“The federal government will restart its free at-home COVID tests program in September as officials prepare the country for the upcoming respiratory virus season.
“Dawn O’Connell, assistant secretary for preparedness and response at the Department of Health and Human Services, said Friday that this is the seventh time the Biden-Harris administration has allowed Americans to order over-the-counter tests at no charge.
“It’s not clear when the website, COVID.gov/tests, will come back online. The website stopped accepting orders in early March.”
“The news comes after the FDA received several reports of “serious adverse events” due to the device becoming entrapped or blocking arteries in the patient’s lungs. Six deaths and four other patient injuries have been associated with the issue so far.
“The ClotTriever XL catheter, like Inari Medical’s other ClotTriever devices, was designed to treat deep vein thrombosis. Marketed as “a large device for the largest vein,” it was built specifically to target issues found in the vena cava.”
From the public health and medical research front,
MedPage Today offers a series of interviews with public health experts on the measles, bird flu, and Covid.
McKinsey and Company share a string of insightful articles on closing the women’s health gap.
“In the quest for women’s equality, the health gap is a major player. Women live longer than men, but they spend 25 percent more of that time in poor health. This gap boils down to disparities in efficacy, data, and care delivery, say McKinsey’s Anouk Petersen, Lucy Pérez, and coauthors.
“Closing this gap could add up to seven more healthy days of life per year, per woman. The key? Recognizing that women’s health is not just a scaled-down version of men’s health but is biologically distinct. Change can begin by tackling specific diseases and conditions at a country or regional level.
“Ahead of Women’s Equality Day [tomorrow] August 26, explore these insights to understand the widespread benefits of closing the chasm.”
“Patients with dementia may instead have hepatic encephalopathy (HE) and should be screened with the Fibrosis-4 (FIB-4) index for cirrhosis, one of the main causes of the condition, new research suggests.
“The study of more than 68,000 individuals in the general population diagnosed with dementia between 2009 and 2019 found that almost 13% had FIB-4 scores indicative of cirrhosis and potential HE.
“The findings, recently published online in The American Journal of Medicine, corroborate and extend the researchers’ previous work, which showed that about 10% of US veterans with a dementia diagnosis may in fact have HE.
“We need to increase awareness that cirrhosis and related brain complications are common, silent, but treatable when found,” corresponding author Jasmohan Bajaj, MD, of Virginia Commonwealth University and Richmond VA Medical Center, Richmond, Virginia, told Medscape Medical News. “Moreover, these are being increasingly diagnosed in older individuals.”
“Cirrhosis can also predispose patients to liver cancer and other complications, so diagnosing it in all patients is important, regardless of the HE-dementia connection,” he said.”
“When doctors and patients consider the appendix, it’s often with urgency. In cases of appendicitis, the clock could be ticking down to a life-threatening burst. Thus, despite recent research suggesting antibiotics could be an alternative therapy, appendectomy remains standard for uncomplicated appendicitis.
“But what if removing the appendix could raise the risk for gastrointestinal (GI) diseases like irritable bowel syndrome and colorectal cancer? That’s what some emerging science suggests. And though the research is early and mixed, it’s enough to give some health professionals pause .
“If there’s no reason to remove the appendix, then it’s better to have one,” said Heather Smith, PhD, a comparative anatomist at Midwestern University, Glendale, Arizona. Preemptive removal is not supported by the evidence, she said.”
Fedweek posted an August update on implementation of the Postal Service Health Benefits Program (“PSHBP”).
“At least one major insurance carrier, FEP Blue Cross Blue Shield, has already sent letters to current participants letting them know that a plan similar to their current plan has been conditionally approved and stating that they’ll share more details on the PSHB benefits and premiums “later this year, in time for Open Season”
“The USPS reports new plan details will be available as of September 15, and will be sent out via hard mail in the weeks that follow.
“The USPS says that participants will receive a “crosswalk letter” in late October showing the new plan into which the USPS intends to enroll them. If you agree, there’s nothing to do: you’ll be enrolled in that plan.”
The FEHB enrollees who may be in for a surprise are those who currently participate in an FEHB plan that is not participating in the PSHBP. In October, OPM will enroll those folks in the lowest cost nationwide plan option that is not a high deductible plan or charge associate member dues. Those folks will have an opportunity to change plans during the regular federal benefits open season. The FEHBlog expects that the PSHBP navigators will be lending a helping hand to those folks, particularly those eligible for Medicare.
“If you were an annuitant entitled to Medicare Part A (typically at age 65) as of Jan. 1, 2024, and did not enroll in Medicare Part B, you and your covered eligible family members may be able to participate in a one-time PSHB Special Enrollment Period (SEP) for Medicare Part B from April 1 through Sept. 30, 2024. Those who choose to enroll during the SEP will have the late enrollment penalty paid for by the Postal Service. Eligibility letters were sent to annuitants and eligible family members in March 2024. If you have misplaced the notification letter mailed to you or believe that you are eligible to participate in the PSHB SEP and did not receive a notification letter, call the PSHB Navigator toll-free help line at 833-712-PSHB (7742) or email retirementbenefits@usps.gov.”
Speaking of the Postal Service, Federal News Network lets us know,
“The Postal Service is planning to roll out several changes next year to drive down its operating costs and ensure more reliable service to most of its customers.
“USPS says the next step of its network modernization plan, which will happen next year, is to get mail and packages to their destination in fewer trips between mail processing plants and post offices.
“The agency expects these adjustments will not only help it squeeze $3 billion of annual overhead costs out of its operations, but enable faster delivery of mail and packages to customers within 50 miles of the agency’s largest regional mail processing plants.
“For customers outside that 50-mile radius, however, USPS, anticipates ”some mail and packages will experience a longer service standard,” according to a filing submitted to its regulator on Thursday.
“In those cases, mail and packages in those more rural areas will remain in transit for about a day longer before reaching their final destination.
“USPS, however, told the Postal Regulatory Commission that these changes will have a “net positive impact” on service for first-class mail, packages and marketing mail, and will be delivered “at the same level of service or faster,” for most customers.”
The American Hospital News expresses distress because
Johnson & Johnson announced Aug. 23 that it would be fundamentally changing the way it makes 340B pricing available for two of its most popular products, Stelara and Xarelto. Starting Oct. 15, J&J will require all disproportionate share hospitals participating in the 340B Drug Pricing Program to purchase these drugs at full price and submit data to J&J. Upon verification of the drug’s 340B status, DSHs would receive a rebate for the discounted 340B price.
Last week, the AHA contacted the Health Resources and Services Administration for more information as soon as it was made aware that J&J was considering these actions. HRSA notified the AHA today that it has informed J&J that its rebate model is inconsistent with the 340B statute and that this model has not been approved by the Secretary of the Department of Health and Human Services. HRSA further informed the AHA that it has told J&J that HRSA will take appropriate action as warranted.
From the public health and medical research front,
The Centers for Disease Control and Prevention (“CDC”) announced today,
“Seasonal influenza and RSV activity are low nationally, but COVID-19 activity is elevated in many areas. * * * “Nationally, the wastewater viral activity level for COVID-19 is currently very high.“
“COVID-19
Many areas of the country are continuing to experience increases in COVID-19 activity, though other areas are experiencing declines in COVID-19 activity following increases this summer. COVID-19 test positivity, emergency department visits, and rates of COVID-19–associated hospitalizations remain elevated, particularly among adults 65+ and children under 2 years. Surges like this are known to occur throughout the year, including during the summer months. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.
“National vaccination coverage for COVID-19, influenza, and RSV vaccines remained low for children and adults for the 2023-24 respiratory illness season. RSV vaccines continue to be available, and updated influenza and COVID-19 vaccines that can provide protection during the 2024–25 respiratory illness season will be widely available in September 2024.”
“High-dose (HD) and adjuvanted influenza vaccines offered the best protection for people aged 65 years and older against symptoms and hospitalization during the 2022-23 flu season, concludes a real-world study published this week in Clinical Infectious Diseases.
“High-dose flu vaccines contain four times the standard dose (SD), while adjuvanted vaccines contain an extra immune-boosting ingredient. In 2022, the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommended high-dose, adjuvanted, or recombinant (cell-based) vaccines over SD vaccines for older adults, who are at elevated risk for severe disease and flu-related hospitalization and death.”
“After a years long lull thanks to Covid-19 precautions like isolation and distancing, whooping cough cases are now climbing back to levels seen before the pandemic, according to data from the Centers for Disease Control and Prevention.
“So far this year, there have been 10,865 cases of whooping cough, or pertussis, nationwide. That’s more than triple the number of cases documented by this time last year, and is also higher than what was seen at this time in 2019. Doctors say these estimates are most likely an undercount, as many people may not realize they have whooping cough and therefore are never tested.
“The pandemic delayed routine childhood vaccinations, including those that protect against whooping cough, and led to fewer pregnant women getting vaccinated. Those factors have likely contributed to the current uptick in cases, said Dr. William Schaffner, an infectious disease specialist at Vanderbilt University Medical Center. Pertussis cases tend to peak in the summer and fall, he said, and so it’s particularly critical to be aware of the disease now, as children head back to school and respiratory illnesses pick up.”
“US teenagers aren’t getting vaccinated against HPV at the same pace as before the Covid pandemic, a trend that could imperil efforts to control a common cause of cervical and other cancers.
“Immunization rates have stagnated for kids aged 13 to 17 for the past two years, according to data that the Centers for Disease Control and Prevention published Thursday. Meanwhile, routine shots for diseases like tetanus and meningitis have returned to pre-pandemic levels, according to the CDC survey, which analyzed results from nearly 17,000 teenagers.
“The trend could cause alarm among public health officials. Each year, human papillomavirus causes more than 21,000 cases of cancer in women and about 16,000 in men. * * *
“This is the only vaccine I know of that prevents cancer,” said Sunil Sood, a pediatrician who specializes in infectious disease at Northwell Health in New York. “Putting it like that has been known to make a difference” to parents who might be resistant to having their children vaccinated, he said.”
Per MedCity News, “Side Effects are Limiting GLP-1 Drug Efficacy: How Can Personalization Offer a Solution? By integrating digitization and machine learning, there is an opportunity to deliver personalized care to all patients and scale precision dosing with minimal physician involvement, maximizing the effectiveness and accessibility of these drugs.”
