DCMedical News: Tuesday, June 16, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, June 16, 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 6-15 at 8:00 p.m. EST worldwide 8,014,554 confirmed cases; 436,306 deaths worldwide; 116,135 U.S. deaths (27%). Politico gathers treatment, testing and public health information (here), noting new projections from the University of Washington Institute for Health Metrics and Evaluation (here) of 200,000 deaths in the U.S. by October 1.
COVID-19 and Society
Return to Work May Be Return to Risk for Many, Says Kaiser Family Foundation Report:
The report (here) notes “We find that over 90 million adults are at greater risk for severe illness from COVID-19 due to underlying health conditions or age. Of these at-risk adults, we estimate that about 37.7 million were employed at a job or business in the prior year, including 10 million people age 65 and older (19.5% of adults age 65 and older, all of whom are considered at greater risk) and 27.7 million non-elderly adults. These at-risk workers comprise 24% of all adult workers.”
ED Visits, Infectious Disease:
The National Syndromic Surveillance Program (NSSP), which collects health utilization information in real time, reports (here, in Morbidity and Mortality Weekly Report) that “Emergency department (ED) visits declined 42% during the early COVID-19 pandemic, from a mean of 2.1 million per week (March 31–April 27, 2019) to 1.2 million (March 29–April 25, 2020), with the steepest decreases in persons aged ≤14 years, females, and the Northeast. The proportion of infectious disease–related visits was four times higher during the early pandemic period.”
Health Politics, Policy and Law:
The Journal of Health Politics, Policy and Law has a special edition on COVID-19, including an essay on the anemic global response to the pandemic (here), and another (here) on how federalism in the U.S. has complicated the national response.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Air Ambulance Surprise Bills
A Brookings/Georgia State/USC/Wake Forest study (here) in the Milbank Quarterly finds that “The financial risk to consumers is high because more than three-quarters of air ambulances are out-of-network and their prices are high and rising. Consumers facing out-of-network air ambulance bills have few legal protections owing to the Airline Deregulation Act’s federal preemption of state laws.” Healthcare Dive (here) reports on the four-year study, noting that during that period “The median charge for in-network claims grew from $24,938 in 2014 to $32,708 in 2017. For out-of-network charges, it grew from $31,974 in 2014 to $41,230.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
RFI for Long Term Monitoring of Health System Resilience
Seeking answers for health system resilience? OASH may want to help. In a Federal Register notice (here) “the Office of the Assistant Secretary for Health (OASH) in the Department of Health and Human Services seeks to gain a more comprehensive understanding of how organizations, networks, non-federal government agencies, and other relevant stakeholders in the United States have operationally defined ‘resilience’ in their respective components of the health system; including their use of data, analytic approaches and proven indicators. OASH also seeks to identify opportunities to strengthen the U.S. healthcare system, as a whole, through public private partnerships in data sharing and comprehensive analytics.” Reply by July 8.
ProPublica Reports on Hospital “Turnaround” Specialists Who Left Oklahoma Hospitals Dizzy, Broke and Closed
The articles (here and here) report “At least 13 hospitals in Oklahoma have closed or experienced added financial distress under the management of private companies. These companies sold themselves to rural communities in Oklahoma and other states as turnaround specialists.”
DRUGS & DEVICES
What’s ‘Special’ About ‘Specialty’ Drugs? The Cost.
A report in the New England Journal of Medicine (here) summarizes the U.S. history of designating some drugs as “specialty.” It begins in the 1970s, when a very few drugs required special handling for injection and infusion. Now “1% of prescription drugs dispensed under Medicare Part D and Medicaid accounted for about 30% of net drug spending in each program in 2015.” The report continues “Today, various stakeholders in the pharmaceutical supply chain assign the specialty label to drugs on the basis of a combination of several unrelated factors, such as whether a drug treats a rare condition, requires special handling, or needs post marketing risk-management plans. But the single most common feature of specialty drugs is high cost. Indeed, the Centers for Medicare and Medicaid Services (CMS) defines specialty drugs as those with monthly costs exceeding $670.”
READINGS & REFERENCES
Preventive Health and Health Costs
The Congressional Budget Office publishes a paper (here) on “How CBO Analyzes Approaches to Improve Health Through Disease Prevention.” One finding: “In the cases that have been studied, about 80 percent of preventive medical services have been found to lead to higher health care spending overall.”
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 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.