald Trump pressured GOP holdouts to change their votes, handing the Louisiana Republican the narrow majority needed to claim the gavel.
    • “Johnson’s dramatic victory clears the way for Republicans to charge headlong into Trump’s second term, taking on an ambitious agenda of tax cuts and border security. While Johnson avoided a repeat of the GOP’s calamitous January 2023 speaker vote, the tally underscored how little room he has to maneuver with the party’s razor-thin margin. It also showed the power of any small group of dissidents to derail the party’s plans.
    • “Working together, we have the potential to be one of the most consequential congresses in the history of this great nation,” Johnson said.
    • “The chain of events previewed how Trump and Johnson will need to move in lockstep to get legislation across the finish line and tamp down dissent, even though the party controls both chambers of Congress and the White House.”
  • Roll Call adds,
    • “A last-minute insertion into House Republicans’ rules package for the 119th Congress substantially raises the bar for voting on legislation under suspension of the rules late in the week or over the weekend, in a concession to conservatives upset about recent deals with Democrats on big-ticket spending bills.
    • “The change requires the House to adopt a special rule to consider bills under suspension of the rules — which bars amendments but requires the support of two-thirds of members present and voting for passage — on any days other than Mondays, Tuesdays or Wednesdays.” * **
    • The House adopted the new rules package on a 215-209 vote late Friday.
  • The Wall Street Journal tells us,
    • “The U.S. surgeon general said alcoholic beverages should carry cancer warnings to increase awareness that the drinks are a leading cause of preventable cancers.
    • “An act of Congress would be required to change the existing warning labels on bottles of beer, wine and liquor. Today, federal rules require only a warning against drunken driving and drinking while pregnant, as well as a general warning that alcohol “may cause health problems.”
    • “Alcohol is a well-established, preventable cause of cancer responsible for about 100,000 cases of cancer and 20,000 cancer deaths annually in the United States,” Dr. Vivek Murthy said in his advisory issued Friday. “Yet the majority of Americans are unaware of this risk.”
  • Per a Health and Human Services Department press release,
    • “Today, the U.S. Department of Health and Human Services (HHS) announced it would award $306 million dollars to continue its H5N1 Avian Flu response. While CDC’s assessment of the risk of avian influenza to the general public remains low, USDA and HHS continue to closely collaborate with Federal, State, local, industry and other stakeholders to protect human health, animal health, and food safety.
    • “While the risk to humans remains low, we are always preparing for any possible scenario that could arise. These investments are critical to continuing our disease surveillance, laboratory testing, and monitoring efforts alongside our partners at USDA,” said Secretary Xavier Becerra. “Preparedness is the key to keeping Americans healthy and our country safe. We will continue to ensure our response is strong, well equipped, and ready for whatever is needed.”
  • MedTech Dive informs us that the “FDA closed 2024 with string of early alerts on device safety risks. Olympus advised providers to stop using an endoscope accessory due to an infection risk linked to 120 injuries and one death.”

From the judicial front,

  • Fierce Healthcare lets us know,
    • “Aetna is taking legal action against Pfizer, Novartis, Teva Pharmaceuticals and others, saying the list of drugmakers conspired to overcharge the insurer, consumers and the federal government for generic drugs.
    • “The complaint, filed Dec. 31, claims the drugmakers communicated secretly at trade conferences or through phone calls, beginning in 2012, to determine the market share, prices and bids of certain drugs. If communication was in writing, they destroyed the evidence, Aetna claimed.
    • “They effectuated their market allocation by either refusing to bid for particular customers or providing outrageously high cover bids,” the complaint said. “This created an artificial equilibrium that enabled the conspirators to then collectively raise and/or maintain prices for a particular generic drug.”
    • “Aetna said that drug purchasers, predominantly insurers, suffered as a result of these actions. Insurers place generic drugs on their formularies to lower costs but instead were paying unfairly high prices for these products.”

From the public health and medical research front,

  • The Centers for Disease Control and Prevention announced today,
    • “COVID-19 activity is increasing in most areas of the country. Seasonal influenza activity continues to increase and is elevated across most of the country. RSV activity is very high in many areas of the country, particularly in young children.
    • “COVID-19
      • “COVID-19 activity is increasing in most areas of the country, with high COVID-19 wastewater levels and increasing emergency department visits and laboratory percent positivity. Based on CDC modeled estimates of epidemic growth, we predict COVID-19 illness will continue to increase in the coming weeks as it usually does in the winter.
      • “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
    • “RSV
      • “RSV activity is very high in many areas of the country, particularly in young children. 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 are low among U.S. adults and children. COVID-19 vaccine coverage in older adults has increased compared with the 2023-2024 season. Vaccination coverage with RSV vaccines remains low among U.S. adults. Many children and adults lack protection from respiratory virus infections provided by vaccines.”
  • Following up on the Surgeon General’s advisory, the Wall Street Journal considers,
    • “How much drinking is bad for you?
    • “Though more people are calling themselves sober-curious or are trying zero-proof replacements for alcohol, drinking is a regular part of social life for most of us. A coupe of champagne can add fun to a celebration. A cocktail can take the edge off a tough day. And a cold beer can liven up a sports game. 
    • “Yet scientists’ warnings about the potential health problems of even small amounts of alcohol are growing more dire. For moderate drinkers, it can be hard to know what’s actually OK to consume: Is two a day that much worse than one? Are two drinks over a week the same as two in a day? 
    • “Averaging no more than about one drink a day is relatively low risk, according to scientists who study alcohol. They warn the risk of cancer rises significantly when you exceed that. Studies have suggested that alcohol contributes to about half a dozen types of cancers, including breast and colorectal, as well as heart and liver disease, among other conditions.” 
  • Per MedTech Dive,
    • “The Food and Drug Administration said a literature review found no safety concerns associated with tampon use and contaminant exposure.
    • “FDA officials commissioned the independent review in September in response to a study that found tampons may expose users to metals. After seeing the findings, the agency continues to recommend FDA-cleared tampons as a safe option for use as a menstrual product.
    • “The FDA is still running an internal bench laboratory study designed to show if metals from tampon materials are released or absorbed in the body. That study will better enable the FDA to complete a risk assessment, the agency said in a Dec. 23 statement.”
  • The Wall Street Journal notes,
    • Researchers have identified a focal point for the forces they suspect of driving up cancer cases in young people: the gut. They are searching people’s bodies and childhood histories for culprits.
    • Rates of gastrointestinal cancers among people under 50 are increasing across the globe. In the U.S., colorectal cancer is the leading cause of cancer death in men under 50 and second for women behind breast cancer. Each generation born since the 1950s has had higher risk than the one before. 
    • “Everything you can think of that has been introduced in our society since really the 1960s, the post-World War II era, is a potential culprit,” said Dr. Marios Giannakis, a gastrointestinal oncologist at the Dana-Farber Cancer Institute in Boston.
    • “Robert F. Kennedy Jr., President-elect Donald Trump’s pick for Health and Human Services secretary, has pointed to ultra-processed foods and chemicals in medicines and the environment. Cancer doctors share some of his suspicionsabout diet and exposure to contaminants such as microplastics, shards that make their way from packaging or clothing into our bodies through water and food. They are scrutinizing those and other potential hazards including “forever chemicals” and even light.   
    • “We’re all concerned and want to do something quickly and act quickly, but we want to do so based on sound science,” said Dr. Andrew Chan, director of epidemiology at Mass General Cancer Center in Boston.” 
  • Per HealthDay,
    • “Not sure what’s causing your child’s asthma?
    • “A new quick-and-easy nasal swab test for kids can diagnose the specific immune system drivers behind their asthma, potentially opening the door to better treatments, researchers say.
    • “The test diagnoses a child’s asthma subtype, also called an endotype.
    • “Because asthma is a highly variable disease with different endotypes, which are driven by different immune cells and respond differently to treatments, the first step toward better therapies is accurate diagnosis of endotype,” senior researcher Dr. Juan Celedon, chief of pulmonary medicine at the UPMC Children’s Hospital of Pittsburgh, said in a news release from the hospital.”
  • A National Institutes of Health news release points out,
    • “A novel class of antibodies that binds to a previously untargeted portion of the malaria parasite could lead to new prevention methods, according to a study from researchers at the National Institutes of Health (NIH) published today in Science. The most potent of the new antibodies was found to provide protection against malaria parasites in an animal model. The researchers say antibodies in this class are particularly promising because they bind to regions of the malaria parasite not included in current malaria vaccines, providing a potential new tool for fighting this dangerous disease.
    • Malaria is a life-threatening disease caused by Plasmodium parasites, which are spread through the bites of infected mosquitoes. Although malaria is not common in the United States, its global impact is devastating, with 263 million cases and 597,000 deaths estimated by the World Health Organization in 2023. Of the five species of Plasmodium that cause malaria, Plasmodium falciparum is the most common in African countries where the burden of malaria is largest and where young children account for the majority of malaria deaths. Safe, effective countermeasures are critical for reducing the immense burden of this disease. * * *
    • “Findings from the study will inform future strategies for the prevention of malaria and may facilitate the development of new antibodies and vaccines against the disease, the researchers indicate. The scientists also note that more research is needed to examine the activity and effectiveness of the newly identified antibody class and epitope, according to their paper. The approach used in this study could also aid the development of a new generation of countermeasures against other pathogens, in addition to malaria.”  

