DCMedical News: Tuesday, April 5, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session.
THE BIG STORY Tuesday, April 5, 2022
Senate Allows $10 Billion for COVID-19 Therapeutics, Vaccines, Research, But Not For Providers
CQ describes the bill (here) passed by the Senate:
"The final deal would give all $10 billion to the Department of Health and Human Services for domestic needs like buying additional therapeutics, testing supplies and vaccines. The bill specifies that half of the funding be used for therapeutics, whether purchasing existing therapies or researching, developing and producing new ones. The measure also would earmark $750 million for research on vaccines for emerging coronavirus variants, including clinical trials, and expanding vaccine manufacturing capacity."
COVID-19 Testing Now Free For Medicare Beneficiaries
InsideHealthPolicy (here) reports that "The administration Monday (April 4) rolled out its program to give Medicare beneficiaries access to eight free COVID-19 tests per month through pharmacies and providers, which the Biden administration says is the first time Medicare has covered a self-administered test."
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
The Mysteries of Technology Diffusion
Robotically assisted surgical devices "diffused" in accord with these factors, according to a study (here) of the English National Health System in Health Policy: "Results show that a higher number of urologists and a wealthier referral area favor robot adoption."
And the Mysteries of Delayed Hospital Discharge
A second study in this month's Health Policy (here) attempts to diagnose and categorize factors associated with delay in the discharge of patients from hospitals in Ontario. "Delayed discharge was a product of spill-over effects (due to rules and eligibility in other health sectors) and variable implementation of policies and guidelines (institutions); competing priorities and tensions among patients, caregivers, providers and organizational leaders (interests); as well as a number of perceived root causes including patient complexity, caregiver burnout, lack of system infrastructure, and an imbalance of system and personal responsibility to support aging adults (ideas) . . . Based on our findings we suggest that cross-sectoral collaboration and strengthening of relationships among stakeholders is required to address this complex policy problem."
HOSPITALS AND OTHER HEALTH CARE FACILITIES
RAND Finds Price Variation, Price Increases in Hospitals, Higher Following Mergers
A RAND study published in Health Affairs (here) finds that commercial health plans pay higher prices than public payers for hospital care and that commercial hospital payment rates changed relative to Medicare rates during 2012–19 with the average commercial-to-Medicare price ratios relatively stable, but varying upward of 38% higher and 38% lower than that average in individual hospital referral regions. Areas where prices went up significantly tended to have more provider consolidation and a higher market concentration.
Nothing to See Here
The American Hospital Association has submitted its comments (here, deadline April 21) in response to a "Request for Information" from the Department of Justice and the Federal Trade Commission in their evaluation of guidelines for evaluating mergers. AHA says the current guidelines need little change, but would be even better if they recognized the quality improvements and cost savings associated with hospital mergers. AHA relies in its letter largely on studies it has paid for, primarily done by Monica Noether and Charles River Associates.
Mandatory Staffing Ratios and Expenditures Implemented for New York State Nursing Homes
Crain's Health Pulse reports that "Gov. Kathy Hochul has lifted her suspension of a new state law that established minimum staffing levels for nursing homes, despite opposition from facility owners who said they still struggle with pandemic-related worker shortages."
"The law requires nursing homes to spend at least 70% of their revenue on direct patient care, including 40% on resident-facing staffing, and provide residents with an average of 3.5 hours of care daily."
James Clyne Jr., President and CEO of LeadingAge New York is quoted by Crain's as saying, "The state's abysmal Medicaid rates for nursing homes do not allow our members to pay wages we need to offer to compete for job applicants." Crain's noted that a study by the New York State Health Facilities Association found that 383 of New York's 611 facilities, or 63%, fell short of the required 3.5 hours of direct care per resident per day, and in fact "an analysis by 1199SEIU of staffing data from the U.S. Centers for Medicare & Medicaid Services found earlier this year that about half of the state's nursing homes met the new staffing ratios required to provide 3.5 hours of care a day."
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicare Advantage Receives 8.5% Bump in Election Year
CQ reports that "The Centers for Medicare and Medicaid Services on Monday finalized an 8.5 percent average increase to Medicare Advantage payments [including calculated risk bonuses] in 2023, up from the 7.98 percent originally proposed," notwithstanding controversial upcoding ("risk assessment") widely believed to increase MA plan reimbursement, as well as unhappiness from physicians who frequently chafe at the limitations imposed by MA plans (compared to "traditional" Medicare), and who received essentially nothing by way of an increase from CMS this year.
"The looming congressional midterms and MA’s increasing popularity might have helped stave off any would-be crackdown in spite of increasing concerns around the program’s higher costs. Around 40 percent of all Medicare beneficiaries are enrolled in MA plans, and nearly 350 lawmakers led an annual letter of support to CMS Administrator Chiquita Brooks-LaSure in January."
DRUGS & DEVICES
Califf: Health Care a Good Business, Not as Good for Patients
Robert Califf, a cardiologist newly confirmed for a second stint as Commissioner of the FDA, addressed the Health Datapalooza gathering, as reported (here) by the Regulatory Affairs Professionals Society. "Califf stressed that while business has been good for much of the healthcare industry in recent years, some outcomes for patients and individuals are not improving . . . He also bemoaned the decline in life expectancy in the US in recent years despite healthcare spending tipping past the $4 trillion mark in 2020. He noted that the losses are more pronounced for some minorities and that life expectancy varies greatly – by as much as 20 years – depending on geographic location."
While urban areas and university towns have life expectancies that rival Scandinavian countries and Japan, Califf said that “Rural areas are experiencing a precipitous decline in life expectancy. In 1990, rural and urban death rates were almost identical. By 2016, there was a 20% higher death rate in rural areas.”
Califf said that part of the issue is the US’s failure to effectively implement its own innovations . . . "We are the innovation engine for the world in terms of technology. But it looks like the rest of the world is figuring out how to use our innovations better than we are.”
READING & REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
April 6, 7, 26, 27, 28, 29
May 10, 11, 12, 13, 16, 17, 18, 19
June 7, 8, 9, 10, 13, 14, 15, 16, 21, 22, 23, 24
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org