From Capitol Hill, Federal News Network identifies five federal workforce items on Congress’s to-do list.
From the omicron and siblings front, the Wall Street Journal reports
The Biden administration is planning for an end to its practice of paying for Covid-19 shots and treatments, shifting more control of pricing and coverage to the healthcare industry in ways that could generate sales for companies—and costs for consumers—for years to come. * * *
Shifting payments for Covid-19 drugs and vaccines to the commercial market is expected to take months, an HHS spokesman said. * * *
Switching vaccine purchasing to the commercial market would mean that each insurer and pharmacy benefit manager would be negotiating with drug manufacturers and prices would likely be higher than what the federal government has paid, said Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation. Insurers would have to start paying for the vaccines, he said, likely raising premiums.
More than 2 years after patients started reporting long-lasting symptoms after acute SARS-CoV-2 infection, the U.S. announced its national long COVID plan.
The National Research Action Plan on Long COVID aims to improve prevention, diagnosis, and treatment for long COVID, which currently affects up to 23 million people in the U.S., about 1 million of whom may be out of the workforce at any given time because of the condition, according to Admiral Rachel Levine, MD, HHS assistant secretary for health. * * *
Long COVID advocates expressed mixed opinions. Hannah Davis, co-founder of the Patient-Led Research Collaborative, noted the fact that “there’s going to be an [Office of Long COVID Research and Practice] is pretty amazing.”
But Davis voiced concerns about the scarcity of prevention efforts addressed by the plan. “I think there’s still a feeling like we can get through this without minimizing cases, but we really need to be focused on prevention as well,” she said.
Diana Berrent, founder of Survivor Corps, told MedPage Today that the administration “nailed the institutional challenge of long COVID” but also thought the plan was insufficient.
“Millions of Americans, young and old, are suffering the aftermath of COVID and need immediate relief from their pain,” Berrent said. “An established office in HHS is a welcome step but nothing short of actual treatments and therapeutics will do the trick.”
From the monkeypox front, Becker’s Hospital Review provides a state-by-state breakdown of monkeypox cases, and MedPage Today reports
The Biden administration is making an additional 1.8 million doses of the Jynneos monkeypox vaccine available beginning Monday, and will be targeting certain large events — such as gay pride marches that attract many LGBTQIA participants — as sites for monkeypox vaccination and outreach, administration officials said Thursday.
From the healthcare costs front, Healthcare Dive reports
U.S. employers will pay 6.5% more on average for employee healthcare coverage in 2023 compared to this year, according to an Aon report out Thursday.
The latest predicted rise, while a jump from the 3.7% growth in employer costs between 2021 and 2022, is still far below the 9.1% Consumer Price Index, a figure reflecting inflation.
Inflation typically hits healthcare costs later than other goods and services due to the multi-year nature of contracts between providers and insurers, but impacts will become more prevalent over the year, according to the report.
Speaking of higher costs, Fierce Healthcare discusses Moody’s report on how an economic downturn would impact health plans.
From the No Surprises Act front, the American Hospital Association informs us “The Centers for Medicare & Medicaid Services has launched a new webpage with resources and guidance related to the dispute resolution process under the No Surprises Act, including guidance for disputing parties and a walkthrough of the federal portal. CMS also has added functionality to the portal for initiating disputes, including a button to upload supporting documents at initiation.”
From the miscellany department —
Fierce Healthcare discusses J.D. Powers’ annual study of Medicare Advantage plans. “[T]he analysts found members’ general satisfaction is up from 2021 and is higher than satisfaction reported by people in employer-sponsored plans. However, while members said they’re happy with access to preventive and routine care, coverage of mental health and substance abuse treatment is lacking.”
STAT News calls our attention to “a new Pew-funded report, by researchers at George Washington University, the federal government can expand methadone access without approval from Congress.” According to the article, “When it comes to fighting opioid addiction, there’s no tool more effective than methadone. Doctors have been prescribing the drug since the 1960s, and patients who use it are far less likely to experience an overdose.”
The FEHBlog is back inside the Capital Beltway this week so let’s kick it off with a link to the President’s remarks at his signing of the budget reconciliation act (H.R. 5376) into law.
Because the new law’s drug pricing changes will impact the FEHB Program most, here is a link to STAT New’s article unpacking those provisions.
From the omicron and siblings front, Federal News Network reports that the Safer Federal Workforce Task Force is following the CDC’s lead by easing restrictions to stop the Covid spread.
MedPage Today offers a fascinating article in which a Johns Hopkins epidemiologist assesses the current case of polio paralysis in New York through a historical lens.
Polio is a fecal-oral pathogen and the Sabin vaccine, as an oral vaccine, more naturally mimicked the natural route of infection and therefore triggers different and more potent immune responses than the injectable Salk vaccine. Also, because it is a “live” vaccine, the vaccine virus is shed and can passively immunize close contacts of vaccinated individuals. For these reasons, the Sabin vaccine eventually came to be a more dominant and preferred vaccine than the [original, injected] Salk version.
However, as polio receded as a public health threat, rare complications elicited by the Sabin vaccine became intolerable in many Western countries. The “live” nature of Sabin’s vaccine, in rare instances, could lead to vaccine-associated paralytic polio. In even rarer circumstances, the virus could mutate or recombine with other viruses to become a circulating vaccine-derived poliovirus (cVDPV) that could be capable of infecting others, and in some cases, causing paralysis. This is why 2 decades ago — with polio no longer an issue domestically — the U.S. switched to an all-Salk injectable polio vaccine regimen for children, away from a combination that used the Sabin oral polio vaccine (OPV) and the injectable polio vaccine. But many countries, especially those in which wild polio still circulates, still use OPV. * * *
In response, [U.S.] healthcare professionals and policymakers need to encourage widespread immunization in areas in which cVDPVs have been found. It is not surprising that this problem has been detected in the same locales in which a very large measles outbreak recently occurred. I suspect other areas likely have cVDPVs circulating as well, and broader wastewater surveillance coupled with targeted catch up immunization will be critical. I can’t stress this point enough: high vaccination rates are required for resiliency.
In related virus news, the Centers for Disease Control released a report titled “Hepatitis C Treatment Among Insured Adults — the United States, 2019–2020.”
What is already known about this topic?
Direct-acting antiviral (DAA) treatment is recommended for nearly all persons with hepatitis C and cures ≥95% of cases. Treatment saves lives, prevents transmission, and is cost saving.
What is added by this report?
Treatment rates are low overall and vary by age and insurance payor. DAA treatment is lowest among young adults aged 18–29 years and Medicaid recipients, and within Medicaid, among persons reporting Black or other race and persons in states with treatment restrictions.
What are the implications for public health practice?
Timely initiation of DAA treatment, regardless of insurance type, is critical to reducing viral hepatitis–related mortality, disparities, and transmission.