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Ardent Health has acquired 18 facilities from urgent care provider NextCare, following through on its plan to expand its urgent and ambulatory care presence.
    • “The for-profit health system, which went public in July, said Friday it acquired six facilities in New Mexico and 12 in Oklahoma. Financial details and terms of the agreement were not disclosed.
    • “An Ardent spokesperson said the deal was part of a larger growth strategy and the system planned to acquire more ambulatory facilities.”
  • Beckers Payer Issues relates,
    • UnitedHealth Group is the world’s largest insurer by net premiums written for a 10th year in a row, according to AM Best’s annual ranking published Jan. 2.
    • In 2025, UnitedHealth expects revenues of up to $455 billion and adjusted net earnings of $29.50 to $30.00 per share.
    • Top four insurers ranked by 2023 NPW:
      • UnitedHealth Group
      • Centene
      • Elevance Health
      • Kaiser Permanente
  • Per Beckers Hospital Review,
    • “The Women’s Choice Award has recognized 457 hospitals on its annual list of the Best Hospitals for Patient Safety.
    • “To compile the ranking, the organization analyzed hospitals’ performance on 13 surgical complication and infection measures from CMS, including central-line associated bloodstream infections, sepsis and serious blood clots after surgery. Hospitals had to report on at least six measures to be included in the analysis and could not rank worse than the national average on any measure.  
    • “Hospitals on the patient safety list were among the top 10% of organizations nationwide with the lowest incidence of adverse medical events and infections. See the full list of winners here.” 

Thursday Report

David Ermer–Congress, FDA, Medical / Rx research, NIH, Obesity, U.S. Healthcare–

From Washington, DC,

  • According to the House of Representatives and Senate press galleries, each body will assemble before noon to adjourn the 118th Congress sine die and at noon will convene for the start of the 119th Congress.
  • Govexec tells us,
    • “Current federal employees, retirees and others impacted by widespread breach of personal data maintained by the Office of Personnel Management took advantage of only a small portion of the money made available in a settlement agreement following the 2015 hack. 
    • “Plaintiffs in the class action lawsuit reached a settlement in 2022 with the government that made $63 million available for those who could demonstrate financial hardship as a result of the breach. A federal judge closed out the case last month after OPM and the Treasury Department doled out just $4.8 million to just more than 5,000 individuals. The remaining $58.2 million is set to go back to the Treasury on Thursday, according to court documents last month.” 

