DCMedical News: Tuesday, May 19, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, May 19, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below).
THE BIG STORY IN HEALTH CARE
Coronavirus News: (reference pages below under Reading & References)
Tracking by Johns Hopkins shows on 5-18 at 8:00 p.m. EST worldwide 4,795,941 confirmed cases; 318,213 deaths worldwide; 90,309 U.S. deaths (28%).
Science and COVID Society
Vaccine, COVID-19: The Hill reports (here) that “The biotech company Moderna on Monday reported ‘positive’ data on its potential coronavirus vaccine from an early clinical trial . . . people given the potential vaccine generated an immune response similar to that in people who had recovered from the disease . . . Still, that early result is only from the first eight participants in the trial.” The NYSE went up more than 900 points. The New York Times reports on Moderna here, and here the Times notes the President’s take on his daily hydroxychloroquine, “All I can tell you is, so far I seem to be OK.”
Vaccination Rates have declined to less than 50% in most children under two years of age. Morbidity and Mortality Weekly Report (here) says “The observed declines in vaccination coverage might leave young children and communities vulnerable to vaccine-preventable diseases such as measles. If measles vaccination coverage of 90%–95% (the level needed to establish herd immunity) is not achieved, measles outbreaks can occur.”
Coronavirus testing rates from state and federal (CDC) reports don’t match, according to this report in The Atlantic. For details on reopening, soon-to-be-reopening and closed status of states, the Times has this interactive map. Two days in L.A.: USC researchers publish in JAMA (here) results of antibody testing April 10-11 in Los Angeles County, finding “The prevalence of antibodies to SARS-CoV-2 was 4.65%. The estimate implies that approximately 367,000 adults had SARS-CoV-2 antibodies, which is substantially greater than the 8,430 cumulative number of confirmed infections in the county on April 10. Therefore, fatality rates based on confirmed cases may be higher than rates based on number of infections. In addition, contact tracing methods to limit the spread of infection will face considerable challenges.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
A Graduation to Remember
The American Medical Association is holding an on-line (YouTube, Facebook, information here) graduation ceremony on May 20 at 6:00 p.m. Central Time for 30,000 medical students, featuring among others Jerome M. Adams, MD, MPH, U.S. Surgeon General; Donald M. Berwick, MD, MPP, Institute for Healthcare Improvement; Anthony S. Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases; Atul Gawande, MD, MPH, surgeon, writer and former CEO of Haven; and a host of faux doctors from popular television shows (Grey’s Anatomy, SCRUBS, The Good Doctor, The Good Wife, Dr. Quinn, The Hangover, and others).
Red State Physicians Make More Money
MedScape surveyed more than 17,000 physicians in more than thirty specialties and were told these results; the top ten states were Kentucky, Tennessee, Florida, Alabama, Utah, Ohio, Oklahoma, Indiana, North Carolina and Georgia. The differences among these states were narrow, however, with the average physician salary for #1 Kentucky at $346,000 and #10 Georgia at $323,000.
Vertical Merger Proposed Rules: Little Guidance and Dubious Economics
UC Berkeley/Hastings researchers report (in Health Affairs, here) that “Significant vertical consolidation (for example, hospitals acquiring physician practices) has mostly been ignored—or in the case of some mega vertical mergers, allowed to proceed subject to promises of good behavior . . . Indeed, hospital acquisitions of physician practices have escaped scrutiny, despite going on apace for years. The percentage of primary care physicians and specialists in practices owned by hospitals/health systems nearly doubled from 2010 to 2018 . . . While vertical integration can promote competition, considerable empirical evidence demonstrates that in health care they often engender higher prices and promises of quality improvement prove ephemeral.”
Telehealth Payment Variation by State
The Source on Healthcare Price and Competition has gathered information on telehealth price and reimbursement. “These maps show existing telehealth mandates by state and those required under a declared state of emergency during the COVID-19 crisis, with respect to reimbursement, cost-sharing, and coverage and access.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Safety Net Hospitals in Peril
A report in Politico (here) says “The New York City hospitals that serve the city’s poorest patients are facing financial ruin after being on the front lines in the U.S. fight against the coronavirus.”
MEDICARE, MEDICAID, AND COMMERCIAL HEALTH INSURANCE
Top 500 Fortune Companies Include 40 in Healthcare
The 500 companies that made this year's list (here) have $14.2 trillion in combined 2019 revenue, representing two-thirds of the U.S. economy, according to Fortune. The 40 healthcare companies on the list are led by CVS Health, $256.8 billion, #5; UnitedHealth Group, $242.2 billion, #7; and McKesson, $214.3 billion, #10.
Proposed FY 2021 IPPS Rule
The FY 2021 proposed payment rule known as the Inpatient Prospective Payment System has its own “home page,” here. The proposal (to be published in the May 29 Federal Register) is here, CMS FAQs here, HFM Executive Summary here.
READINGS & REFERENCES
Coronavirus Public Health Resources and References:
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here. American Public Health Association information here. Association of American Medical Colleges Clinical Guidance Repository, here. CDC information page here. CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here. Council of State Governments, here. JAMA Network’s COVID-19 resource center here. Library of Congress Coronavirus Research Guide, (here) from the In 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. The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here. State actions, Kaiser Family Foundation, here. UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here. The White House open research dataset (CORD-19) here. World Health Organization COVID-19 page 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
May 20, 21
June 1, 2, 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.