Also of note,
Across insurance types, ≥75% of persons treated initiated treatment within 180 days after diagnosis. The smaller percentage of persons treated within 180 days after diagnosis might indicate lack of access to a hepatitis C treatment provider, insurance denial, or loss to follow-up. Treatment coverage can be increased by providing integrated care, patient navigation, and care coordination (15). The introduction of simplified hepatitis C treatment algorithms reducing the number of laboratory tests and in-person visits can facilitate patient-centered treatment (20).
From the U.S. Healthcare business front
The Food and Drug Administration issued “a final rule to improve access to hearing aids which may, in turn, lower costs for millions of Americans. This action establishes a new category of over-the-counter (OTC) hearing aids, enabling consumers with perceived mild to moderate hearing impairment to purchase hearing aids directly from stores or online retailers without needing a medical exam, prescription or a fitting adjustment by an audiologist.” The rule will take effect in 60 days / mid-October.
STAT News reports Merck has cut a deal to enter the mRNA market.
On Tuesday, the company announced a deal to develop mRNA-based vaccines and therapies with Orna Therapeutics, a Cambridge-based startup that launchedduring the pandemic with a slightly different take on mRNA technology. Merck will pay Orna a $150 million upfront fee, invest $100 million in a new funding round for the company, and offer $3.5 billion in longer-term milestones.
The American Hospital Association tells us.
Hospital patients are sicker and more medically complex than they were before the COVID-19 pandemic, driving up hospital costs for labor, drugs and supplies, according to a new AHA report.
“Combined with rapidly rising economy-wide inflation and reimbursement shortfalls, these mounting costs are threatening the financial stability of hospitals around the country,” the report notes.
Hospital patient acuity as measured by average length of stay (ALOS) rose almost 10% between 2019 and 2021, including a 6% increase for non-COVID-19 Medicare patients as the pandemic contributed to delayed and avoided care, the report notes. For example, ALOS rose 89% for patients with rheumatoid arthritis and 65% for patients with neuroblastoma and adrenal cancer. In 2022, patient acuity as reflected in the case mix index rose 11.1% for mastectomy patients, 15% for appendectomy patients and 7% for hysterectomy patients.
These increases have occurred at a time of significant financial challenges for hospitals and health systems, which have still not received support to address the delta and omicron surges that have comprised the majority of all COVID-19 admissions. As a result, AHA is asking Congress to halt its Medicare payment cuts to hospitals and other providers; extend or make permanent certain waivers that improve efficiency and access to care; extend expiring health insurance subsidies for millions of patients; and hold commercial insurers accountable for improper and burdensome business practices.
From the federal policy front, Fierce Health tells us about four healthcare policy changes beyond government negotiation of a subset of Medicare-covered drugs and extension of ACA subsidies found in the budget reconciliation bill that Congress approved last week. The President is scheduled to sign the bill into law tomorrow.
Here are four other health policy changes to look for in the bill:
First, expands eligibility for the full amount of low-income Part D subsidies from 135% of the federal poverty line to 150% of the FPL.
Gets rid of the cost-sharing for adult vaccines for Medicare Part D. The FEHBlog has personal experience with this one. In 2020 he received the new Shingrix vaccine under Medicare Part D. The vaccine was eligible for no cost sharing when administered in-network under the Affordable Care Act. However, under Part D, the FEHBlog was charged $200 for each of the two doses. This big bowl of wrong will be remedied in 2023.
Delays the controversial Part D rebate rule, again. “The Trump-era rule would eliminate the safe harbor for Part D rebates, leaving them open to prosecution under federal anti-kickback laws. The rule passed at the tail end of Trump’s term but has never gone into effect. The law would delay the rule from going into effect again into 2032.”
Limits the premium growth on Medicare Part D to no more than six percent a year from 2024 through 2029. “The cap on premium growth is intended to mitigate the impact of other changes to Part D, said Ryan Urgo, managing director of the policy practice at consulting firm Avalere Health. The legislation includes a $2,000 out-of-pocket cost cap on Part D drugs, spread out in installments for the beneficiary over a calendar year. Part D plans will also have to pick up more of the costs for spending in the catastrophic coverage phase, which a beneficiary reaches when their drug costs reach a certain level.”
From the Omicron and siblings front, BioPharma Dive informs us
British drug regulators on Monday approved a two-pronged vaccine from Moderna that’s designed to fight both the original version of the coronavirus and the omicron variant.
The decision makes the U.K. the first country to clear a COVID-19 booster that’s been specifically tailored to a newer form of the virus. While the original shots, like Moderna’s Spikevax, remain strongly effective at preventing hospitalization and death, they’ve had a harder time warding off infections from omicron and its subvariants. * * *
Speaking to a [U.S.] advisory committee in June, executives from Moderna and Pfizer said dual-acting boosters with a BA.4 or BA.5 could be available in large volumes in October and November, although they would first need to undergo regulatory review before they could be administered.
Separately, Novavax on Monday asked the FDA to authorize its COVID-19 vaccine as a booster shot in people 18 and older. The shot is only available as a primary series to those who haven’t yet been vaccinated.
The Centers for Disease Control released updated guidance on what to do if exposed to Covid.
The Wall Street Journal reports on assessing Covid-19 risks after easing CDC guidelines, which began last week. The headline notes, “More decision-making is shifting to individuals, and here is what doctors recommend.”
From the monkeypox front, the Journal discusses “What to Know About Symptoms, Vaccines and How It Spreads,” and Beckers Hospital Review offers five monkeypox updates, including a complete explanation of how the World Health Organization is going about changing the disease’s name.
From the mental healthcare front, about ten years ago, the FEHB Program under OPM’s leadership was the first large employer-sponsored program to cover a form of autism therapy called “applied behavior analysis” (ABA). A STAT News investigation discloses
ABA has long been viewed as the gold standard for kids with autism, so much so that every state mandates insurance coverage. For some families, it is the only option that insurance will cover at all.
But like other pockets of the health care industry, this one has been transformed over the past decade by a flood of investments from private equity firms, drawn by the promise of insurance reimbursement and the rising rate of autism in children across the U.S., now estimated at 1 in 44 kids.
Families and clinicians who once believed fully in the promise of ABA say the financial investors’ fixation on profit has degraded the quality of services kids receive, turning it into the equivalent of fast food therapy. They’ve grown disillusioned with the industry, they told STAT.
The HHS Inspector General is auditing Medicaid claims for ABA. The final audit report is expected later this year.
From the Rx coverage front, the Drug Channel blog discloses
Here’s a summer surprise for fans of the 340B Drug Pricing Program: Drug Channels has just obtained the 2021 figures from the Health Resources and Services Administration (HRSA)! Even better, my Freedom of Information Act (FOIA) request was able to pry out detailed purchases by covered entity type.
The data tell a familiar story. For 2021, discounted purchases under the 340B program reached a record $43.9 billion—an astonishing $5.9 billion (+15.6%) higher than its 2020 counterpart. Hospitals accounted for 87% of these skyrocketing 340B purchases.
What’s more, the difference between list prices and discounted 340B purchases also grew, to $49.7 billion (+$7.0 billion). This figure approximates the money collected by 340B covered entities.