From the public health and medical research front,

  • The Washington Post reports, “More children are getting kidney stones. Experts think it’s their diet.”
    • “Some research suggests that genetic predisposition may play a role, but experts say the increase more likely reflects dietary habits and lifestyle.
    • “A North Carolina doctor detected a potential culprit: salt-laden diets. Sodium intake has increased significantly among children in the past few decades.
    • “There is so much added salt to the American diet today, and when the kidney is excreting the sodium, it pulls calcium with it and increases the risk of calcium-based stones,” John S. Wiener, a pediatric urologist at Duke Health, said.”
  • The American Medical Association discusses “Raw milk: Questions patients may have and how to answer.” Econtalk host Russ Roberts chats with Brown University economist Emily Oster about raw milk and similar public health issues in his latest podcast.
  • HealthDay lets us know,
    •  “Alzheimer’s disease experts have updated their diagnosis guidelines for the first time in more than 20 years, laying out how family doctors and brain specialists can best detect dementia.
    • “The guidelines call for the use of three general criteria to assess a person’s brain health, according to a report published Dec. 23, 2024, in the journal Alzheimer’s & Dementia:
      • “The patient’s overall level of cognitive impairment
      • “Specific symptoms they’re suffering, which can involve memory, reasoning, language or mood
      • “Brain diseases most likely to be causing these symptoms
    • “These three areas of diagnosis were intentionally left broad, so that new tests can be incorporated into the guidelines as researchers learn more about dementia and Alzheimer’s, Dr. Alireza Atri, a lecturer on neurology at Harvard Medical School, said in a news release from the Alzheimer’s Association.”
  • Per National Institutes of Health news releases,
    • “Based on new brain mapping research funded by the National Institutes of Health (NIH), scientists have discovered that not all cell types in the brain age in the same way. They found that some cells, such as a small group of hormone-controlling cells, may undergo more age-related changes in genetic activity than others. The results, published in Nature, support the idea that some cells are more sensitive to the aging process and aging brain disorders than others.
    • “Aging is the most important risk factor for Alzheimer’s disease and many other devastating brain disorders. These results provide a highly detailed map for which brain cells may be most affected by aging,” said Richard J. Hodes, M.D., director of NIH’s National Institute on Aging. “This new map may fundamentally alter the way scientists think about how aging affects the brain and also provide a guide for developing new treatments for aging-related brain diseases.”
    • “Scientists used advanced genetic analysis tools to study individual cells in the brains of 2-month-old “young” and 18-month-old “aged” mice. For each age, researchers analyzed the genetic activity of a variety of cell types located in 16 different broad regions — constituting 35% of the total volume of a mouse brain.”
  • and
    • ‘In a small clinical trial, a CAR T-cell therapy—a type of immunotherapy that uses a patient’s own immune cells to fight cancer—shrank tumors in several children and young adults with diffuse midline gliomas. This fast-growing form of brain and spinal cord cancer typically causes death within a year of diagnosis.
    • “In the trial, several participants were still alive 2 years or more after receiving the treatment.” * * *
    • “This study breaks new ground,” said study co-investigator Crystal L. Mackall, M.D., of Stanford Medicine. “It demonstrates that CAR T cells can have real, meaningful benefit for solid cancers, something that many people have not believed [was possible].”  
    • “In the trial, 9 of 11 patients who received the GD2 CAR T-cell therapy had neurological improvement. Of those, 7 had tumor shrinkage and in some cases the effects were quite dramatic. As patients’ tumors shrank, their symptoms improved and many regained physical functions they had lost from the disease, such as hearing, walking, and taste sensation. 
    • “Participants lived a median of nearly 2 years after treatment, with two patients still alive past the study’s 2.5-year follow-up period. One of these patients had a complete disappearance of his tumor and remains cancer free 4 years after his diagnosis. 
    • “It’s really remarkable,” said Rosandra N. Kaplan, M.D., of NCI’s Center for Cancer Research, who is also running a GD2 CAR T-cell therapy clinical trial but was not involved in this study. “This is a tumor for which nothing has ever worked. I think this is the start of a revolution in understanding how to treat these patients.”   
  • The Hill reported yesterday
    • “Broccoli sold at Walmart stores in 20 states has been recalled.
    • “Braga Fresh last week issued a voluntary and precautionary advisory for 12-ounce bags of Marketside Broccoli Florets that may be contaminated with Listeria monocytogenes.” * * *
    • “According to the U.S. Food and Drug Administration (FDA), which posted the advisory Tuesday, the pathogen can cause “serious and sometimes fatal infections” in young children, elderly people and others with weakened immune systems.” * * *
    • “It was distributed to stores in Alaska, Arkansas, Arizona, California, Colorado, Idaho, Illinois, Indiana, Kentucky, Louisiana, Michigan, Montana, Nevada, Ohio, Oklahoma, Oregon, Texas, Utah, Washington and Wyoming.
    • “No illnesses have yet been reported in connection with the product, the advisory said.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “Sanford Health closed its merger with Marshfield Clinic Health System on Wednesday.
    • “The combined system, led by Sanford President and CEO Bill Gassen, has more than $10 billion in revenue and operates 56 hospitals across seven states, in addition to two health plans with roughly 425,000 members. It has almost 56,000 employees, including about 13,000 employees from Marshfield, according to a Thursday news release.“
  • and
    • “CareSource has completed its acquisition of Common Ground Healthcare Cooperative, the nonprofit health insurers announced in a news release Thursday.
    • “Privately held CareSource, which has 2 million Medicare, Medicaid and health insurance exchange members, gains 54,000 marketplace customers in Wisconsin through the deal. Common Ground CEO Cathy Mahaffey remains as chief executive of Common Ground Healthcare Cooperative and was named CareSource market president for the Badger State.”
    • “Common Ground had been one of three remaining member-owned cooperative health insurers supported with funding from the Affordable Care Act of 2010.” * * *\
    • “Of the 23 co-ops that debuted on the exchanges in 2013, only Community Health Options in Maine and Mountain Health CO-OP in Idaho, Montana and Wyoming are still in operation.”
  • Beckers Hospital Review lists “the hospitals patients are most likely to recommend in every state using Hospital Consumer Assessment of Healthcare Providers and Systems data from CMS.”
  • Beckers Payer Issues identifies the fifteen insurers exiting Medicare Advantage markets in 2025.
  • BioPharma Dive points out “ten clinical trials to watch in the first half of 2025. Expected readouts in diabetes, cancer and depression headline a series of study results that could help the biotechnology sector regain its footing after a shaky year.”
  • Forbes reports,
    • “The anti-obesity drug Zepbound made by Eli Lilly & Co. could be one of the biggest cost drivers for health insurers, employers and government health programs that cover it this year.
    • “Already, GLP-1 weight loss prescriptions Wegovy, Rybelsus and Saxenda—along with Ozempic—are the “single biggest driver” of employer health costs, adding 1% to the total premium expense for 2025, data released last fall from the benefits consultancy Aon said.
    • ‘These GLP-1 drugs are adding to general healthcare inflation that is projected to increase employer-sponsored health insurance coverage by 9%, eclipsing $16,000 per employee in 2025. The spike in premiums, which is higher than the 6.4% increase employers faced in 2024 and in 2023, comes before any “cost savings strategies” are implemented, Aon said.
    • “But a new report from GlobalData indicates Zepbound is poised to overtake other GLP-1 drugs.
    • “Zepbound’s superior efficacy and strategic market expansion suggest that the drug will dominate the obesity market, surpassing Novo Nordisk’s Wegovy (semaglutide),” GlobalData said in a report the market research firm released Tuesday.”
  • Per BioPharma Dive,
    • “Neumora Therapeutics, a well-funded biotechnology company, lost more than 80% of its value Thursday because its most advanced drug failed a major test.
    • “After seeing positive signs in a smaller study in 2023, Neumora pushed the drug into a trio of late-stage clinical trials to evaluate it as a treatment for the most common type of depression. The company just released data from the first of those trials, which found the drug no better than a placebo at alleviating depression.
  • and
    • “Pfizer won’t move forward with asking regulators to approve a gene therapy for hemophilia A and instead will hand back rights to development partner Sangamo Therapeutics in a blow to the California-based biotechnology company. In a Dec. 30 statement, Sangamo CEO Sandy Macrae said his company was “surprised and extremely disappointed” by Pfizer’s decision, which comes some five months after the treatment met its goal in a Phase 3 study of people with the inherited bleeding disorder. Sangamo plans to search for an “optimal path” forward, which could include partnering with another company. Pfizer has steadily retreated from gene therapy, although it sells a hemophilia B gene therapy called Beqvez that it obtained from Spark Therapeutics.”
  • and
    • “After many years of effort, Novartis has obtained positive results from a Phase 3 study for a form of its spinal muscular atrophy gene therapy Zolgensma that’s delivered via spinal injection rather than intravenous infusion. Data from the study, called Steer, showed treatment improved motor abilities in people with the neuromuscular disease who were two years of age or older and could still sit but had never walked independently. U.S. regulators suspended testing of the intrathecal formulation in late 2019 over safety concerns, but in August 2021 permitted Novartis to begin the Steer study. Novartis plans to share the new data with health authorities to support approval of the gene therapy in a broader range of people with spinal muscular atrophy.”

Happy New Year!

David Ermer–CDC, FDA, Medical / Rx research, NIH, U.S. Healthcare–
Photo by Natalie Kinnear on Unsplash

Happy New Year, FEHBlog readers, and greetings to the Postal Service Health Benefits Program which launched today.

The New York Times offers “10 Ways to Keep Your Mind Healthy in 2025” and “12 Ways to Get Fitter in 2025.”

The Wall Street Journal advises “Want to Lose Weight This Year? Start With What You Drink. Sugary drinks are sneakier than equally high-calorie foods—and even diet soda can affect your metabolism.” Stick with water.

