DCMedical News: Friday, June 24, 2022
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Publication will resume with the edition of July 12, 2022.
THE BIG STORY Friday, June 24, 2022
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Health and Wealth
A Medscape report on physician wealth and debt (here) says that one quarter of orthopedic specialists have a net worth of at least $5 million, and that while orthopedics is among the top five wealthiest specialties, plastic surgery (at 26 percent), dermatology (at 23 percent), urology (at 23 percent) and cardiology (at 23 percent) are other specialties with physicians reporting a net worth of at least $5 million.
July 1 Looms as Medicare Pay Cut Date
A group of medical professional organizations are urging Congress (here) to act before July 1, when the “sequester” (a budget balancing 2% reduction of Medicare payment for health services) resumes. “The Protecting Medicare and American Farmers from Sequester Cuts Act authorized a three-month delay of 2% Medicare sequester payment reductions (January 1, 2022 - March 31, 2022), followed by a three-month, 1% reduction in Medicare sequester payment reductions (April 1, 2022 - June 30, 2022). The resumption of the Medicare sequester before the end of the PHE would unnecessarily hinder our caregiving abilities, especially when the emergence of a new, potentially more dangerous and/or contagious variant continues to loom.” The Medical Group Management Association (here) notes other Medicare payment provisions which, taken together, may amount to a 7% cut in physician pay July 1, under current legislation.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Warnings and Fines Continue for Hospitals Non-Compliant With Transparency Law
InsideCMS reports that “Stakeholders are watching for CMS’ next moves after the first two hospitals were fined for not meeting hospital price transparency requirements, as the agency says more than 350 hospitals have been warned they are not meeting the requirements and only about 170 have since complied and had their cases closed. Northside Hospital Atlanta on June 7 was fined more than $883,000 for failing to make its standard charges public, and Northside Hospital Cherokee was fined more than $214,000 for noncompliance.” Letter to the hospitals from CMS is here; the letter summarizes the legislative history of the transparency law, the requirements for posting of hospital charges and prices, and the manner in which the Atlanta hospitals fell short of those requirements.
The hospital said that its telephonic and e-mail services for patients would give them specific pricing information, and that “Northside’s price estimation process is the best method for providing patients with a good faith estimate of what they should expect to pay out of pocket.” CMS responded that “Such price estimation method does not comply with the regulatory requirements to make hospital charge information public electronically via the internet or internet-based tool.” After it was contacted by the agency, the hospital removed other price information that had been available online.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Universal Health Insurance and Pandemic Mortality
Scientific American (here) reports that “A new study quantifies the severity of the impact of the pandemic on Americans who did not have access to health insurance. According to findings published on Monday in Proceedings of the National Academy of Sciences USA [here], from the pandemic’s beginning until mid-March 2022, universal health care could have saved more than 338,000 lives from COVID-19 alone. The U.S. also could have saved $105.6 billion in health care costs associated with hospitalizations from the disease—on top of the estimated $438 billion that could be saved in a nonpandemic year.”
The report continues, “Prior to the pandemic, 28 million American adults were uninsured, and nine million more lost their insurance as a result of unemployment because of COVID-19 . . . [and] employer-based insurance can be cut off when it is needed most.” The researchers “compared the mortality risks of COVID-19 among people with and without insurance, as well as their risks of all other causes of death. The researchers compiled population characteristics of all uninsured Americans during the pandemic, taking into account things such as age-specific life expectancy and the elevation in mortality associated with a lack of insurance. They calculated that 131,438 people in total could have been saved from dying of COVID in 2020 alone. And more than 200,000 additional deaths from COVID-19 could have been averted since then, bringing the total through March 12, 2022, to more than 338,000.”
A comment from a researcher uninvolved in the study: “The new study likely underestimates the deaths that could have been avoided through universal health care because it does not consider the lower rates of chronic disease that often accompany single-payer systems.”
Most Favored Hospital Prices
A new study in Milbank Quarterly (here) says “20 states have restricted most-favored-nation (MFN) clauses in some health care contracts” and that “Banning MFN clauses between insurers and hospitals in highly concentrated insurer markets seems to improve competition and lead to lower hospital prices.”
“Our results show that bans on MFN clauses reduced hospital price growth in metropolitan statistical areas (MSAs) with highly concentrated insurer markets. Specifically, we found that mean hospital prices in MSAs with highly concentrated insurer markets would have been $472 (2.8%) lower in 2016 had the MSAs been in states that banned MFN clauses in 2010. In 2016, the population in our sample that resided in MSAs with highly concentrated insurer markets was just under 75 million (23% of the US population). Hence, banning MFN clauses in all MSAs in our sample with highly concentrated insurer markets in 2010 would have generated savings on hospital expenditures in the range of $2.4 billion per year.”
Pandemic Policies in (Part of) the English Speaking World
A study in Health Policy (here) compares COVID-19 responses in Canada, Ireland, the UK and US during the first wave of the COVID-19 pandemic. The UK and its former territories “faced a number of challenges in putting in place requirements for an effective pandemic response, including rapidly scaling-up testing capacity, implementing effective and joined-up test, trace and isolate systems, ensuring adequate supplies of PPE and other essential equipment and creating surge capacity.”
“Many of these issues were exacerbated by countries entering the COVID-19 pandemic with shortages of health workers, insufficient hospital capacity and inadequate pandemic stockpiles. All countries introduced innovative solutions to try and overcome these issues such as enhanced use of digital health technologies, and assessing their effectiveness will be important to help countries prepare for future waves.”
“Experiences also reveal that strong and consistent alignment between public health, health system and political leadership and messaging will be key to ensuring public compliance with any future public health measures. Moreover, universal coverage is important to reduce unmet care needs and health inequalities among vulnerable population groups that have placed some groups at higher risk from COVID-19 than others. In the longer-term, investing in health sector physical infrastructure and training and retaining an adequate domestic health workforce will be fundamental to create a resilient health system, both in the countries studied and elsewhere.”
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References may be found here.
Monkeypox resources, CDC (here), JAMA Patient Page (here).
2022 CQ Congressional Calendar here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
July 12, 13, 14, 15, 18, 19, 20, 21, 26, 27, 28, 29
August, Congress adjourned, no editions of DCMN
September 13, 14, 15, 16, 19, 20, 21, 22, 28, 29, 30
Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org