DCMedical News: Tuesday, June 2, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, June 2, 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 6-1 at 8:00 p.m. EST worldwide 6,246,042 confirmed cases; 374,452 deaths worldwide; 105,003 U.S. deaths (28%).
CBO Reports on House Coronavirus Bill as Passed, and on the Economic Impact of the Pandemic in the U.S.
The Congressional Budget Office has scored (here) the House-passed aid bill (here) at $3.5 trillion. No action is planned in the Senate, and a Presidential veto has been threatened. CBO also reported (here) that “Fallout from the coronavirus pandemic is expected to shrink the size of the U.S. economy by roughly $8 trillion over the next decade,” a 3% decline in U.S. gross domestic product compared with its initial estimate. “The pandemic will hamper U.S. economic growth by reducing the amount of consumer spending and closing numerous businesses,” although “the impact will be mitigated by the more than $2 trillion the federal government has already approved in emergency spending for households and businesses.”
Nursing Home Deaths Counted
With 80% of the nation’s nursing homes reporting, in line with new CMS directives (here), 26,000 deaths have been counted in 12,500 homes. Monday CMS announced new inspection, enforcement and consultative resources for nursing homes, (here).
Hospital Financial Calamity, Analysis
Case Western’s J.B. Silvers reports for MarketWatch (here) on the financial health of the nation’s hospitals. Silvers writes that “Virtually all hospitals in the U.S. — large and small, urban, suburban and rural, nonprofit and investor owned — will face financial crisis by fall unless there is a bailout on the order of what we did for our banks in 2008.” He notes that “So far the limited payments along with large layoffs has allowed hospitals to continue operations at a maintenance level as they wait for the surge to pass and hope for normal demand to return. While this bandage may keep hospital systems barely afloat during the crisis, it just postpones the financial disaster. These Medicare advance payments have to (be) repaid. They will be offset against payment for actual treatment to seniors on Medicare when and if they return. Unfortunately, this probably means zero net Medicare payment for several months in the fall as hospitals theoretically return to normal and begin to bill Medicare. Effectively we have just shifted their financial disaster by three months, not avoided it.”
Treatment
Eli Lilly and Co. announced Monday that trials have begun for a potential treatment for COVID-19. Lilly said LY-CoV555 is the first potential new medicine specifically designed to attack SARS-CoV-2, the virus that causes COVID-19. The treatment uses an antibody from a blood sample taken from one of the first U.S. patients who recovered from COVID-19. Results are anticipated by the end of June.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Church Sponsored Hospitals Lead in Jobs Export
A feature story in Modern Healthcare (here) notes that the top three health systems exporting hospital jobs during the past decade were Ascension, Catholic Health Initiatives and Providence (Source: Department of Labor Trade Adjustment Assistance program.) The story focuses on the decimation of economies in smaller communities whose hospitals were acquired by the church-affiliated chains.
MEDICARE, MEDICAID, AND COMMERCIAL HEALTH INSURANCE
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 (published in the May 29 Federal Register) is here, CMS Fact Sheet here, HFM Executive Summary here.
CMS has issued an appeal (here) for comments on measures contained in the proposed rule to promote “interoperability” of electronic medical records. Comments are due by July 11.
DRUGS & DEVICES
Pharma Price Inflation Rate May Have Been Boosted by Rebates
Chernew, Chandra and Kakani publish (in a National Bureau of Economic Research Working Paper, here) a study of drug prices from 2012 to 2017, showing that the average rebate as a percentage of the prescription drug list price rose from 32% to 48%. The impact on consumers is uneven, the rebates of no use to the uninsured, and of only variable use to the insured, depending on drug category and insurer and pharmacy benefit manager financial arrangements.
Capping Insulin Cost Only a Part of Diabetes-Related Financial Challenges for Patients
A review in JAMA Internal Medicine (here) finds that “Although capping insulin copayments is a step in the right direction, . . . (it) does not protect many individuals with federally regulated insurance plans, with Medicare, or without any insurance.” The piece notes that “mean annual out-of-pocket spending on insulin, diabetes-related supplies, diabetes-related services, and all other health care services was $2414 per person in 2018. Of this total, spending on insulin amounted to $435 and accounted for 18% of out-of-pocket expenditures.”
READINGS & REFERENCES
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information 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.
The New York Times Coronavirus coverage, 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
June 3, 4, 9, 10, 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
August, none
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.