From the public health and medical research front,

  • Per an NIH news release,
    • “Since 1996, HPAI H5N1 influenza viruses have circulated in at least 23 countries. In late 2021, HPAI H5N1 spread from Europe to North America causing sporadic infections among wild birds and poultry farms. In 2022, the virus spread to South America where it devastated birds and marine mammals. In March 2024, USDA scientists identified HPAI H5N1 in U.S. dairy cows, and it subsequently reached herds in 16 states. The virus has been detected in dairy herds in three states over the past 30 days, according to USDA/APHIS. In 2024, the virus has caused 66 confirmed and 7 probable cases of influenza in people in the U.S. and one case in Canada. These human cases have been caused by either the H5N1 type circulating in birds (D1.1) or the type circulating in dairy cows (B3.13).
    • “Against this backdrop, Drs. Marrazzo and Ison say there are four keys to controlling the current outbreak. The first imperative is timely, effective collaborations among investigators in human and veterinary medicine, public health, health care, and occupational workers, such as dairy and poultry workers.
    • “This involves cultivating trust not only between numerous entities, but with people seeking care for symptoms of concern, including conjunctivitis, the authors write. Fortunately, so far most U.S. cases of HPAI H5N1 have been mild and resolved on their own without the need for treatment.
    • “Their second key is a focus on the Canadian HPAI H5N1 patient, who developed respiratory failure and required life-saving medical intervention and treatment before recovering. The authors write that mutations found in the virus in this patient highlight an urgent need for vigilant disease surveillance to identify and assess viral changes to evaluate the risk for person-to-person transmission. Effective surveillance, they say, requires that complete genomic sequencing data from animals and people are made rapidly and readily available.
    • Without information pertaining to where and when isolates were collected, the data cannot be linked phylogenetically to other reported sequences, limiting insight into how the virus is spreading, they write. These data would also provide opportunity for early detection of mutations that might portend avidity for human respiratory epithelium, which may require as little as one mutation in the virus.
    • “Third, researchers must continue to develop and test medical countermeasures—such as vaccines and therapies that eliminate or alleviate disease—against H5N1 and other influenza viruses. Fortunately, current vaccine candidates neutralize the circulating strains, which so far are susceptible to antivirals that could mitigate transmission and severity of illness, they write.
    • “Lastly, Drs. Marrazzo and Ison encourage people to take precautions to prevent exposure to the virus and minimize the risk of infection. For example, people who work with poultry and cows should use personal protective equipment and educate themselves about occupational risks when working with birds and mammals, as CDC and USDA have repeatedly recommended.
    • “Ideally, following these four steps will help scientists and public health officials investigating HPAI H5N1 to answer the many remaining questions more quickly about how the virus is spreading, evolving, and affecting people, other mammals, and birds.”
  • MedPage Today adds,
    • “A 13-year-old Canadian girl recovered after being hospitalized in critical condition with H5N1 avian influenza, researchers reported.
    • “The girl was hospitalized on Nov. 7 and transferred to BC Children’s Hospital the next day, where she was intubated and put on extracorporeal membrane oxygenation (ECMO) and treated with three different antivirals, David Goldfarb, MD, of BC Children’s Hospital in Vancouver, and colleagues reported in the New England Journal of Medicine (NEJM).”
  • Precision Vaccinations lets us know,
    • “A recent study found that 73% of adult Portuguese patients with urinary tract infections (UTIs) reported a reduction in symptom severity or duration of illness after treatment with Uromune™ (MV140). This inactivated oral spray serves as a novel sublingual mucosal-based bacterial vaccine.
    • “This prospective observational study, which involved 125 patients with complicated and uncomplicated recurrent UTIs, was published in the journal MDPI Vaccines (12(12), 1426) on December 18, 2024. In addition to the primary outcome of symptom reduction, the study assessed overall patient satisfaction, adverse events, and the effectiveness of Uromune in subgroups with specific UTI risk factors.
    • “During the 12 months following the start of treatment, 38% of patients were free of UTIs. Meanwhile, 34% reported experiencing one or two episodes, while the remaining 28% had three or more recurrent UTIs.”
  • Beckers Hospital Review informs us,
    • “The FDA approved a subcutaneous injection version of Bristol Myers Squibb nivolumab and hyaluronidase-nvhy for the treatment of several cancers including melanoma, non-small cell lung cancer and renal cell carcinoma. 
    • “The approval covers both monotherapy and combination therapy options, including use of chemotherapy and combination therapy options including use with chemotherapy or cabozantinib, according to a Dec. 27 news release from the agency. “
  • Here’s a link to the December NIH Office of Reseach on Women’s Health Pulse newsletter.
  • Per Medscape,
    • “Researchers are gaining new insight into the relationship between the human cytomegalovirus (HCMV), a common herpes virus found in the gut, and the immune response associated with CD83 antibody in some individuals with Alzheimer’s disease (AD).
    • ‘Using tissue samples from deceased donors with AD, the study showed CD83-positive (CD83+) microglia in the superior frontal gyrus (SFG) are significantly associated with elevated immunoglobulin gamma 4 (IgG4) and HCMV in the transverse colon (TC), increased anti-HCMV IgG4 in the cerebrospinal fluid (CSF), and both HCMV and IgG4 in the SFG and vagus nerve.
    • “Our results indicate a complex, cross-tissue interaction between HCMV and the host adaptive immune response associated with CD83+ microglia in persons with AD,” the investigators including Benjamin P. Readhead, MBBS, research associate professor, ASU-Banner Neurodegenerative Disease Research Center, Arizona State University, Tempe, Arizona, noted.
    • “The results suggest antiviral therapy in patients with biomarker evidence of HCMV, IgG4, or CD83+ microglia might ward off dementia.
    • “We’re preparing to conduct a clinical trial to evaluate whether careful use of existing antivirals might be clinically helpful in preventing or slowing progression of CD83+ associated Alzheimer’s disease,” Readhead told Medscape Medical News.”

From the U.S. healthcare business front,

  • STAT News asked “Four digital health unicorns on what they expect in 2025.” For example,
    • “Sean Duffy, the CEO of Omada Health, jokes that 2024 was “the year of Gs” when GLP-1s and GPT were all anybody talked about. While the description could have just as easily applied to 2023, Omada’s most important move this year was all about GLP-1s: a deal with Cigna subsidiary Evernorth to offer its digital behavior change program as a key piece of EncircleRx, which helps employers manage the growing boom in interest for the weight loss drugs. In October, Cigna reported that it had 8 million covered lives in the program. 
    • “Looking ahead to 2025, Duffy said that by the end of the year, Omada hopes to have data that show the company’s lifestyle programs have a meaningful impact on the success of GLP-1s.
    • “Glen Tullman, the CEO of Transcarent, is elated that next year Apple, a company that’s legendarily fastidious about design, will be one of the first users of Transcarent’s new WayFinding tech. The AI chat interface answers questions about care and benefits and represents a sophisticated real-world example of patient-facing generative AI. 
    • “Transcarent already has plans to launch the tool to 1 million people, and Tullman said that ambitiously, he’d like to roll it out to 5 million members by the end of 2025. Tullman thinks of Transcarent as a more sophisticated health care benefit for self-insured employers. Over the last few years, he said the company has poured over $100 million into developing AI for its app that serves as the focal point for the company’s services including virtual care, pharmacy benefits, as well as specialized services for mental health, cancer, surgery and more.” 
    • “Maven Clinic has grown to be a vanguard in the women’s health space by taking a broad approach to fertility benefits, which includes access to additional family planning resources, menopause care, and support for men.
    • “CEO and founder Kate Ryder says in 2024, she’s proud the company launched a comprehensive fertility benefit offering that integrates care coordination, coaching, virtual care, and financial support. One stat the company often cites is that 30% of members in its fertility program conceive without IVF — which Ryder points out can save tens of thousands of dollars per family. * * *
    • “Looking ahead, Ryder said she believes the company can lean on artificial intelligence to create a more personalized experience for members.  “We know what great personalization looks like in other areas of consumer tech, but we haven’t seen that in health care yet,” she said.”
  • The Healthcare Management Financial Association tells us,
    • “Accelerating hospital-focused expenditures helped spur a 2023 increase in national health spending, according to newly released actuarial data.
    • ‘Spending on hospital services surged by 10.4% for the year, up from a 3.2% increase in 2022 and 3.4% for the three-year period spanning 2020-22. The 2023 increase was the biggest seen since a 10.8% jump in 1990.
    • “Partially as a result, total healthcare spending (including clinical research and public health activities) jumped by 7.5% to reach $4.9 trillion, or 17.6% of GDP. In 2022, spending had risen by 4.6% and amounted to 17.4% of GDP. The 2023 share of GDP still was lower than in the peak pandemic years of 2020-21 and roughly the same as it was in 2019.
    • “The spending increase dropped from 7.5% to 4.4% when accounting for healthcare price inflation, up from 1.4% using that adjustment in 2022. Spending per capita reached $14,570.”
  • Modern Healthcare reports,
    • “Elevance Health completed its acquisition of Indiana University Health Plans, according to a Tuesday news release from the insurance company’s subsidiary Anthem Blue Cross and Blue Shield.
    • “IU Health Plans — which will operate under Anthem Blue Cross and Blue Shield in Indiana — offers Medicare Advantage plans in 36 Indiana counties, with 19,000 members. It also offers fully insured commercial plans to employers, covering approximately 9,600 members.”
  • Per MedPage Today, “IV fluid shortage [created by Hurricane Helene is] likely to extend Into early 2025. Major supplier damaged by Hurricane Helene continues to bring production lines back online.”
  • Beckers Hospital Review reports,
    • “Several major pharmaceutical companies, including Pfizer, Bristol Myers Squibb and Sanofi, are set to raise prices on more than 250 branded medications in the U.S. starting Jan. 1, 2025, according to a Reuter’s exclusive report. 
    • “Data analyzed by healthcare research firm 3 Axis Advisors showed the price increases will affect a range of drugs, including Pfizer’s COVID-19 treatment Paxlovid, Bristol Myer Squibb’s cancer therapies and vaccines from Sanofi. 
    • “Most of the price hikes are below 10%, with the median increase across affected drugs at 4.5%. This aligns with the median price increase for 2024, as drugmakers have scaled back large price hikes over the years following public scrutiny. 
    • “The price adjustments apply to list prices, which do not include rebates or discounts negotiated with pharmacy benefit managers.”

Monday report

David Ermer–Generative AI, Medical / Rx research, Mental health care, NIH, Obesity, OPM, SDOH, U.S. Healthcare–
Thanks to Justin Casey for sharing their work on Unsplash.

