DCMedical News: Tuesday, February 9, 2021
DCMedical News-DCMN
Washington, D.C.
Tuesday, February 9, 2021
DCMedical News is published every day both the House and the Senate are scheduled to be in session. Subscription information and archives here.
THE BIG STORY IN HEALTH CARE
Coronavirus
Tracking: Johns Hopkins (here) shows at 8:00 p.m. on 2-8-21 worldwide 106,442,696 COVID-19 cases, 27,083,278 U.S. cases, 25%. Deaths worldwide are 2,324,110, of which 464,831 are in the U.S., 20%.
Vaccine: Conflict and confusion consume the national vaccination effort, according to this Sunday editorial in The New York Times. The Guardian echoes the view, here, that key aspects of tracking variants have eluded the U.S. program. Another view of the problem, with focus on unanticipated out-of-pocket COVID-19 costs, here, from the Los Angeles Times. A regional view of “categorical vaccination” challenges from The River, here: smokers are in 1C per the CDC, and in New Jersey, but not in New York, while vaccinees with asthma are eligible in New York, but not in Massachusetts.
Policy: Markup of allocation amounts authorized under S.Con.Res. 5 (budget reconciliation to support the Biden COVID relief plan) continues, here are the Education, Labor, Community Services, Premium Support and 99 pages of related provisions, with a 3-page explanatory fact sheet here and a section-by-section summary here from the House Committee on Education and Labor.
In addition to Education and Labor’s work, the House Committee on Ways and Means also released its bill (here, summary of health insurance provisions here), another portion of the $1.9 trillion COVID-19 relief bill which would increase health insurance subsidies for laid-off workers and health insurance plans purchased on the exchanges. Ways and Means has responsibility for $941 billion of the $1.9 trillion total. CQ reports that in the Ways and Means bill “the legislation would eliminate the existing cap on federal subsidy assistance for households making up to 400 percent of the federal poverty level. The cost of premiums for families making up to 150 percent of the poverty level would be covered. The bill would also suspend required repayments from individuals who received excess premium subsidies for 2020,” and would subsidize 85% of the cost of employer-sponsored health insurance for workers who leave their jobs under COBRA through Sept. 30, while “Another provision would reimburse employers and plans for covering any COBRA subsidies through a payroll tax credit.”
Supplies: Echoing anecdotal reports (above) concerning vaccination, supplies and PPE, GAO reports (here, in 346 pages), that “As of January 2021, 27 of GAO’s 31 previous recommendations remained unimplemented. GAO remains deeply troubled that agencies have not acted on recommendations to more fully address critical gaps in the medical supply chain.”
HOSPITALS, SKILLED NURSING FACILITIES AND OTHER HEALTH CARE FACILITIES
Innovation in Palliative Care: Die at Home
Crain’s Health Pulse (NY) reports (here) that Mount Sinai Hospital has begun a palliative care at home program, with “home care workers embedded in the community,” managed by a Nashville company, Contessa.
DRUGS & DEVICES
Deaths From Overdose of Stimulant Drugs Rising Faster than Opioids
A report in the American College of Physicians’ Internist (here) says “Mortality from stimulants, including cocaine and methamphetamine, rose faster than deaths from opioids from 2010 to 2017, according to data from the National Center for Health Statistics” with the mortality rate from stimulants, for which no “reversal” drug is available, doubling every four years.
Bedside MR Scanning Which “Anyone” Can Control
Radiology Business (here) profiles “SWOOP,” the world’s first portable, FDA-approved bedside magnetic resonance device. Says Dr. Khan Siddiqui of the Hyperfine company, “MR scanners typically start at $1 million, and ours is $50,000 . . . Swoop is accessible, and it is designed with very simple training. You don’t need to have an MR degree. You can have a radiology tech who does portable x-rays run the scanner, too. We’ve designed this in such a way that it can be controlled wirelessly through either a tablet or even remotely from a laptop. So, the tech can sit in the MR suite and control 10 different scanners at the same time. We’ve made it so simple that it’s like an iTunes playlist. You select why you want to do the scan, hit play, and that’s it. A nurse can do it, a physician can run it, anyone can.”
AI in Health
The Department of Health and Human Services has published (here) what it refers to as the department’s first concerted effort to transform itself into an “AI-fueled enterprise,” a summary guide to “steer HHS’s vision for advancing AI-incorporating projects throughout the department and beyond,” and has named Oki Mek the department’s first chief artificial intelligence officer (CAIO). AI in Healthcare has published (here) a list of ten “notable FDA approvals of AI in medical devices over the past 90 days, including breast cancer diagnostics, brain MRI interpretation, advanced cancer tracking, coronary artery disease diagnostics, fundus photography assistance, brain volumetric analysis, remote personal electrocardiography, automated bone scan index calculation, virtual liver biopsy and echocardiogram view selection.
The University of Virginia has promoted AI for monitoring COVID-19 patients (here), “Continuously computing their physiological data in order to predict whether life-threatening trouble might arise. Using numbers drawn every two seconds, and models updated every 15 minutes, the software actually predicts possible clinical issues before they happen, giving clinicians – especially nurses – critical time to head off a potential crisis hours before it strikes.”
READINGS & REFERENCES
Hospital Consolidation and the Biden Administration
Harvard’s Leemore Dafny addresses hospital consolidation (here) in JAMA, noting “Without needed reforms, health care organizations will continue to consolidate partly to avoid being left on the sidelines while everyone else merges, buoyed by the belief that bigger is better, or at least might increase the odds an organization will remain afloat. The new administration can take immediate action to deter transactions and behaviors that are likely to limit competition.”
Transparency References
The final rules on health insurance transparency (here) and hospital price transparency (here) from the November 12 and 27, 2019 Federal Registers.
MACStats
The Medicaid and CHIP data book, December 2020, here, from the Medicaid and CHIP Payment and Access Commission.
Select Coronavirus Public Health Resources and References (alphabetical):
AMA resource page for physicians here. AMA guide to medical education and COVID-19, 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.
JAMA Network’s COVID-19 resource center 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.
State actions, Kaiser Family Foundation, here.
The COVID Tracking Project (The Atlantic Monthly), here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
February 10, 11, 23, 24, 25, 26
March 16, 17, 18, 19, 22, 23, 24, 25
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.