DCMedical News: Thursday, July 23, 2020
DCMedical News-DCMN
Washington, D.C.
Thursday, July 23, 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 7-22 at 8:00 p.m. EST worldwide 15,077,182 confirmed COVID-19 cases; 620,257 deaths worldwide; 142,942 U.S. deaths (23%). Statista (here) finds the U.S. employment to population ratio at a 50-year low; Statista also finds (here) fewer people paying attention to the pandemic, with results partly related to party affiliation.
Adequate Supply of PPE Months Away, Foreign Sourcing a Basic Problem
CQ reports that “The United States is still months away from meeting demand for COVID-19 personal protective equipment, according to the top federal official in charge of emergency response during a House hearing on Wednesday. Peter Gaynor, the administrator for the Federal Emergency Management Agency, acknowledged before the House Homeland Security Committee that meeting the demand would continue to be a challenge.” Gaynor noted that, in an attempt to substitute domestic for foreign production of masks and other personnel protection, the Defense Production Act had been deployed fourteen times. Time (here) explores delays in testing and in obtaining results; delays render much of the testing pointless.
U.S. Health Care Post-Pandemic—Big Changes, or None?
The Economist projects the future of the U.S. health care system (here) as follows: “Those on America's left who see the crisis as a chance to reform what they see as an unjust system, which charges more than other rich countries for worse health outcomes, may be disappointed. Investors who hold their nerve for the next year or two might not be.” A “Perspective” in the New England Journal of Medicine (here) asks whether U.S. hospitals are still “recession-proof.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
CMS Publishes Open Payments Records for 2019
The Centers for Medicare and Medicaid Services has published (here) the “Open Payments” records for 2019. The results, “$10.03 billion in payments and ownership and investment interests made by applicable manufacturers and GPOs [Group Purchasing Organizations] to physicians and teaching hospitals. This amount is comprised of 10.98 million total records attributable to 614,910 physicians and 1,196 teaching hospitals.” Since 2013, when the program began, “CMS has published 76.25 million records, accounting for $53.06 billion in payments and ownership and investment interests.”
Is Centralization to High-Volume Hospitals the Right Strategy for High-Risk Surgery?
An opinion piece in JAMA (here) finds that “There is significant variation in surgical quality among high volume hospitals, and some low-volume hospitals have very good outcomes.” The authors write, “Despite considerable enthusiasm for centralizing high-risk operations at designated centers, it remains unclear whether this delivery model is feasible in the US.” The essay notes that “In 2016, less than 25% of hospitals that performed pancreatic, lung, rectal, and esophageal cancer surgery met even modest volume standards put forth by the Leapfrog Group.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Publishing Hospital Charges Lowers Their Growth Rate
A study published in Medical Care (here) found that “Public reports of hospital inpatient charges by DRG appear to influence subsequent charges, slowing their growth.” While CMS’ 2013 initiative was limited to high volume DRG charges, the study found that “after 3 years, the growth in charges for reported DRGs in New York hospitals was 4%–9% lower than for unreported diagnosis-related groups. In Florida, it was 2%–8% lower.”
DRUGS & DEVICES
New Study of Drug R&D Costs Pegs Total at Less Than Half of Previous “Tufts” Findings
After accounting for the costs of failed trials, the median capitalized research and development investment to bring a new drug to market was estimated at $985.3 million.” The study noted that “Differences from previous studies may reflect the spectrum of products analyzed, the restricted availability of data in the public domain, and differences in underlying assumptions in the cost calculations.” The well-known Tufts finding in a 2016 Journal of Health Economics study (here) used the same (10.5%) cost of capital as the more recent study; the Tufts researchers found the median development cost to be $2.87 billion. Another study (in 2017, published in JAMA Internal Medicine, here) found the median cost to be $757 million, using 7% cost of capital.
READINGS & REFERENCES
MEDPAC publishes July 2020 data book, here.
Physician Workforce Projections from the AAMC
The Association of American Medical Colleges has published (here) “The Complexities of Physician Supply and Demand: Projections From 2018 to 2033.”
Delays in Medical Care Are Relative
The New York Times reports (here) on delays in receiving care through the UK’s National Health. “The number of people on the waiting list for elective care fell from 3.94 million in April to 3.84 million in May, according to N.H.S. figures . . . With hospitals operating at reduced capacity to accommodate patients suffering from Covid-19, the waiting list could soar to 10 million people by the end of the year, according to the N.H.S. Confederation, which represents hospitals and other health care providers.”
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
July 24, 27, 28, 29, 30, 31
August, none
September 8, 9, 10, 11, 14, 15, 16, 17, 22, 23, 24, 25, 30
October 1, 2
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.