From Washington, DC

  • Per a press release,
    • “OPM joins the nation in mourning the passing of President Jimmy Carter. President Carter showed that public service isn’t just a line of work – it is life’s calling. From a young naval officer to a political leader, to leading as a humanitarian building homes and curing diseases, President Carter answered the call to public service. He set an example for every American to give back to their communities. He will truly be missed.” 
  • The Washington Post reports,
    • Memorial services for former president Jimmy Carter are expected to span several days and include public events in Atlanta and Washington.
    • Carter’s state funeral will be held Jan. 9 at 10 a.m. inside Washington National Cathedral after a procession from Georgia and a ceremony in which his body will lie in state in the U.S. Capitol, according to a news release from the Joint Task Force-National Capital Region.
    • “The 39th president will then be buried in a private ceremony in his hometown, Plains, Georgia.”
  • Govexec adds,
    • “President Biden issued an executive order on Monday to close federal agencies and offices next month in recognition of former President Jimmy Carter, who died Sunday at 100 in his home in Plains, Georgia.”
    • In accompanying guidance, Office of Personnel Management acting Director Rob Shriver said all federal employees would be excused from duty Jan. 9 “except those who, in the judgment of the head of the agency, cannot be excused for reasons of national security, defense, or other essential public business.” 
    • The day off applies to federal employees nationwide and will be treated like a holiday for purposes of pay and leave, the memorandum said.  

From the public health and medical research front,

  • The Wall Street Journal reports,
    • “When President Jimmy Carter was diagnosed in 2015 with cancer in his liver and brain, he said that he would like to see the last Guinea worm die before he did.
    • “That just about came true.
    • “There were 3.5 million cases of the parasitic worm disease in 1986, when the 39th U.S. president took up the cause of eradicating it. In 2023, there were 14 human cases, and 11 from January through early December 2024, according to a provisional count.
    • “We’re not there yet, but thanks to him we’re very close,” said Dr. Donald R. Hopkins, former vice president of health programs and now special adviser on Guinea worm eradication to the Carter Center, the human-rights nonprofit the former president founded in 1982 with his wife, Rosalynn Carter.”
  • The Washington Post reports,
    • “Cases of the illness known as norovirus — which induces miserable bouts of vomiting and diarrhea — are surging across the United States, according to the Centers for Disease Control and Prevention. Ninety-one outbreaks of the gastrointestinal bug were reported the week of Dec. 5, the latest period for which data is available. That’s 22 more outbreaks than in the last week of November.
    • “While sometimes referred to as the stomach flu, the disease is not caused by the influenza virus, which results in respiratory illness.
    • “There are about 2,500 reported outbreaks each year in the United States, happening most frequently between November and April. When new strains of norovirus emerge, case counts usually rise, according to disease trackers.
    • “This year, the number of reported norovirus outbreaks have exceeded the numbers that we’ve seen recently and in the years before the pandemic,” according to the CDC.”
    • The article delves into signs and symptoms, treatment options, etc.
  • The American Medical Association tells us what doctors wish their patients knew about depression.
  • Neurology Advisor adds, “One in 6 women experienced symptoms of postpartum depression 2 months after cesarean delivery, according to study findings published in the American Journal of Obstetrics and Gynecology.“
  • The Wall Street Journal tells us about a 24 year old man who is trying to “outrun” schizophrenia.
    • “For the past four years, Kevin has been part of a living experiment. Shortly after he began hallucinating, during his junior year at Syracuse University, his doctors recommended him for an intensive, government-funded program called OnTrackNY. It provided him with therapy, family counseling, vocational and educational assistance, medication management and a 24-hour hotline.
    • “Such programs — there are around 350 in the United States — challenge the old idea that psychotic disorders are degenerative, a long slide to permanent disability. They operate on the notion of a golden hour. By wrapping a young person in social supports early on, the theory goes, it may be possible to prevent the disorder from advancing.” * * *
    • “But now, after four years, his time in the program was up. An estimated 100,000 people experience a first episode of psychosis every year, roughly four times the number of spots available in early intervention programs. So in December, it would all go away: the team of five providers and the hotline and the therapist who reminded him of his mother.
    • “What would happen to him without their support? Even as enthusiasm for early intervention builds, long-term studies are casting doubt on whether its benefits last after discharge. For Kevin, leaving the program meant a sudden blast of autonomy and a million questions about what his future, with schizophrenia, would look like.
    • “The training wheels are coming off,” he said.”
  • Per MedPage Today,
    • “There was “low but improving uptake” of reporting about the diversity of participants in summary documents for FDA-cleared pulse oximeters after voluntary guidance was issued in 2013, an analysis of public FDA records found.” * * *
    • “The most important finding is that although there were more mentions of skin color descriptors in performance testing after the FDA’s guidance, a majority of the public clearance documents for pulse oximeters did not include any mention of testing in diverse individuals,” Ferryman told MedPage Today in an email.
    • “Clinicians who work in hospital settings often do not get to choose which pulse oximeter device they use with their patients,” Ferryman said. “Because this research is based on the public record, it suggests that even if clinicians wanted to do their own research on the performance of pulse oximeters across diverse populations, the majority of FDA-cleared device records do not include any information about testing in different skin tones.”
    • Pulse oximeter readings in patients with darker skin tones tend to overestimate oxygen saturation, a long-standing issue described in multiple studies and discussed by an FDA advisory committee. * * *
    • “Newer FDA guidance on pulse oximeter testing that’s under development may correct some of these problems, but no single change in guidance “is likely to be sufficient to fully correct the problems of development, marketing, and dissemination of fully equitable pulse oximeters,” the [researchers] wrote.”
  • Per National Institutes of Health press releases,
    • “A study of nearly 10,000 adolescents funded by the National Institutes of Health (NIH has identified distinct differences in the brain structures of those who used substances before age 15 compared to those who did not. Many of these structural brain differences appeared to exist in childhood before any substance use, suggesting they may play a role in the risk of substance use initiation later in life, in tandem with genetic, environmental, and other neurological factors.
    • “This adds to some emerging evidence that an individual’s brain structure, alongside their unique genetics, environmental exposures, and interactions among these factors, may impact their level of risk and resilience for substance use and addiction,” said Nora Volkow M.D., director of NIDA. “Understanding the complex interplay between the factors that contribute and that protect against drug use is crucial for informing effective prevention interventions and providing support for those who may be most vulnerable.”
    • “Among the 3,460 adolescents who initiated substances before age 15, most (90.2%) reported trying alcohol, with considerable overlap with nicotine and/or cannabis use; 61.5% and 52.4% of kids initiating nicotine and cannabis, respectively, also reported initiating alcohol. Substance initiation was associated with a variety of brain-wide (global) as well as more regional structural differences primarily involving the cortex, some of which were substance-specific. While these data could someday help inform clinical prevention strategies, the researchers emphasize that brain structure alone cannot predict substance use during adolescence, and that these data should not be used as a diagnostic tool.”
  • and
    • “Among people with dialysis-dependent kidney failure, a form of psychological therapy called pain coping skills training reduced how much pain got in the way of their daily lives, also known as pain interference. The clinical trial, funded by the National Institutes of Health (NIH), found that training people on how to manage pain reduced the extent to which pain affected their work and social activities, mood, and relationships. The pain coping skills training, which was adapted for people undergoing long-term dialysis, also improved other effects of pain, including the intensity of pain, depression, anxiety, and quality of life. Pain coping skills training is an approach widely used for chronic pain, but it had not previously been tested for people treated with dialysis.
    • “Very few interventions have been shown to improve the quality of life for people with end-stage kidney disease being treated with dialysis,” said Dr. Paul Kimmel, program director at NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which led the study. “For example, opioids, which have been a main treatment for pain in this population, have side effects that can be more pronounced in the presence of kidney failure, making pain management challenging.” * * *
    • “The study results indicate that pain coping skills training may be an appealing alternative or complement to pain medications. Although the effect of the pain coping skills training on the overall cohort was modest, its high acceptability, tolerability, and safety and its observed benefits to pain, anxiety, depression, and quality of life support further research on developing nonpharmacologic, non-invasive strategies for managing pain in dialysis populations.
    • “Future work will focus on how to prolong the favorable effects of pain coping skills training and how to broadly implement this intervention in clinical practice,” said lead author Dr. Laura M. Dember, nephrologist and clinical investigator at the University of Pennsylvania Perelman School of Medicine, Philadelphia. “Based on the successful results of this study, our hope is that this intervention can be made available broadly to patients receiving dialysis.”
  • The Wall Street Journal offers a quiz about the FDA’s latest guidance on whether a particular food is healthy. For what it’s worth, the FEHBlog scored 100.