340B advocates have been screaming that “drug companies are cutting 340B,” but the data tell a very different story. Only in the U.S. healthcare system can billions more in payments and spreads be considered a cut.
From the U.S. healthcare business front, Beckers Payer Issues provides an interview with “Kyu Rhee, MD, a senior vice president at CVS Health and chief medical officer at Aetna. He sat down with Becker’s to discuss ongoing trends across the healthcare industry and how he is working to create a “values-based” care system through opportunities offered by a global pandemic.”
Congress is on a State / District work break until after Labor Day.
The Change Healthcare antitrust trial is ongoing. The judge Hon. Carl J. Nichols will be deciding the case without a jury. He was heard evidence for ten days already. The case is U.S. v UnitedHealth Group et al., 22-cv-481, U.S. District Court for the District of Columbia.
From the Omicron and siblings front, Bloomberg Prognosis informs us
Scientists fear that the omicron shots coming this fall won’t be all that much better at keeping people from getting Covid than the shots we already have. That’s pushing drugmakers to start working on next-generation vaccines that don’t have to be updated that often, if at all, writes Bloomberg’s Madison Muller, Riley Griffin and Fiona Rutherford.
“Even with the highly flexible platform of mRNA, which is more flexible than virtually anything we’ve had before, it’s going to be very difficult to keep up with the pace of newly evolving variants,” Anthony Fauci, President Joe Biden’s chief medical adviser told Bloomberg. “Which gets us to the question: What about a pan-coronavirus vaccine?”
Aim high.
From the monkeypox front, the World Health Organization has renamed the disease that is quite bland.
Consensus was reached to now refer to the former Congo Basin (Central African) clade as Clade one (I) and the former West African clade as Clade two (II). Additionally, it was agreed that the Clade II consists of two subclades.
A clade means “a group of organisms believed to have evolved from a common ancestor, according to the principles of cladistics, e.g., “the great ape and human clade.” How will WHO distinguish between the monkeypox clade and the chickenpox clade? Time will tell.
From the U.S. healthcare business front, Fierce Healthcare tells us
Humana will acquire a Wisconsin managed care plan in a bid to bulk up its Medicaid services, the insurer announced Friday.
Inclusa, Inc. offers long-term care coverage as well as supporting 16,600 older adults and adults with disabilities in Wisconsin’s Family Care program. The managed care organization has worked with local providers and community resources for more than 20 years to connect members with necessary support and services.
Inclusa partners with more than 6,000 service providers across about 40 service categories, as well as contracts with the state to provide family care services in 68 of Wisconsin’s 72 counties, according to the announcement.
The Wall Street Journal offers two expert interviews on mental health issues:
Speaking of eating, Forbes offers the five best diets for people with diabetes in 2022.
NPR reports on initial experience with the 988 lifelines.
The 988 hotline is the nation’s most comprehensive mental health crisis service and can provide crucial help to those in emotional distress. If you’re thinking about suicide but not taking steps to act on it, 988 is unlikely to call law enforcement without your consent. Instead, 988 counselors can provide resources, referrals and a kind ear. However, if you’re at imminent risk and could act on a plan to kill yourself, police may be called, and you could be taken to a hospital involuntarily.
Sonyia Richardson, a licensed clinical social worker who owns a counseling agency that serves mostly Black and brown clients in Charlotte, N.C., said she didn’t immediately tell her clients about 988 when it launched. Even though she’s a member of her state’s 988 planning committee, she said she needed time to develop trust in the service herself. When she learned at a recent committee meeting that fewer than 5% of 988 calls in North Carolina led to a law enforcement response, she felt reassured.
Based on the Centers for Disease Control Covid Data Tracker and using Thursday as the first day of the week, here is the FEHBlog latest weekly chart of new Covid cases:
Note: the massive surge on the left is the original Omicron surge, but the label didn’t carry over from the spreadsheet to the FEHBlog.
The CDC’s weekly review of its Covid statistics tells us
As of August 10, 2022, the current 7-day moving average of daily new cases (103,614) decreased 13.8% compared with the previous 7-day moving average (120,151). * * *
CDC Nowcast projections* for the week ending August 13, 2022, estimate that the combined national proportion of lineages designated as Omicron will continue to be 100% with the predominant Omicron lineage being BA.5, projected at 88.8% (95% PI 87.5-90.0%). The national proportion of BA.4 is projected to be 5.3% (95% PI 4.9-5.7%), BA.4.6 is projected to be 5.1% (95% PI 4.1-6.4%), and BA.2.12.1 is projected to be 0.8% (95% PI 0.7-0.9%).
Here’s the CDC’s Daily Trends in Number of New COVID-19 Hospital Admission chart from its weekly review.
The CDC’s weekly review adds, “The current 7-day daily average for August 3–9, 2022, was 6,003. This is a 2.6% decrease from the prior 7-day average (6,163) from July 27–August 2, 2022.”
Here’s the FEHBlog latest daily chart of new Covid deaths for 2022:
Unfortunately, both labels fell off this chart. The missing label under the horizontal axis 3 -5 reads Omicron, and the missing label over weeks 14 – 17 reads Omicron’s siblings. The CDC’s weekly review adds, “The current 7-day moving average of new deaths (400) has decreased 6.7% compared with the previous 7-day moving average (429).”
New cases, new admissions and new deaths have plateaued and are trending down.
Here’s the FEHBlog’s weekly chart of Covid vaccinations distributed and administered from the first week of the Covid vaccination era in December 2020 to this week.
Administered vaccines jumped back up to over 2 million this week. The CDC’s weekly review adds.
Overall, about 262.0 million people, or 78.9% of the total U.S. population, have received at least one dose of vaccine. About 223.5 million people, or 67.3% of the total U.S. population, have been fully vaccinated.* Of those fully vaccinated, about 107.9 million people have received a booster dose,** but 50.0% of the total booster-eligible population has not yet received a booster dose.
COVID-19 mRNA vaccines have been safe for pregnant women, according to observational data from a large Canadian study.
In fact, the pregnant women reported fewer serious health events than non-pregnant women in the 7 days following vaccination and a similar number of events as a control group of unvaccinated pregnant respondents, as researchers led by Manish Sadarangani, DPhil, of the BC Children’s Hospital Research Institute in Vancouver, reported in The Lancet Infectious Diseases.
The Wall Street Journal reflects on yesterday’s CDC easing Covid restrictions intended to shut down the disease, a state which will not happen anytime soon.
Federal health officials’ move this week to relax pandemic precautions gave business leaders the momentum many have been looking for to return to pre-Covid behaviors.
The new guidelines, issued Thursday by the Centers for Disease Control and Prevention, generally bring the federal guidance in line with policies that had already shifted at companies, schools and public transportation, among other settings. The agency said it no longer recommends that people quarantine after being exposed to the virus, as long as they don’t feel sick, get tested after five days and wear a high-quality mask around others for 10 days.