“There is a clear and unique opportunity to apply dose optimization to GLP-1s to improve real-world persistence and adherence, supporting patients to continue treatment long enough to experience the full benefits, such as positive cardiovascular outcomes. We know clinicians are seeing the need for this and are already making necessary interventions but struggling still to find a scalable solution. Pairing drugs with proven digital solutions, within a single label, can facilitate personalization across the GLP-1 market, improving the effectiveness of these drugs and diminishing side effects. Not only can pharma leverage this approach to deliver best-in-class clinical and commercial outcomes, but it also promises to revolutionize disease management, enhancing patient safety and outcomes by tailoring treatment to individual needs, truly bringing precision care to all.”
Pulmonary Advisor notes, “About two-thirds of adults who smoked wanted to quit in 2022, although fewer than 10% were successful, according to study findings published in the Morbidity and Mortality Weekly Report.
From the U.S. healthcare business front,
EBRI offers an Issues Brief concerning “Trends in Self Insured Health Coverage; ERISA at 50.”
“Stryker said Thursday it has agreed to acquire Vertos Medical, an Aliso Viejo, California-based company whose minimally invasive technology treats chronic lower back pain, for an undisclosed sum.
“The Vertos procedure, which can be performed in an outpatient setting, is designed to provide pain relief for patients with lumbar spinal stenosis by restoring space in the spinal canal and reducing nerve compression.
“This acquisition strengthens our minimally invasive pain management portfolio with differentiated treatments and expands our reach across ambulatory surgery centers,” Andy Pierce, head of Stryker’s medical and surgical equipment and neurotechnology business, said in a statement.”
“Republican leaders on the House Homeland Security Committee want to know what the Biden administration is doing about Havana syndrome, mysterious brain injuries that became public in 2016 after State Department officials in Cuba’s capital city were affected.
“We are deeply alarmed that these incidents continue to take place here and abroad, and that there has been little to no explanation from the administration as to who or what has caused these phenomena,” wrote full committee Chairman Mark E. Green, R-Tenn., and Counterterrorism, Law Enforcement and Intelligence Subcommittee Chairman August Pfluger, R-Texas, in a letter to National Security Advisor Jake Sullivan Tuesday.
“The brain injuries, referred to as anomalous health incidents, include symptoms of headaches, pain, nausea, disequilibrium and hearing loss. Additional reports of similar symptoms later emerged from federal employees in other countries such as China, Russia, Vietnam, Colombia and various parts of Europe.
“Green and Pfluger, who have held numerous hearings and briefings on this matter, requested a committee briefing from the National Security Council. They also urged the administration to prioritize expending unused funds allocated to provide care for AHI victims and to fully implement the HAVANA Act, a 2021 law that authorizes payments to impacted intelligence, diplomatic and other governmental personnel.”
“The U.S. Navy has received more than 546,500 claims for compensation from people impacted by decades of contaminated water at Marine Corps Base Camp Lejeune in North Carolina, a new court filing shows, putting it squarely among the largest injury cases of all time.
“That number may fluctuate up or down by a few thousand, the government said in the filing, opens new tab. The U.S. Navy is reviewing additional claims received up to the Aug. 10 deadline and removing claims that are found to be duplicates.
“The number of administrative claims filed with the U.S. Navy – a step claimants must have taken by the Aug. 10 deadline to receive compensation for injuries they attribute to the water – surpasses the nearly 400,000 lawsuits filed over 3M Co’s military-issue earplugs, which is regarded as the largest multidistrict litigation in history.”
The Chair and Ranking Member of the House Education and Labor Committee sent a letter to the Assistant Secretary of Labor who handles ERISA matters. The letter asks the Assistant Secretary about the Department’s efforts to “address troubling practices of certain group health plan service providers.”
Federal News Network interviews Colleen Heller-Stein, the first career fed to lead the CHCO Council.
From the public health and medical research front,
“Today, the U.S. Food and Drug Administration approved and granted emergency use authorization (EUA) for updated mRNA COVID-19 vaccines (2024-2025 formula) to include a monovalent (single) component that corresponds to the Omicron variant KP.2 strain of SARS-CoV-2. The mRNA COVID-19 vaccines have been updated with this formula to more closely target currently circulating variants and provide better protection against serious consequences of COVID-19, including hospitalization and death. Today’s actions relate to updated mRNA COVID-19 vaccines manufactured by ModernaTX Inc. and Pfizer Inc.”
Beckers Hospital Review offers three notes on the FDA action.
“The two shots [Pfizer and Moderna] will be available to anyone over 6 months of age, a move that comes as Covid hospitalizations continue to climb and remain higher than they were at this time last year, according to data from the Centers for Disease Control and Prevention.
“Doctors say everyone who is eligible should get a shot. But older people who have skipped other recent vaccine updates should especially consider it.
“I saw a lot of people in the hospital who got a lot of shots in the beginning of the pandemic and then didn’t get any shots for a year or two years,” said Dr. Peter Chin-Hong, a professor of medicine at University of California-San Francisco and an infectious-disease specialist. * * *
“Unless you’re very concerned about acquiring Covid right now, my recommendation would be to get it in September or October,” said Dr. William Schaffner, a professor of preventive medicine at the Vanderbilt University School of Medicine. “That will provide the best protection throughout the winter season.”
“The CDC recommends people get one of the new vaccines by the end of October. Both will be available at local clinics and pharmacies.”
The American Hospital Association News lets us know,
“The Food and Drug Administration Aug. 22 granted emergency use authorization for two new combined COVID-19 and influenza tests. The Nano-Check Influenza-COVID-19 Dual Test is authorized for use by laboratories to detect and differentiate influenza A and B and SARS-CoV-2 in nasal swab specimens. The Flowflex Plus COVID-19 and Flu A/B Home Test is authorized for home use for people aged two and older.”
The American Medical Association lets us know what doctors wish their patients knew about pre-eclampsia.
MedPage Today suggests that “Europe Offers Clues for Solving America’s Maternal Mortality Crisis.”
The Brown and Brown consulting group makes an urgent call for employers worldwide to become more aware of the risk of suicide among their employees and engage in suicide prevention efforts.
Beckers Hospital Review shares patient safety goals at top rated U.S. hospitals.
Per HealthDay, “The overdose-reversing drug naloxone can help save the lives of people whose hearts have stopped due to an opioid OD, a new study shows.”
The Institute for Clinical and Economic Review’s “independent appraisal committee voted that current evidence is not adequate to demonstrate net health benefits for imetelstat added to best supportive care when compared to best supportive care alone; treatment [for the treatment of anemia in patients with low-to-intermediate risk myelodysplastic syndrome] would meet common thresholds of cost effectiveness if priced between $94,800 to $113,000 per year, therapy currently priced at approximately $365,000 per year.”
A federal judge’s ruling this week that blocked the Federal Trade Commission’s near-total ban on noncompete clauses in employment contracts is creating more uncertainty for healthcare employers as they await the agency’s next move.
Federal regulators have cracked down on what they view as anticompetitive behavior in recent years, particularly in healthcare. The FTC’s nationwide noncompete ban will no longer take effect Sept. 4, but that doesn’t mean the issue is resolved.
Noncompete agreements are common in the healthcare industry. Many organizations, including hospitals, health systems, physician groups, insurance companies and pharmacy benefit managers, use the agreements in employment contracts to protect business interests and ensure competitors don’t obtain proprietary information.” * * *
“The FTC has said Tuesday’s ruling does not remove its authority to challenge noncompete bans on a case-by-case basis.”
“There’s not going to be any certainty on this for a while,” said Jason Weber, an employment attorney at law firm Polsinelli.” * * *
“Polsinelli’s Weber said companies should try to reduce confusion by educating employees on the ruling and emphasizing that noncompete obligations remain in effect.
Weber said employers also have a good opportunity to assess their existing agreements and reevaluate whether noncompete clauses are essential to protecting their businesses. For example, employers could use less-restrictive options such as non-solicitation covenants, he said.”
“Several insurers [that] landed on Forbes’ annual ranking of the “Best Employers by State.”
“The 2024 ranking, published Aug. 20, sorts 1,294 top employers in the U.S. by state. Forbes surveyed more than 160,000 employees at companies with more than 500 people. Respondents evaluated their current employers, employers they’d worked with in the past two years and organizations they knew through their industry.
“Insurers appeared among the top employers in most states, except for Alaska, Delaware, Washington, D.C., Idaho, Maine, Mississippi, Montana, Oklahoma, Rhode Island, Vermont and Wyoming.”
“Most physicians oppose the way standardized relative value units (RVUs) are used to determine performance and compensation, according to Medscape’s 2024 Physicians and RVUs Report. About 6 in 10 survey respondents were unhappy with how RVUs affected them financially, while 7 in “10 said RVUs were poor measures of productivity.
The report analyzed 2024 survey data from 1005 practicing physicians who earn RVUs.” * * *
“[O]ver half of clinicians said alternatives to the RVU system would be more effective, and 77% suggested including qualitative data.”
“A Thursday afternoon [bankruptcy] sale hearing scheduled for several Steward Health Care hospitals was shelved in favor of an amended bankruptcy court itinerary hashing out multiple disputes related to the company’s pending deals for hospitals in Florida and Pennsylvania.” ***
“Though not the focus on Thursday’s hearing, Steward’s counsel also opened the hearing with quick updates on developments in Massachusetts and Ohio.
“For the former, Candace Arthur, who represents Steward, said that the company’s estate is “very close to the finish line and still fully engaged in mediation” regarding the deal announced last week.
“As for Ohio, where closure notices were issued yesterday for two Steward hospitals, Arthur described those filings as “a deadline thing.”
Beckers Payer Issues explains how members of Congress receive their health benefit coverage. Of course, since 2014, the answer has been and remains the DC Affordable Care Act exchange. However, retired members of Congress often are eligible for federal pension which includes FEHB coverage with the full government contribution.
“The Office of Personnel Management is starting to see the light at the end of the tunnel on its never-ending journey to modernize its retirement systems.
“A pilot to test out a new online retirement application platform is showing promise with several federal payroll providers.
“Guy Cavallo, OPM’s chief information officer, said the pilot includes the Agriculture Department’s National Finance Center and several others to reduce both the amount of paper needed and the error rate in processing retirement applications. Guy Cavallo is the CIO at the Office of Personnel Management.