From the U.S. healthcare business front,

  • Fierce Pharma offers a “2025 forecast: After Novo, Lilly expansion sprees, ‘positive signals’ emerge around future supply of GLP-1 drugs.”
  • The Washington Post informs us,
    • “They don’t get fruitcakes or Christmas cards from grateful patients, but for decades robots have been helping doctors perform gallbladder removals, hysterectomies, hernia repairs, prostate surgeries and more. While patients lie unconscious on the operating table, robotic arms and grippers work on their bodies at certain stages in these procedures ― all guided by doctors using joystick-like controllers, a process that minimizes human hand tremor.
    • “Now, a team of Johns Hopkins University and Stanford University researchers has reported a significant advance, training robots with videos to perform surgical tasks with the skill of human doctors.
    • “The robots learned to manipulate needles, tie knots and suture wounds on their own. Moreover, the trained robots went beyond mere imitation, correcting their own slip-ups without being told ― for example, picking up a dropped needle. Scientists have already begun the next stage of work: combining all of the different skills in full surgeries performed on animal cadavers.
    • “A new generation of more autonomous robots holds the potential to help address a serious shortage of surgeons in the United States, the researchers said.
  • Check this out!
    • “As 2025 nears, healthcare is undergoing unprecedented transformation, particularly with headlines about artificial intelligence (AI) technologies shifting away from grandiose promises as the dust starts to settle around the potential of Generative AI (GenAI). These innovations and others aim to reshape how healthcare is delivered. 
    • “To shed light on anticipated trends, challenges and opportunities in healthcare technology in 2025, leading experts from Wolters Kluwer Health offer their outlook on 2025 across a variety of topics. Diffusing the hype, the predictions offer an eye-opening look at what’s ahead and lead us toward a smarter, more resilient future in healthcare technology.” 

Weekend update

David Ermer–Congress, U.S. Healthcare–

From Washington, DC

  • On December 23, 2024, President Biden signed a raft load of Congressionally approved bills into law.
  • The 119th Congress convenes on Friday January 3, 2025. Here are links to the 2025 House of Representatives calendar and the 2025 Senate calendar.
  • Per Govexec,
    • Jimmy Carter, the 39th president of the United States and arguably the most dedicated to reforming the operations of the government, died on Dec. 29 at his home in Plains, Georgia. He was 100.

From the public health and medical research front,

  • Pew Research tells us,
    • “The number of Americans ages 100 and older is projected to more than quadruple over the next three decades, from an estimated 101,000 in 2024 to about 422,000 in 2054, according to projections from the U.S. Census Bureau. Centenarians currently make up just 0.03% of the overall U.S. population, and they are expected to reach 0.1% in 2054.
    • The number of centenarians in the United States has steadily ticked up since 1950, when the Census Bureau estimates there were just 2,300 Americans ages 100 and older. (The Census Bureau uses calculated estimates for years prior to the 1990 census because it has identified large errors in the census counts of centenarians for those years.)
    • “In the last three decades alone, the U.S. centenarian population has nearly tripled. The 1990 census counted around 37,000 centenarians in the country.”
  • The Wall Street Journal reports,
    • “The rich get richer—and older. People with high salaries and net worth tend to live longer lives, research shows.
    • “Once Americans make it to their late 50s, the wealthiest 10% live to a median age of around 86 years, roughly 14 years longer than the least wealthy 10%, according to a study published earlier this year in JAMA Internal Medicine.
    • “People with more money can afford healthier food, more healthcare and homes in safer, less-polluted neighborhoods, says Kathryn Himmelstein, a co-author of the study and a medical director at the Boston Public Health Commission.
    • “Though you can’t add more months or years to your online shopping cart yet, health and aging researchers say there are ways to spend money to improve your chances of living longer. They suggest favoring purchases that help you track your health, stay active and reduce stress.”
  • Medscape points out,
    • A booster dose of recombinant pertussis vaccines provides sustained immunity in adolescents and young adults even after 5 years, with pertussis toxin (PT)–neutralizing antibody levels remaining 2.5- to 3-fold higher than pre-vaccination levels. 
  • Per MedPage Today,
    • A study presented at the American Society of Hematology (ASH) annual meeting revealed that multiple myeloma patients with higher socioeconomic deprivation, as measured by the Area Deprivation Index (ADI), experienced poorer outcomes, emphasizing the need for targeted interventions.

From the U.S. healthcare business front,

  • The Wall Street Journal lets us know,
    • “Since the assassination of his top lieutenant Brian Thompson on Dec. 4, Andrew Witty has been keeping long difficult hours at the Minnesota headquarters of the giant company he runs, UnitedHealth Group.
    • “Witty has been telling company executives during meetings and rank-and-file employees in videos that the work they do is important, lifesaving and deeply appreciated following the killing of Thompson, who had run the company’s health-insurance division.
    • ‘More quietly, Witty is telling executives that the company is expecting to hit financial records by the end of the year. 
    • “It is up to Witty, a knighted former pharmaceutical chief who went on to a rare second act running the even larger and more powerful healthcare conglomerate that is UnitedHealth, to steer through one of the worst corporate crises imaginable: the targeted killing of one of its own executives.
    • “Witty must ease the concerns of his company’s anxious 440,000 employees following Thompson’s assassination, and keep its complex business humming, while also responding to a wave of outrage over health-insurance practices since the killing in Midtown Manhattan.”
  • Per Beckers Payer Issues,
    • “UnitedHealth Group and home health company Amedisys have agreed to extend the deadline for a planned $3.3 billion merger due to a legal challenge by the Department of Justice.
    • “In a Dec. 26 regulatory filing, the two companies waived their right to terminate the agreement if it does not occur before an agreed-upon date: either 10 business days after a final court ruling that blocks the merger or December 31, 2025. They also made adjustments to the terms, including a potential penalty fee of up to $325 million if regulatory conditions aren’t met.
    • “UnitedHealth’s Optum first announced its plans to merge with Amedisys in June 2023. The Baton Rouge, La.-based company was founded in 1982 and provides home health, hospice and high-acuity care services across more than 500 care centers in 37 states and the District of Columbia.
    • “In November, the Justice Department sued to block the deal in a Maryland federal court, citing concerns of lessened competition in the home health market because the two companies are “direct competitors.” The lawsuit claims the purchase could increase home healthcare prices across 23 states and in Washington, DC. The Attorneys General of Maryland, Illinois, New Jersey, and New York have also joined the complaint.
    • “The proposed merger has been under an antitrust review by the DOJ since August 2023. In March 2024, Oregon regulators opened their own review after a preliminary report found the deal could hurt competition in the state’s home health markets.”

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity retrospection and predictions front as we approach New Year’s Day,

  • CSO lists the “top 7 zero-day exploitation trends of 2024,” and “IT leaders’ top 9 takeaways from 2024.”
  • Dark Reading points out “Emerging Threats & Vulnerabilities to Prepare for in 2025. From zero-day exploits to 5G network vulnerabilities, these are the threats that are expected to persist over the next 12 months.”
  • Federal News Network offers a “2024 review: ‘Typhoons’ bookend [the Change Healthcare breach in a] busy year in cyber. From Volt Typhoon to Salt Typhoon, major cyber incidents in 2024 shined a spotlight on how agencies are managing cyber threats to critical infrastructure.”
  • Healthcare Dive recounts “seven of the biggest healthcare cyberattack and breach stories of 2024 Cyberattacks targeting the healthcare industry continued to rise this year. Here are some of the largest incidents, from Change Healthcare to Ascension.”