Many executives and city leaders who had been struggling to break pandemic work-from-home habits see this as a boost to their halting efforts to bring people back into the workplace. They say that previous CDC recommendations made it difficult to enforce their policies, since one exposure could send an entire team home.
It’s worth noting that the CDC issued the revised guidance even though its Spring 2022 innovation based on community levels of the Covid is blinking red.
Overall, 51 out of 52 jurisdictions* had high- or medium-level counties this week. Nevada is the only jurisdiction to have all counties at low Community Levels.
The American Hospital Association calls our attention to another aspect of the Administration’s revised guidance:
The Food and Drug Administration yesterday advised people who get a negative result from an at-home COVID-19 antigen test to test themselves again after 48 hours to reduce the risk of missing an infection and spreading the virus to others.
“Today’s recommendations are based on the latest study results from people with likely omicron infection showing that repeat testing after a negative at-home COVID-19 antigen test result increases the chance of an accurate result,” the agency said
Govexec brings us up to date on the ongoing litigation against the federal government’s Covid vaccination mandate
Remember the vaccine mandate for federal contractors that President Biden issued last September?
Ambika Biggs, a partner at the law firm Hirschler who specializes in government contracting, told Government Executive earlier this week the matter is likely to be appealed to the Supreme Court, especially if there is a circuit split on decisions.
These cases really “come down to the interpretation of the Federal Property and Administrative Services Act, which is just called the Procurement Act” and “whether President Biden had authority under that act to issue the executive order that put the federal contractor mandate in place,” said Biggs. The main argument she’s seen in the pleadings is that “there wasn’t a close enough nexus between wanting an economical and efficient system for procurement and the actual vaccine mandate,” and the mandate was more about public health, which is usually under states’ jurisdiction.
The FEHBlog does not expect this issue to get to the Supreme Court.
From the monkeypox front, Beckers Payer Issues recounts seven payer reactions to the announcement of a public health emergency.
From Capitol Hill, the American Hospital Administration reports
The House today voted 220-207 [along party lines] to pass the Senate’s [budget reconciliation bill] (H.R. 5376), sending it to President Biden for his signature. Passed by the Senate Sunday, the roughly $700 billion social spending package would extend for three years the American Rescue Plan Act’s expanded subsidies for coverage purchased through the Health Insurance Marketplaces; allow Medicare to negotiate prices for insulin and certain other drugs; implement tax changes and spending subsidies to address climate change; and reduce the deficit, among other provisions.
The International Foundation of Employee Benefit Plans offers six aspects of the legislation that are relevant to employers and health plan sponsors.
While the prescription drug provisions of the law are tied only to Medicare Parts B and D, employers and plan sponsors that provide retiree health care benefits, especially through employer group waiver plans (EGWPs), will want to be familiar with this legislation and its impact. They may wish to discuss changes with their advisors to see how their plans may be affected.
That’s good advice.
From the U.S. healthcare costs front, the benefits consulting firm Mercer announced
While significantly higher than the increase of 4.4% projected for 2022, the 2023 increase lags overall inflation, which is currently running at about 9% (see Figure 1). According to Sunit Patel, Mercer’s Chief Actuary for Health and Benefits, “Because health plans typically have multi-year contracts with health care providers, we haven’t felt the full effect of price inflation in health plan cost increases yet. Rather it will be phased in over the next few years as contracts come up for renewal and providers negotiate higher reimbursement levels. Employers have a small window to get out in front of sharper increases coming in 2024 from the cumulative effect of current inflationary pressures.”
From the U.S. healthcare business front, Becker’s Payer Issues reports
Humana has completed the sale of a 60 percent stake in its subsidiary Kindred at Home’s hospice and personal care business to the private equity firm Clayton, Dubilier & Rice. The divisions have been restructured into a standalone company, according to an Aug. 11 Humana news release. The $2.8 billion deal was first announced in April. “Humana will continue to support the long-term success of these operations through our minority ownership and ongoing strategic partnership,” CFO Susan Diamond said in the news release.
Health Care Service Corp. has signed an agreement to purchase Trustmark Health Benefits from employee benefits firm Trustmark for an undisclosed amount. HCSC, the parent company of BCBS Illinois, Montana, New Mexico, Oklahoma and Texas, said in an Aug. 11 news release the acquisition would allow the company to serve more members that desire more customizable health benefits. Trustmark Health Benefits provides voluntary benefits, fitness management products and small group plan administration. The Lake Forest, Ill.-based company said no changes to benefits for existing members will occur when the deal is expected to close later this year.
UnitedHealthcare is rebranding one of its fastest-growing health plan designs. Surest plans, first launched in 2016 as Bind, are available nationwide for self-funded employers and in 11 states for fully insured plans. UHC said it plans to make Surest available as an option for fully insured customers in five more states by the end of the year. Surest plans have the fastest growth rate among its employer-sponsored plan designs, the insurance giant said Thursday.
From the Capitol Hill front, Health Affairs Forefront offers articles from
Prof. Katie Keith on the Affordable Care Act provisions in the budget reconciliation bill (H.R. 5376) that the House of Representatives will take up on Friday, and
Prof. Rachel Sachs on the Democrats’ drug pricing proposal in that bill.
The FEHBlog found information in Prof. Sachs’ article about the proposed $35 cap on insulin copayments.
[T]he IRA was drafted to include a $35 out-of-pocket cap on insulin not only for Medicare beneficiaries, but also for privately insured patients. The parliamentarian ruled that the application of this out-of-pocket cap to privately insured patients did not comply with the reconciliation rules. Rather than unilaterally remove this provision (as the Democrats did with the inflationary rebate provision), Democrats chose to advance the bill with the provision included. Republican Senators then chose to challenge its inclusion, and 43 Republicans voted to strip the $35 out-of-pocket cap for privately insured patients from the bill, enough to result in its removal. (Although seven Republicans voted with all 50 Democrats to keep the cap, the provision needed 60 votes to remain in the bill.)
The Hill adds “Senate Majority Leader Charles Schumer (D-N.Y.) said Monday night that he is going to bring a $35 cap on [non-Medicare] patients’ insulin costs back up for a vote this fall after Republicans blocked it over the weekend.”
Roll Call discusses the cost shifting between Medicare and other insurance programs, including the FEHBP, once the law is enacted and takes effect. Medicare does not negotiate prices with providers; it sets them.
President Biden announced on Wednesday his intent to appoint a prominentsurgeon and professor who has been at the vanguard of advances in cancer treatment to lead the federal government’s main agency for cancer research and training.
The president will appoint Dr. Monica Bertagnolli to be director of the National Cancer Institute, part of the National Institutes of Health, which has about 4,300 employees and had a $6.35 billion budget in fiscal 2021. She is currently the Richard E. Wilson professor of surgery in the field of surgical oncology at Harvard Medical School, a surgeon at Brigham and Women’s Hospital, and a member of the Gastrointestinal Cancer and Sarcoma Disease Centers at Dana-Farber Cancer Institute, a top cancer hospital. Bertagnolli will be the first woman to hold this position.
