DCMedical News: Monday, June 15, 2020
DCMedical News-DCMN
Washington, D.C.
Monday, June 15, 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 6-14 at 8:00 p.m. EST worldwide 7,887,221 confirmed cases; 432,632 deaths worldwide; 115,729 U.S. deaths (27%).
COVID-19 and Society
Statista: Pandemic ends longest economic growth cycle in U.S. history, here.
CDC: New guidance on events and gatherings, here; and deciding to go out, here. The New York Times observes, with CDC, “what went wrong,” here, and The Wall Street Journal reports (here) “How New York’s Coronavirus Response Made the Pandemic Worse”; after 90 interviews the Journal concluded “The hasty expansion of medical facilities by state, city and hospital leaders led to grave mistakes.”
Morbidity and Mortality Weekly Report: 80%+ support for social distancing, limitations on group sizes and stay at home orders, here. “During May 5–12, 2020, a survey among adults . . . found widespread support of stay-at-home orders and nonessential business closures and high degree of adherence to COVID-19 mitigation guidelines.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Financial Resilience Survey
McKinsey (here) finds little, in survey of hospital finance executives. One quarter have less than 90 days of cash; one third expect the hospital financial crisis to worsen before year’s end; 45% expect to take 18 months or more to return to pre-COVID-19 revenues; almost two thirds expect government-funded patients to increase by 5% or more next year. “Despite the anticipated impact, the CFOs and finance executives indicated that, at this point, they are taking only a limited number of actions to address these anticipated financial challenges.”
Private Equity-Backed Hospital Owners “Paid Owners Millions and Got Low Care Ratings”
Bloomberg Health Law & Business News puts its spotlight on Leonard Green and Prospect Medical Holdings, here. Seven of Prospect’s ten hospitals have declined in CMS quality metrics since acquisition, nine rank at two stars (of five) or below.
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 HFM summary is here (147 pages), assessment of key financial impacts here, including this note: CMS makes many data files available to support analysis of the proposed rule. These data files are generally available at: https://www.cms.gov/medicare/acute-inpatient-pps/fy-2021-ipps-proposed-rule-home-page. Numbered tables that were historically included in the IPPS rule are now only available on the CMS website [which] can be found at the above hyperlink.”
Some specifics: “Hospital Readmissions Reduction Penalty (HRRP): Hospitals with higher-than-expected risk adjusted readmissions rates over a three-year period for acute myocardial infarction, heart failure, pneumonia, chronic obstructive pulmonary disease (COPD), elective knee/hip replacement and coronary artery bypass grafting will be subject to a maximum 3% penalty. CMS does not provide an estimate of hospital payment reductions in FY21 as a result of the HRRP in the proposed rule. Value Based Purchasing (VBP) Program: The estimated amount of base operating MS-DRG payment amount reductions for the FY21 program year and, therefore, the estimated amount available for value-based incentive payments for FY21 discharges is approximately $1.9 billion. All hospitals will be subject to a 2% reduction in base operating DRG payments [sequestration].” The comment period on the proposed rule ends July 10.
DRUGS & DEVICES
The Wild West of COVID-19 Serology
Kaiser Health News reports (here) “Hype Collides With Science As FDA Tries To Rein In ‘Wild West’ of COVID Blood Tests.”
READINGS & REFERENCES
Victor Fuchs in JAMA (here) on “Health Care Policy After the COVID-19 Pandemic”
Some of his thoughts: “An important goal of health care reform should be to replace the current byzantine system of premiums, taxes, tax exemptions, deductions, subsidies, and out-of-pocket payments with a much simpler system of financing health care. An equally important goal is to replace the current multiplicity of public and private health insurance programs with 1 universal program that covers everyone from birth to death. Because the US health care system is so large, it would probably be necessary to approach these goals in stages. It is important, however, to realize that the complexity of the current system is one of the main reasons it is so costly, with high administrative expenses.” And “If US health care spending was at the same per-capita rate as other high-income countries, the total would be $2.7 trillion instead of $3.7 trillion.” Fuchs cites The Prince, “As Machiavelli observed, proposals for a new order face strong opposition from those who benefit from the old order.”
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 for professionals here, Morbidity and Mortality Weekly Reports on Coronavirus, 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 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.