Biden to nominate Brooks-LaSure to oversee CMS. President Biden plans to nominate Chiquita Brooks-LaSure, a health policy consultant, to the role of CMS administrator, STAT reports.
Welcome to the Health Evolution CEO Reading List. Chief executives of providers, payers and life sciences organizations can look to this list for articles and resources about health care and leadership.
Shared stewardship: Who is willing to invest in people and place with the most to gain? In what they claim to be the first study of its kind, The Rippel Foundation’s ReThink Health Initiative, the RAND Corporation and the Robert Wood Johnson Foundation, took the pulse of stewardship value across eight organization types between October 2020 and June 2021. “Although the survey shows near universal agreement on several core values about thriving together, it also reveals a stark difference in contributors’ priorities for equitable investment. That matters because we believe equitable investment is necessary to end systemic injustice and unlock America’s full potential to thrive,” according to an article in Health Affairs. “When we expect everyone to thrive, it becomes easier to see who has further to go and how best to tailor investments — a strategy known as targeted universalism. What will it take to make that kind of pragmatic, equitable investment a norm across the US?”
Too much AI may not be good for your health or the NHS. Indications are emerging that AI is widely falling short of its promise in medicine, including one study that found 94 percent of AI systems designed to scan for breast cancer were less accurate than a human. “The resulting stumbles from this culture clash not only hurts company profits, it also threatens to corrode patient trust in the NHS and other healthcare systems,” the Washington Post reported. “More disturbing than any failed experiments is that some patients risk their privacy when AI in health care goes wrong.”
How wearables and health apps can diagnose and treat diseases. In a podcast from The Economist, digital health experts discuss how machine learning can filter data to identify a picture of the health of individuals and are increasingly playing a role in helping to treat the diseases they detect.
Travel nurses see swift change of fortunes as COVID-19 money runs dry. It’s no secret that many nurses have become travel nurses during the pandemic, often doubling or tripling their previous salary. But that appears to be changing. “As covid hospitalization rates stabilize, at least for now, and federal and state COVID relief funding dries up, travel nurse contracts that were plentiful and lucrative are vanishing,” Hannah Norman writes for Kaiser Health News. “And after the pressure cooker of the past two-plus years led to staff turnover and a rash of early retirements, hospitals nationwide are focused on recruiting full-time nurses.”
What if the future of work is exactly the same? “What does the future of work actually look like for the majority of Americans whose jobs require them to show up in person?” Rani Molla and Emily Stewart ask on Vox. Despite widespread consensus that the future holds potential for higher wages, particularly among low-wage earners, greater flexibility with remote work, “many of the circumstances that have made the current moment possible, including unprecedented support from the federal government, are fading or already have expired. For many workers, the current state of work looks very much the same or even worse. In many ways, so does the future.”
Why May 2022 is pivotal to U.S. health care: 4 reasons. Projecting that this month will likely be “the most consequential in health care for years,“ Paul Keckley points to the cumulative impact of the beginning of campaign season, observances notably mental health month and nurses month, administrative clarity coming from the Centers for Medicare & Medicaid Services and adjustments to consumer spending as factors. “May is the pivot point from which the health system transitions from its response to a menacing global pandemic to a uniquely American institution in need of repair,” he writes in the Keckley Report. “To that end, operators and Boards must be vigilant about market trends and changes in laws and prepared to alter strategies, capital bets, business relationships and timing to address new opportunities and threats.”
Value-based payment models in the commercial insurance sector: A systematic review. To answer the open and ongoing question about how value-based payment models are performing in the private sectors, authors writing in Health Affairs determined that 81 percent of studies found positive results for quality outcomes, 58 percent for utilization and 56 percent for spending—though they noted that less rigorous research yielded more positive results. “Given the mixed nature of the findings, commercial insurers should identify ways to strengthen value-based payment programs or leverage other strategies to improve health care value.”
Toxic culture is driving the great resignation. With some 24 million Americans leaving their job in mid-2021, authors in MIT Sloan Management Review analyzed 34 million employee profiles to inform leaders about how to predict turnover and effectively respond. “Our research identified four steps — offering lateral career opportunities, remote work, social events, and more predictable schedules — that may boost retention in the short term. Leaders who are serious about winning the war for talent during the Great Resignation and beyond, however, must do more.”
Addressing social determinants of health in federal programs. Examining the U.S. Department of Health and Human Services approach to addressing social determinants of health, authors in JAMA Network explain that the three-pronged strategy comprises data, health and human services connections and whole-of-government collaborations. “At its core, the administration’s focus on social determinants of health is motivated by a commitment to improve health, eliminate health disparities, and improve well-being more broadly. The nation’s investment in health care spending—more than $4 trillion in 2020—needs to be accompanied by longer-term investments addressing the upstream causes of poor health outcomes,” write Nancy De Lew and Benjamin D. Sommers, MD, both of the Office of the Assistant Secretary for Planning and Evaluation, HHS.
Kaiser’s Earth Day pledge to keep fighting climate change. Drawing learnings from the Fourth National Climate Assessment, Kaiser Permanente notes that exposure to rising temperatures and poor air quality as well as natural disasters include floods, droughts, heat waves and wildfires increase the risk of both physical and mental illness. As such, the organization is working to reduce emissions, move toward carbon neutrality, embrace green construction, conserve energy and water and, ultimately, lead change outside its workforce and local communities. “Looking to the future, we’ll continue to plan and invest in ways to improve our environment and our health.”
What is value-based care, really? Addressing the premise that it would be helpful for all CEOs and leaders in the industry to take a closer look at what value-based care really means, both the good and bad, SCAN Group and Health Plan CEO Sachin Jain, MD, evokes a number of questions about the transition to new payment models, notably: Is it anti-hospital? Does it limit choice? Is it truly pro-teamwork? Anti-innovation? And so on. “This set of questions and observations should not be read as a defense of the costly, traditional fee-for-service system, which has its own skew towards over-delivering care, often with little to no benefit to patients. Nor should it be read as a rebuke of value-based care,” Jain writes in Forbes. “But with all of the optimistic fanfare (a small portion of which I, too, am guilty of generating) must also come a dose of realism. Value-based care can indeed be an answer to some of what ails American healthcare, but at its foundation there must be something somewhat increasingly quaint and elusive: An ethical underpinning to always do what’s right for the patient.”
Tom Daschle and Susan Brooks: The dangerous thread connecting Avian flu, COVID-19 and the war in Ukraine. Given that every American has now witnessed or experienced the consequences that a devastating biological event can wreak on the globe, former members of Congress Rep. Susan Brooks and Sen. Tom Daschle, MD, explain in the Chicago Tribune that the U.S. is also grappling with an avian influenza outbreak – and the potential for biological warfare in the Ukraine and elsewhere. “We simply cannot fall into a cycle of complacency, moving on to the next crisis when one ends,’ Brooks and Daschle write. “We have seen this happen too many times before. We must learn lessons and ensure past mistakes are not repeated. Our national biodefense must be robust enough to meet and defeat the array of biological threats bearing down on us — both at home and around the world.”
Patterns of potential moral injury in post-9/11 combat veterans and COVID-19 health care workers. Research that included 618 military veterans deployed to a combat zone after September 11, 2001 and 2099 health care professionals who worked during the COVID-19 pandemic gauged “personal moral injury” within both groups. “Among the veteran sample, 46.1 percent endorsed experiencing other-induced PMI and 24.1 percent endorsed experiencing self-induced PMI during their military service. For the HCWs, 50.7 percent endorsed experiencing other-induced PMI and 18.2 percent reported self-induced PMI in the context of their work during the COVID-19 pandemic,” the authors noted in the Journal of General Internal Medicine.