“Throughout her career, Dr. Bertagnolli has been at the forefront of the field of clinical oncology, advancing, in particular, current understanding of the gene that promotes gastrointestinal cancer development,” said an announcement from the White House. “As a physician-scientist, she led gastrointestinal science initiatives from 1994 to 2011 within the [National Cancer Institute]-funded Cancer Cooperative Groups.” She also served as the chief of the division of Surgical Oncology for the Dana-Farber Brigham Cancer Center from 2007 to 2018.
Good luck, Dr. Bertagnolli.
From the omicron and siblings front, Forbes reports
Pfizer and BioNTech have completed clinical trials for vaccines that include specific protection against the original omicron variant. Now the two companies have begun testing for vaccines specific to the BA.4 and BA.5 Omicron subvariants, which are the fastest spreading variants of Covid-19 in the United States. Manufacturing for the new vaccines has already begun, and could be rolled out as early as October pending regulatory approvals. That’s good news as we approach the fall and winter, which have been the times of year where Covid spread is at its highest. Competitor Moderna has also begun testing an omicron-specific booster, but the FDA has not yet authorized any Omicron-specific vaccines.
Researchers have identified monkey antibodies that are effective against numerous Covid variants and other coronaviruses, a discovery that could help scientists develop better vaccines and prepare for future pandemics as pharma firms race to update their shots.
If the monkey antibodies research is successful, then the WHO definitely should change monkeypox’s name.
From the medical research front, STAT News tells us
With the tumultuous rollout of Aduhelm behind them, partners Biogen and Eisai have the rare opportunity for a do-over, with all-important data on their next Alzheimer’s disease therapy expected next month.
By the end of September, the world will learn whether lecanemab, another treatment aimed at toxic brain plaques called amyloid, can significantly slow the cognitive decline that characterizes Alzheimer’s.
The outcome is vitally important for millions of patients awaiting a medicine that can meaningfully impact the disease, and success could spell a massive financial windfall for Biogen and Eisai. Failure would damage — though not destroy — the idea that targeting amyloid might ever make for an efficacious treatment.
Fingers crossed for a successful outcome.
From the U.S. healthcare business front, Fierce Healthcare reports
Amazon Care, which currently offers virtual health visits, in-person primary care visits at patients’ homes or offices and prescription delivery, is adding behavioral health care to its slate of services.
Amazon’s health service business plans to team up with teletherapy startup Ginger as an optional add-on to Amazon Care. Through the partnership, Amazon Care users will be connected to Ginger’s on-demand mental health services including behavioral health coaches, licensed therapists and psychiatrists, according to a live website about the service. * * *
The new service hasn’t launched yet, according to people familiar with the matter, Business Insider reported.
As an aside, Smart Brief discusses telemedicine in pediatrics.
Fierce Health also tells us
A company with a long history of providing medical supplies for chronic conditions is expanding its business into monitoring and coaching services for diabetes patients.
CCS, which now includes CCS Medical and CCS Health, aims to provide a more integrated experience for chronic care management, Tony Vahedian, CEO of CCS, said in an interview. * * *
“We believe we’re in the appropriate position to really take that fragmented experience and make it an integrated, seamless experience because not only can we deliver the products at the time, but we also can coach them and provide that clinical care,” the CEO noted. CCS can combine its home-delivered medical supplies business with accredited clinicians supported by proprietary data and technology to simplify the patient experience, he added.
The company supports more than 200,000 patients living with chronic conditions in the U.S. and delivers more than 1.2 million shipments of medical supplies to patients in their own homes.
From the nudging front, Health Payer Intelligence shares another survey illustrating that participants in employer-sponsored health plans need more help with health plan literacy.
The Federal Times seeks to project the timeline for implementing the new law requiring the Veterans’ Administration to cover illnesses contracted by Iraq and Afghanistan veterans who were exposed to burn pit smoke while overseas.
The Republicans on the House Ways and Means Committee offer their perspective on the budget reconciliation bill that Senate passed yesterday and the House will take up this Friday.
From the OPM front, the FEHBlog noticed today that its Office of Inspector General (OIG) has posted on its revamped website the OIG’s semi-annual report to Congress for the period ended March 31, 2022. This report is always worth a gander to those who are interested in the FEHB Program.
From the Omicron and siblings front, the Wall Street Journal reports
Parents are having their say about the Covid-19 vaccines for children under 5, and for most, the answer so far is no.
More than a month after the U.S. Centers for Disease Control and Prevention recommended shots for about 17.4 million childrenages 6 months through 4 years, about 4% to 5% of them have received a shot, according to the most recent agency data and population estimates from the American Academy of Pediatrics.
By contrast, the vaccination rate for children 5 to 11 years reached about 18% a month after the CDC first recommended shots last November. The rate now stands at about 38%. * * *
Uptake has varied by state, recent counts from around the U.S. show. In Massachusetts, roughly 40,541 children under 5, about 11% of the state’s population in that age group, have received one dose. In New Jersey, more than 21,000 young children, or 4.6% of the children under 5 in that state, have received one dose.
A lawyer writing on the Society for Human Resource Management advises “employers with workers who test positive for COVID-19 should follow guidance from the Centers for Disease Control and Prevention (CDC), including its guidelines on quarantining and isolation, to minimize safety and legal risks, even though the guidance is somewhat complex.”
From the public health front, the Department of Health and Human Services announced today its Health Resources and Services Administration (HRSA) is
awarding nearly $90 million in American Rescue Plan funding to nearly 1,400 community health centers across the country to advance health equity through better data collection and reporting. On Friday, August 5, President Biden issued a proclamation on National Health Center Week to recognize the vital role health centers play in safeguarding the well-being of Americans and honor the heroic staff who keep these facilities running.
What’s more, the American Hospital Association tells us
[HRSA] today awarded $45.7 million from the American Rescue Plan Act [ARPA]to develop the public health workforce in rural and tribal communities. The grants will help train dental hygienists, medical and dental assistants, doulas and other community health workers; health information technology and telehealth technical support staff; community paramedical workers; and respiratory therapists and care coordinators for patients with long-term COVID-19 effects and chronic medical conditions.
In addition to the ARPA grants, the agency awarded $9.7 million to help hospitals and others establish new medical residency programs in rural communities; $2.9 million to improve health outcomes in rural counties; and nearly $1 million to improve access to care for rural veterans.
From the No Surprises Act front, Healthcare Dive informs us
The Medical Group Management Association, which represents physician practices, is urging the HHS and the CMS to delay enforcing certain requirements of the No Surprises Act to allow providers time to understand and implement the mandates.
In a letter to HHS Secretary Xavier Becerra and CMS Administrator Chiquita Brooks La-Sure, MGMA asked that medical group practices be given six months’ notice before enforcement of additional surprise billing requirements.
The provider group requested the enforcement delay following publication of more anticipated rulemaking including an advanced explanation of benefits, continuity of care protections and provider directory requirements.