“We believe doing the online checking will help really reduce that back and forth that often is needed. We’re also rebuilding the way calculations are done, and we’re implementing a digital file system so that we can stop dealing with millions and millions of pages of paper to be part of retirement,” Cavallo said in an interview with Federal News Network. “It’s going to take many years for us to do this, but by taking the heart of that, we’re improving the way somebody starts to retirement. We’re making sure the calculation service is correct, and then we’re working to get rid of paper versions and move to digital. Those are our first three building blocks.
“Cavallo said the goal of the test is to test out the technology and the process changes and continually improve them. He said there is no specific time frame for how long the pilot will last.”
“The FDA is building a post-market surveillance program for medical devices.
“The agency will look for medical device-related safety issues reported in EHRs, billing claims and pharmacy data, according to a U.S. Government Accountability Office report released Aug. 15.
“The program will begin surveillance of two medical devices by December, with plans to increase the number of devices under investigation each year over the next five years.
“There were more than 1.7 million injuries, and 83,000 deaths linked to medical device safety issues over a 10-year period, according to FDA data from 2018, the report said.”
From the public health and medical research front,
“The average age of hip- and knee-replacement patients is getting younger.” * * *
“For patients ages 45 to 64, there was a 211% increase in inpatient hip replacements and a 240% increase in inpatient knee replacements between 2000 and 2017, according to data from the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality. (Records after 2017 are less accurate due to changes in Medicare coding.)
“There was also an increase in joint replacements for patients ages 65 to 84, but the rise wasn’t as steep.
“This tracking doesn’t include the growing share of replacements that are outpatient surgeries, which allow patients to go home the same day as their procedure. More than a million hip and knee replacement surgeries are performed in the U.S. every year.”
“Without a sharp pivot in state and federal policies, the bird flu virus that has bedeviled American farms is likely to find a firm foothold among dairy cattle, scientists are warning.
“And that means bird flu may soon pose a permanent threat to other animals and to people.
“So far, this virus, H5N1, does not easily infect humans, and the risk to the public remains low. But the longer the virus circulates in cattle, the more chances it gains to acquire the mutations necessary to set off an influenza pandemic.
“I think the window is closing on our ability to contain the outbreak,” said Dr. Krutika Kuppalli, an infectious-disease physician who worked at the World Health Organization until April.”
Here’s a link to the CDC’s website on the disease.
“Lack of research into miscarriage in the U.S. — its prevalence, its causes, and how best to treat people who’ve experienced pregnancy loss — has helped to reinforce what has long been a culture of silence and shame around miscarriage. That knowledge gap means that people who miscarry, and miscarry repeatedly, like Hanson, aren’t given the emotional support they need at a time when they are most vulnerable. Equally important, they aren’t given the medical treatment, screening, and support from the health care system that might help them avert future miscarriages. And research into the possible reasons for recurrent pregnancy loss has been limited and siloed, several experts told STAT.” * * *
“When Carol Gilbert, an assistant professor at the University of Nebraska Medical Center College of Public Health, examined CDC data for her 2021 Ph.D. dissertation on perinatal periods of risk, she realized that she needed more complete data for losses before 20 weeks. For public health researchers like Gilbert, incomplete data prevents them from making accurate comparisons between states.When she examined the data, she understood why the CDC doesn’t publish statistics on fetal losses before 20 weeks of gestation.
The individual case data on pregnancy losses are collected by hospitals, assembled by states, and then forwarded to the CDC. But a trifecta of quality problems may explain why the CDC does not publish what data it does receive on losses before 20 weeks of gestation. First, laws regarding the gestational age at which fetal losses need to be reported vary across states. The second problem Gilbert found was that states were inconsistent in their reporting, failing to follow their own laws. This was especially true for fetal deaths between 20 and 24 weeks.
“The third problem was that not all states fill forms completely, leaving out data elements like birthweight and basic maternal characteristics. Some of this is inevitable because it is difficult to weigh fetal tissue in the early stage of pregnancy loss. A CDC spokesperson told STAT that “information regarding early pregnancy losses before 20 weeks’ gestation, including ectopic pregnancies and miscarriages, is challenging to obtain as these outcomes are not routinely reported to CDC.”
“Rachel Gross wants to clear up misconceptions about children and Covid-19. A pediatrician and population health researcher, she recalls a time four years ago when people didn’t think children could even contract the disease. Then, after accepting kids’ vulnerability to the virus, it was thought only adults could suffer from the myriad symptoms that persist or crop up post-infection, collectively known as long Covid.
“Now that it’s clear kids can also develop long Covid, Gross wants to correct assumptions that the condition looks the same in adults as in children, no matter their age. In new research published Wednesday in JAMA, Gross and the RECOVER-Pediatrics Consortium report that school-age children and adolescents experience similar long Covid symptoms across multiple organ systems, but those symptoms cluster in ways that vary depending on their age while diverging to some degree from the pattern seen in adults.” * * *
“Gross told STAT the study’s purpose was to learn how to identify children experiencing long Covid and how these symptoms change over time. “Then we will be able to better understand the question we really want to know: Why is this happening?”
Medscape adds, “Severe COVID-19 was associated with elevated risks for depression and serious mental illness months after infection, especially among unvaccinated people, a cohort study involving more than 18 million individuals in the U.K. found.”
“Renton, Wash.-based Providence posted an operating loss of $123 million in the second quarter of 2024, a $79 million improvement from the $202 million loss the 51-hospital system posted during the same period last year.
“Operating revenues increased by 6% compared to the same period last year, according to an Aug. 21 Providence news release shared with Becker’s. Operating expenses increased 5% for the three months ended June 30.
“Providence saw higher volumes in the second quarter of 2024, according to the release. Inpatient admissions and case mix adjusted admissions were both up 5% compared to the same period last year.
“Despite ongoing headwinds, our strategies for renewal and recovery are driving positive results, and we remain focused on continued improvement in 2024,” Providence CFO Greg Hoffman said in the release.”
“Dallas-based Steward Health Care plans to close Trumbull Regional Medical Center and Hillside Rehabilitation Hospital, both in Warren, Ohio, on or around Sept. 20 after the facilities failed to attract qualified buyers, the health system said in an Aug. 21 statement shared with Becker’s.
“Steward, which sought Chapter 11 protection May 6, shared that the “regrettable but unavoidable situation” has occurred due to its “significant cash constraints.”
“We remain hopeful we can find an alternative solution that would keep the hospitals open and preserve the jobs of our dedicated team members,” the statement said. “We want to help save this hospital and will continue to work with qualified bidders during this process.”
“Higher medical costs and utilization among older adults have perplexed Medicare Advantage insurers for more than a year. They didn’t see it coming and made promises to investors they couldn’t keep.
“Through the second quarter of this year, Aetna and Humana seem to be dealing with the biggest issues. Both insurers project that higher utilization will persist and have implemented cost-cutting initiatives. UnitedHealthcare, Elevance Health, Centene and Molina Healthcare appear to be better controlling Medicare Advantage costs, based on their financial reports and public statements.
“A federal judge ruled the US Federal Trade Commission can’t enforce its near-total ban on noncompete agreements that was set to go into effect next month, blocking an effort by the agency to make labor markets more competitive.
“In a ruling Tuesday, US District Judge Ada Brown in Dallas sided with the US Chamber of Commerce and a Texas-based tax firm that sued to block the measure. The judge said the FTC lacked the authority to enact the ban, which she said was “unreasonably overbroad without a reasonable explanation.”
“The ruling represents a significant blow for the FTC and further divides the judiciary over the regulator’s powers. A federal judge in Pennsylvania had previously sided with the FTC. The rule is likely to be headed for appellate review. Brown had previously delayed implementation of the ban, which was scheduled to take effect on Sept. 4.”
The American Hospital Association News lets us know,
“The Centers for Medicaid and Medicare Services Aug. 20 released a report presenting data on complaints and enforcement efforts by the agency concerning title XXVII of the Public Health Service Act, which includes both the surprise billing and price transparency provisions of the No Surprises Act. As of June 30, 2024, CMS received more than 16,000 complaints and closed 12,700 with 400 complaints with PHS violations. In total the agency reported over $4 million in restitution for closed cases. Top complaints against plan issuers include non-compliance with Quality Payment Amount requirements, late payment after independent resolution determination, and non-compliance with 30-day initial payment or notice of denial payment requirements. Top complaints against providers relate to surprise bills and good faith estimates.”
“Today, the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS), announced more than $1.4 billion in Ryan White HIV/AIDS Program funding for the HRSA AIDS Drug Assistance Program and related awards. This HRSA funding ensures that individuals with HIV who have low incomes receive lifesaving medication, quality HIV health care and essential support services. This announcement supports and advances the Biden-Harris Administration’s National HIV/AIDS Strategy.
“HRSA-supported AIDS Drug Assistance Programs pay for HIV medication, co-pays and co-insurance for HIV medication, and premiums for health insurance that covers HIV medication. This critical support helps individuals with HIV receive antiretroviral therapies, which help people reach viral suppression, meaning they cannot sexually transmit HIV and can live longer and healthier lives. Without access to lifesaving HIV medication provided by HRSA-supported AIDS Drug Assistance Programs, HIV medication could cost an individual more than $40,000 per year, putting it otherwise out of reach. HRSA supports critical HIV care and medication in all 50 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and six U.S. Pacific territories.”
“The Postal Service is facing a potential “retirement wave,” its inspector general’s office warns, with nearly one in five of its employees now retirement-eligible, and more than half its workforce eligible to retire within a decade.
“The USPS OIG, in its latest report, found USPS experienced no significant shortage of career employees last year, despite a tight labor market in the U.S. and record-low unemployment rates.
“Between fiscal years 2019 and 2023, USPS grew its workforce by more than 8,000 employees — a more than 1% growth rate. The agency employs about 637,000 total workers.
“The agency, however, may also need to prepare for a large contingent of its workforce to retire.”
From the public health and medical research front,
“The number of births declined in the United States in 2023, ending two years of upticks during the COVID-19 pandemic, according to a new federal report.
“A report published early Tuesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics showed there were 3,596,017 babies born in 2023.
“This is a decrease of 2% from the 3,667,758 babies born in 2022 and the 3,664,292 babies born in 2021.”
