DCMedical News: Tuesday, December 3, 2019
DCMedical News-DCMN
Washington, D.C.
Tuesday, December 3, 2019
DCMedical News is published every day both the House and the Senate are in session. Subscription information below.
THE BIG STORY IN HEALTH CARE
Congress Returns
The House and the Senate are both in session again, beginning this morning. Impeachment (the Judiciary Committee begins hearings tomorrow) overshadows other activities. Health care initiatives in the House and Senate are likely to focus on drug pricing, and appropriations (still) for FY2020, which began October 1. CQ roundup here.
Legislative calendars for 2020 are beginning to appear, for example from the House Majority Leader (here), demonstrating “District Work” for the entirety of the month of August, and for all but two days from October 1 to November 16.
Value-Based Payment
A major new study (here, editorial here) finds that “US life expectancy has not kept pace with that of other wealthy countries and is now decreasing.”
The study examined life expectancy figures for the period 1959 to 2016. In that period, US life expectancy increased from 69.9 years to 78.9 years. However, the annual life expectancy decreased for three consecutive years after 2014. “Midlife all-cause mortality rates” increased from the period 2010 to 2017, led by drug overdoses, alcohol abuse, suicides, and “a diverse list of organ system disease.”
The most significant increases in mortality rates occurred in New England and in the Ohio Valley. The authors of the accompanying editorial (Koh and colleagues) note that “hypertension, which affects nearly half of US adults and is mostly uncontrolled” is an important contributor to increased mortality.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Centralization and its Impact on Physician Practice
The evidence that centralization (even that which is nominally physician-friendly) has an adverse impact on clinical practice is reported (here) in the November Health Affairs. Kanter and colleagues report that accountable care organizations “may incentivize consolidation of physician groups.” They write that “This is particularly concerning as previous research has shown that consolidation is associated with lower quality and higher prices.” They find a 4-percentage point increase in large practices (those with 50 or more physicians) in counties with the greatest ACO penetration, concentrated in specialty and hospital-owned practices.
Alexa, Create Me a Competitor for EPIC
Modern Healthcare (here) reports that Amazon has entered the medical transcription market, aiming for precision. “Cerner Corp., which entered into a cloud collaboration with Amazon this summer, has already signed on as a customer of the new machine-learning service. Cerner is using Transcribe Medical to develop a digital voice scribe that can ‘listen’ in the background during a patient's visit and transcribe physician-patient conversations into text. Cerner's goal is to create a tool that can then automatically document notes into its electronic health record system.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
“America’s Hospitals are a Racket”
So says the headline in The Economist (here), noting that hospitals “need a dose of transparency – and tougher antitrust action, too.”
Addressing the problem of access, the article says, “Mr. Obama cut a deal with America’s powerful health-care lobbies and built a grand coalition for reform that included hospitals, insurers and Big Pharma…Unfortunately, since that success the second problem - - exorbitant costs - - has spiralled even further out of control.”
Partners No More
Becker’s reports (here) that Partners will “rebrand” to “Mass General Brigham.” The story notes, “At this point it's unclear if the rest of the health system's hospitals will keep their names.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Medicaid Enrollment in September 2019
Medicaid enrollment (here) was 71,389,515 individuals in Medicaid and CHIP in 51 states, 64,738,198 in Medicaid, 6,651,317 in CHIP.
READINGS AND REFERENCES
UK Election Continues to Focus on the National Health
The coming general election in the United Kingdom continues to focus on challenges facing the National Health Service. Prime Minister and Candidate Boris Johnson has promised (here) 50,000 extra (presumably new) nurses, especially through restoration of “bursaries” for trainees. Johnson’s Conservative party, in its election manifesto, also said it would hire 6,000 extra doctors to deliver 50 million extra general practice appointments each year. (This would be 33 visits per doctor per working day for 250 working days, were they all evenly spaced.)
Also (here) the health secretary has approved an emergency package of pension reforms “to given incentives to high-earning doctors to work extra shifts.” A report in the Financial Times indicates that the “highly unusual move reflects growing Tory fears that increasing pressure in hospitals, particularly emergency departments, could tip over into a full-blown crisis days before the poll on December 12. Under the emergency measure, the NHS would cover tax bills incurred by frontline clinical staff in England who have breached their annual pension savings limits.” The report notes that “Hospital consultants across the UK are refusing to take on extra shifts over fears the additional income could trigger six-figure pension tax charges.” Then there is the Labour Party’s accusation that the NHS is for sale, documented in a 451-page “dossier” that appears (here) to be part of a Russian disinformation campaign, from Secondary Infektion, via Reddit.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Members at https://www.senate.gov/general/contact_information/senators_cfm.
Committees and Members at https://www.senate.gov/committees
House and Senate 2019 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
December 4, 5, 6, 9, 10, 11, 12
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.