DCMedical News: Wednesday, February 26, 2020
DCMedical News-DCMN
Washington, D.C.
Wednesday, February 26, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
Coronavirus News
CDC warns of pandemic preparation: CQ reports that “A top Centers for Disease Control and Prevention official warned Tuesday that disruption from the coronavirus in the United States could be ‘severe,’ as health officials prepare for an eventual outbreak.”
Tracking at https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6 by Johns Hopkins shows on 2-25 at 5:00 p.m. EST 80,413 confirmed cases, 2,708 deaths, 27,879 patients recovered. CDC information page: https://www.cdc.gov/coronavirus/2019-nCoV/hcp/index.html
Congress: Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chairwoman Anna G. Eshoo (D-CA) will hold a hearing this afternoon with Health and Human Services (HHS) Secretary Alex Azar on President Trump’s budget request for HHS and its agencies for Fiscal Year (FY) 2021 as well as the ongoing coronavirus outbreak.
The Economy: The Boston Globe reported that “Stocks slumped again on Wall Street Tuesday, piling on losses a day after the market’s biggest drop in two years as fears spread that the growing coronavirus outbreak will put the brakes on the global economy. The Dow Jones Industrial Average fell nearly 900 points, or about 3.15 percent, at market close.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MACStats: The Medicaid and CHIP Data Book
Announcement (here) and text (here) of the annual report on Medicaid and Children’s Health Insurance Program data. Highlights for state policy: “Medicaid and CHIP accounted for 17.2 percent of national health expenditures in calendar year 2017, less than either Medicare at 20.2 percent or private insurance at 33.9 percent. Medicaid’s share of state budgets in 2017 was 28.9 percent when federal and state funds were counted, but accounted for only 19.7 percent of state budgets when only state general revenue was included, and 16.0 percent when the share included state and local funds, such as general revenue, provider taxes, and proceeds from bonds. Disproportionate share hospital (DSH), upper payment limit, and other types of supplemental payments accounted for over half of fee-for-service payments to hospitals in FY 2018.”
Commercial Health Insurers Show Big Gains in 2019
Profits were up by two-thirds in 2019, according to Modern Healthcare (here), where the seven top companies had combined revenue of $913 billion (up 31%) and net income of $35.6 billion. The story notes that interrelationships (especially acquisitions) among the insurers of different business types (pharmacies, pharmacy benefit managers, providers) make it increasingly difficult to categorize the companies as simply health insurers. Happily for the companies, the federal government has now signaled (here, Economic Report to the President, NYTimes coverage here) that anticompetitive activity and resulting monopoly prices are of no more interest than they were during the last administration. This notwithstanding a recent flurry of “vertical” (well head to gas pump) mergers in health care.
Employers Unhappy with Big Financial Gains of Commercial Health Insurers and Providers
Nearly three-quarters of 90 medium- and large-size employers surveyed favor hospital rate regulation (Modern Healthcare story here). They don’t want Medicare-for-All, but they like the idea of a public option with capped provider rates. The report from the “National Alliance of Healthcare Purchaser Coalitions” follows on publication by the Health Care Cost Institute that per capita health spending for the 160 million Americans covered by employer-sponsored plans grew more than 4% for the third consecutive year.
DRUGS AND DEVICES
FDA Launches “Purple Book”:
The Food and Drug Administration has launched a “Purple Book” as lists and a database of FDA-licensed (approved) biological products, including biosimilar and interchangeable products. “This first phase contains information on FDA-licensed biosimilar and interchangeable products, as well as their reference products. Subsequent releases will expand the number of FDA-licensed biological products included in the Purple Book online database until the final release, which will include information about all FDA-licensed biological products.” The product will eventually resemble the Orange Book, https://www.accessdata.fda.gov/scripts/cder/ob/index.cfm, Approved Drug Products with Therapeutic Equivalence Evaluations.
NAM on AI in Drug Development
The National Academy of Medicine and the General Accountability Office together report (here) on the use of artificial intelligence in drug development. In a related but unrelated story, the Financial Times reports (here) that “A drug molecule invented entirely by artificial intelligence is set to enter human clinical trials for the first time, marking a critical milestone for the role of machine learning in medicine. The new compound, which has been designed to treat patients with obsessive compulsive disorder, was developed by Oxford-based AI start-up Exscientia in collaboration with the Japanese pharmaceutical firm Sumitomo Dainippon Pharma. In a sharp acceleration of the typical path to drug development, which can take about four and a half years, the AI-designed compound reached the point of entering clinical trials within just 12 months.” JAMA features an editorial and perspective (here) on AI in health care.
READINGS AND REFERENCES
If You Have Seen One Patient, You’ve Seen One Patient…
“Caring for the Individual Patient, Understanding Heterogeneous Treatment Effects,” a new publication of the National Academy of Medicine (121 pages), here. From the preface, “Trouble is, there aren’t very many average patients out there…”
Research Methods Homework
JAMA Surgery publishes a series of short essays with examples and references on research methods. Today (here) a guide to implementation science (IS). IS is the “study of methods and strategies to promote the adoption and integration of proven clinical treatments, practices, organizational, and/or management interventions into routine practice and hence to improve health.” For example, there is the Translating Evidence Into Practice (known as TRIP, not TEIP) model, the Consolidated Framework for Implementation Research (CFIR). With comments on statistics, and a bibliography.
Warren Buffett’s Annual Letter
The letter (here) has both sober and light moments, a lot about succession, and also about retained earnings, all in preparation for the Berkshire Hathaway annual meeting fest in Omaha May 2. The sage of modern equity investment writes, “Moreover, if I were ever scheduled to appear on Dancing With the Stars, I would immediately seek refuge in the Witness Protection Program. We are all duds at one thing or another. For most of us, the list is long. The important point to recognize is that if you are Bobby Fischer, you must play only chess for money.”
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 27, 28
March 2, 3, 4, 5, 9, 10, 11, 12, 23, 24, 25, 26, 27, 30, 31
April 1, 2, 3, 20, 21, 22, 27, 28, 29, 30
May 12, 13, 14, 15, 18, 19, 20, 21
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.