DCMedical News: Monday, March 2, 2020
DCMedical News-DCMN
Washington, D.C.
Monday, March 2, 2020
DCMedical News is published every day both the House and the Senate are in session.
THE BIG STORY IN HEALTH CARE
Coronavirus News
Tracking by Johns Hopkins shows on 3-1 at 8:00 p.m. EST worldwide 88,375 confirmed cases, 2,996 deaths, 42,769 patients recovered.
Public Health Resource Pages: AMA resource page for physicians here. CDC information page here. NIH information page here. National Library of Medicine Coronavirus page here, New England Journal of Medicine update page here.
Epidemiology and Clinical Treatment
Two infectious disease specialists summarize in JAMA (here) what is known and not known about coronavirus at this time. “Since first reported in Wuhan, China, in late December 2019, the outbreak of the novel coronavirus now known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has spread globally. As of February 27, 2020, more than 82 000 cases of coronavirus disease 2019 (COVID-19) (the disease caused by SARS-CoV-2) and 2800 deaths have been reported, of which approximately 95% of cases and 97% of deaths are in China. Cases have now been reported in 49 other countries . . . The data surrounding the biology, epidemiology, and clinical characteristics of the SARS-CoV-2 virus have been growing daily, with more than 400 articles listed in PubMed . . . This Viewpoint updates previous guidance for clinicians and summarizes what is known, what is unknown, and what are the next steps based on available evidence to address and halt the outbreak.”
Economy
The Financial Times reports (here, preventing the “Doom Loop”) that “Disruptions caused by the coronavirus outbreak that originated in China and is now spreading through the rest of the world are driving the global economy closer to a recession, triggering calls for fiscal and monetary intervention.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Is Private Equity Physician Practice Acquisition the Next “Physician Practice Management Company” Imitation?
Praveen Suthrum analyzes hospital and insurer acquisition of physician practices, and the role of private equity investors in backing the alternative of physician practice consolidation. Suthrum writes (here) in STAT+ that “As these deals continue, it’s important to understand the role of private equity and be aware of the mistakes made by physician practice management (PPM) companies when they tried to consolidate medical practices in the 1990s. PPMs brought in fresh capital and management talent, added new ancillary services, negotiated better contracts, and rushed to demonstrate to the market growth and higher revenues. Unfortunately, they also charged hefty management fees and used confusing accounting practices to make the platforms look more profitable than they were. In the end, physician practice management companies struggled to execute on their business plans and ran out of money.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Becker’s on Hospital Metrics
Becker’s publishes average per diem expenses for public, proprietary and private non-profit hospitals by state, here, and hospital metrics from Moody’s ratings here. Helpful for “order of magnitude” measurement, note sources.
FTC and Pennsylvania Attorney General Sue to Halt Jefferson-Einstein Merger Underway Since 2018
The Federal Trade Commission and Pennsylvania’s AG sued (news release here, complaint here) to halt a hospital system consolidation of Jefferson Health and Einstein Health Network, contending that they would control 60% of the North Philadelphia hospital inpatient market. Axios reports that this is the first time the FTC has opposed a hospital merger since the unsuccessful attempt (here) in 2016 to keep Mountain States and Wellmont from forming Ballad Health under a Certificate of Public Advantage. The FTC has not challenged proposed hospital mergers in court since 2015, when it went after the merger of Cabell Huntington and St. Mary’s hospitals in West Virginia (complaint here), the combination of Penn State Hershey Medical Center and PinnacleHealth (announcement here) and the combination of Advocate and NorthShore (announcement here, complaint here).
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
MedPAC Meets This Thursday and Friday, March 5-6
The agenda for the Congressional advisory group is here, past reports here, home page and index to MedPAC comments on proposed regulations here. Health Capital Topics has an excellent summary of the January 16-17 meeting, here, with 50 footnoted references to source documents. The transcript of the January MedPAC meeting is here. The next MedPAC meeting is April 2-3.
The Over-Under on “Medicare for All” Predicted by Action of House Democrats, Says Forbes Analyst Roy
Avik Roy writes (here) that “House Democrats' Capitulation on Surprise Billing Proves They'll Never Pass 'Medicare for All'.” Roy notes that 27% of hospital admissions result in a surprise bill, averaging $3,500, about 30 times what Medicare would pay for the same hospital service. Roy notes that a Senate HELP Committee bill would have used the median in-network private insurance payment rates as a benchmark against which to assess the reasonableness of surprise bills; those medians are four to seven times higher than Medicare rates for the same services.
Roy writes, “The specialists who engage in surprise billing . . . alongside the private equity firms that back them, got together to try to sink the Senate legislation altogether.” On February 12, the House Ways & Means Committee passed H.R. 5826, the Consumer Protections Against Surprise Medical Bills Act of 2020, which would use an arbitration system favored by health field lobbyists. “Under the House bill, there would [be] no limit on the size of surprise medical bills that health care providers took to arbitration, and no limit on the frequency with which those providers gummed up the works with frivolous arbitration requests,” wrote Roy. “After the Ways & Means Committee voted on their version of the bill, the committee boasted of the support it has received from—you guessed it—the American Hospital Association, the Federation of American Hospitals, and the American College of Emergency Physicians.”
READINGS AND REFERENCES
Research Methods Homework: Understand, and Judge Not . . .
JAMA Surgery publishes a series of short essays with examples and references on research methods. Today (here), a “Practical Guide to Qualitative Analysis.” From the introduction, “The goal of qualitative research is to understand not just how often, but why and how a phenomenon occurs by describing in rich detail procedures, processes, and relationships. Particularly in clinical domains like surgery, even the most advanced quantitative methods and the use of big data will leave us with residual questions about how to identify a specific path forward to address study findings.”
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
March 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.