“Public health experts from some of the nation’s leading research institutions have deployed a massive medical trailer to rural parts of the South to test and survey thousands of local residents. The goal: to understand why the rates of heart and lung disease are dramatically higher there than in other parts of the U.S.
“This rural health disadvantage, it doesn’t matter whether you’re white or Black, it hurts you,” said Dr. Vasan Ramachandran, a leader of the project who used to oversee the Framingham Heart Study — the nation’s longest-running study of heart disease. “No race is spared, although people of color fare worse.
“The researchers aim to test the heart and lung function of roughly 4,600 residents of 10 counties and parishes in Alabama, Kentucky, Louisiana and Mississippi while collecting information about their environments, health history and lifestyles. They are also giving participants a fitness tracker and plan to survey them repeatedly for years to check for any major medical events.”
The U.S. Preventive Services Task Force made the following final recommendation today:
For asymptomatic pregnant adolescents and adults: The current evidence is insufficient to assess the balance of benefits and harms of screening for iron deficiency and iron deficiency anemia in pregnant persons. Grade: I statement
This recommendation aligns with the prior 2015 recommendation.
“Researchers Challenge USPSTF’s Lung Cancer Screening Criteria — Alternate criteria based on years of smoking has higher sensitivity and specificity, study says.
Messaging strategies led to higher support for breast cancer screening cessation [among older women].
Messages from multiple vs. one or no source led to higher intentions of screening cessation.
“One important contributor to overscreening is that patients have received pro-screening messages for many years from the media, the broader social environment and health care professionals. In contrast, there has been little messaging about the harms of overscreening, or that stopping screening may be appropriate for some women,” Eli Lilly’s LLY 3.05%increase; green up pointing triangle anti-obesity drug Zepbound significantly reduced the risk of Type 2 diabetes among people with excess weight and elevated blood-sugar levels in a new study.
The finding widens the list of additional health benefits beyond weight loss for a hot new crop of anti-obesity drugs. Prior studies have found that Novo Nordisk’s Wegovy reduces the risk of heart attacks and strokes, and Lilly’s Zepbound eases the severity of obstructive sleep apnea. associate professor in the division of geriatric medicine and gerontology in the department of medicine at Johns Hopkins University School of Medicine,and colleagues wrote in JAMA Network Open. “Messaging strategies have been used successfully to reduce other unwanted health behaviors such as smoking but are an understudied approach to reduce overscreening.”
To top things off, the Wall Street Journal reports,
“Eli Lilly’s anti-obesity drug Zepbound significantly reduced the risk of Type 2 diabetes among people with excess weight and elevated blood-sugar levels in a new study.
“In the study, weekly injections of Zepbound for more than three years reduced the risk of progression to Type 2 diabetes by 94%, compared with a placebo, among people with excess weight and prediabetes, Lilly said Tuesday.
“The drug also led to significant weight reduction at an average of between 15% and nearly 23%, depending on the dosage, compared with the 2.1% reduction in patients who received a placebo.
“Some of the benefits appeared to last, however, only as long as patients were taking the drug. During a 17-week off-treatment follow-up period, patients who discontinued Zepbound began to regain weight and had some increase in the progression to Type 2 diabetes. Including the 17-week off-treatment period, patients who took Zepbound in the study had an 88% reduction in the risk of progression to Type 2 diabetes compared with the placebo.”
“Regulators in both the U.S. and Europe have looked into the potential link between suicidal thoughts and Novo Nordisk’s blockbuster semaglutide franchise after reports sounded the alarm last year. While the agencies found no increased risk for the popular diabetes and obesity drug, a new study could fuel the debate.
“In a study recently published in the Journal of the American Medical Association (JAMA), researchers found a “significant disproportionality” for semaglutide-associated suicidal ideation compared with other medicines, particularly among patients who also use antidepressants.
“No such link was found for Novo’s earlier-generation GLP-1 med, liraglutide, according to the team. The study was based on the World Health Organization’s (WHO’s) database of suspected suicidal and self-injurious adverse drug reactions.
“Branded as Wegovy, Ozempic and Rybelsus, Novo’s semaglutide medicines—and their liraglutide counterparts Victoza and Saxenda—all fall under the GLP-1 umbrella.”
“Epic is planning to deepen its relationships with health insurance companies, the electronic health record giant said at its annual user group meeting Tuesday.
“The EHR company is working with health systems and large insurers such as CVS Health subsidiary Aetna, Elevance Health and multiple Blue Cross and Blue Shield plans to streamline prior authorization requests and ease provider appeals to payers, Epic founder and CEO Judy Faulkner said during a keynote address. The event was held at Epic’s headquarters in Verona, Wisconsin.
“Projected health care cost trend jumped to almost 8% for 2025, the highest amount in more than a decade, according to Business Group on Health’s2025 Employer Health Care Strategy Survey.
“The predicted surge in employer health care spending – actual health care costs have grown a cumulative 50% since 2017 – comes against a backdrop of inflation, heightened demand for expensive drugs such as GLP-1s, potentially curative but high-cost cell and gene therapies, and the ongoing burden of treating cancer and other chronic conditions.
“Employers are steadfast in their desire to provide comprehensive offerings to their workforces,” said Ellen Kelsay, president and CEO of Business Group on Health. “They continue to absorb much of the upticks in cost and remain keenly focused on lowering spending and improving outcomes and experiences for employees. However, the foreboding cost landscape has accelerated the need for bold transformation, and employers seek partners who will make that happen.”
“The Business Group survey, released today in Washington, D.C., also showed that pharmacy spending was largely responsible for the increased health care trend in 2023; that GLP-1s have created challenges for employers; and that while cancer and musculoskeletal conditions remained the top two cost drivers, this year saw more employers reporting cardiovascular conditions as the third costliest.
“The survey gathered data on a range of critical topics related to employer-sponsored health care for the coming year. A total of 125 large employers across varied industries, who together cover 17.1 million people in the United States, completed the survey between June 3, 2024, and July 12, 2024.”
“Mass General Brigham’s operating income slipped to $47 million for the quarter ended June 30 despite a 7% year-over-year increase in total operating revenue, the major nonprofit system reported last week.
“The fiscal third-quarter numbers, which reflect a 0.9% operating margin, follow the prior year’s $69 million operating income and 1.4% operating margin.
“When including nonoperating items such as investment income, Mass General Brigham logged a net income of $277.5 million, also down from the third quarter of 2023.
“The Massachusetts system is showing a slight year-over-year improvement across the first months of its 2024 fiscal year, having turned the prior year’s $5 million loss into a $41 million operating income (0.3% operating margin, not inclusive of $118 million of onetime revenue tied to prior year healthcare provider activity).”
“The Food and Drug Administration has approved a new combination drug regimen from Johnson & Johnson to treat a common type of advanced lung cancer with certain genetic mutations.
“J&J’s Rybrevant is now cleared for use with another drug called Lazcluze in people with previously untreated non-small cell lung cancer that’s metastasized or advanced locally. Only people with specific mutations in a gene known as EGFR are eligible for treatment.
“The approval is based on results from a study that compared the combination to AstraZeneca’s lung cancer drug Tagrisso. In a statement, J&J described the new treatment as the first chemotherapy-free regimen that’s demonstrated superiority to Tagrisso in this setting.”
“Johnson & Johnson has agreed to acquire V-Wave, the maker of an implantable device to treat heart failure, in a deal worth up to $1.7 billion.
“J&J will pay $600 million upfront, plus potential additional payments up to about $1.1 billion if regulatory and commercial milestones are met, the company said Tuesday. J&J expects the acquisition to close before the end of the year.
“V-Wave’s device, known as the Ventura Interatrial Shunt, is designed to reduce elevated left atrial pressure in people with congestive heart failure by creating a shunt between the left and right atrium. It received the Food and Drug Administration’s breakthrough device designation in 2019 and Europe’s CE mark in 2020. J&J said the device could be the first of its kind to reach the market.”
“The U.S. Department of Health and Human Services (HHS) launched a new national campaign today to inform the public about common respiratory viruses and available vaccines. The campaign, Risk Less. Do More., aims to increase awareness of vaccines that reduce serious illness from influenza (flu), COVID-19, and respiratory syncytial virus (RSV) in high-risk populations and to limit the spread of these viruses among all Americans.” * * *
“For more information on the Risk Less. Do More. campaign, please visit RiskLessDoMore.hhs.gov.”
“For more information about respiratory illnesses, please visit cdc.gov/RiskLessDoMore.”
The American Hospital Association News lets us know,
“The Organ Donation and Transplantation Alliance has created new resources for health care providers to encourage more organ donation and transplants. It has launched an educational guide to enhance collaboration between organ procurement organizations, transplant centers and hospitals. The Alliance last week hosted a workshop complementing the guide launch. An on-demand learning pathway video and other supporting materials will be available in September.”
“The Biden administration says federal agencies are getting rid of office space they no longer need, and will shed millions of square feet in the coming years, now that many federal employees are on a hybrid schedule of in-office and work-from-home days.
“The Office of Management and Budget, in a sweeping report released earlier this month, said telework-eligible federal employees are working in their offices about 60% of the time.
“That hybrid schedule allows agencies to reevaluate their office space needs, and shed excess leased and government-owned real estate.
“While agencies reach more durable, long-term decisions about their telework and work environment posture, they are also considering the impacts of these changes on their real property portfolios,” OMB wrote. “Agencies have undertaken considerable work to dispose of unneeded property, reduce costs, and improve overall utilization of real estate.”
From the public health and medical research front,
“In the study, which was published Monday in the journal Nature Medicine, researchers transformed deep brain stimulation — an established treatment for Parkinson’s — into a personalized therapy that tailored the amount of electrical stimulation to each patient’s individual symptoms.
“The researchers found that for Mr. Connolly and the three other participants [with Parkinson’s Disease], the individualized approach, called adaptive deep brain stimulation, cut in half the time they experienced their most bothersome symptom.
“Mr. Connolly, now 48 and still skateboarding as much as his symptoms allow, said he noticed the difference “instantly.” He said the personalization gave him longer stretches of “feeling good and having that get-up-and-go.”
“The study also found that in most cases, patients’ perceived quality of life improved. “That’s very important,” said Dr. Sameer Sheth, a professor of neurosurgery at Baylor College of Medicine who was not involved in the research.