Synthetic patient data in health care: A widening loophole. With the rise of AI in health care comes a need for data, and synthetic data holds the potential to enhance clinical research by diversifying datasets, and protecting patient data, according an article in The Lancet. “The rise of synthetic data has heralded an industry of companies seeking to monetize fake data and enable cross-border data sharing beyond the confines of data protection legislation,” the authors write. “Concerningly, there are no robust and objective methods of determining whether a synthetic dataset is sufficiently different from the original real dataset to be classed as truly anonymous.”
When workplaces address employees’ mental health, they will save lives and costs. In a Miami Herald OpEd, Guidewell & Florida Blue CEO Pat Geraghty weighs in on the business case for confronting the mental health crisis in workforces — which is particularly critical given that CEOs ranked workforce as their top priority for the first time since 2004, according to the American College of Healthcare Executives. “More than half of your colleagues or employees could be struggling with significant mental health issues as you read this,” Geraghty writes. “Supporting employees’ mental well-being is not just the right thing to do, it’s also good for the bottom line. A 2021 National Safety Council and University of Chicago analysis found that organizations that support mental health see a return of $4 for every dollar invested.” Bonus: Frontline workers are stressed to the brink. Here’s what they need from leadership
Workplaces are in denial over how much Americans have changed. Even prior to the COVID-19 pandemic, Yale historian Frank Snowden explained that “epidemic diseases reach into the deepest levels of the human psyche. They pose the ultimate questions about death, about mortality: what is life for? What is our relationship with God?” The Guardian reports. “This wave of companies trying to resume operations certainly feels like these societal and personal changes are being waved away as merely a phase. In reality, more pandemics could be coming, and workers now know that this current economy is not built for this new world. They know that this current system wiped out their savings within a few months of the country shutting down, and it will do it again.”
Digital literacy, health inequalities and the COVID-19 pandemic. The accelerated progress of telehealth and digital tools for virtual care was critical in the pandemic. Longer-term, however, those same tools both promise to advance equity and have the potential to widen inequities and gaps in care unless they are deployed with intention to address the issues. “It is imperative that public health study inequities associated with telemedicine to make sure that the increase of telemedicine does not widen the current health disparities,” according to the American Journal of Public Health.
Reimagining hunger responses in times of crisis. Using U.S. Indian Country as an example of a region that is experiencing food insecurity at alarmingly higher rates than White households during the pandemic, a partnership between the Native American Agriculture Fund, the Food Research & Action Center and the Indigenous Food & Agriculture Initiative at University of Arkansas published an analysis of household-level food insecurity. “Recommendations actionable by Congress and USDA include improvements to agricultural infrastructure, the federal nutrition programs, and data collection methods,” the authors write.
An overhaul of prison health care is long overdue. Prisoners explain that people “suffer and decay” in jail for anything other than a straightforward medical condition and research shows that in New York more than half of patients left medical appointments with concerns untreated. “There needs to be a discussion of the level and quality of care that people get when inside,” said Tracie Gardner, SVP, Advocacy, Legal Action Center, a nonprofit for incarcerated in The Nation. “That will not be addressed until there is more ownership of health inside by the health care system.”
Please stop using these phrases in meetings. Among aspects comprising the future of work that the pandemic has created an opportunity to re-evaluate is the so-called “meeting-speak” lexicon. Yes, the list includes a kinder way of telling a speaker “you’re on mute,” as well others that existed before and persisted throughout the pandemic. “Rephrasing has the power to reframe your work,” Ringel Group President Rae Ringel writes in Harvard Business Review
5 signs you’re headed for burnout. Despite their position or perhaps even because of it, CEOs and other top executive are not immune to professional burnout. But how to differentiate between actual burnout and more common stress, frustration, and fatigue? “These major symptoms are easy to spot,” according to a Fast Company article. The list: negative expectations, feeling underappreciated, detaching from work, acting impulsively and being impatient. “If you catch them early enough, you can take steps to minimize the impact.”
The growing link between climate change and health. “There’s an enormous opportunity for health professionals to help patients see the connections between climate change and their health,” Renee N. Salas, MD, Faculty, Harvard Global Health Institute, is quoted as saying in an NEJM Catalyst report. That’s because fewer than half (43 percent) of U.S. respondents’ patients have moderate or high awareness of how climate change, notably fossil fuels, can negatively impact human’s health; among respondents outside the U.S. 50 percent said the same. “This is fundamentally driven by our mission to prevent harm and improve health. As patients see these connections, climate change becomes personal and action becomes a prescription for improving health.”
Why employee wellness programs won’t work. Despite the Kaiser Family Foundation statistics that 80 percent of large employers offer a wellness program with a range of free screening and incentives to stay healthy while companies pay an average of $16,000 per employee on health care, evidence of such programs’ efficacy is scant. “The essential issue here is that these programs are a redistribution [of incentives] from the unhealthy to the healthy, but behavior isn’t changed for either of these two groups,” said Iwan Baranky, a Wharton Management professor in the Wharton Business Daily podcast. “What we need to do is listen to our employees. We have to talk to them to understand what their barriers are to start engaging.”
When AI takes a human touch: How a team effort to improve patient care in hospitals paid off. A three-year AI initiative at Northwestern Medicine has resulted in the algorithm prompting some 5,000 physician interventions with patients and more than 2,000 additional tests analyzing imaging results to identify lung and adrenal nodules that human clinicians often miss, according to a STAT article that examines the various people who made it happen: the annotators, model builder, the alert architects, the loop closers. “It remains a work in progress, with additional tweaks to ensure the AI remains accurate and that the alerts are finely-tuned. Some doctors remain skeptical, but others said they see a value in AI that wasn’t so clear when the project started.”
5 terms you should learn to be a better DEI ally. Whether it’s about supporting people of color, exposing racist or sexist comments or increasing inclusive language in the workplace, “the first step to becoming an ally at work is understanding the concepts that will help you act in support of your colleagues,” Kelsey Alpaio and Rakshitha Arni Ravishankar write in Harvard Business Review. Those words: privilege, microaggressions, ableism, benevolent sexism and opportunity gap. It’s not enough to just learn the definitions or use these words in a sentence. You have to take action.”
Without Build Back Better, will the end of the public health emergency leave even more people uninsured? With the ACA as a safety-net during the pandemic and economic crisis, the total number of uninsured Americans did not increase, Kaiser Family Foundation research shows. “But, perhaps ironically, we could see a big jump in the uninsured rate as the public health emergency ends if people who continue to be eligible for Medicaid are not able to retain coverage and legislation like the Build Back Better Act fails to pass,” KFF explains.
Metaverse: 5 questions shaping the next frontier of human experience. “At the threshold of any new technology wave there are competing visions of dystopia and utopia; the metaverse is no different,” EY explains in a report about the complexities and opportunities in the metaverse that outlines the critical considerations relative to the metaverse. “While we cannot fully imagine the entire gamut of benefits or risks that will emerge, it is clear that we are about to launch into a fascinating new dimension of the human experience.”
CMS innovation center launches new initiative to advance health equity. Last year, the CMS Innovation Center conducted an internal review of which health equity was among the components. “One of many lessons learned from our review was that health equity was not always a priority in model design, participant recruitment and selection, implementation, or evaluation. As a result, some models have not included numbers of underserved beneficiaries proportional to their presence in the general Medicare population. Further, limited and incomplete sociodemographic data has stymied robust monitoring and evaluation of model outcomes for all populations,” Dora Lynn Hughes, MD, Chief Medical Officer at the CMS Innovation Center writes in Health Affairs. “To specifically address the CMS Innovation Center’s statutory charge to test ways to enhance health care quality, we have included ‘Advancing Health Equity’ as one of our five strategic objectives for realizing the CMS Innovation Center’s 2030 vision.”
