DCMedical News: Thursday, June 18, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, June 18, 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
Tracking by Johns Hopkins shows on 6-17 at 8:00 p.m. EST worldwide 8,317,055 confirmed cases; 447,581 deaths worldwide; 117,663 U.S. deaths (26%). The Texas COVID-19 Data Resource (here) compiled by the non-profit Texas 2036 looks at the surging case load in that State.
COVID-19 and Society
Testing and Paying
Sarah Kliff in The New York Times reports on the collision of wacky U.S. health care pricing and Coronavirus testing, here. “Insurers have paid Gibson Diagnostic Labs as much as $2,315 for individual coronavirus tests. In a couple of cases, the price rose as high as $6,946 when the lab said it mistakenly charged patients three times the base rate. The company has no special or different technology from, say, major diagnostic labs that charge $100. It is one of a small number of medical labs, hospitals and emergency rooms taking advantage of the way Congress has designed compensation for coronavirus tests and treatment.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Randomized Clinical Trial (RCT) Sponsorship and Research Quality in Interventional Cardiology
A study of 216 RCTs in JAMA Internal Medicine by researchers at Weill Cornell (here) reported on randomized clinical trials in interventional cardiology. “Commercial sponsorship was associated with a statistically significantly greater likelihood of favorable outcomes reporting and with the reporting of findings that are inconsistent with the trial results. Discrepancies between the registered and published primary outcomes were found in 82 trials (38.0%), without differences in trial sponsorship.” The authors conclude, “These results suggest that contemporary RCTs of invasive cardiovascular interventions are relatively small and fragile, have short follow-up, and have limited power to detect large treatment effects. Commercial support appeared to be associated with differences in trial design, results, and reporting.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Consolidation of Hospitals Will Lead to Financial Stability. Or Not.
Becker’s reports (here) that “For the three months ended March 31, some of the biggest nonprofit health systems in the U.S. reported losses.” The report shows seven “name” systems that reported first quarter losses of $1 billion or more.
The Joint Commission Sponsors a Webinar on Resilience for Health Professionals
The Joint Commission and the National Council on Behavioral Health sponsor a webinar on “COVID-19 Health Care Staff Trauma and Resilience Oriented Healing,” here.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Telemedicine Takes Off Among Health Insurers
Bloomberg Health Law & Business News reports that telemedicine visits are climbing, supported by third parties who calculate savings, compared to the cost of physician office or hospital outpatient visits. “Telehealth services have been available for years, primarily for people in rural areas or those who lack access to specialized services, but use has been anemic. More than 70% of people with health insurance have access to telehealth through their plans, and many insurers have partnerships with telehealth providers.”
An Oliver Wyman consultant is quoted by Bloomberg as saying “Before Covid, fewer than 10% had ever used it. Now with Covid, a lot more people have tried it.” The story notes that “The cost savings can be substantial. Visits with medical providers using telehealth services such as Teladoc Health Inc., a U.S.-based multinational telemedicine and virtual health-care company, can be as low as $75 for cash payments and even less if covered by insurance, compared with a typical charge of $150 to $300.” CMS rules for telemedicine here. AHIP publishes an 80-page guide (here) describing the policies of its member commercial health insurance plans. Telehealth advocates told the Senate HELP Committee that payment rates (remote versus in-office) should be equal.
The IRS checked in with new advice (here) which provides that “Under the CARES Act, a high deductible health plan (HDHP) temporarily can cover telehealth and other remote care services without a deductible, or with a deductible below the minimum annual deductible otherwise required by law. Telehealth and other remote care services also are temporarily included as categories of coverage that are disregarded for the purpose of determining whether an individual who has other health plan coverage in addition to an HDHP is an eligible individual who may make tax-favored contributions to his or her HSA.” The FCC, according to Healthcare Dive (here), “Has allocated almost $105 million in funding for 305 nonprofit and public health providers to build up their telehealth infrastructure in 42 states and Washington, D.C. in the wake of the COVID-19 pandemic,” but only one provider has actually received funds.
READINGS & REFERENCES
Bloomberg Businessweek says “U.S. Healthcare Flunks Its Most Important Exam,” here. Excerpt: CDC Director Robert Redfield told a House committee on June 4: “You think we weren't prepared for this, wait until we have a real global threat for our health security.”
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.
Reproduction rate (rt), website https://rt.live/ tracks the highest and lowest COVID-19 reproduction.
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 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.