“Although the study was small, it represents the strides being made in using brain implants and artificial intelligence to personalize treatment for neurological and psychiatric disorders — essentially developing pacemakers for the brain.”
“The distress from receiving a cancer diagnosis is something that clinicians widely anticipate in patients, but suffering often doesn’t just afflict the patient. It can blanket an entire household, burdening spouses and other family members with stress and anxiety and the exhausting routine of treating a life-threatening disease.
“But while standards exist for assessing and managing distress in patients, it’s often “hidden” in family members, sometimes with devastating consequences, said Weiva Sieh, an epidemiologist at MD Anderson Cancer Center. In a study published in JAMA Oncology on Thursday, spouses of cancer patients were found to be at significantly higher risk of suicide attempt and death compared to those married to people without cancer.
“Psychosocial distress in cancer patients themselves are better anticipated, widely known, and accepted,” said Sieh, who did not work on the study but wrote an accompanying editorial in JAMA Oncology. “This problem is not extremely well recognized. Fortunately, mental health is often treatable. It’s just a question of recognizing it.”
“Primary care practitioners (PCPs) provided the majority of prescriptions for HIV preexposure prophylaxis (PrEP) in the U.S., but the odds of patients filling a PrEP prescription were better when it came from an infectious disease (ID) specialist, according to a cross-sectional study.”
Fierce Healthcare asserts that “Insurers push ‘food is medicine’ interventions but rarely weigh in on ultra-processed food.”
Beckers Hospital Review calls attention to five drugs now in shortage.
“Rochester, Minn.-based Mayo Clinic reported an operating income of $449 million (8.9% margin) in the second quarter, a substantial improvement on the $300 million operating gain (5.9% margin) it posted in the same period last year.
“Second-quarter revenue increased 12.1% year over year to $5 billion while expenses grew by 9.4% to $4.6 billion, according to financial documents published Aug. 19. Solid patient volumes and increased donor contributions drove revenue growth during the second quarter.
“Labor costs increased 7% year over year to $2.6 billion while supplies and services expenses rose 13.3% to $1.6 billion. The 7% increase in labor costs — which accounted for 56.9% of total second-quarter expenses — is attributed to staff growth to accommodate higher volumes and a 4% annual salary increase for all allied health staff.
“After factoring in nonoperating items, including philanthropy and returns from investments, Mayo reported a net income of $613 million in the second quarter, compared to $547 million in the second quarter of 2023.”
“Bankruptcy filings in the healthcare sector have slowed so far in 2024 after spiking last year, according to a report by healthcare restructuring advisory firm Gibbins Advisors.
“This year is on track to see 58 filings by healthcare companies with at least $10 million in liabilities, compared with 79 cases in 2023.
“But the decline doesn’t necessarily mean the financial headwinds driving bankruptcies have lessened, according to the advisory firm. Restructuring could be taking place outside of courts, and case volumes might increase later this year, Clare Moylan, principal at Gibbins Advisors, said in a statement.”
“Bristol Myers Squibb’s highly anticipated schizophrenia drug KarXT is fast approaching a September deadline for the Food and Drug Administration to decide on approval. Yet competition already looms for a market that’s estimated to soon be worth billions of dollars.
“KarXT, a so-called muscarinic agonist, may become the first new kind of schizophrenia drug in decades. Close behind it is AbbVie’s emraclidine, which works in a similar fashion.
“People with schizophrenia experience a broad range of symptoms, from hallucinations and delusions to cognitive impairments and social withdrawal. Clinical testing has shown that, like KarXT, emraclidine, which AbbVie acquired from Cerevel Therapeutics in a multibillion-dollar deal, is effective at controlling symptoms without the debilitating side effects or drawbacks of traditional antipsychotics, which cause almost three-quarters of patients to abandon treatment.
“But experts say once-daily dosing versus twice-daily treatment, and a potentially more gut-friendly formulation, may give emraclidine an edge over KarXT, which Bristol Myers Squibb acquired in a $14 billion acquisition of Karuna Therapeutics.”
MedCity News considers “Why Primary Care Physicians Are Reluctant to Join Value-Based Care.”
“New Jersey Democratic Gov. Phil Murphy intends to appoint his former chief of staff, George Helmy, to fill the Senate seat that Sen. Bob Menendez will vacate next week, multiple New Jersey media outlets reported Wednesday evening, citing sources.
“Helmy, who has most recently worked as executive vice president and head of external affairs for RWJBarnabas Health, will serve until the end of the 118th Congress. The seat for the full term starting in January will be filled by the winner of the November election between Rep. Andy Kim, the Democratic nominee, and Republican Curtis Bashaw.”
On August 16, the Congressional Budget Office released to the House Oversight and Accountability Committee a report on H.R. 7868, the FEHB Protection Act.
The problematic aspect of the bill is that it focuses on tightening up oversight of family member eligibility when OPM does not give FEHB plans the information to confirm that plan enrollees are paying the proper premium or any premium for their coverage, which creates a yawning gap in internal controls. OPM can cure this problem by implementing the HIPAA 820 enrollment roster transaction.
From the public health and medical research front,
Fortune Well identifies where COVID has been spiking in the U.S. this summer.
“In the four-week period ended Aug. 10, the national test positivity rate was 15.6%. During that time, five states in the South-Central U.S. saw the highest test positivity, 21%. These states collectively make up the CDC’s Region 6:
Arkansas
Louisiana
New Mexico
Oklahoma
Texas
“States in Region 9—Arizona, California, Hawaii, and Nevada—had the next-highest four-week positivity rate, 18.8%. Ten other states across two Midwestern regions were also above the national average. No state—as well as the District of Columbia, Puerto Rico, and the Virgin Islands—had a positivity rate below 10%.”
“The Centers for Disease Control and Prevention is warning clinicians to be on the lookout for a viral disease that is spread by small flies and some types of mosquitoes and that causes sudden fever, severe headaches and chills.
“Cases of Oropouche virus disease have been climbing in South America and the Caribbean in the past two years and turned deadly for the first time this year.
“Though appendectomies have been the gold standard of care since before the turn of the 20th century, doctors have been treating appendicitis with antibiotics since the 1950s, as soon as they became available — a “dark secret” in the surgery world, says David R. Flum, professor of surgery and director of the Surgical Outcomes Research Center at the University of Washington. A 1959 paper detailed the use of antibiotics to treat nearly 500 people (a mix of adults and children) with appendicitis. They were — and still are — often used in people whose appendicitis is so advanced that surgery risks spreading the infection further. The military relied on antibiotics for service members who got appendicitis while in inaccessible locations, like submarines.
“But the treatment didn’t get wider attention until the late 1990s and early 2000s, Flum says, when researchers began to collect data on how often antibiotics don’t work and found that failure was not as common as they thought.
“Then came two large, randomized trials in adults. In the first, published in 2015, 257 adults received an antibiotic treatment. Seventy of those patients, or 27 percent, had to have an appendectomy within one year. But the rest were fine.
“A second, larger study of 1,552 adults had similar results: Twenty-nine percent of the 776 people who received antibiotics underwent surgery within 90 days; 4 percent of people in the antibiotics group had serious adverse events, compared with 3 percent in the appendectomy group. The New England Journal of Medicine published the results in 2020. The same year, the American College of Surgeons added nonoperative management as an option in its guidelines for treating appendicitis.
“It wasn’t a slam dunk, but the studies showed that antibiotics could be a good choice.”
The New York Times discusses “The Painkiller Used for Just About Anything. In huge numbers, older people are taking gabapentin for a variety of conditions, including itching, alcohol dependence and sciatica.”
“It’s crazy how many [off label] indications it’s used for,” said Dr. Michael Steinman, a geriatrician at the University of California, San Francisco, and a co-director of the U.S. Deprescribing Research Network. “It’s become a we-don’t-know-what-else-to-do drug.”
“What has fueled this multipurpose popularity? “The history of gabapentin is really a history of uses getting ahead of the evidence,” said Dr. Joseph Ross, an internist and health policy researcher at Yale School of Medicine.” * * *
Dr. Steinman called it a “sticky” drug. He was an author of a 2022 study on older adults who were prescribed gabapentin after surgery, most commonly hip and knee replacements. One in five refilled the prescription more than three months later, when “presumably their surgical pain has long since resolved,” he said.
As older patients seek to find relief from chronic pain, “we don’t have a lot of great options,” Dr. Steinman said of health care providers. Prescribers try to avoid opioids, and nonsteroidal anti-inflammatories like ibuprofen are recommended only for short-term use.
Some find relief from medical cannabis, topical medications like creams and patches, and non-pharmacological approaches such as acupuncture, therapeutic massage and exercise.
“Often the single best thing I can do for patients with pain is to get them to physical therapy,” Dr. Steinman added.
“Orlando Health has offered to buy Steward Health Care’s three “Space Coast” Florida properties, including three hospitals and a medical practice, for $439 million, according to a court document filed Wednesday.
“Bankrupt Steward Health Care and Orlando Health have entered into a binding asset purchase agreement to sell Rockledge Regional Medical Center, Melbourne Regional Medical Center, Sebastian River Medical Center. The proposed deal also includes Steward Medical Group Practices in East Central Florida.
“According to the court document, filed in U.S. bankruptcy court in the southern district of Texas, Steward designated Orlando Health a “stalking horse bidder,” which is the first to negotiate a purchase agreement with a debtor in bankruptcy. The bidder sets a minimum price and protects the debtor from low bids.
“The purchase agreement for Steward’s northern Florida assets is for $439.42 million in cash, according to the court document.
“Orlando Health’s bid will be subject to higher or better-qualified bids received by August 26, at which time a bankruptcy court-approved auction may occur, according to a press release from Steward Health Care.”
“Steward Health Care System was in such dire straits before its bankruptcy that its hospital administrators scrounged each week to find cash and supplies to keep their facilities running.
“While it was losing hundreds of millions of dollars a year, Steward paid at least $250 million to its chief executive officer, Dr. Ralph de la Torre, and to his other companies during the four years he was the hospital chain’s majority owner.
“Steward filed for bankruptcy in May, becoming one of the biggest hospital failures in decades.” * * *
“The Senate Committee on Health, Education, Labor and Pensions in a bipartisan vote authorized an investigation and subpoenaed de la Torre to testify at a Sept. 12 hearing.”