From the cybersecurity policy front,

  • Yesterday the Health and Human Services Department’s Office for Civil Rights announced its proposed amendments to the HIPAA Security Rule which is intended to protect electronic personal health information. The public comment deadline is March 7, 2025, sixty days from January 6, 2025, the date that proposed rule will be published in the Federal Register.
  • Here is a link to the OCR’s fact sheet for the proposed rule. The HIPAA Security Rule dates back to 2003, and its hallmark was flexibility in implementation. To that end, the HIPAA Security rule set forth required standards and addressable standards. Because a lot has changed since 2003, I expected standard changes, but I did not expect OCR to do away with the required / addressable standard distinction in favor of exceptions. Like many other regulations issued by the current administration, the proposed amendments are loaded with new paperwork and oversight requirements. Hopefully the next administration will pull back the proposed rule so that the changes focus on requiring tools that are known to work, e.g., multi factor authentication, encryption, adequate backups.
  • Cybersecurity Dive lets us know,
    • “Lax security controls played a significant role in allowing a China-government sponsored threat group to gain broad and full access to U.S. telecom networks, a senior White House official said Friday.
    • “From what we’re seeing regarding the level of cybersecurity implemented across the telecom sectors, those networks are not as defensible as they need to be to defend against a well-resourced, capable, offensive cyber actor like China,” Anne Neuberger, deputy national security advisor for cyber and emerging technology, said during a Friday media briefing.
    • “Neuberger’s remarks came as the White House confirmed a ninth telecom company was among those compromised by Salt Typhoon’s widespread intrusion of U.S. telecom networks. The unnamed company recently determined it was impacted after reviewing threat hunting and hardening guidance provided by the U.S. government, Neuberger said.
    • “Earlier this month, U.S. officials said at least 8 U.S. telecom providers or infrastructure companies were compromised in a campaign that went undetected for months and has been underway for up to two years.”
  • Per Federal News Network,
    • “The DoD’s big cybersecurity program advanced earlier this month. It’s a big rule to carry out if it becomes effective. For what the rule means and what comes next in the Cybersecurity Maturity Model Certification Program, Deltek cybersecurity researcher Michael Greenman joined the Federal Drive with Tom Temin for details.”
    • The article offers a transcript of this interview

From the cybersecurity breaches, ransomware, and vulnerabilities front,

  • The Cybersecurity and Infrastructure Security Agency (CISA) added one known exploited vulnerability to its catalog this week.
  • Here is a link to a Security Affairs explanation of the vulnerability.
  • Bleeping Computer pointed out on December 24,
    • The Clop ransomware gang started to extort victims of its Cleo data theft attacks and announced on its dark web portal that 66 companies have 48 hours to respond to the demands.
    • The cybercriminals announced that they are contacting those companies directly to provide links to a secure chat channel for conducting ransom payment negotiations. They also provided email addresses where victims can reach out themselves.
    • In the notification on their leak site, Clop lists 66 partial names of companies that did not engage the hackers for negotiations. If these companies continue to ignore, Clop threatens to disclose their full name in 48 hours.
    • The hackers note that the list represents only victims that have been contacted but did not respond to the message, suggesting that the list of affected companies may be larger.
    • “The Cleo data theft attack represents another major success for Clop, who leveraged leveraging a zero-day vulnerability in Cleo LexiCom, VLTransfer, and Harmony products to steal data from the networks of breached companies.” * * *
    • “The zero-day flaw exploited this time is now tracked as CVE-2024-50623 and it allows a remote attacker to perform unrestricted file uploads and downloads, leading to remote code execution.
    • “A fix is available for Cleo Harmony, VLTrader, and LexiCom version 5.8.0.21 and the vendor warned in a private advisory that hackers were exploiting it to open reverse shells on compromised networks.”
  • and
    • “The North Korean hacker group ‘TraderTraitor’ stole $308 million worth of cryptocurrency in the attack on the Japanese exchange DMM Bitcoin in May.
    • “In a short post, the FBI attributed the attack to the state-affiliated threat actor TraderTraitor, also tracked as Jade Sleet, UNC4899, and Slow Pisces.
    • “The crypto heist occurred in May 2024 and forced the platform to restrict account registration, cryptocurrency withdrawals, and trading until the completion of the investigations.”

From the cybersecurity defenses front,

  • Netxgov/FCW alerts us that “Government and private sector organizations have begun to recognize that physical and virtual assets must be protected from cyber threats in the same way as IT.”
  • Dark Reading discusses “Defining & Defying Cybersecurity Staff Burnout. Sometimes it feels like burnout is an inevitable part of working in cybersecurity. But a little bit of knowledge can help you and your staff stay healthy.”
  • Here is a link to Dark Reading’s CISO Corner, which was updated this week.

Friday Report

David Ermer–CDC, Congress, COVID-19, Federal employment benefits, NCQA, U.S. Healthcare–
Hanukkah greeting template. Nine candles and wishing. Hand drawn sketch illustration. White, yellow and blue colors

From Washington, DC,

  • The Washington Examiner reports,
    • Debate within the intelligence community over the origins of COVID-19 ran much deeper than previously known, particularly within the Pentagon’s Defense Intelligence Agency. 
    • Three scientists at the National Center for Medical Intelligence, a branch of the Defense Intelligence Agency, conducted a scientific investigation in the summer of 2021, concluding that COVID-19 was likely manipulated in a biolaboratory. But the information was suppressed by the Pentagon and not included in White House briefings on the virus, according to a new report from the Wall Street Journal.”  * * *
    • “The National Center for Medical Intelligence examines global health threats, including infectious diseases and bioweapons, to determine what threats could endanger troops. The agency received a significant boost in funding in the immediate aftermath of the 9/11 attacks on the World Trade Center as the threat of biowarfare increased in the 21st century. 
    • “Three scientists at the medical intelligence center determined through genetic testing that a segment of the novel bat coronavirus, known as the spike protein, had been manipulated to infect human cells. They argued these changes indicated that Chinese scientists at the Wuhan Institute of Virology were engaging in gain-of-function experiments to see if they could make the virus more dangerous for humans.” * * *
    • “Sen. Rand Paul (R-KY) has promised to pick up where the House investigation left off and said he plans to use his new chairmanship of the Senate Homeland Security and Governmental Affairs Committee to delve deeper into what happened at the Wuhan Institute of Virology and what occurred behind closed doors within federal public health agencies.”
  • NCQA shares its insights about a December 9, 2024, White House listening session concerning the ongoing opioid crisis.
  • Federal News Network lets us know,
    • “With an incoming presidential administration and a new Congress both starting up at the beginning of 2025, there are many unknowns about what’s to come for the federal workforce.
    • “But at least one thing is for certain — telework for the federal workforce will remain a high-priority topic for agencies, employees, lawmakers, unions and many others.
    • “Already, key Republicans in Congress are looking ahead to further investigations into telework options for federal employees. House Oversight and Accountability Committee Chairman James Comer (R-Ky.) announced plans to hold a hearing on federal telework once the 119th Congress begins.”