Breaking the rules of health care: Restoring the value of primary care. Continuing the series about health care rules, Robert Pearl, MD, former CEO of The Permanente Medical Group, examines the fourth rule: Doctors achieve high status by doing the impossible. “If status in medicine were determined by saving lives (rather than doing the impossible), primary care physicians would quickly re-ascend the hierarchy,” Pearl writes. How to make that happen? Adequately fund primary care and identify and reward physicians who save the most lives. “The hard part will be convincing public and private insurers to foot the bill. Payers will demand reliable performance data that tie their financial investment directly to lives and dollars saved. This brings us to the second change,” Pearl writes. “Over time, with better pay and greater recognition, primary care’s status will increase — and so will the life expectancy of Americans.”
2022: One of the hardest times to run a company. Not even two full months into the calendar year and already corporate leaders and analysts are saying 2022 is more difficult than 2020. “Uncertainty, CEOs’ dreaded nemesis, abounds. Supply chain snarls, lingering COVID disruptions, labor shortages, inflation, rising pay and soaring demands for new benefits and work flexibility are driving up costs and complexity,” Axios reports. “The Great Resignation is forcing companies to raise wages and beef up benefits to try to attract talent. America has some 11 million open jobs, but people aren’t jumping to apply to them.”
What big tech should actually do in health care. Admitting his admiration for Google, Apple and Amazon, SCAN Group and Health Plan CEO Sachin Jain, MD, also wonders if anyone else is growing tired of hearing about all the great things technology companies are going to do in health care. “The truth is, Big Tech has consistently failed to meet expectations when it comes to their investments in health care,” Jain writes in Forbes. He points to four key factors such companies underestimate: the industry’s multi-matrixed environment that makes scaling hard, the reality that fee-for-service is changing slowly, the risk that health care organizations have to manage and the small margins so many leaders operate under. “Large tech companies could do wonders for the healthcare industry. But they have to stop tinkering around the margins,” Jain adds. “It’s time for the tech companies to get serious about changing American health care. They need to show us the art of the possible by changing health care from within not as customers, but as owners. And the way they can do that is buy acquiring a large health system and integrating advanced, tech-driven health solutions with solid risk management operations.”
Association of hospital interoperable data sharing with alternative payment model participation. Tracking the years from 2014-2018, researchers conducted a cohort study of 3,928 hospitals to determine how much progress was made building an interoperable health system and whether aligning financial incentives via alternative payment models contributed to such data interoperability. In short: The results of this study suggest that building a nationally interoperable health care system remains a complex and challenging task that requires more than just alignment of financial incentives via voluntary payment reform programs,” researchers wrote in JAMA Network.
NIH issues a seismic mandate: Share data publicly. The National Institutes of Health said that beginning early next year it will require most of the 2,500 institutions and 300,000 researchers it funds to both include “a data management plan in their grant application and eventually make their data publicly available,” an article in the journal Nature explains. “Researchers largely applaud the open-science principles underlying the policy — and the global example it sets. But some have concerns about the logistical challenges that researchers and their institutions will face in complying with it.”
Patients are coming after hospital monopolies. Citing “all or nothing” and “anti-steering” contracts and monopolistic power to drive prices up for patients as well as payers and employers, a citizen group in Connecticut is suing Hartford HealthCare in case that some say should be concerning “even if you don’t live in Connecticut.” Hartford HeathCare issued a statement saying the suit lacks merit and “misrepresents how it is working to transform health care.”
Executives are quitting to spend time with family … really. In a new twist for the old familiar business cliché about leaving a high-powered position or taking time off to “spend with family,” The New York Times reports that amid the Great Resignation that posturing is actually true in certain instances. “Chief executives, chief financial officers and other C-level executives are walking off the job. And while some are inevitably leaving one role to take a new one, some are dropping out altogether, at least for a bit,” according to the Times. “They are propelled by a mix of needing a break, reassessing the role of work in their lives and wanting to pursue new ventures.”
Future of health. The year is 2028. The scene opens with a mother interacting with a robot vocally walking her through the steps to check whether a child that the robot identified as coughing in the night needs to see a doctor. While this sophisticated at-home technology may seem light years away, interconnected devices like this already exist. Voice powered devices can make appointments and order over the counter medicines in real time through the speaker on your counter the size of a hockey puck. Further, data sharing between devices and the cloud is also being utilized more and more to help make our daily lives a bit easier,” writes Mordechai Pavlovsky, MD, Chief Medical Officer and Head of Operations and Innovation at Sutter Health-Aetna on a LinkedIn post. “I compare this moment in healthcare to that of the Industrial Revolution.”
Ageism in artificial intelligence for health. In a policy brief, the World Health Organization examines how AI is being used relate to older people in medicine and public health. “AI can exacerbate or introduce new forms of ageism,” WHO explains. To that end, the brief includes legal, non-legal and technical measures for maximizing AI benefits older people while minimizing AI’s impact on ageism.
Digital health can make health care more open, inclusive and patient-centered. Here’s how. Describing the growth in both processing power and data accumulation as “a transformational opportunity for patient care to become more precise, predictive, personalized and convenient,” Belén Garijo, Chair of the Executive Board and Chief Executive Officer, Merck, writes on the World Economic Forum site. Achieving that will require: open and transparent ecosystems that facilitate trust, a code of digital ethics, digital health for diversity and inclusion.
NFTs offer new method to control personal health information. Nonfungible tokens, aka NFTs, have inspired many an eye roll or even become the butt of jokes, but an article in the journal Science contends that NFTs could prove useful in health care. “Federal regulations already give patients the right to connect an app of their choice to their doctor’s electronic health record and download their data in a computable format,” said Kenneth Mandl, MD, co-author of the paper, director of the Computational Health Informatics Program at Boston Children’s Hospital and Donald A.B. Lindberg Professor of Pediatrics and Biomedical Informatics at Harvard Medical School. “It’s intriguing to contemplate whether NFTs or NFT-like technology could enable intentional sharing of those data under smart contracts in the future.”
Top issues confronting hospitals. For the first time in nearly two decades surveyed CEOs indicated that financial challenges have been surpassed by workforce as the top challenge they face. “Both long- and short-term solutions are needed to address the shortages in critical front-line staff shown in our study to ensure hospitals have workforces that can meet the demands for safe, high-quality care both today and in the future,” says Deborah Bowen, President & CEO, ACHE, in a statement. “Longer term solutions include increasing the pipeline of staff to these positions, as well as organization-level efforts to increase staff retention. More immediate solutions include supporting and developing all staff, building staff resilience and exploring alternative models of care.”
Expanding health coverage to residents of the poorest states that have not expanded Medicaid. While the Affordable Care Act was designed to cover most Americans, the 2012 Supreme Court ruling on the ACA left millions without health insurance but now President Biden’s proposed Build Back Better Act would establish marketplace coverage in states that opted not to expand Medicaid. “The policy represents a commonsense strategy for working around the practical and legal fallout of the U.S. Supreme Court’s 2012 decision that left millions of the nation’s poorest adults uninsured,” according to the Commonwealth Fund. “The federal fallback in Medicaid nonexpansion states is an enormous breakthrough, a constitutional workaround for an intractable problem that has had profound health equity implications. Enacting it will help advance health care coverage for all Americans.” See also: Nearly 50 organizations have signed the Health Equity pledge.
From facility to home: How health care could shift by 2025. McKinsey estimates that as much as 25 percent, or $265 billion, of care services under Medicare fee-for-service and Medicare Advantage could move from facilities to the home and do so without reducing quality of access. Moving care into the home “could create value for payers, health care facilities and physician groups, care at home providers, technology companies, and investors,” the firm wrote. “It could also improve patients quality of care and experience.” McKinsey also highlights the factors that could inhibit progress and suggests what stakeholders can do about those.