The FEHBlog supports the MGMA’s position because Congress goofed in the NSA by not treating the good faith estimate and advance EOB as HIPAA electronic transaction standards.
STAT News discusses the stress that providers and payers are experiencing as they wait for the Labor Department to issue its final rule (following receipt of public comments on its interim final rule) about the NSA’s independent dispute resolution process.
Karuna Therapeutics said Monday that a novel combination pill reduced psychosis and related symptoms experienced by patients with schizophrenia, achieving the main goals of a late-stage clinical trial.
With positive study results in hand, the Boston-based biotech intends to submit a marketing application with the Food and Drug Administration by the middle of next year. If approved, the Karuna drug would usher in the first new class of medicines for the treatment of schizophrenia in decades.
Called KarXT, the Karuna drug targets muscarinic acetylcholine receptors in the brain to reduce psychotic symptoms. Current antipsychotics — which mostly block dopamine receptors — have become blockbuster schizophrenia medicines despite causing troubling side effects like weight gain and somnolence. Peak sales for KarXT could also reach into the billions of dollars, analysts forecast.
Kaiser Permanente posted a thinned operating margin and nearly $1.3 billion net loss during its second quarter “driven largely by investment market conditions,” according to topline financials for the quarter ended June 30 reported Friday evening.
The massive integrated nonprofit health system notched $23.47 billion in total operating revenues, representing a minor 0.9% dip from the second quarter of last year. Total operating expenses inched nearly 0.2% upward year over year, to $23.38 billion.
The result was an operating income of $89 million (0.4% operating margin) during the most recent quarter, down from the prior year’s $349 million (1.5% operating margin).
“Much like the entire health care industry, we continue to address deferred care while navigating COVID-19 surges and associated expenses. Kaiser Permanente’s integrated model of providing both care and coverage enables us to meet these challenges as demonstrated by our moderate increase in year-over-year operating expenses for the second quarter,” EVP and Chief Financial Officer Kathy Lancaster said in a statement accompanying the filing.
Pfizer on Monday said it has agreed to acquire Global Blood Therapeutics for $5.4 billion in a deal that will hand it a recently approved drug for sickle cell disease, as well as two other experimental medicines for the rare blood condition. Under terms of the deal, Pfizer will pay $68.50 in cash per Global Blood share * * *. * * * Pfizer and Global Blood expect the deal, which has been approved by the boards of directors at both companies, to close as early as the fourth quarter, pending the sign off regulators and Global Blood shareholders.
Becker’s Hospital Review is running a series on health information interoperability:
Health data interoperability has long been a goal of health IT executives and policy experts. But it’s 2022 — and the healthcare system doesn’t appear all that close to getting there.
Becker’s spoke to experts from health systems, industry and academia on what it will take to create an open exchange of healthcare information in the U.S.
The first entry in the series is a Q&A with Donna Roach, CIO of University of Utah Health in Salt Lake City
The Senate passed its budget reconciliation bill (H.R. 5376) this afternoon by a 51-50 vote, with Vice President Harris casting the deciding vote. The Senate Democrats have created a one-page summary of the bill.
The deal would dedicate $64 billion to extending for three years the Affordable Care Act subsidies that first kicked in under the 2021 American Rescue Plan. Nearly all of the 13 million people who get federal subsidies under the ACA would be spared from higher health-insurance premiums they would see next year without an extension. * * * The change would push the next expiration beyond the 2024 election.
The measure would also allow Medicare to negotiate the cost of some prescription drugs with pharmaceutical companies, a longtime goal of many Democrats that has been opposed by the drug industry, which says it would stifle innovation. That move would save the government $288 billion, according to the summary.
Here is a link to the Senate Democrat’s summary of the Medicare changes.
[While Medicare was cleared [yesterday] to negotiate drug prices for the first time by the Senate’s top rules official, the Democrats’ proposal intended to cap price increases for prescription drugs in the commercial market was blocked. * * *
The rulings are a partial victory for drug makers, who could try to make up their lost profits in Medicare on private insurers.
Axios notes that during the amendment “vote-a-rama” preceding the vote on H.R. 5376, a provision to cap insulin copayments at $35 was stripped from H.R. 5376.
The House of Representatives will convene on Friday, August 12, to consider and, in all likelihood, pass H.R. 5376. Otherwise, both Houses of Congress are now on their August State/District work break.
In U.S. healthcare business news, the Wall Street Journal reports
CVS Health Corp. is seeking to buy Signify Health Inc., according to people familiar with the matter, as the drugstore and insurance giant looks to expand in home-health services.
Signify Health is exploring strategic alternatives including a sale, The Wall Street Journal reported this past week. Initial bids are due this coming week and CVS is planning to enter one, some of the people said. Others also are in the mix, they said, and CVS could face competition from other managed-care providers and private-equity firms.
There is no guarantee any of them will reach a deal for Signify, which has a market value of around $4.7 billion after its shares rose on the news of a potential sale.
From the Rx coverage front, BioPharma Dive informs us
A new targeted treatment for breast cancer could reshape how doctors classify and treat the disease, offering another option for people whose tumors have spread or are unable to be removed through surgery.
On Friday, the Food and Drug Administration approved Enhertu, a medicine developed by AstraZeneca and Japanese drugmaker Daiichi Sankyo, for patients with advanced breast cancer that has low levels of a protein called HER2. It’s the first targeted drug to be approved for this group of patients.
For more than two decades, HER2 status has shaped treatment of breast cancer. Named after the gene that encodes it, the protein’s presence in high levels is linked to more aggressive tumors that grow and spread faster. But the approval in 1998 of a HER2-targeting drug called Herceptin gave doctors a powerful treatment to combat breast cancers positive for the protein. Since then, several other drugs aimed at HER2 have joined Herceptin on the market.
Until now, HER2 status has been black or white — either positive or negative. However, testing showed Enhertu to be dramatically effective in treating tumors with very low levels of HER2, levels that would typically be considered negative.
The drug’s approval therefore creates a new classification on which doctors can act. About 60% of breast cancer patients who would previously be categorized as having HER2-negative tumors can be now be counted as HER2-low and potentially receive Enhertu, the FDA estimated. HER2-negative cancers are estimated to be by far the most common, accounting for between 80% to 85% of the more than 250,000 people who are diagnosed with breast cancer in the U.S. each year.
From the health information technology front, the FEHBlog picked up this tidbit from a Health Data Management email from “Fred Bazzoli, Editor-in-Chief” this morning:
Much has been changing in healthcare– for providers, payers and consumers.
With a lot of change to assimilate, it’s no wonder that the results are delayed and hard to see. A case in point is healthcare APIs that enable patients to access their medical data. Industry players spent heavily to ready systems for patients to use APIs to access their records. But at this week’s WEDI Summer Forum in Chicago, attendees reported that there was little or no activity in patients using such capabilities. Shoot, only 5 percent to 20 percent of patients are using portals for that purpose now, one payer executive at the forum estimated – so it will take time for them to learn about these apps and get used to using them. Consumers don’t want multiple sources of medical information, or services…they want simplicity, which change doesn’t always seem to provide immediately.
