DCMedical News: Wednesday, March 25, 2020
DCMedical News-DCMN
Washington, D.C.
Wednesday, March 25, 2020
DCMedical News is published every day both the House and the Senate are in session. Coronavirus resources in orange.
THE BIG STORY IN HEALTH CARE
Tracking by Johns Hopkins shows on 3-24 at 8:00 p.m. EST worldwide 417,966 confirmed cases, 18,615 deaths, 107,705 patients recovered. Beware of fake Johns Hopkins coronavirus map, HHS notice here.
Public Health Resource Pages (alphabetical): AMA resource page for physicians here. CDC information page here. CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here. JAMA Network’s COVID-19 resource center here. Library of Congress Coronavirus Research Guide, (here) from the Custodia Legis Blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports. NIH information page here. National Library of Medicine Coronavirus page here, New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here. Washington State (epicenter) coronavirus page here. The Lancet covid-19 Resource Centre here. The White House open research dataset (COVID-19 Open Research Dataset, CORD-19) here. World Health Organization COVID-19 page here.
News, medical: The Commonwealth Fund hosted a webinar on Coronavirus and health system capacity, featuring Harvard’s Ashish Jha. Dr. Jha noted that there are widely varying estimates of the percentage of the U.S. population who will be infected with coronavirus, from 20 – 70%; his group’s studies have assumed 40%. The capacity to manage the resulting infections and hospitalizations varies widely across the country. Assuming the 40% infection rate over six months, and assuming also that 50% of patients who are otherwise hospitalized can be discharged (elective surgery, marginal clinical status, alternative sites), there would still be a need for three times as many beds as would be made available (at the 50% census reduction) to accommodate the 40% infection rate. In addition, estimates of ventilators also vary widely, from 60,000 to 160,000 in the country (questions of repair, availability, outdated equipment), whereas the projected need is 400,000.
News, general: Axios coronavirus dashboard here. FEMA Coronavirus Rumor Control page here.
Congress Approaches Completion of the Third Coronavirus Bailout Bill
First bill
The first bill (here) was The Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020 (P.L. 116-123), signed March 6, 2020, providing $8.3 billion in emergency funding for federal agencies to respond to the coronavirus outbreak. This included funds for research and development of vaccines, therapeutics, and diagnostics, funding for the purchase of vaccines, therapeutics, and diagnostics and $100 million for HRSA grants for the isolated and medically vulnerable. An additional $1.9 billion was for the Centers for Disease Control and Prevention (CDC), half for state and local response efforts. This was the bill removing restrictions on Medicare providers allowing them to offer telehealth services to beneficiaries, estimated to cost $500 million.
Second bill
The second bill was the Families First Coronavirus Response Act, (here, Kaiser Family Foundation summary and analysis here) providing paid sick leave and free coronavirus testing, expanding food assistance and unemployment benefits, and requiring employers to provide additional protections for health care workers.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Cancer Pays
JAMA Network (here) publishes a study of 14 medical schools’ faculty oncologists. “Direct payments from industry to academic physicians are common in the US and differ from payments to medical centers for clinical research. Although most US medical schools have conflict of interest policies for faculty members, the restrictions vary.” The study compares industry to annual salaries for academic oncologists at US public medical schools.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
CDC Announces ICD-10-CM Code for Coronavirus
The new code will be effective April 1 (report here).
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Health Spending to Rise, a Lot
A study (here) from the Office of the Actuary for CMS published in Health Affairs predicts that “National health expenditures are projected to grow at an average annual rate of 5.4 percent for 2019–28 and to represent 19.7 percent of gross domestic product by the end of the period. Price growth for medical goods and services is projected to accelerate, averaging 2.4 percent per year for 2019–28, which partly reflects faster expected growth in health-sector wages. Among all major payers, Medicare is expected to experience the fastest spending growth (7.6 percent per year), largely as a result of having the highest projected enrollment growth. The insured share of the population is expected to fall from 90.6 percent in 2018 to 89.4 percent by 2028.” JAMA Network has an infographic (here) on the most costly health conditions in 2016 (#1=low back and neck pain).
Congressional Interest in Vertical Antitrust Monopolies in Health Care
Forty members of Congress have petitioned (here) the Department of Justice and the Federal Trade Commission to examine “vertical” (well head to gas pump, versus horizontal, lots of well heads) mergers and the inflationary impact of those mergers on health costs. “In the health care market, several of these mergers have occurred with minimal benefit to patients. As a result, a concentrated number of vertically integrated, for-profit companies are largely in control.” Not mentioned in the letter is the vertical merger of “non profit health systems” buying physician practices, increasing the use of health system services and raising the price of physician services. (Cooper study here, other reports here, here, here and here.) And quality? Don’t ask. (Recent Axios piece here.)
MedPAC Sends Report to Congress
The Medicare Payment Advisory Commission (MedPAC) sent their March 2020 report to Congress (executive summary here, fact sheet here, news release here, report here), making recommendations for the Medicare fee-for-service program (FFS) and for Medicare Advantage (MA) and Part D (drug) programs. The report noted that MA and Part D enrollees increased by 10% between 2018 and 2019, to 22.2 million or 34% of all Medicare beneficiaries. Medicare spent much of the two chapters on MA on attempts to prevent “gaming” of reimbursement, including recommendations concerning plan coding practices and the “Star Rating System,” as well as attempts to develop a new Medicare Advantage Value Incentive Program (MA-VIP) for the plans. Benchmarks for the MA plans averaged 107% of traditional FFS Medicare rates.
Obamacare Turns 10 Years Old
On March 23? On March 30? On both dates! The Patient Protection and Affordable Care Act (March 23) and the Health Care Education and Reconciliation Act (repair job, March 30), collectively (if not entirely accurately) referred to as the Affordable Care Act, is a decade old. Some problems, here, but more states want to expand eligibility, here.
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 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.