Children’s Hospital of Colorado hires first-ever chief of mental health after declaring state of emergency. Noting that suicide is the second leading cause of death for people between 10 and 24 and the fact that its emergency department is frequently filled with suicidal kids, the health system moved to address the crisis by appointing child psychiatrist K. Ron-Li Liaw as chief of mental health. “It’s been scary, actually, to watch over the last 10 years the level and the severity of mental health presentations for younger and younger kids,” Liaw told the Colorado Sun. “The reason I’m here is because I see a lot of potential.”
Inaction on medical education puts good health for the needy in Jeopardy. ChenMed CEO Christopher Chen, MD, draws inspiration from the popular game show Jeopardy to illustrate why medical schools should invite more Black and Hispanic applicants. “The fact is that the system is searching for a certain profile,” Chen notes. “All primary care doctors need to understand the human body and its pathophysiology. But what makes the good ones good isn’t their ability to apply technical knowledge to ‘rescue’ or ‘fix’ a patient, or route them to a specialist. Rather, the ideal kind of primary care delivers an outcome by preventing, managing, and owning the problem. That takes both technical skills and ‘softer’ skills.”
Lancet commission on the value of death. Describing the story of dying in this century as a “paradox.” The Lancet Commission puts forth and new vision for both dying and death that includes community involvement, health and social services and enhanced bereavement. “COVID-19 has meant people have died the ultimate medicalized deaths, often alone in hospitals with little communication with their families. But in other settings, including in some lower income countries, many people remain undertreated, dying of preventable conditions and without access to basic pain relief,” the commission explains.
5 skills public health officials need to combat the next pandemic. Jay K. Varma, MD, professor of population health sciences at Weill Cornell Medical School, Theodore G. Long, MD, senior vice president of ambulatory care and population health at New York City Health + Hospitals, and Dave A. Chokshi, MD, the 43rd health commissioner of New York City reflect on the massive turnover among public health officials during the pandemic and look to what’s necessary for the future. “While many people have the technical qualifications to fill these newly vacant positions, they also require key leadership skills,” they write in Harvard Business Review. Those include: translating science, framing the move from evidence to decision making, thinking big, spending political capital wisely and in certain situations thinking like a lawyer.
Medicare helps close racial gaps in access to health care. An analysis of American Community Survey data found that in 2019 only 9 percent of White Americans under 65 years of age were uninsured while percentages in Black and Hispanic populations were notably higher at 14 percent and 26 percent, respectively, leading the Yale School of Medicine to examine whether expanding coverage could be a lever to reducing outcomes disparities. “Once Medicare becomes available, racial and ethnic gaps in healthcare access and self-reported health start to close, suggesting that expanded access to Medicare or other universal health insurance could put a dent in these disparities, according to Yale Insights. “These relative gaps across race and ethnicity are persistent in this country. More access to insurance appears to narrow these gaps, and expanding Medicare is one way to provide this access.”
Using virtual health to push equity in health care. While the early days of the COVID-19 outbreak illustrated the value of virtual care — and the potential for such offerings to scale more quickly than previously understood — utilization has since settled such that many executives are left wondering what to expect as health care moves into the next phases of the pandemic and beyond. “If virtual health programs are designed with equity as a guiding principle, virtual health could improve access, continuity of care, and care management. These shifts could transform care delivery to be more convenient, accessible, and efficient — ultimately leading to improved outcomes,” Deloitte authors write in a new report, explaining that achieving that future will involve infrastructure and access, digital engagement and cultural competency, technology and analytics.
Physician compensation arrangements and financial performance incentives in U.S. health systems. It’s a key question amid the ongoing transition from to value-based care: “Do health system physician compensation arrangements primarily incentivize volume or value?” researchers ask in JAMA Network. Among the conclusions from the study of 31 physician organizations affiliated with 22 health systems: “Despite growth in VBP arrangements and a push to improve value in health care, physician compensation arrangements in health systems do not currently emphasize value. Volume-based incentives dominate health system PCP and specialist compensation, with quality and cost performance incentives representing a relatively small portion of compensation.”
The uncertainty agenda for hospitals in 2022. In the latest Keckley Report, Paul Keckley compiles a comprehensive list of uncertainties, beginning with market volatility, Build Back Better 2.0, pandemic pivot to endemic, alternative payment model changes. Those are just the start of more than a dozen issues leaders are grappling with. “The uncertainty punch list is getting longer. Addressing each item requires partnerships with physicians, scenario planning with boards and market vigilance. Responses will vary by market, financial resources and institutional mission but legacy assumptions about the future for hospitals are largely obsolete—regardless of reputation,” Keckley writes.
Breaking the rules of health care: Selecting the best doctors. Former Permanente Medical Group CEO Robert Pearl, MD, explains that technology can help doctors make better decisions and avoid medical mishaps more effectively than clinicians’ relying on their memory. “Knowing this, why do medical-school deans and residency directors continue to select future doctors based on standardized test scores, which—more than anything else — measure one’s ability to memorize thousands of arcane facts? The answer to this question lies in the ‘rules’ of the medical profession,” Pearl writes in Forbes. “The foundational skills doctors need for tomorrow include technological competence, complex problem-solving abilities and effective communications.”
‘We must change’: Health systems invest more heavily in digital health. “Mayo Clinic is committed to leading the transformation of health care. We know we have to start with transforming ourselves,” Mayo Clinic CEO Gianrico Farrugia said in a STAT article about a recent talk Farrugia gave. “Mayo is not alone in its sense of urgency. Hospitals nationwide are aggressively increasing investments in digital health companies, forming new and larger venture funds to help bankroll the development of software tools and artificial intelligence,” the article reports. “Their financial support signals enthusiasm for the future of the red-hot digital health sector, but also points to a creeping realization: If they don’t jump on the innovation train, they will miss out on an opportunity to shape the future — and make money doing it.”
Factors associated with overuse of health care within US health systems. Based on a cross-sectional study of 676 health systems in America, researchers in JAMA Network that organizations overusing health care are more likely to be investor-owned and have more beds and more physician groups, while having fewer primary care physicians and less likely to include a teaching hospital. The researchers also created an Overuse Index to measure low-value health care and to determine health system features that are associated with overuse. “Overuse of health care is a pervasive threat to patients that requires measurement to inform the development of interventions,” they write.
The big Medicare Advantage players keep getting bigger. Medicare Advantage enrollment increased nearly 9 percent year over year to more than 28.5 million and an Axios analysis of CMS data projected that enrollees will surpass the agency’s estimated 29.5 million in 2022. But which health plans are the new members joining? “Concentration at the top remains high. Six health insurers control roughly three-quarters of the fast-growing Medicare Advantage market,” Axios reports. At the same time: “Even a small number of MA members translates into big bucks, which is why startup insurers have rushed to enter the $412 billion market.”
10 health care trends to watch in the year ahead. Dubbing 2022 “the year of the caregiver,” Providence CEO Rod Hochman outlines the most pressing issues for the next 12 months. “Doubling down to support the nation’s caregivers will be the No. 1 health care priority. After two traumatic years on the front lines, supporting the mental health and well-being of health care professionals and rebuilding the workforce will be an absolute imperative,” Hochman writes. Other trends include the data revolution, ransomware and cybersecurity, new entrants, and more.
Unvaccinated COVID-19 hospitalizations cost billions of dollars. Even though vaccines have been widely available since April 2021, 17 percent of adults over 18 in the U.S. are still unvaccinated, according to the Peterson-KFF Health System Tracker. “These COVID-19 hospitalizations are devastating for patients, their families, and health care providers. The hospitalizations are also costing taxpayer-funded public insurance programs and the workers and businesses paying health insurance premiums,” Krutika Amin and Cynthia Cox of KFF write. Using an estimated $20,000 average cost for COVID-19 hospitalizations, they determined that the more than 690,000 preventable COVID-19 hospitalizations between June and November of 2021 cost American taxpayers $13.8 billion.
