DCMedical News: Tuesday, September 15, 2020
DCMedical News-DCMN
Washington, D.C.
Tuesday, September 15, 2020
DCMedical News is published every day both the House and the Senate are scheduled to be in session this year. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
The (Presidential and Other) Campaigns
The Kaiser Family Foundation has published an “Issue Brief” on “President Trump’s Record on Health Care” (here), an expansion of a previous brief comparing the Trump and Biden statements on COVID-19 (here). KFF also maintains a web site on 2020 election, polling and health issues (here).
Healthcare Financial Management’s senior writer Rich Daly profiles (here) Chris Jennings, an Obama-Clinton veteran “mentioned” as a possible HHS Secretary in a Biden Administration. HFM’s Daly writes “Jennings in August addressed the National Academy for State Health Policy meeting and underscored healthcare policy priorities that a Biden administration is likely to pursue, including a so-called public option, increased antitrust enforcement of hospital mergers and acquisitions (M&A), and price negotiations with hospitals.”
Coronavirus
Tracking: By Johns Hopkins (here) shows on 9-14 at 8:00 p.m. EST worldwide 29,179,130 confirmed COVID-19 cases; 926,923 deaths worldwide; 194,467 U.S. deaths (21%).
Medicine and Science:
Young people get it, too, and suffer, but not quite in the same numbers as their elders, according to a study in JAMA Internal Medicine (here). The report says “Young adults age 18 to 34 years hospitalized with COVID-19 experienced substantial rates of adverse outcomes: 21% required intensive care, 10% required mechanical ventilation, and 2.7% died. This in-hospital mortality rate is lower than that reported for older adults with COVID-19, but approximately double that of young adults with acute myocardial infarction.”
Hydroxychloroquine and Azithromycin:
The combination can kill you, it turns out. The study, in Lancet Rheumatology (here), finds that “Hydroxychloroquine treatment appears to have no increased risk in the short term among patients with rheumatoid arthritis, but in the long term it appears to be associated with excess cardiovascular mortality. The addition of azithromycin increases the risk of heart failure and cardiovascular mortality even in the short term.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Radiologists Up in Arms Over 2021 Physician Fee Schedule
Radiology Business News reports (here) that “92 lawmakers want Congress to waive budget-neutrality requirements stemming from a proposed pay increase for office-based evaluation and management services in 2021. Absent such a decision, the imaging industry stands to lose some $10 billion over the next decade” according to the American College of Radiology.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Are Hospitals Making Money on COVID-19 Patients?
Modern Healthcare (here) discusses the issue: hard to know, but larger systems and chains may benefit financially. The Wall Street Journal reports (here) that a new requirement (September 1) for a positive COVID-19 test in hospitalized patients for whom the 20% Medicare bonus is claimed; CMS has received a report that the bonus may have stimulated “overreporting.” Says the Journal, “CMS in April had indicated that documentation from a doctor was all that was required for the funding boost. Under the new requirement, a lab test must be performed either before or during the admission.” Hospitals appear caught up (here) in political controversy over reporting the numbers of COVID-19 cases they see.
Hospitals Investing in Housing
Two medical students and a Harvard Professor discuss (in JAMA Internal Medicine, here) the rationale for hospital investment in housing. They count 57 hospital systems which have invested $1.6 billion from 2017-2019 for housing needs of patients. They discuss the tax exemption of hospitals, compared to the value of hospitals to their communities. They write, “On average, nonprofit hospitals return less than half of this value [tax exemption] to the community in the form of charity care or community health programs. Thus, growing interest in housing may reflect hospitals’ financial calculus to minimize costs of maintaining tax exempt status amidst new pressure to align benefit spending with community needs.
In addition, the provision of transitional post discharge housing may increase hospital revenue by freeing up beds. Temporarily housing patients who cannot otherwise be safely discharged because of unstable housing can shorten hospital stays, availing beds for other patients and additional payments. Because spending on such housing qualifies as charitable, governments may be granting tax exemptions to hospitals for profit-generating investments, undermining the spirit of community benefit spending—to give back, not earn more.” And, they ask, “Why do hospitals have the resources that local governments ostensibly lack to make additional investments in housing? The ability of dominant hospital systems to command high prices from commercial insurers is well-documented. These prices, which translate into higher premiums and lower wages, amount to a tax on local communities; high prices transfer resources from households and governments to hospitals.”
DRUGS & DEVICES
Executive Order(s)
The Administration released President Trump’s Executive Order (here) on drug price control. The Order amounts to instructions to the Department of Health & Human Services to begin a rule-making process to test a “payment model” for a limited number of drugs. The process would test the feasibility of linking prices paid through the Part B and Part D Medicare program to prices paid by other, comparable countries (“reference” pricing). New York Times coverage of the Executive Order is here.
READINGS & REFERENCES
Select Coronavirus Public Health Resources and References (alphabetical):
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.
The Guardian and Kaiser Health Network, report on health professionals dead from COVID-19, 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.
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.
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.
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
September 16, 17, 22, 23, 24, 25, 30
October 1, 2
November 16, 17, 18, 19, 20
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.