DCMedical News: Wednesday, February 9, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Publication will resume February 28th.
THE BIG STORY Wednesday, February 9, 2022
Government to Stay Open
The Hill reports that "The House on Tuesday passed a stopgap measure to extend federal government funding until March 11 to prevent a shutdown next week while negotiations over a longer-term package remain ongoing. The chamber voted 272-162 to pass the short-term funding bill on Tuesday evening, just one day before the House is set to be out of session until the week of Feb. 28."
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
One Year Out of the COVID ICU
Research in JAMA (here) reports on "What are the 1-year outcomes among patients who survive intensive care unit (ICU) treatment for COVID-19?"
The answer: "Of the 452 eligible patients, 301 (66.8%) patients could be included, and 246 (81.5%) patients completed the 1-year follow-up questionnaires. At 1 year after ICU treatment for COVID-19, physical symptoms were reported by 182 of 245 patients, mental symptoms were reported by 64 of 244 patients, and cognitive symptoms were reported by 39 of 241 patients. The most frequently reported new physical problems were weakened condition, joint stiffness, joint pain, muscle weakness, and myalgia." (Confidence Intervals omitted.)
63 Members of the House Sign On for Support of Increased Physician Fees in 2022
The issue addressed in the letter (here) is "extensive cuts for office-based specialists under the 2022 Physician Fee Schedule . . . These “clinical labor” cuts are the most significant negative impact of the 2022 Physician Fee Schedule by far and are expected to cut reimbursement by more than 20 percent for some specialties."
The group added, "We firmly believe that another round of 20 percent cuts as planned by the 2022 Physician Fee Schedule will cause many of the remaining office-based centers to simply close their centers and complete the migration to large health systems. As a result, Medicare spending and patient copays will increase, and the Medicare Part A Trust Fund will move closer towards insolvency."
In Curtailing Low Value Care, Financial Limits May Be More Powerful Than Education
Redberg and colleagues (here) in JAMA Internal Medicine opine that education of clinicians to avoid low-value care may be useful. For example, "Prior successful strategies to reduce low-value care have used a combination of clinician education with clinical decision support or clinician feedback." However, they write that "Unfortunately, the roles of education, clinical decision support, audits, and feedback are typically modest. We believe that it is time for more robust approaches to limit low-value care, including changes in payment structures and incentives."
One major problem: "The enthusiasm of health systems for reducing low-value care is limited by the lack of regulatory oversight and financial compensation for such efforts. Almost all quality measures currently reward health systems for providing more care, not for limiting low-value care. We believe that organizations, such as the Joint Commission and the US Centers for Medicare & Medicaid Services, should include quality measures that incentivize health systems to reduce low-value care services."
HOSPITALS AND OTHER HEALTH CARE FACILITIES
Five Star Ratings Clash with Hospital Acquired Condition Penalties
Kaiser Network News reports (here) that "The federal government has penalized 764 hospitals — including more than three dozen it simultaneously rates as among the best in the country — for having the highest numbers of patient infections and potentially avoidable complications." The report noted that "The penalties — a 1% reduction in Medicare payments over 12 months — are based on the experiences of Medicare patients discharged from the hospital between July 2018 and the end of 2019, before the pandemic began in earnest. The punishments, which the Affordable Care Act requires be assessed on the worst-performing 25% of general hospitals each year, are intended to make hospitals focus on reducing bedsores, hip fractures, blood clots, and the cohort of infections that before covid-19 were the biggest scourges in hospitals. Those include surgical infections, urinary tract infections from catheters, and antibiotic-resistant germs like MRSA."
The hospitals (complete list here) penalized include Cedars-Sinai Medical Center in Los Angeles; Northwestern Memorial Hospital in Chicago; a Cleveland Clinic hospital in Avon, Ohio; a Mayo Clinic hospital in Red Wing, Minnesota; and a Mayo hospital in Phoenix. Paradoxically, all those hospitals have five stars, the best rating, on Medicare’s Care Compare website."
Kaiser reports that "Eight years into the Hospital-Acquired Condition Reduction Program, 2,046 hospitals have been penalized at least once . . . But researchers have found little evidence that the penalties are getting hospitals to improve their efforts to avert bedsores, falls, infections, and other accidents." A professor of health care management at the University of Michigan told Kaiser "Unfortunately, pretty much in every , the program has been a failure.”
Falling Birth Rates, Economists Check In
Researchers in the Journal of Economic Perspectives (here) report that "Between 1980 and 2007, US birth rates generally fluctuated within a narrow range of roughly 65 to 70 births per 1,000 women between ages 15 and 44. Since then, US birth rates have plummeted, reaching 55.8 per 1,000 women in 2020—about a 20 percent decline over 13 years . . . The decline began at the onset of the Great Recession and continued during the ensuing recovery, with no signs of reversing."
Milbank-sponsored researchers (here) report that "State-level social and economic policies that expand tax credits, increase paid parental leave, raise the minimum wage, and increase tobacco taxes have been demonstrated to reduce adverse perinatal and infant health outcomes."
READINGS & REFERENCES
AMA and Manatt Health Publish Recommendations for State Policies on Drug Overdose
The publication (here) is presented as a "State Toolkit to End the Nation's Drug Overdose Epidemic.”
CMS Publishes FAQs on COVID Coverage Policies
The paper (here), is entitled "FAQS ABOUT FAMILIES FIRST CORONAVIRUS RESPONSE ACT AND CORONAVIRUS AID, RELIEF, AND ECONOMIC SECURITY ACT IMPLEMENTATION PART 52."
OTHER REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 28
March 1, 2, 3, 7, 8, 9, 10, 15, 16, 17, 18, 28, 29, 30, 31
April 1, 4, 5, 6, 7, 26, 27, 28, 29
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org