DCMedical News: Wednesday, June 24, 2020
DCMedical News-DCMN
Washington, D.C.
Wednesday, June 24, 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 6-23 at 8:00 p.m. EST worldwide 9,183,225 confirmed cases; 474,572 deaths worldwide; 121,157 U.S. deaths (26%). Dr. Fauci expresses concern to Congress, here. Twenty-six states show increased number of cases, here.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Hospital-Acquired Condition Penalties Produce More Savings for CMS Than Penalized Conditions Would Have Cost
A study in The Joint Commission’s Journal on Quality and Patient Safety (here) finds “The penalties levied under the HACRP far exceed the potential cost savings accruing from a 1%–20% reduction in HACs that might result from hospitals’ efforts in response to the program.” The background: “The Hospital-Acquired Condition Reduction Program (HACRP) from the Centers for Medicare & Medicaid Services (CMS) reduces Medicare payments to hospitals with high rates of hospital-acquired conditions (HACs) by 1% each year. It is not known how the savings accruing to CMS from such penalties compare to savings resulting from a reduction in HACs driven by this program. This study compares the reported savings to CMS from financial penalties levied under the HACRP with savings resulting from potential reductions in HACs.” The results: “All HACs were associated with significant increases in total 90-day episode spending, ranging from $3,183 for iatrogenic pneumothorax to $21,654 for postoperative hip fracture. The total estimated savings to Medicare from potential reduction in all HACs ranged from $2.2 million to $44 million per year, an amount much lower than the $361 million in penalties levied on hospitals per year for HACs.”
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
House Unveils PPACA Improvement Proposal
House Democrats hold a news conference today to unveil the "Patient Protection and Affordable Care Enhancement Act," aimed at lowering health costs and prescription drug prices.
CMS Shows COVID-19 Impact on Medicare Beneficiaries
CMS Administrator Seema Verma reported (here) on Medicare enrollees and COVID-19 cases and hospitalizations. She wrote, “The new data show that more than 325,000 Medicare beneficiaries had a diagnosis of COVID-19 between January 1 and May 16, 2020. This translates to 518 COVID-19 cases per 100,000 Medicare beneficiaries. The data also indicate that nearly 110,000 Medicare beneficiaries were hospitalized for COVID-19-related treatment, which equals 175 COVID-19 hospitalizations per 100,000 Medicare beneficiaries. Blacks were hospitalized with COVID-19 at a rate nearly four times higher than whites.”
CMS Announces Burden Reduction, but Impact May be Primarily on Health and Safety Guarantees
Ms. Verma also announced new “burden reduction” initiatives (here), intended to lessen the administrative “burden” of CMS rules on providers. The announcement is the “creation of the Office of Burden Reduction and Health Informatics to unify the agency’s efforts to reduce regulatory and administrative burden.” The Office was originally created through regulations published last September 30 (Federal Register final rule here, “Fact Sheet” here). Most, if not all, of the “burdens” involve health and safety provisions of the Medicare Conditions of Participation (CoP), such as annual review of emergency plans; decreased training and testing of staff for emergency conditions; allowing multi-hospital systems to merge quality programs of their individual member hospitals (notwithstanding evidence that mergers of hospitals into larger systems lowers quality, e.g. here, here and here); loosening requirements for autopsies in cases of unusual deaths; lessening requirements for smaller hospitals to provide social work and dental care for patients; and eliminating the requirements that ambulatory surgery centers have transfer agreements with hospitals, and that patients of ASCs have a comprehensive medical evaluation prior to surgery. Other CoP changes lower standards for transplant centers, hospices, home health agencies, and outpatient rehabilitation, mental health and x-ray services. Other changes reduce the administrative burdens on Religious Nonmedical Health Care Institutions, by eliminating the requirement that they prepare a discharge plan to a medical facility. To augment the use of non-physician practitioners in hospitals, “Changing the term ‘Licensed Independent Practitioner’ in the hospital Patient’s Rights CoP to ‘Licensed Practitioner.’”
Commonwealth Fund Survey Finds Substantial Health Insurance Loss in Pandemic
In what it calls the first comprehensive look (survey report here, slides here, press release here) at the impact of the COVID-19 pandemic and resulting job losses on health insurance, the Commonwealth Fund surveyed 2,271 people. It found “One of five of the 41 percent of adults reporting job disruption and having job-based coverage said they and/or their spouse or partner is now uninsured. Fifty-three percent said that one or both of them still had coverage through a job from which they had been furloughed.”
DRUGS & DEVICES
The UK is launching a subscription plan to incentivize drug companies to produce antibiotics. “It will see pharmaceutical companies paid upfront for their products, based on the value it provides to the NHS rather than how much is used.” Report in the BMJ here. “The government has said it is particularly interested in antibiotics that can provide alternative treatment options for serious infections, such as bloodstream infections, sepsis, and hospital acquired pneumonia.”
READINGS & REFERENCES
Senate HELP Committee Report on Pandemic Planning
“What the United States has learned from the past twenty years of public health preparedness and response and how it can better prepare for future pandemics.” Report here.
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 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
August, none
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.