3…2…1…TEFCA is go for launch. Now that the Trusted Exchange Framework and Common Agreement is officially available, National Coordinator Micky Tripathi and Sequoia Project CEO Mariann Yeager explain that the “milestone marks the beginning of a new era of electronic health information exchange in the U.S. And he outlines ONC’s goals for TEFCA: “Goal 1: Establish a universal policy and technical floor for nationwide interoperability. Goal 2: Simplify connectivity for organizations to securely exchange information to improve patient care, enhance the welfare of populations, and generate health care value. Goal 3: Enable individuals to gather their health care information.”
Opinion: COVID vaccine and treatment misinformation is medical malpractice. It should be punished. Pointing out that a vocal minority of doctors are “weaponizing their white coats,” de Beaumont Foundation CEO Brian Castrucci and No License for Disinformation Executive Director Nick Sawyer state that misinformation is harmful to individual patients and the broader public alike. “From making false claims about vaccines to offering to sign medically unnecessary mask exemptions in exchange for payment, these ‘disinformation doctors’ are amplifying lies and often profiting from a cottage industry of social media posts, websites, live and virtual conferences and podcasts,” they write on NBC’s website. “Unless state medical boards begin to hold these physicians accountable, the trust of the entire medical profession is in jeopardy.”
A national strategy for the “new normal” of life with COVID. “COVID-19 is here to stay,” Ezekiel Emanuel, MD, PhD, Michael Osterholm, PhD and Celine Gounder, MD write in JAMA Network. The authors explain how the second half of 2021 demonstrated that relaxing CDC guidance for mask wearing and social distancing last July were premature. “It is imperative for public health, economic, and social functioning that US leaders establish and communicate specific goals for COVID-19 management, benchmarks for the imposition or relaxation of public health restrictions, investments and reforms needed to prepare for future SARS-CoV-2 variants and other novel viruses, and clear strategies to accomplish all of this,” they write and call for redefining the appropriate national risk level and rebuilding public health.
To slow the spread of COVID-19, we need to bring back the Swiss Cheese model of pandemic response. While the so-called Swiss Cheese model drew attention earlier in the pandemic, Thoai Ngo, PhD, Vice President of Social and Behavioral Science and the Founding Director of the GIRL Center at the Population Council said that the time has come to deploy the model to reduce COVID-19 transmission and to prevent deaths. “The Swiss Cheese Model, published twenty years ago to understand why accidents happen and how to prevent them, is a systems approach that recognizes human fallibility and builds layers of defense, visualized as multiple stacked cheese slices, to mitigate adverse effects,” Ngo writes in Health Affairs. “The idea is that each slice has holes or weak spots where errors might occur, but when multiple slices are aligned, the overall risks are significantly reduced.”
The patchwork U.S. public health system. Focusing on the variations in response to foodborne illness outbreaks as an example that highlights the health care system’s complexity, Megan Wallace, Dr.P.H. and Joshua M. Sharfstein, M.D. explain that the U.S. comprises 21 federal, 50 state, and approximately 2800 local health depts— all existing and operating with “no clear administrative structure that organizes the many federal agencies involved in public health,” the authors note in the New England Journal of Medicine. “Understanding this haphazard architecture is a step toward appreciating the U.S. paradox of enormous health expenditures but poor outcomes for population health.”
Sacrifice Zones: The most detailed map of cancer-causing industrial air pollution in the U.S. Examining five years’ worth of data available from the U.S. Environmental Protection Agency, ProPublica mapped the production of emissions known to cause cancer down to the neighborhood level. CEOs leading health systems, health plan or life sciences organizations can use the map to better understand excess cancer risks in the geographical region, communities and patient populations the organization serves.
Board diversity increased in 2021. Some ask what took so long? Citing research published earlier this year by ISS Corporate Solutions, the New York Times reports that among the Russell 3000 stock index Asian, Black, Hispanic or Middle Eastern people occupy approximately 4,500 board seats, which is 25 percent more than 2020 and 50 percent more than in 2019. Also, women of all races now account for 27 percent, up from 24 percent the year prior. “Executives and recruiters have often complained that there aren’t enough women and nonwhite people qualified to be directors, a phenomenon often described as a ‘pipeline’ problem,” according to the article. “But under pressure to achieve more diversity in senior ranks — from advocates for social change and, at times, their own employees — companies appear to be discovering that a big talent pool of nonwhite people and women for board seats does, in fact, exist.”
Health Evolution Summit 2022, April 6-8, Laguna Niguel, CA: Apply to Attend
DIG this: The complexity and big tech and health continues. From Providence’s Digital Innovation Group, aka DIG, Chief Digital Officer Aaron Martin and Sara Vaezy, SVP and Chief of Digital and Growth Strategy, share their thoughts on Oracle’s $28.3 billion acquisition of EHR giant Cerner announced just before 2021 drew to a close. “The Oracle/Cerner transaction supports our thesis that big tech will continue to engage heavily in health care via different approaches. Some, like Microsoft and now Oracle will be tech enablers to incumbents. This is just the beginning,” Martin said. Vaezy added: “You’ll see more acquisitions of important technologies that enable digital transactions and patient engagement as Microsoft, Oracle, AWS, Salesforce, and probably Google look to enable health systems and payers.” See also: Disruptors or incumbents? They just may need each other And: Oracle, Cerner and the EHR innovation opportunity ahead
A WHO official weighs in on COVID, vaccines and mistakes that were made. In an interview with STAT, the World Health Organization’s head of health emergency programs Mike Ryan discusses where he expects the world to be in a year (“very, very hard to predict”), what he wished the world had done differently throughout the pandemic and what to expect moving forward. “If we’re looking at pandemic preparedness for the future it’s not all going to be about technology and the machines that go ping and surveillance systems and AI and all of this stuff. We need a social solution for future pandemics, much more than we need a technological solution. Because we’re dealing with a fractured world, fractured communities,” Ryan said. “We’re dealing with a breach and prolonged breakdown in trust.
5 critical priorities for the U.S. health care system. It’s no secret that COVID-19 has dominated conversations across industries since early last year and in health care it has also shone a light on problems that need to be addressed. Since early 2020, the dominating presence of the Covid-19 pandemic has redefined the future of health care in America. “It has revealed five crucial priorities that together can make U.S. health care accessible, more affordable, and focused on keeping people healthy rather than simply treating them when they are sick,” Marc Harrison, MD, CEO, Intermountain Healthcare, writes in Harvard Business Review.
What 20,000+ health care workers say about the Great Resignation. Citing new research from the American Medical Association, the Advisory Board notes that “overall, the study found that higher levels of burnout, stress, workload, fear of infection, and anxiety/depression were associated with a greater intention to reduce hours or leave the health care practice. This trend is likely to continue. However, hospitals can mitigate these high turnover rates by implementing specific programs to address burnout.”
Recognizing decline in physician wellbeing: When to seek help or intervene. Researchers at Washington University’s psychiatry department explain that burnout among physicians can be as high as 50 percent. “It is extraordinarily important for healthcare workers, especially physicians, to recognize their own mental health needs and know when they require help. It is also important for them to know how to help their peers recognize their mental problems and seek care,” they write. The article includes resource for assessing others and self-assessment as well as guidance for discussing wellbeing in the workplace.
How Morgan Health is making its accountable care pitch to providers. JPMorgan Chase is increasing its post-Haven health care efforts. “Morgan Health is building expertise in accountable, value-based care and looking to Medicare as a foundation for innovation in the employer market,” according to an article in Fierce Healthcare. That includes hiring people who previously worked at the Center for Medicare and Medicaid Innovation and focusing on metrics proven in the Medicare realm, notably improving diabetes management, decreasing disease-related inequities and reducing problems that stem from missed care. “We are kind of in a nice situation where we will have data on all these metrics and we will be able to report on them as well,” Morgan Health CEO Dan Mendelson said in the article.