“The battle to empower the federal government to negotiate lower prices for Medicare enrollees was years in the making. The war has just begun.
“After years of opposition from the pharmaceutical industry and lawsuits seeking to halt the law that led to the new prices, resistance paled and legal efforts failed. The talks settled into a sometimes testy back and forth: hundreds of pages of paperwork, offers and rejected counteroffers, then rounds of meetings in windowless rooms with strict rules on how many people could attend.
During the meetings, many manufacturers lowered counter offers while federal officials moved up from their initial offers, said Meena Seshamani, director of the Center for Medicare and a deputy administrator of Medicare’s parent agency, the Centers for Medicare and Medicaid Services.” * * *
“Round two is just around the corner.
“Companies and officials are already preparing for negotiations over more drugs that could take a bigger bite out of high drug costs, and possibly their bottom lines. Next up are prices of 15 more drugs the government will identify by Feb 1.
“The two sides are also fighting over how the talks should work. Among the drug industry’s demands: clarity on how CMS determines the price of a drug. Drug companies are also fighting the agency’s potential changes for next year, including possibly cutting back the number of in-person meetings to fewer than three.”
“Proactively implementing this rule would save lives by ensuring that your workforce is protected with the most up-to-date heat safety standards,” the lawmakers wrote in a letter to Postmaster General Louis DeJoy.
“The proposed rule, if finalized, would be the nation’s first-ever federal heat rule.”
“Federal employees on official travel will soon enjoy another bump in reimbursable travel costs, as the General Services Administration has increased per diem rates for lodging and meals.
“Starting Oct. 1, the reimbursable daily limit will rise to $178, from $166 last year. This increase marks the third consecutive year feds saw lodging rates go up, while rates for meals and incidental expenses (M&IE) last went up in 2022.
“The standard per diem lodging rate within the continental United States (CONUS) went up from $107 to $110, while the rates for M&IE increased from a range of $59 to $79, to a range of $68 to $92.
‘Agencies [and experience rated FEHB contractors] use per diem rates to reimburse employees for lodging and M&IE during official travel. Even with inflation growth in the U.S. now losing steam, the continued increase in per diem rates reflect the persistent rise in overall costs that Americans face across the board.”
From the public health and medical research front,
The Centers for Disease Control and Prevention tells us,
Seasonal influenza and RSV activity are low nationally, but COVID-19 activity is elevated in most areas.
COVID-19
“Many areas of the country are continuing to experience increases in COVID-19 activity, though other areas are experiencing declines in COVID-19 activity following increases this summer. COVID-19 test positivity, emergency department visits, and rates of COVID-19–associated hospitalizations remain elevated, particularly among adults 65+ and children under 2 years. Surges like this are known to occur throughout the year, including during the summer months. There are many effective tools to prevent spreading COVID-19 or becoming seriously ill.”
“National vaccination coverage for COVID-19, influenza, and RSV vaccines remained low for children and adults for the 2023-24 respiratory illness season. RSV vaccines continue to be available, and updated influenza and COVID-19 vaccines that can provide protection during the 2024–25 respiratory illness season will be widely available in September 2024.”
“Nationally, wastewater detections of SARS-CoV-2 are at the very high level for the second straight week. The highest levels are still in the West and South, followed by the Midwest and the Northeast. The CDC’s latest update, however, shows downward trends from high levels in the South and Midwest.”
“Federal authorities are preparing to approve updated coronavirus vaccines targeting the latest virus variants late next week, a move that could make shots available before Labor Day, according to a federal health official and a person familiar with the plans who spoke on the condition of anonymity to discuss a confidential process.
“The mRNA shots manufactured by Pfizer-BioNTech and Moderna designed to target the KP.2 variant can hit the market within days of approval by the Food and Drug Administration. A third protein-based vaccine made by Novavax, preferred by people who are cautious about mRNA vaccines or who have had bad reactions to them, will probably take longer to be approved and will be distributed in subsequent weeks, according to the federal health official.
“Consumers should be able to start getting shots at pharmacies within a week after approval and at doctor’s offices soon after.”
“The Food and Drug Administration on Friday authorized the first at-home [, over the counter,] syphilis test amid surging cases of the bacterial infection and calls from federal health officials for innovative strategies to detect the disease.
“The manufacturer, NowDiagnostics, anticipates the 15-minute test called First to Know, being available in pharmacies, major retail stores and online as early as September. FDA staff hailed the new product as an advancement in testing for sexually transmitted illnesses but noted that an additional test by a health-care provider is needed to confirm a positive result.
“Syphilis was nearly eliminated in the 1990s, but rates have since soared to a 70-year high. Between 2018 and 2022, cases rose nearly 80 percent, according to the most recent data from the Centers for Disease Control and Prevention.
“Pfizer and BioNTech on Friday said a combination flu and COVID-19 shot they’ve been developing met one of its main goals in a Phase 3 trial but missed another, leaving the vaccine’s future in doubt.
‘The study tested Pfizer and BioNTech’s vaccine against separately administered, marketed COVID and flu shots in more than 8,000 people between the ages of 18 and 64. While the combination vaccine spurred a comparable immune response against COVID and influenza A, it didn’t meet that mark against the “B” strain of the flu.
“As a result, two companies are “evaluating adjustments” that would improve the vaccine’s performance against influenza B while discussing next steps with health authorities.”
“The National Institutes of Health said Thursday that an antiviral often used to treat mpox did not resolve patients’ symptoms faster than placebo in a randomized trial.
“The results are notable because the drug, tecovirimat, has rarely been studied clinically for mpox, despite its wide use during the 2022 and 2023 outbreaks in the U.S. and Europe.”
The American Medical Association shares “Top health tips sleep medicine physicians want you to know.”
“Among a select group of women with uterine factor infertility, uterus transplant was feasible and associated with a high live birth rate after successful graft survival, data from a case series show.
“In an analysis of the Dallas Uterus Transplant Study (DUETS), researchers also found that although adverse events were common, including complications requiring surgical intervention, infants born to women who received a uterine transplant had no congenital abnormalities or developmental delays, though follow-up of the cohort is ongoing.
“We show that uterus transplantation is not only feasible and safe, but also associated with a success rate that is comparable with and even favorable to other infertility treatments,” Liza Johannesson, MD, PhD, of the Annette C. and Harold C. Simmons Transplant Institute at Baylor University Medical Center, told Healio.“[What is] important is that the children born after uterus transplant are healthy and developing normally.”
Medscape offers an interview with a Harvard medical professor about preventing dementia.
“Hello. This is Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women’s Hospital. I’d like to talk with you about a new report on the preventability of dementia that is both exciting and paradigm-shifting. The new study, published in TheLancet by the Lancet Commission on Dementia, estimates that close to 50% of cases of dementia worldwide can be prevented or delayed by improving 14 modifiable risk factors.”
From the U.S. healthcare business front,
MedCity News discusses the future of retail healthcare.
“Older Americans are having little success getting prescriptions for weight-loss drug Wegovy covered by Medicare despite the federal healthcare program’s decision to pay for patients with obesity at risk of heart disease, according to their doctors.
“In interviews with Reuters, seven obesity and heart disease specialists from various parts of the United States said their prescriptions for the Novo Nordisk (NOVOb.CO), opens new tab drug have been denied repeatedly by the healthcare companies that administer Medicare drug benefits, with some prescriptions approved only following an appeal for each application.”
“Massachusetts’ governor has announced that deals in principle have been reached for Steward Health Care’s four remaining hospitals in Massachusetts.
“Should the deals be finalized, Lawrence General Hospital will operate both campuses of Holy Family in Haverhill and Methuen. Lifespan would take over operations of Morton Hospital and Saint Anne’s Hospital. Boston Medical Center will take over operations of Good Samaritan Medical Center.
“Boston Medical Center also intends to operate Saint Elizabeth’s down the line. The state is first taking control of the hospital through eminent domain, according to an announcement from the governor’s office.”
The American Hospital Association News informs us,
“The Centers for Medicare & Medicaid Aug. 15 announced it negotiated lower prices with drug makers for 10 high-cost, sole-source drugs, with the new prices becoming effective in 2026 for individuals with Medicare Part D coverage. The drugs treat conditions such as heart disease, diabetes and cancer, and about nine million Medicare beneficiaries use at least one of the 10 drugs selected for negotiation. The new prices are estimated to save $1.5 billion in out-of-pocket costs for individuals with coverage. A CMS fact sheet includes more information about the newly negotiated prices. The agency last year announced the first list of 10 Medicare Part D drugs subject to price negotiations.”
“The White House is touting just how much its new Medicare negotiation process cut drug prices. The problem is the numbers it’s using don’t actually mean much.”
“In a striking side-by-side comparison, President Biden tweeted out a graphic showing newly negotiated prices that Medicare will pay for 10 drugs including blood thinners, cancer treatments, and diabetes medications, among others. The table compares the new prices to the list price of the medicines last year, showing discounts ranging from hundreds to thousands of dollars.
“However, Medicare generally doesn’t pay list prices for medications. Currently, prescription drug plans negotiate discounts off of the list prices at a smaller scale than the new program — but those prices are secret, even in a public program.
“The White House did release more meaningful overall numbers tied to the amount Medicare actually pays for drugs that show discounts of roughly 22% on the 10 drugs collectively, compared to what the program paid last year. That’s more modest than the exaggerated discounts based on list prices that show price reductions of up to 79%.”
In any case, why didn’t Congress align the effective dates for the enormous consumer improvements in Part D, discussed yesterday, with the “negotiated prices”?
“The Biden administration on Wednesday announced a new initiative aimed at improving the hiring process for federal job applicants, hiring managers and other agency HR officials alike, as the White House continues to search for ways to speed up the process and better compete for top talent.
“Strategic human capital management has been on the Government Accountability Office’s famed High-Risk List, a biennial report highlighting issues that present potential liabilities of at least $1 billion for the federal government, for more than two decades. In 2021, GAO found that the government had actually regressed in its effort to address difficulties in hiring new federal workers during the final two years of the Trump administration.