Change is also hard – WEDI is compiling challenges with rules requiring providers to provide patients with good faith estimates. Seemingly simple, providing accurate estimates is wrought with difficulty and peril, as forum attendees heard (see my story next week). More time is needed, WEDI contends.
Slowing down change to allow for consumer adjustment seems to be the right course of action now.
From the public health front, the American Medical Association shares what doctors wish their patients knew about family immunizations.
Based on the CDC’s Covid Data Tracker and using Thursday as the first day of the week, here is the FEHBlog’s latest weekly chart of new Covid cases:
The CDC’s weekly review of its Covid statistics indicates
As of August 3, 2022, the current 7-day moving average of daily new cases (117,351) decreased 7.3% compared with the previous 7-day moving average (126,537).
CDC Nowcast projections* for the week ending July 30, 2022, estimate that the combined national proportion of lineages designated as Omicron will continue to be 100% with the predominant Omicron lineage being BA.5, projected at 85.5% (95% PI 83.8-87.0%).
Here’s the CDC’s chart of “Daily Trends in Number of New COVID-19 Hospital Admissions in the United States”:
The CDC’s weekly review notes “The current 7-day daily average for July 27–August 2, 2022, was 6,112. This is a 4.4% decrease from the prior 7-day average (6,396) from July 20–26, 2022.”
U.S. hospitalization data indicate the latest Covid-19 surge is starting to cool, marking a hopeful sign after months of sustained, high virus transmission due to BA.5 and other Omicron subvariants.
The seven-day average for people hospitalized with Covid-19 has recently flattened, while numbers of newly admitted patients have mostly trended lower since late July, federal data show. Though Covid-19 cases are loosely tracked now, as people test more at home, hospital data can reflect how much the virus is spreading in communities.
“We definitely have hit the plateau,” said Eric Topol, director of the Scripps Research Translational Institute in La Jolla, Calif.
The news is welcome, he said, as the U.S. nears the weeks in which most children will be crowding back into schools. Colleges are scaling back Covid-19 precautions for the fall as they prepare for an influx of students on campus.
Here’s the FEHBlog’s latest weekly chart of new Covid deaths:
The CDC’s weekly review states “The current 7-day moving average of new deaths (378) has decreased 4.9% compared with the previous 7-day moving average (397).” The Wall Street Journal adds
The U.S. has recently averaged 377 reported Covid-19 deaths a day, the CDC data show, far below all-time highs but above the low hit last summer. Known cases recently averaged about 117,000 a day, down slightly over the past week, though epidemiologists believe the true number of infections is significantly higher.
Here’s the FEHBlog’s weekly chart of Covid vaccinations distributed and administered from the beginning of the Covid vaccination era, the 51st week of 2020, through the 31st week of this year.
Covid vaccines administered dropped to around 500,000 last, a new low.
The Wall Street Journal reports
As of Thursday there were 1,344 counties—about 42% of the total—that have high Covid-19 community levels based on case and hospitalization trends, according to the Centers for Disease Control and Prevention. This is down 133 counties from the CDC’s count a week earlier.
About 55% of the U.S. population is now in a high-ranked county with elevated levels of disease, still significantly up from levels below 1% in March and April, but down from 61% a week earlier.
In sum, things are looking up from a Covid era perspective.
From the monkeypox front, the CDC released an information sheet on Monkeypox and Safer Sex.
From the patient safety front, Cardiovascular Business informs us
In 1999, the Institute of Medicine published a shocking report on medical errors that led to in-hospital deaths, noting that as many as 98,000 people per year were dying due to preventable errors.
Now, more than two decades later, are things any better? A team of researchers explored that very questions in JAMA, drawing mostly optimistic conclusions.[1]
To determine whether adverse in-hospital events are on the decline, Noel Eldridge, MS, of the U.S. Department of Health and Human Services, and coauthors looked at data from the Medicare Patient Safety Monitoring System from the years 2010 and 2019. The total number of adverse events dropped from 218 to 139 adverse events per 1,000 discharges for acute myocardial infarction (AMI), and from 168 to 116 adverse events per 1,000 discharges for heart failure, suggesting a significant improvement over time.
The Senate is “on track” to start debating a roughly $300 billion deficit-reducing budget package Saturday after Democrats reached agreement late Thursday on changes to the bill needed to secure 50 votes, Senate Majority Leader Charles E. Schumer said.
The changes, the New York Democrat said at a news conference Friday, include dropping a provision modifying the taxation of “carried interest,” providing exemptions to the 15 percent corporate minimum tax that would reduce its estimated revenue raised over 10 years from $313 billion to $258 billion, and adding some climate provisions related to drought.
“We’re feeling pretty good,” Schumer said, noting he believes the agreement will have the votes to pass.
If so, the bill would then go to the House, which is expected to reconvene Aug. 12 to vote on it, according to a notice Friday from Majority Leader Steny H. Hoyer, D-Md.
Fierce Health summarizes the second quarter results of publicly traded health insurers.
A STATS News journalist provides three takeaways from the this year’s Alzheimer’s Association International Conference, which he attended.
The Senate is expected to begin consideration of Democrats’ climate, tax and health care package on Saturday, leaving about two days for the party to shore up support for the bill.
Senate Majority Leader Charles E. Schumer said Thursday that he’s expecting a vote on the motion to proceed Saturday afternoon, which would follow a nomination vote he scheduled for 12:30 p.m.
The motion to proceed is a simple majority threshold; no Republicans are expected to back it.
If Democrats can secure the votes to move forward, it would trigger up to 20 hours of debate before a “vote-a-rama,” when senators can offer unlimited amendments and motions to delay the process. The debate time is equally divided between the parties and senators on either side can choose to yield back time in order to get to the vote-a-rama quicker.
It remained unclear Thursday afternoon whether party leaders had secured crucial backing from Sen. Kyrsten Sinema. * * *
Democrats are also working to wrap up the “Byrd bath,” in which the Senate parliamentarian hears arguments from both parties and issues opinions on whether provisions meet conditions of the budget reconciliation rules. Reconciliation allows the bill to avoid a filibuster and pass with only Democrats’ votes in the 50-50 Senate. * * * [Sen.] Sinema is expected to wait for the process to play out before making her position on the package known.
While the FEHBlog was writing this post, Politico reports
Sen. Kyrsten Sinema announced on Thursday night that she’s signed off on Democrats’ climate, tax and health care legislation after securing a handful of changes.
The Arizona Democrat was not consulted during July’s dealmaking between Senate Majority Leader Chuck Schumer and Sen. Joe Manchin, but after changes to several tax provisions she okayed the agreement on Thursday. “We have agreed to remove the carried interest tax provision, protect advanced manufacturing, and boost our clean energy economy in the Senate’s budget reconciliation legislation. Subject to the Parliamentarian’s review, I’ll move forward,” Sinema said.