Marshfield Clinic’s ambitious social determinants screening plan to advance equity. While Marshfield Clinic Health System has been focusing on advancing health equity for years, the system has embarked on a new initiative to screen the 320,000 people it serves annually for social determinants of health, the American Medical Association explained in a post. “The SDOH data will help measure a community’s broadband internet access, level of food security, and its education, housing and transportation needs. MCHS has an ambitious target to screen 50,000 patients for SDOH by this time next year,” AMA states. Based on the data, Marshfield intends to ultimately connect people with appropriate community-based organizations to address those determinants and inequities.
Why hospitalizations are now a better indicator of COVID’s impact. With the U.S. facing a fifth wave of infections and deaths related to the pandemic during the winter months, the time has to come to “shift to hospitalization-based guidance,” Monica Gandhi, MD an infectious-disease doctor and the director of the Center for AIDS Research at the University of California, San Francisco and Leslie Bienen, a faculty member at the O.H.S.U.-Portland State University School of Public Health contend in an opinion piece in The New York Times. “In counties and states with high vaccination rates, policymakers should stop considering bumps in case numbers alone as the criteria for restrictions, although they should continue to monitor data on reported infections tallied by health departments,” they noted.
Achieving racial and ethnic equity in U.S. health care. For evaluating health equity across race and ethnicity as well as within and between states with the stated goal of illuminating how state health systems perform for Black, White, Latinx/Hispanic, American Indian/Alaska Native, and Asian American, Native Hawaiian and Pacific Islander populations, the Commonwealth Fund published a scorecard on state performance. “Our hope is that policymakers and health system leaders will use this tool to investigate the impact of past policies on health across racial and ethnic groups, and that they will begin to take steps to ensure an equitable, antiracist health care system for the future,” Commonwealth Fund authors wrote.
Growing use of home COVID-19 tests leaves health agencies in the dark about unreported cases. Citing a Halloween concert in Las Vegas after which hundreds of people shared positive test results and discussed symptoms on Facebook instead of which clinicians or public health departments, STAT reports that the proliferation of rapid home testing, while positive for well-known reasons, is causing some problems at a rather inopportune time. “As the U.S. moves into a second pandemic holiday season with the Omicron variant looming, state and local health departments are increasingly relying on incomplete data and educated guesses to guide decision-making. Home-testing samples aren’t submitted for genomic sequencing, which could delay identification of the Omicron variant in communities. And contact tracers can’t trace cases they don’t know about.”
Pharmacy’s new era—in the home. McKinsey predicts changes to the $460 billon retail pharmacy sector as it becomes more convenient and embraces tech-enabled omnichannel approach to reaching consumers, including an increasingly prevalence of home delivery. “This shift may be welcomed by many stakeholders because e-commerce penetration in retail pharmacy is low relative to most other retail categories,” the McKinsey authors note. Factors fueling this evolution include: demand tailwinds, technology innovations, growth in homebound populations, payer actions, and more.
Medicare beneficiaries’ use of telehealth 2020: Trends by beneficiary characteristics and location. A new research report from the U.S. Department of Health and Human Services examines nearly 35 million Medicare FFS beneficiaries’ in-person and telehealth visits and found that 52.7 million visits were conducted virtually, representing a “63-fold increase over 2019.” And that’s despite overall usage in 2020 being down 11. 4 percent compared to 2019. “We estimate potential audio-only eligible telehealth visits increased 100-fold from 2019 to 2020. At the same time, use of telecommunication services – virtual check-ins and e-visits – increased more than 200-fold from 14,000 in 2019 to 3.1 million in 2020.”
Squid Game, Ted Lasso and unicorn fatigue: Top 10 health care industry predictions for 2022. Sachin Jain, MD, CEO, SCAN Group and Health Plan begins his annual list by admitting that “I rarely get everything right. But looking back at last year, I think I did pretty well.” So what does he anticipate for the next 12 months? “We may be turning a corner,” Jain writes in Forbes, forecasting continued debate about Medicare Advantage, more talk than action on equity, a sustained rush to primary care, advancements in AI for diagnostics, and more. “Expect this to be the year that healthcare bounces back from the doldrums of pessimism. You may not see clinicians dancing down the hallways of the hospital, but I do think you’ll see them ever more appreciative of each other—and proud of the work they do.”
Representation of women in the leadership structure of the U.S. health care system. In a JAMA Network Open article including research spanning 3,911 senior executives within health systems, health insurance groups and the U.S. Department of Health and Human Services, the authors found that 17.5 percent of health system board chairs are women, as are 21.3 percent of payer BOD chairs. Women CEOs constitute 15.3 percent and 15.8 percent among health systems and health plans, respectively. Their underrepresentation “likely diminishes their role in policy decisions that affect population and women’s health,” the authors write. They added that a separate recent study about gender diversity and organizational performance suggests “the loss of cognitive capital with the underrepresentation of women on executive teams.”
Strategies to repair a broken system: Mental health care. “Mental health care has long been tightly segregated from the rest of the health care system and, in its isolation, starved of resources and critical synergistic connection,” according to an article by The Penn Leonard Davis Institute of Health Economics. During a recent Penn LDI webcast three strategies for addressing the problem were discussed: 1) robust integration of mental and physician health care 2) rethinking workforce policies and practices to better meet real needs and 3) organizing and mobilizing a new constituency for mental health advocacy. “The COVID-19 pandemic has spawned broad waves of stress, anxiety and need for mental health care that have drawn increased attention in policymaking circles.”
KFF: Average family premiums rose 4 percent this year to top $22,000. Annual family premiums for employer-sponsored health insurance rose 4% to average $22,221 this year, according to the annual benchmark KFF Employer Health Benefits Survey released. KFF says “the annual change in premiums roughly matches the year-to-year rise in workers’ wages (5 percent) and inflation (1.9 percent), though what workers and employers pay toward premiums over time has risen more quickly.”
Why health care workers are quitting in droves. With the pandemic causing death on previously unseen scales, approximately one out of every five health care professionals is leaving their job, according to The Atlantic. “Health care workers want to help their patients, and their inability to do so properly is hollowing them out,” the article noted. “COVID patients are also becoming harder to deal with. Most now are unvaccinated, and while some did not have a choice in the matter, those who did are often belligerent and vocal.
A telehealth effort to treat PTSD and bipolar disorder in rural areas showed ‘huge gains.’ Now comes the hard part. The Study to Promote Innovation in Rural Integrated Telepsychiatry (SPIRIT) achieved a 32 percent improvement in mental health functioning among 1,000 participants spanning three states. “Now comes the inevitable question that follows ay technology breakthrough: Does it scale?” STAT reports. “Following the success with veterans, SPIRIT appears to have shown that collaborative care could be hugely impactful for rural mental health, but there are significant hurdles to rolling such an approach out — and paying for it.”
David Feinberg, the new CEO of Cerner, is profiled in STAT. Experts say it may be the end of the Epic vs. Cerner rivalry. They also report on the challenges that Feinberg will face in the role. “There are folks who feel (Cerner) faces an extremely uphill battle,” Jonathan Slotkin, a former colleague of Feinberg’s at Geisinger and chief medical officer of Contigo Health, told STAT. “It’s a moment of identity choice. Are we trying to be a centered, principally standard EHR vendor, or is there a next way?”
This report, from the Center from Medical Economics and Innovation, looked at 340B hospitals, who are supposed to help the vulnerable and compared them to non-340B hospitals. The researchers found that hospitals in the CMS database provided 2.03 percent of net patient revenues toward charity care in 2017, compared to 340B hospitals providing a small 1.66 percent. Evaluating each hospital’s net income relative to net revenue, the profitability for 340B hospitals was 37 percent larger compared to the average of all hospitals.
In this personal essay, Alexis Madrigal, co-founder of the COVID tracking project, talks about his experience in getting COVID-19, despite his precautions. “Right now most policies appear designed to make life seem normal. Masks are coming off. Restaurants are dining in. Planes are full. Offices are calling. But don’t be fooled: The world’s normal only until you test positive,” Madrigal writes.