“The Office of Personnel Management and Office of Management and Budget worked jointly on the effort, announced Wednesday in a memo to agency heads entitled “Improving the Federal Hiring Experience.” The document encompasses plans to improve strategic workforce planning, making it easier for potential job applicants to find jobs they are interested in and making the hiring process both faster and more transparent for jobseekers, as well as making hiring less agonizing for the hiring managers and other human resources personnel.”
“Today, the U.S. Food and Drug Administration marked a milestone building on Phase I of its voluntary sodium reduction targets and issued draft guidance for Phase II in a data-driven, stepwise approach to help sodium reduction across the food supply. Prior to 2021, consumer intake was approximately 3,400 milligrams per day on average, far higher than the limit recommended by the Dietary Guidelines for Americans of 2,300 milligrams per day for those 14 years and older. If finalized, the new set of voluntary targets would support reducing average individual sodium intake to about 2,750 milligrams per day. This reduction is approximately 20% lower than consumer intake levels prior to 2021.
FedWeek explains the uncommon exceptions to the FEHB Program’s five-year rule which governs whether a federal employee can continue FEHB coverage into a civil service retirement with the full government contribution.
From the public health and medical research front,
“Americans, and especially those under age 35, are changing their tune on alcohol use, with a growing share endorsing the view that moderate drinking is bad for health — and a new study backs them up.
“According to a Gallup poll released Tuesday, almost half of Americans, 45%, say that having one or two alcoholic drinks a day is bad for a person’s health. That’s the highest percentage yet recorded by the survey, which has been conducted 10 times since 2001.”
The National Institutes of Health (NIH) Director, writing in her blog, discusses “Mapping Psilocybin’s Brain Effects to Explore Potential for Treating Mental Health Disorders.”
“Psilocybin is a natural ingredient found in “magic mushrooms.” A single dose of this psychedelic can distort a person’s perception of time and space, as well as their sense of self, for hours. It can also trigger strong emotions, ranging from euphoria to fear. While psilocybin comes with health risks and isn’t recommended for recreational use, there’s growing evidence that—under the right conditions—its effects on the brain might be harnessed in the future to help treat substance use disorders or mental illnesses.
“To explore this potential, it will be important to understand how psilocybin exerts its effects on the human brain. Now, a study in Nature supported in part by NIH has taken a step in this direction, using functional brain mapping in healthy adults before, during, and after taking psilocybin to visualize its impact. While earlier studies in animals suggested that psilocybin makes key brain areas more adaptable or “plastic,” this new research aims to clarify changes in the function of larger brain networks and their connection to the experiences people have with this psychedelic drug.”
“The National Institutes of Health (NIH) has launched a program that will support Native American communities to lead public health research to address overdose, substance use, and pain, including related factors such as mental health and wellness. Despite the inherent strengths in Tribal communities, and driven in part by social determinants of health, Native American communities face unique health disparities related to the opioid crisis. For instance, in recent years, overdose death rates have been highest among American Indian and Alaska Native people. Research prioritized by Native communities is essential for enhancing effective, culturally grounded public health interventions and promoting positive health outcomes.”
The New York Times reports that “In an experiment that surpassed expectations, implants in an ALS patient’s brain were able to recognize words he tried to speak, and A.I. helped produce sounds that came close to matching his true voice.” Truly amazing.
“Employer-sponsored health plan costs are expected to rise 9% in 2025, totaling more than $16,000 per employee before cost-saving measures, according to professional services and consulting company Aon.
“Aon predicts that demand for prescription drugs such as glucagon-like peptide-1 agonists and growth in medical claims for high-cost treatments such as gene and cell therapies are among the main drivers of rising costs for employers.
Janet Faircloth, senior vice president of innovation and integrated solutions for Aon, said employers are expected to apply cost-saving strategies used in previous years, including raising out-of-pocket costs for employees and bidding between insurers for the best price.
For 2024, Aon predicted health plan costs would increase by 8.5%, but the firm projects employer cost-saving efforts are likely to hold the increase to 6.4% overall.
“We generally see a 1% to 2% reduction from the initial trend expectation after employers make their changes,” Faircloth said.
The International Foundation of Employee Benefit Plans released a similar report Thursday, estimating employer-sponsored health plan costs would rise 8% in 2025 due to the same factors Aon cited.
“Health insurers have invested heavily in building out their Medicare and Medicaid businesses in recent years, tempted by the prospect of healthy margins and growing membership in the government-run insurance programs.
“But privately run Medicare Advantage and safety-net Medicaid plans are seeing their profitability shrink amid ongoing operational pressures, creating a sharp reversal in expected fortunes — much to health insurance executives’ chagrin.
“For much of the past year, insurers bemoaned the headwinds in MA as seniors using more medical care caused spending to snowball. But in the second quarter, many payers suggested Medicaid has become a bigger problem, as states remove ineligible beneficiaries from the safety-net coverage, sickening insurers’ risk pools and saddling them with higher costs.”
Beckers Payer Issues illustrates the fact that “The CEOs of the six largest for-profit insurers have different perspectives on Medicare Advantage.”
“Technological medical advancements have shifted an array of procedures previously rendered in inpatient hospitals to ambulatory surgical centers (ASCs). For example, same-day procedures (e.g., cataracts surgery) that do not require an overnight hospital stay and musculoskeletal procedures, such as arthroscopy, are commonly performed at ASCs.
“Because they operate independently of brick-and-mortar hospital facilities, ASCs are considered “off site.” Compared to procedures rendered in hospital outpatient departments, ASC’s receive lower reimbursement. For low-risk procedures, ASCs may be a cost-efficient site of care. Recent market analysis found that procedures at ASCs have grown over time and now account for half of all outpatient surgeries.
“In this brief, we compare employer-sponsored insurance (ESI) ASC reimbursement amounts for a subset of procedures to Medicare fee-for-service (FFS) payment for the same procedures. We find that, on average, ESI pays two times more than Medicare FFS for procedures provided at ASCs. If ESI reimbursed at Medicare average rates, spending would have been nearly $9 billion lower in 2021.”
“Cleveland Clinic saw an operating income of $45.3 million at a 1.2% margin in the second quarter of 2024 for the three months ended June 30, a 312% increase from a $21.4 million operating loss (-0.6% margin) during the second quarter of 2023, according to its Aug. 16 financial report.
“Total revenue for the system was $3.9 billion in the second quarter of 2024, up from $3.6 billion during the same period last year.
“Net income for the health system was $187.8 million for the three months ended June 30, 2024, up from $145.2 million during the second quarter of 2023.
“Expenses increased 8% to $3.7 billion, with salaries, wages and benefits also increasing 8% to $2.3 billion. Cleveland Clinics outstanding and long term debt was $5.4 billion, the report said.”
“Neuronetics said Monday it has agreed to merge with Greenbrook TMS to acquire treatment centers that use its mental health devices.
“Greenbrook provides transcranial magnetic stimulation (TMS) and other mood treatments from 130 sites. Neuronetics sells a TMS device to treat major depressive disorder (MDD).
“William Blair analysts said in a note to investors that the merger changes Neuronetics’ profile “from device-centric to a device-service business operating brick-and-mortar facilities.”
Per Reuters,
“Eli Lilly (LLY.N) has sent cease-and-desist letters to U.S. healthcare providers in recent days to stop the promotion of the compounded versions of its drugs for weight loss and diabetes, as their supply increases, the company said on Wednesday.
“The letters were sent to telehealth companies, wellness centers and medical spas selling compounded versions of the drugmaker’s popular treatments Zepbound and Mounjaro, a spokesperson told Reuters.”
Kevin Moss, writing in Govexec, explains the pros and cons of Medicare Part D coverage for FEHB annuitants over age 65. The key point is that for 2025 the Medicare Part D out of pocket maximum is $2000. Also, Part D members with higher Part D cost sharing can spread out the Part D cost sharing over the plan / calendar year using Medicare Part D’s new Medicare Prescription Payment Plan (MPPP). The MPPP savings coupled with the $2000 out of pocket max could make Part D valuable for folks who otherwise would use manufacturer coupons.
Although not discussed in the Govexec article, Postal Service Health Benefit (PSHB) annuitants over age 65 generally will be required to use the PSHB plan’s Part D EGWP. Those who opt out are ineligible for the PSHB plan’s regular Rx benefits, and there’s no concomitant premium reduction. We are waiting for OPM’s final supplemental PSHB rule which will include the Part D opt out penalty details.
Politico discusses a Biden Harris administration initiative to subsidize standalone Part D plans with a a $15 per Part D member payment to stabilize Part D premiums in consideration of these significant Part D improvements. The article observes,
“The Part D market has two types of plans. One is a standalone plan that only offers drug coverage, and the other is coverage included in a privately run Medicare Advantage plan that covers other health services.
“Medicare Advantage plans can absorb higher costs better than a standalone option, according to a 2023 analysis from the consulting firm Avalere Health.
“Since a Medicare Advantage plan offers a wide array of both medical and drug benefits, it can spread out the cost impact. Standalone plans do not have such flexibility, and the law is causing some to exit the market.”
It’s worth noting that Part D EGWPs absorb the basic Part D premium typically charged to the Medicare beneficiary. Part D EGWPs do not absorb the extra IRMAA tax on high income Medicare beneficiaries.
Last week, the Centers for Medicare and Medicaid Services released 2025 enrollment and disenrollment guidance for Medicare Advantage and Part D plans.
“Among the 167 million people with employer-sponsored insurance in 2022, 3.4 million used at least one of the first 10 drugs identified for Medicare price negotiations, according to a new KFF analysis. Medicare is expected to release the negotiated drug prices, which will go into effect in 2026, by no later than September 1, 2024.
“The most used drug for people with employer-sponsored health insurance was Jardiance, a drug used to treat diabetes and heart failure, which was taken by more than 911,000 enrollees.
In the future, the Medicare program will negotiate prices for additional drugs, which millions more people with employer coverage could also be taking. As the policy currently stands, lowering drug prices in Medicare has no direct effect on private insurance plans, and the indirect effects are still unclear. Some argue lower negotiated prices in Medicare will result in higher prices in private insurance plans, while others suggest Medicare prices could serve as a benchmark and lead to savings.
“The full analysis and other data on health costs are available on the Peterson-KFF Health System Tracker, an online information hub dedicated to monitoring and assessing the performance of the U.S. health system.”