From the Omicron and siblings front
The New York Times explores the question “Is This What Endemicity Looks Like?” The article points out “The basic footprint of the disease has been consistent for a few months.”
We’ve been at roughly the same number of hospitalizations and deaths in the country since the end of the initial Omicron wave in the winter. And because so much of that has to do with how much better our immune systems are working against Covid than in the past, there’s probably no reason to think that those dynamics are going to dramatically change unless there’s an out-of-left-field new variant like the original Omicron.
And I think that fits the layperson’s understanding of what an endemic disease is: It’s circulating, but it’s sort of in the background, and while there are some little peaks and some little valleys, they aren’t so dramatic that they threaten to really upend life at a community level, let alone at a national level. That’s a pretty fair description of where we are right now.
While Omicron remains a dangerous virus, particularly for the elderly, which of course is where we started, we now have vaccines against severe illness and treatments for the virus.
Most patients with smell or taste dysfunction related to COVID-19 reported complete recovery of their senses at 2 years, according to a cross-sectional survey conducted in Italy.
Among 119 patients with smell or taste dysfunction within 4 weeks of COVID onset, 88.2% reported complete resolution at 2 years, 9.2% reported a decline in symptom severity, and 2.5% reported unchanged or worsening symptoms, said Paolo Boscolo-Rizzo, MD, of the University of Trieste, and colleagues.
And Los Angeles schools plan on updating COVID-19 protocols for the upcoming school year by dropping “overly aggressive” testing, masking, and vaccination requirements. (KTLA).
The White House today declared monkeypox a public health emergency.
“We are prepared to take our response to the next level in addressing this virus and we urge every American to take monkeypox seriously,” Health and Human Services Secretary Xavier Becerra said to reporters during a briefing on Thursday.
A public health emergency can trigger grant funding and open up more resources for various aspects of a federal response. It also allows the Secretary to enter into contracts for treatments and other necessary medical supplies and equipment, as well as support emergency hospital services, among other things. Public health emergencies last for 90 days but can be extended by the Secretary.
CDC Director Rochelle Walensky, said the declaration will provide resources and increase access to care. She also said it will expand the CDC’s ability to share data.
Also Thursday, FDA Commissioner Robert Califf announced the agency was considering allowing Bavarian Nordic’s Jynneos, the only vaccine licensed in the United States to prevent monkeypox, to be given in two doses that are one-fifth the size of the licensed doses, via intradermal administration. Doing so could allow five times as many people to be vaccinated with existing supplies than if the licensed dosage was employed.
The vaccine is licensed as a two-dose product, with the doses administered via intramuscular injection 28 days apart.
“We believe this could be a promising approach,” Califf said.
In other public health news, the Department of Health and Human Services announced
Our nation’s blood and plasma supply dropped to historic lows during the COVID-19 pandemic. While some areas of the country have seen improvement, other areas are still struggling to meet the demand. Blood and plasma are needed on an ongoing basis to treat a variety of life-threatening conditions, which is why the U.S. Department of Health and Human Services (HHS), is launching a new campaign, Giving = Living. * * *
Visit hhs.gov/givingequalsliving to learn more about the importance of donation and make an appointment at a donation location near you.
Cigna reported net income increased 6% year over year to $1.6 billion during the second quarter as fewer people were admitted to the hospital, had fewer surgeries and visited the emergency room less.
The Connecticut-based insurer said medical costs for both COVID-19 and non-COVID-19 care were lower than projected. The insurer’s medical loss ratio, an important measure of how much is spent on medical care, fell to 80.7% for the second quarter. Analysts said price hikes helped the MLR, too.
As a result of the quarterly performance, Cigna raised financial targets for the year for revenue and income from operations.
Telehealth company Amwell is working with CVS Health to roll out the retail drugstore giant’s new virtual primary care service.
CVS announced at the end of May plans to launch a virtual care service that gives consumers access to primary care, on-demand care, chronic condition management and mental health services. Eligible Aetna and CVS Caremark members will be able to use the virtual primary care service to access healthcare services on demand, whether at home or in a retail or community-based setting, the drug store company said.
CVS’ virtual care platform is a “consumer-centric offering designed to bring together the many elements of CVS Health ecosystem services into a single integrated experience with a unified digital front door,” Dr. Ido Schoenberg, chairman and co-chief executive officer of Amwell, said during the company’s second-quarter earnings call Thursday.
Elevance Health is betting big on primary care with a new nationwide partnership with Aledade.
The team-up will focus on assisting primary care practices in transitioning to value-based care, to boost health outcomes and lower costs. Independent primary care practices that are within the insurer’s network will be able to access Aledade’s suite of technology and local, in-person services.
Aledade’s platform provides the tools, support and resources that PCPs need to roll out value-based care, the companies said.
Pfizer Inc. will spend $470 million to expand its vaccine research facilities 25 miles northwest of New York City, where the company hopes to maintain its edge in the booming field of messenger RNA, the technology behind its blockbuster Covid-19 shot.
The drugmaker will construct a new building and renovate existing facilities on its campus in Pearl River, New York, which has been the nexus of laboratory research driving its vaccine programs, including the one for Covid in partnership with BioNTech SE.
From the substance use disorder front, NPR explains
Music festivals once frowned upon naloxone, and some banned it. But even though what’s known as harm reduction — the concept of minimizing the negative effects of illicit drug use without trying to stop it altogether — has gained acceptance, it’s far from embraced. Less accepted than naloxone among concert promoters is helping people test their drugs for fentanyl. Companies don’t want to be seen as condoning drug use. They’re also navigating a legal gray area and battling public perceptions. * * *
Overdose deaths continue to climb in the U.S. Drug fatalities topped 100,000nationwide in 2021, with two-thirds caused by synthetic opioids. This has prompted federal and state governmentsto try to think of new ways to combat the crisis, with the Biden administration giving $30 million to support programs that have often operated in the shadows. In the past few years, the Substance Abuse and Mental Health Services Administration also has fully embraced fentanyl test kits.
Still, many communities far beyond music festival grounds are resistant to harm-reduction strategies, especially fentanyl-testing tools. Dr. Yngvild Olsen, director of SAMHSA’s Center for Substance Abuse Treatment, said harm reduction requires an evolution in thinking, and she encourages organizations to consider harm reduction a lifesaving tool — especially when mass overdoses are possible.
From the telehealth front, Health Payer Intelligence reports
Telehealth flexibilities during the coronavirus pandemic contributed to a 26 percent spike in overall utilization of in-network outpatient behavioral health, according to a report from UnitedHealth Group.
“Prior to the COVID pandemic, telehealth was broadly viewed as a potential strategy for improving access to behavioral health care,” the report explained.
“During the pandemic—which saw increased rates of depression, anxiety, and substance use disorder—federal and state policymakers and commercial health plans established temporary flexibilities to increase access to care, and patients and providers increased their use of virtual visits as an alternative to in-person office-based care.”
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