With the U.S. Bureau of Labor Statistics finding that nearly 20 million employees left their job since April 2021, “employers must recognize that over the past 18 months, the workplace-worker dynamic has seismically shifted,” according to Fortune. “The gap between what workers are after and what their employers are offering has widened enough to warrant a phenomenon with a name you may have heard: the Great Resignation. But for employers, it’s not a lost cause. The Great Resignation can serve as an opportunity to reimagine the parameters of their business and their most valuable employee relationships.”
Opinion: The official pandemic death toll is 5 million. But more perished because of it. Comparing global deaths to the number of people in Chicago and Houston combined, the Washington Post editorial board holds up excess mortality as “a vital yardstick” and cites The Economist’s estimate of as many as 16.8 million deaths. “The enormity of the death toll is hard to fathom, even at the official numbers. We ought not be numbed by losses and must extract lessons from the misery. The true cost of the pandemic is not only those who died of covid but many others who died because of it.”
COP26: Life sciences, health care and the climate. Leading into COP26, Forbes reports that the health care sector creates more emissions than some countries and constitutes 4.4 percent of annual emissions. “The lion’s share of the sector’s emissions, 71 percent, comes from its supply chain. There is an inconvenient truth about the development and manufacture of the many life-saving drugs we use today. It is an energy and resource intensive process.” The challenge is not in developing fewer drugs, of course, but in focusing on sustainability. “Addressing the worst excesses of environmental pollution would have a transformational impact on the health and wellbeing of the planet’s people.”
Here’s who wins and loses in Democrats’ new prescription drug pricing deal. While some details in the deal Congressional Democrats put forward on Tuesday are not yet clear, STAT breaks down what appear to be the early winners and losers. Winners include House Speaker Nancy Pelosi, moderate Democrats, employers and seniors with high drug costs. Losers include drug makers, pharmacy benefit managers, and progressive democrats. The package’s path forward is unclear, but its inclusion at all is a coup for Democrats facing stiff opposition from the pharmaceutical industry,” STAT reports.
How federal rules can help public health agencies get the data they need. In response to the final Physician Fee Schedule Rule (to published in the Federal Register Nov. 19, 2021) from the Centers for Medicare and Medicaid Services, a Pew analysis explains that “the recent moves from CMS represent a major step toward giving agencies timely, electronic data, which can help save lives.” Pew adds, however, that the rules are not enough to enable adequate sharing of information. “States and localities also need to ensure their public health agencies can accept this data and require that it be sent to them electronically.”
A new report from Milliman and the Better Medicare Alliance’s Center for Medicare Advantage examined the cost benefit of Medicare Advantage (MA) plans vs. Medicare Fee-for-Service (FFS) plans. The report found that the additional benefits and reduction in cost sharing for MA plans compared to Medicare FFS plans comes out to $123 per member per month. The findings suggest that MA plans offer a significant value to the federal government,
Dallas Mavericks owner and entrepreneur Mark Cuban has started his own pharmacy benefit manager (PBM), Mark Cuban Cost Plus PBM. The company’s CEO, Alex Oshmyansky, said the organization will share 100 percent of the rebates it receives from drug makers and details of the operating costs. The company will make back its costs plus a 15 percent margin. The three largest PBMs control 77 percent of the market.
A report from Kaiser Health News examines how a couple who gave birth to a child during a routine procedure and got billed for emergency services. The takeaway from KHN is that “anything in our health system labeled as an emergency room service likely comes with a big additional charge.”
Fortune details how a new hospital in Loma Linda, California, valued at $1.5 billion, features a variety of design features intended to improve its resiliency in the face of Earthquakes and other massive trauma events. This protection comes through a “unique and relatively uncommon system that will allow the quaking earth to move beneath the main hospital building without any but the most intense shaking felt above.”
There have been at least 30 strikes of health care workers so far this year, according to a tracker from Cornell University’s School of Industrial and Labor Relations. A record number of health care workers are quitting their jobs. Politico reports how these strikes are impacting hospitals in pandemic hot spots.
The 19th News looks at a transgender health clinic in Western Massachusetts. According to the 2015 U.S. Transgender Survey by the National Center for Transgender Equality, just 40 percent of transgender people were out to all of their health care providers. Many providers have also historically struggled to provide truly comprehensive transgender care.
Amazon is hiring lobbyists for its health care operation, according to STAT, which reports the company “has started a search for three additional health care policy advocates who will focus on federal health care policy, health devices and services, and state-level health policy.” Ivan Adler, a D.C.-based headhunter specializing in lobbying, told STAT: “Someone like Amazon, when they set out to hire four more health care lobbyists, that’s an indication of their priorities. There’s no doubt that health care is a growth area for them.”
Private equity investments as a divining rod for market failure: Policy responses to harmful physician practice acquisitions. That private equity into health care and physician practices has increased is not a matter of debate – but whether the impact overall is positive or negative remains to be seen. “Given a recent surge in acquisitions and the relatively nascent evidence base, it will take time to understand the impact of private equity investment on physician practices … It is unclear whether private equity investment is itself a problem or whether, in the absence of private equity, other sources of capital—such as public equity, venture capital, health systems, and insurers—would similarly exploit existing market failures and legal loopholes in the health care system,” the Brookings authors noted. The authors also offer four recommendations to address the issue with policies targeting both private equity and “market dysfunction not related to private equity.”
Francis Collins’ resignation could complicate the fight over funding for ARPA-H. Describing ARPA-H as “arguably the largest initiative the [NIH] has undertaken in decades,” STAT reports that the proposed $6.5 billion to advance progress in major diseases, including Alzheimer’s, cancer and diabetes, could lose momentum as Collins leaves the agency. “His departure could further complicate the debate over how much new funding the NIH and ARPA-H should receive, and whether the two agencies could end up in a de facto battle for the same pot of research money.”
Opinion: Drug companies say we can have innovation or lower prices. That’s a false choice. Ezekiel Emanuel, writing in Politico, counters the common argument that the federal government imposing controls on drug pricing will inhibit innovation. “There are several reasons to think drug price regulation will not reduce R&D for innovative drugs. Companies in other industries spend more on R&D than do drug companies, even though they have lower profit margins,” Emanuel explains. “Clearly, many other industries do not need the same super high prices and profits to justify high investments in innovation.” (Editor’s note: For more on drug pricing and innovation see the item immediately below written by Commonwealth Fund President David Blumenthal.)
David Blumenthal, MD, president of the Commonwealth Fund and former National Coordinator for Health IT in the Obama Administration, argues in Harvard Business Review that large pharma companies are “no longer the dominant source of true innovation, and maintaining their enormous profits at current levels — which, at 15% to 20% of revenues, well exceed market standards — is no longer an efficient way to promote biomedical innovation.” He and others lay out a plan to increase drug innovation.
According to a new report from Rock Health, “Q3 2021 secured $6.7B across 169 deals, just beating out Q1 ($6.4B) to be the second-highest quarter of digital health funding ever, surpassed only by its immediate predecessor Q2 ($8.2B).”
This report from Kaiser Health News examines a dispute between Anthem, United Healthcare and other insurers and several hospitals across the country. Hospitals claim the insurers are behind in payments, to the tune of billions, owed to them because of “onerous new reimbursement rules, computer problems and mishandled claims.”
We’re already barreling toward the next pandemic. Writing in The Atlantic, Ed Yong notes that the U.S. collectively set itself up to fail against the Delta variant by not learning from the original SARS-CoV-2 virus but instead declaring victory, easing restrictions, scaling back reporting in some states and even throwing away rapid test kits. “Delta was an audition for the next pandemic, and one that America flubbed,” Yong wrote. “How can a country hope to stay 10 steps ahead of tomorrow’s viruses when it can’t stay one step ahead of today’s?”
