DCMedical News: Wednesday, February 10, 2021
DCMedical News-DCMN
Washington, D.C.
Wednesday, February 10, 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 2-9-21 worldwide 106,862,101 COVID-19 cases, 27,184,813 U.S. cases, 25%. Deaths worldwide are 2,338,004, of which 467,918 are in the U.S., 20%.
Treatment: The Eli Lilly antibody combination of bamlanivimab and etesevimab received FDA emergency use authorization (FDA fact sheet, 32 pgs., here), for patients at high risk for hospitalization or severe forms of COVID-19. Bamlanivimab alone for use in patients with mild to moderate symptoms was approved by the FDA in an EUA in November. A similar antibody combination had been approved for Regeneron, also in 2020. Lilly reported that the newly approved combination cut the chances of hospitalization and death by 70% in high-risk patients. A Yale group reports on cardiac problems with COVID-19 patients, in The American Journal of Cardiology (here), finding that “poor prognostic markers among hospitalized patients with COVID-19 included older age, pre-existing cardiovascular disease, respiratory failure, altered mental status, and higher troponin T concentrations.” The Los Angeles Times reports (here) on the consequences of delayed surgery due to the volume of COVID-19 patients in hospitals.
Vaccine: The White House has announced (here) increased production and distribution of vaccine to the states (5% increase to 11 million doses per week), a retail pharmacy program and increased FEMA support for distribution and administration. Also announced Tuesday (here) is a program to distribute vaccine directly to some federally qualified community health centers, starting Feb. 15. The CDC updated (here) guidance for providers enrolling in the vaccination program. The Medical Group Management Program says that physician offices are being cut out of vaccine distribution and administration; MGMA’s survey (here) reports that a “staggering 85 percent of independent practices and 45 percent of hospital or health system-owned practices actively seeking the COVID-19 vaccine for their patients report having obtained none to date. The majority of practices that have obtained the vaccine report only receiving enough to vaccinate 1 percent or less of their patients.” Drs. Topol and Burton of the Scripps Clinic publish in Nature (here) a proposal for variant-proof vaccine development, reported on in The New York Times (here). Kesselheim and colleagues analyze FDA vaccine approval protocols and the implication for COVID-19, in Health Affairs, here.
Testing and Tracking: Researchers at the Institute for Health Policy in Sri Lanka report in Health Affairs (here) that RT-PCR [reverse transcription, polymerase chain reaction] testing had a significant impact in reducing the number of new cases of COVID-19. “A tenfold increase in the ratio of tests to new cases reported reduced the average reproduction number by 9 percent across a range of testing levels . . . [and] helps explain how some nations achieved near-elimination of COVID-19 and the failure of lockdowns to slow COVID-19 in others. Our findings suggest that the testing benchmarks used by the World Health Organization and other entities are insufficient for COVID-19 control. Increased testing and isolation may represent the most effective, least costly alternative in terms of money, economic growth, and human life for controlling COVID-19.” A report in the Annals of Internal Medicine (here) found that “at least one third of SARS-CoV-2 infections are asymptomatic.” Kaiser Health News reports (here) on the difficulty of tracking re-infection: “Scientists have confirmed that reinfections after initial illness caused by theSARS-CoV-2 virus are possible, but so far have characterized them as rare . . . But scientists’ understanding of reinfection has been constrained by the limited number of U.S. labs that retain covid testing samples or perform genetic sequencing. A KHN review of surveillance efforts finds that many U.S. states aren’t rigorously tracking or investigating suspected cases of reinfection.”
Workplace Safety: A report in the American Health Law Association Newsstand (here) says that the State of Virginia has become the first state in in the nation to implement a permanent COVID-19 workplace safety and health standard. The Permanent Standard, which applies to all employers in the Commonwealth, is here (58 pgs.)
HOSPITALS, SKILLED NURSING FACILITIES AND OTHER HEALTH CARE FACILITIES
Northwell Sues Insurers, Harbinger of Covid Claims
Northwell (New York State’s largest employer, a 23-hospital group) has sued its insurers (Lexington, Interstate), alleging breach of the insurers’ coverage of “all risk” property damage secondary to the Covid-19 pandemic, notwithstanding Northwell having paid for “loss caused by communicable disease” and “costs to clean and decontaminate Northwell’s premises.” The Complaint (here) may be a harbinger of many others involving business interruption, the direct expense of Covid-19 management, and associated damages.
MEDICARE, MEDICAID AND COMMERCIAL HEALTH INSURANCE
Humana to Offer Hospital-at-Home Payment
Humana has announced (here) payment for hospital level care-at-home services. The Humana announcement, made with home provider DispatchHealth, says they “plan to target patients living with multiple chronic conditions, including COPD, cellulitis, kidney infections and more. The Centers for Medicare & Medicaid Services helped [pave] the way for the partnership back in November, when it announced a new waiver program to allow providers to offer acute care at home. Humana and Dispatch believe their partnership is the first such U.S. home care program involving a national health insurer,” thus far in a limited number of states.
Medicare OEP Underway
Medicare’s Annual Election Period (AEP) ended December 7, but the Medicare Advantage Open Enrollment Period or OEP (here) is open. In the OEP the MA member can switch from one Medicare Advantage Plan to another; disenroll from a Medicare Advantage Plan and return to original Medicare; or switch to original Medicare and join a separate Medicare Prescription Drug Plan. Disenrolling from an MA plan within 12 months of joining means it is possible—on a one-time basis—to purchase a Medigap or Medicare Supplement Plan without underwriting. The OEP runs from January 1 to March 31.
DRUGS & DEVICES
STAT reports on a study reporting that “Asking a Medicare beneficiary to pay about $10 more each time they fill a prescription makes them almost 33% more likely to die in a given one-month span.” The report from Chandra and colleagues is a working paper (here) from the National Bureau of Economic Research. “The analysis showed that increasing the cost of a prescription fill by $10.40 leads to a 23% drop in drug consumption, including for critical medicines.”
AI in Health
AI Required for Heart Patients in NHS
HeartFlow, a California company has announced (see Cardiovascular Business, here) that “hospitals in England are now required to use the company’s AI-based fractional flow reserve CT (FFRct) software to diagnose patients with coronary heart disease (CHD) . . The model simulates blood flow, indicating how blockages may be affecting the patient’s health and helping physicians determine if further treatment is necessary.” The NHS’ new MedTech Funding Mandate aims to speed up patient care, improve outcomes and reduce costs through the use of advanced technology.
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.
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 11, 23, 24, 25, 26
March 16, 17, 18, 19, 22, 23, 24, 25
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.