From the public health and medical research front,

  • The Centers for Disease Control and Prevention announced today,
    • “Due to the holidays, a short summary of this week’s respiratory virus illness findings is presented here, and updated data are provided in subsequent pages. No additional data summaries will be provided this week. Regular updates will resume on Friday, January 3, 2025.
    • “COVID-19, seasonal influenza, and RSV activity continue to increase across the country.
    • ‘COVID-19
      • “COVID-19 activity is increasing in most areas of the country, with high COVID-19 wastewater levels and increasing emergency department visits and laboratory percent positivity. Based on CDC modeled estimates of epidemic growth, we predict COVID-19 illness will continue to increase in the coming weeks as it usually does in the winter.
      • “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
    • “RSV
      • “RSV activity is high and continues to increase in most areas of the country, particularly in young children. Emergency department visits and hospitalizations are increasing in children and hospitalizations are increasing among older adults in some areas.
    • “Vaccination
      • “Vaccination coverage with influenza and COVID-19 vaccines are low among U.S. adults and children. COVID-19 vaccine coverage in older adults has increased compared with the 2023-2024 season. 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 CIDRAP adds,
    • “The genetic analysis of the H5N1 avian flu virus in specimens from the nation’s first severely ill hospitalized patient in Louisiana reveals mutations that may enable upper-airway infection and greater transmission, concludes a technical summary from the Centers for Disease Control and Prevention (CDC).
    • ‘But the authors of the report, released late yesterday afternoon, say the risk of an influenza pandemic amid the ongoing outbreak remains low.
    • “In related news, Los Angeles County and Stanislaus County this week announced their first human H5N1 cases in two dairy workers. Both workers had mild symptoms and are recovering after receiving antiviral drugs. No related cases have been identified. 
    • “California, which has reported a total of 37 cases, recently announced a public health emergency for H5N1 to free up more resources with the virus now spreading to dairy farms beyond the Central Valley and further south.
    • “The US total for human cases is now at 65.”
  • The Washington Post reports,
    • “Whooping cough continues to surge in the United States, with reported cases soaring to more than 32,000 this year — nearly five times the 6,500 cases recorded during the same period last year — marking the highest levels in a decade.
    • “Health experts cite as main culprits for the increase waning vaccination rates and a loss of broad immunity tracing to coronavirus lockdown protocols.
    • “The disease, caused by the bacterium Bordetella pertussis, is highly transmissible from person to person through the air. Because of their immature immune systems, infants younger than 1 year old are at highest risk of contracting whooping cough — also known as pertussis — and are at most significant risk of severe illness.
    • “Vaccination rates with the DTaP shot — which protects against diphtheria, tetanus and pertussis — declined from March through September 2020 at the height of the coronavirus pandemic. But because people were following pandemic protocols such as masking and social distancing, cases did not soar. Some children who missed getting their shots during that period may never have received them, experts have said.”
  • The Wall Street Journal informs us about “What Your ‘Face Age’ Can Tell Doctors About Your Health Scans of face photos are estimating people’s ‘biological age’ and even predicting how long they’ll live.”
    • “The FaceAge test is an artificial intelligence model trained on tens of thousands of photos from patients and public-image databases to look for signs of aging in the face. [Dr. Raymond] Mak and his team ran a study that found that the algorithm did a better job than doctors at predicting how long cancer patients would live. 
    • “Their hope is that one day, the tool could be a standard part of assessing health. Already, separate versions of face-age tests exist online where anybody can upload a selfie and get an estimate of their biological age. 
    • “Your face reflects the wear and tear of your lifetime,” says Mak, a radiation oncologist at Brigham and Women’s Hospital, who co-led the study alongside other Mass General Brigham researchers. “We viewed this as a way to quantify a doctor’s clinical intuition.”
  • Per STAT News,
    • “Blood stem cell transplants have been central players in treating blood cancers for decades. These procedures can improve patients’ chances of survival and can even offer the opportunity for a cure in some cases.
    • “But over the last decade, physicians say they’ve started doing transplants for fewer cancer types, particularly lymphomas, and are instead reaching first for newer immune or targeted therapies that are safer and often more effective.
    • “That’s progress that experts hope will continue. “I know from my days as a transplanter, there was nothing better than when a patient didn’t have to be transplanted,” said Andy Kolb, the president and CEO of the Leukemia and Lymphoma Society. “Because it’s toxic.”
  • Per HealthDay,
    • “When supplies of certain generic, platinum-based cancer chemotherapies dwindled in 2023, oncologists feared it might lead to under-treatment and many more cancer deaths.
    • “Fortunately, that did not turn out to be the case, a new study published recently in the Journal of the National Cancer Institute shows.
    • “When we looked at the data on prescribing practices over the shortage period, compared to the previous year, we found that although reporting of the shortages was widespread, it didn’t affect as many patients as we had feared,” said lead study author Dr. Jacob Reibel. He’s a third-year fellow in hematology-oncology at Penn Medicine’s Abramson Cancer Center in Philadelphia.”

From the U.S. healthcare business front,

  • Modern Healthcare reports,
    • “National health expenditures in 2025 are forecast to rise 2.2% over 2024 levels, according to the Centers for Medicare and Medicaid Office of the Actuary. But some analysts say the predictions should be taken with a measure of skepticism.
    • “The predictions, released annually from CMS actuaries, project changes to healthcare spending by governments, businesses and households several years into the future. The report’s methodology acknowledges limitations, including relying on law and government policy in force at the time the projections were made.
    • “The office, which is independent from CMS leadership, predicts personal healthcare spending — which includes provider and retail revenue from medical goods and services — will increase 2.3% in 2025.
    • “Kevin Holoran, a senior director with data and analytics firm Fitch Group, said the projected 1.7% increase in spending on hospital care “feels a little low.” In December, Fitch Ratings released a 2025 outlook for nonprofit hospitals and health systems suggesting the sector would benefit from boosted cash flows and improved equity market returns.
    • “The Office of the Actuary predicted a 4.5% increase in prescription drug spending. Fitch Senior Director Mark Pascaris — who, along with Holoran, is a lead nonprofit hospital analyst at the firm — said those projections are consistent with growth in the sector, which Fitch expects to continue in 2025. Actuaries’ predicted 3.7% boost in home healthcare spending also makes sense, Pascaris said.
    • “The personal healthcare spending category additionally includes dental services; nursing home and continual care facilities; durable and non-durable medical products; other health, residential and personal care; and “other” professional services not included in the other subcategories.”
  • and
    • “Per diem nursing is replacing travel nursing as the preferred solution to providers’ staffing issues.” * * *
    • “Many employers, including Franklin, Tennessee-based Community Health Systems and Dallas-based Tenet Healthcare have said they’ve lowered their contract labor costs. And a June survey from employment firm Incredible Health found 67% of health executives did not increase travel nurse positions in 2024. The survey also found nurse interest in travel work dropped by 22% in 2024.
    • “Per diem nurses typically operate “on-demand,” picking up shifts for permanent staff who call out, are on a short leave or when a hospital needs extra help when a patient population is high. They are usually local residents and do not require long-term contracts, compared with travel nurses who often require relocation assistance and guaranteed pay regardless of whether a facility needs extra nurses.”
  • The Healthcare Cost Institute updated its assessment of no value care in the employer sponsored and traditional Medicare health insurance markets.
    • “In this brief, we calculated the prevalence and spending among a subset of “no value care” services between 2018 and 2022 among the employer-sponsored insurance and Traditional Medicare populations.
    • “Vitamin D Screening in administrative claims accounted for nearly $708 million in ESI and $312 million in Traditional Medicare spending in 2022. In that year, we estimate that 23% of all Vitamin D Screenings had no evidence of clinical benefit in administrative claims data among those with Employer Sponsored Insurance, much higher than the estimated 4% no value tests among those with Traditional Medicare. The prevalence of arthroscopic knee surgeries for osteoarthritis amounted to $389 million in ESI and $30 million Traditional Medicare spending in 2022.
    • “Our analysis focused just on these three services and, accordingly, does not speak to the prevalence of “no value care” in the employer-sponsored insurance and Traditional Medicare population broadly. Due to absence of clinical and health care operation data elements, we are not able to identify and measure most “no value care” or related challenges, such as medical mistakes, preventable infections, lack of care coordination, and lack of access to care.”
  • Beckers Payer Issues explains why Premera Blue Cross wants its employees to get creative with artificial intelligence.
  • Beckers Hospital Review shares what’s on pharmacy leaders’ radar screens for 2025 and its updated list of 2024 hospital closures which merited a Beckers report.

Slow News Day

David Ermer–Uncategorized–

On Sunday, December 22, the FEHBlog announced his plan to take off December 23 through December 25. However, due to a flood of news on Monday, he issued a FEHBlog extra. In retrospect he should have taken off December 24 through December 26, Boxing Day. Due to Monday’s Extra and it being a very slow news day, the FEHBlog is continuing its hiatus until tomorrow.