“This week, the Africa Centres for Disease Control and Prevention (Africa CDC) declared the mpox clade I outbreak a Public Health Emergency of Continental Security, and the World Health Organization (WHO) declared this outbreak a Public Health Emergency of International Concern. The United States government supports those declarations. The United States will continue to work closely with African governments, Africa CDC and WHO to ensure an effective response to the current outbreak and to protect the health and lives of people of the region.” * * *
“The risk to the general public in the United States from clade I mpox circulating in the DRC is very low, and there are no known cases in the United States at this time. Due to efforts over the last nine months, the United States is well prepared to rapidly detect, contain, and manage clade I cases should they be identified domestically. The United States has a robust surveillance system in place, including through clinical testing and wastewater analysis. We continue to encourage those at high risk to get vaccinated with the JYNNEOS mpox vaccine, which has been demonstrated to be safe and highly effective at preventing severe disease from mpox. Those who have already had clade II mpox or are fully vaccinated against mpox are expected to be protected against severe illness from clade I mpox.
“CDC has issued an updated Health Alert Network advisory urging clinicians to consider clade I mpox in people who have been in DRC or neighboring countries in the previous 21 days; clinicians are also asked to submit specimens for clade-specific testing for these patients if they have symptoms consistent with mpox. Given the geographic spread of clade I mpox, the U.S. CDC issued an updated Travel Health Notice on Aug. 7, 2024, recommending travelers to DRC and neighboring countries practice enhanced precautions.”
“The federal interagency National Integrated Heat Health Information System (NIHHIS) today released a National Heat Strategy for 2024-2030. The strategy aims to promote proactive coordination related to heat planning, response, and resilience. * * *
“For more information on the National Heat Strategy, please click here – PDF. To learn more about HHS’ climate change-related efforts, please visit HHS’ Office of Climate Change and Health Equity. To find more information about the federal government’s heat-related initiatives and resources, please visit heat.gov.”
“The Food and Drug Administration on Wednesday approved a new treatment for primary biliary cholangitis, an autoimmune liver disease mainly affecting women that causes decreased liver function, debilitating itching, and fatigue.
“The drug, called Livdelzi, will be sold by Gilead Sciences, following the $4.3 billion acquisition of CymaBay Therapeutics, its developer, earlier this year.
“Regulators cleared Livdelzi for patients with primary biliary cholangitis, or PBC, that doesn’t respond adequately to initial treatment with a commonly used medicine. Gilead estimates there are approximately 130,000 people in the U.S. who are impacted by PBC, of which about 30,000 to 40,000 don’t respond to first-line therapy.
“Competition will come primarily from two drugs: Ipsen’s Iqirvo, which won FDA approval in June; and an older medicine called Ocaliva, developed by Intercept Pharma and recently acquired by Alfasigma, an Italian pharmaceutical firm.
“There’s still a real need out there for patients with PBC today, despite all the new arrivals. We believe Livdelzi can make a real difference for these people,” said Gilead Chief Commercial Officer Johanna Mercier.”
From the public health and medical research front,
The American Hospital Association News lets us know,
“The Centers for Disease Control and Prevention Aug. 13 issued an advisory alerting of an uptick of cases of parvovirus B19 across the U.S. Parvovirus B19 is a seasonal respiratory virus spread by respiratory droplets through symptomatic or asymptomatic individuals. Many people are asymptomatic, but immunocompetent children and adults with symptomatic disease typically develop a biphasic illness, CDC said. The first phase lasts approximately five days and includes symptoms of fever, myalgia and malaise, which develop about a week after infection. During the second phase, children often develop a facial rash which may be followed by reticulated body rash or joint pain one to four days later. For immunocompetent adults, the most common symptoms of parvovirus B19 disease typically occur during the second phase and include a reticular rash on the trunk and joint pain. Parvovirus B19 infection could also lead to adverse health outcomes among people without pre-existing immunity who are pregnant, immunocompromised or have chronic hemolytic disorders.”
Here is a link to the National Cancer Institute’s latest cancer information highlights.
“Two National Institutes of Health (NIH)-supported trials of an experimental malaria vaccine in healthy Malian adults found that all three tested regimens were safe. One of the trials enrolled 300 healthy women ages 18 to 38 years who anticipated becoming pregnant soon after immunization. That trial began with drug treatment to remove malaria parasites, followed by three injections spaced over a month of either saline placebo or the investigational vaccine at one of two dosages. Both dosages of the vaccine candidate conferred a significant degree of protection from parasite infection and clinical malaria that was sustained over a span of two years without the need for a booster dose—a first for any malaria vaccine. In an exploratory analysis of women who conceived during the study, the vaccine significantly protected them from malaria in pregnancy. If confirmed through additional clinical trials, the approach modeled in this study could open improved ways to prevent malaria in pregnancy.
“Spread by Anopheles mosquitoes, malaria parasites, including those of the species Plasmodium falciparum (Pf), can cause illness in people of any age. However, pregnant women, infants and very young children are especially vulnerable to life-threatening disease. Malarial parasitemia in pregnancy is estimated to cause up to 50,000 maternal deaths and 200,000 stillbirths in Africa each year.
“National Institutes of Health (NIH) researchers discover that while artificial intelligence (AI) tools can make accurate diagnoses from textbook-like descriptions of genetic diseases, the tools are significantly less accurate when analyzing summaries written by patients about their own health. These findings, reported in the American Journal of Human Genetics, demonstrate the need to improve these AI tools before they can be applied in health care settings to help make diagnoses and answer patient question.” * * *
“For these models to be clinically useful in the future, we need more data, and those data need to reflect the diversity of patients,” said Dr. Ben Solomon [,the study’s senior author]. “Not only do we need to represent all known medical conditions, but also variation in age, race, gender, cultural background and so on, so that the data capture the diversity of patient experiences. Then these models can learn how different people may talk about their conditions.”
“Beyond demonstrating areas of improvement, this study highlights the current limitations of large language models and the continued need for human oversight when AI is applied in health care.
“These technologies are already rolling out in clinical settings,” Dr. Solomon added. “The biggest questions are no longer about whether clinicians will use AI, but where and how clinicians should use AI, and where should we not use AI to take the best possible care of our patients.”
For many, middle age is associated with midlife crises and internal tumult. According to new research, it is also when the human body undergoes two dramatic bouts of rapid physical transformation on a molecular level.
In a new study, scientists at Stanford University tracked age-related changes in over 135,000 types of molecules and microbes, sampled from over 100 adults. They discovered that shifts in their abundance — either increasing or decreasing in number — did not occur graduallyover time, but clustered around two ages.
“Obviously you change throughout your entire life. But there are two major periods when there are lots of changes: One is when people hit their mid-40s, and one is they hit their 60s,” said Michael Snyder, a geneticist at Stanford University who co-wrote the study, in a phone interview. On average, the changes clustered around the ages of 44 and 60.” * * *
“The exact reason these molecular changes cluster at the mid-40s and 60s is unclear. But the study’s authors say their findings show that from your 40s, people stand to gain particular benefits from taking care of their health. This includes getting regular medical check ups — at least twice a year once you hit your 40s, Shen suggested — as well as making lifestyle adjustments.”
“The U.S. Department of Agriculture said on Tuesday it will expand bird-flu testing of beef entering the food supply as part of its response to the ongoing outbreak among dairy cattle, adding that U.S. beef and dairy products remain safe to consume.
‘USDA officials, in a call with reporters along with staff from other U.S. health agencies, said the tests will begin in mid-September and urged livestock workers to remain vigilant.”
“Elevance and its private equity partner have officially introduced their care delivery platform, called Mosaic Health, after teasing the joint venture earlier this spring.
“Mosaic is comprised of two of Clayton, Dubilier and Rice’s primary care portfolio companies — Apree Health and Millennium Physician Group — along with the care delivery and enablement assets of Elevance’s health services division Carelon.
“However, Mosaic is launching without Carelon’s advanced primary care platform, according to the announcement on Wednesday. Carelon’s assets will join Mosaic subject to ongoing regulatory approvals. An Elevance spokesperson did not respond to a request for comment on the timeline of approvals.”
“Otsuka’s digital health subsidiary has launched its first product, an app-based treatment for major depressive disorder.
“The app, called Rejoyn, is available only by prescription and is intended to be used in addition to medications. It consists of a six-week program with cognitive behavioral therapy-based video lessons and exercises for identifying emotions. Otsuka announced the launch on Tuesday.
“Sanket Shah, president of the Japanese pharmaceutical company’s new Otsuka Precision Health subsidiary, said the treatment was priced at $50 on a cash-pay basis, with the goal of making it accessible. “This is, to be honest, not going to make money,” Shah said in an interview. “We have to put the investment into this to build this out because we do believe in the [digital therapeutics] model and digital solutions and using technology to really help patients.”
“Startup Abridge has notched its largest partnership to date as Kaiser Permanente is making the company’s AI-powered medical note-taking app available to more than 24,000 doctors across its system.
“The integrated nonprofit is rolling out Abridge’s technology at 40 hospitals and more than 600 medical offices in eight states and Washington, D.C., the organization announced Wednesday. The health system’s clinical staff includes 24,600 physicians and 73,600 nurses.
“Kaiser Permanente’s venture arm also is one of Abridge’s investors. The company, founded in 2018, has raised $212.5 million to date, including a $150 million series C funding round in February.
“The health system has worked with Abridge over the past year to implement the AI-based medical documentation technology. Desiree Gandrup-Dupre, senior vice president of care delivery technology services at Kaiser Permanente, said it was the largest implementation to date of ambient listening technology.
“At Kaiser Permanente, we have a long history of successfully deploying proven technologies on a broad scale, as we continue to provide health care and services when, how, and where our patients need it,” Gandrup-Dupre said in a statement.
“The goal is to help doctors reduce time spent on administrative tasks, allowing them to be more present with patients during medical visits, Kaiser Permanente executives said.”
“The Social Security cost-of-living adjustment for 2025 could shrink in 2025 from this year’s 3.2% increase as inflation cools.
“COLA could be 2.6% in 2025, according to Mary Johnson, an independent Social Security and Medicare analyst and former analyst with the Senior Citizens League. The new forecast compares to her forecast in July that called for a 2.7% increase.
“The 2.6% increase would be the lowest COLA since 2021, but average for the past 20 years, Johnson said.”
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