Why U.S. talent shortages are at a 10-year high. More than half of employers globally are experiencing talent shortages and, in the United States, 69 percent report that they are struggling to fill positions, which is both a marked increase from the14 percent in 2010 and the highest rate in more than a decade, according to ManpowerGroup. “With the majority of Baby Boomers moving out of the workforce by 2030, younger generations will not necessarily have the experience or training necessary to fill many of the jobs left behind,” according to Forbes. “And for those that do, many are rethinking whether climbing the corporate ladder is really worth it.”
’Health equity tourists’: How white researchers are colonizing research on health disparities. With the NIH committing nearly $100 million to health disparities research, a STAT investigation found “a gold rush mentality where researchers with little or no background or training in health equity research, often white and already well-funded, are rushing in to scoop up grants and publish papers.” Even worse, the outlet identified dozens of instances in which white researchers either use the work of or consult with Black and Brown researchers without citing them as expert sources or otherwise giving credit.
Why I chose Cerner. Incoming CEO David Feinberg, MD, explains the reasoning behind leaving Google to join an EHR company and illustrates the point with two stories. The first is about a 12-year-old boy having a psychotic break, the second includes a third-grade girl who wrote a Haiku about suicide. “I join Cerner this week after having built my early career around helping children and families, which then led to opportunities at UCLA, Geisinger and Google. The greatest impact I can have on health care quality and accessibility is at a company where every day we wake up thinking about how to use technology to improve people’s lives,”Feinberg wrote in a post on LinkedIn.
How the COVID-19 pandemic laid bare America’s diabetes crisis According to the CDC, 40% or more of the people who died with COVID-19 also had diabetes. This is because when the pandemic hit, people with the chronic disease were already in worse shape than in years. Reuters has a new report examining this American crisis.
There is a record number of people quitting health care jobs. According to Bloomberg, turnover is getting worse across certain sectors and types of jobs, including record number of people quitting in health care. This report on the tight labor market should be eye opening for any CEO.
Biden administration seeks to expand telehealth in rural America. HHS announced last month it was distributing nearly $20 million to strengthen telehealth services — usually medical appointments that take place by video or phone — in rural and underserved communities, The New York Times reports. This funding, from the Health Resources and Services Administration, is separate from the money that was part of the American Rescue Plan.
Digital messages from patients to doctors spiked during the pandemic. The number of digital messages from patient to doctor increased by over 150 percent at the start of the COVID-19 pandemic, and the levels stayed high over the course of 2020, The Verge reports citing data from EHR company Epic. “We turned on 24/7/365 access for patients (who of course like it) with no operational or business model to handle it,” Bob Wachter, MD chair of the department of medicine at the University of California, San Francisco wrote on Twitter.
If businesses can mandate vaccines, they should mandate affordable health care, too. Noting that the U.S. is facing “the moment of truth for medical spending,” Robert Pearl, MD, former CEO of the Permanent Medical Group, called on United Airlines, Google, Facebook and other top-tier companies to apply similar behavioral science that has gained acceptance regarding vaccines to make health care itself more affordable. “Why stop with vaccines? American businesses have the ability and opportunity to solve our nation’s other major medical crisis: the unaffordability of health care,” Pearl wrote in Forbes. “If private institutions can save lives with vaccine mandates, they could also save lives by lowering the costs of medical care. To do so, businesses must team up, demand greater efficiency and quality from healthcare’s stubbornest forces, and drive innovation in an industry that’s still stuck in the last century.”
Unvaccinated COVID patients cost the U.S. health system billions of dollars. A Kaiser Family Foundation analysis of CDC and HHS data determined that there were 287,000 preventable COVID-19 hospitalizations during June, July and August of 2021. “If each of these preventable hospitalizations cost roughly $20,000, on average, that would mean these largely avoidable hospitalizations have already cost billions of dollars since the beginning of June,” Krutika Amin and Cynthia Cox wrote on the Peterson-KFF Health System Tracker website. “Based on our estimates, we find preventable COVID-19 cost $5.7 billion from June to August in 2021.”
The Keckley report: American College of Physicians urges limits on private investments in health care. In response to what he described as the ACP’s “strongly worded position paper recommending regulatory actions to limit the role of private investments in health care,” Paul Keckley counters that the current financial climate is opportune for private investment. “Financial investors like Bain, Goldman Sachs, TA, Vestar and 200 others along with strategic investors like Optum, Amazon and CVS see healthcare as an untapped market for shareholder value creation. Strong corporate earnings and the friendly monetary policy of the Fed have bolstered private equity’s dry powder to $703 billion, including $179.6 billion raised in the first half of this year,” Keckley wrote. “Hot spots for deals are in mental health, clinical analytics, home-based services, managed health plans and primary care — where some funds are paying up to 14 times adjusted EBITDA and borrowing up to 8 times the target’s EBITDA to finance their deals.”
Over 230 medical journals: Climate crisis is the greatest health threat. In a first for so many publications aligning messaging to world leaders, the New England Journal of Medicine, the Journal of the American Medical Association, the Lancet and the British Medical Journal and others published an editorial ahead of the Un General Assembly scheduled for November, according to Axios. “Despite the world’s necessary preoccupation with Covid-19, we cannot wait for the pandemic to pass to rapidly reduce emissions,” the authors wrote.
Can health care be disrupted? ChenMed CEO Chris Chen, MD, participated in the Health Evolution Summit and walked away with that very question. “Disruption is inevitable,” Chen wrote. “But the question of ‘when’ remains.” Likening the status quote health care industry to Goliath as being both protected and weighed down buy its armor, Chen called for smaller organizations to be courageous. “Quick and nimble disruptors like David can prevail if they – and those who can enable them – summon the courage to take on the bigger opponent.”
9 behaviors that make effective leaders, according to Google Research. To try and pinpoint what makes leaders effective, Google sends employees a 13-question survey about their managers. The company then leveraged that data “on high-performing teams into a feedback mechanism that helps leaders understand how they’re doing and which traits they might need to develop further,” Fast Company reported. Some of the nine attributes are likely straightforward to most CEOs, notably the need to give actionable feedback, show consideration for people and keep the team focused on results. Others include the ability to have meaningful conversations that guide employees career development.
HHS establishes Office of Climate Change and Health Equity. The Biden administration has created the Office of Climate Change and Health Equity (OCCHE) within HHS. The office will aim to identify communities with disproportionate exposures to climate hazards and vulnerable populations and address health disparities exacerbated by climate impacts to enhance community health resilience. “We’ve always known that health is at the center of climate change, and now we’re going to double-down on a necessity: fighting climate change in order to help protect public health in our communities.” said HHS Secretary Xavier Becerra.
Lack of a vaccine mandate becomes competitive advantage in hospital staffing wars. Kaiser Health News reports how rural health care facilities are being forced to forgo a vaccine mandate as available labor within the industry is at all time low. “Obviously, it’s going to be a real challenge for these small, rural hospitals to mandate a vaccine when they’re already facing such significant workforce shortages,” Alan Morgan, head of the National Rural Health Association, said to KHN.
Five decades later, Medicare might cover dental care. The New York Times reports that adding a dental benefit to Medicare, through the budget reconciliation process, has universal support of Democrats and could improve affordability for elderly dental care. Nearly half of Americans 65 and over didn’t visit a dentist in the last year, and nearly one in five have lost all their natural teeth, according to The Times.
Biden’s top-down booster plan sparks anger at FDA. Politico says it spoke with 11 current and former health officials and people familiar with the matter who described growing exasperation with the administration’s disjointed process for implementing its booster plan.
Will breaking apart Google’s health bets give them a better shot at success? STAT reports that industry observers say that Google breaking apart its health division may actually strengthen its work across various parts of the business. “I can easily imagine that splitting up parts of Google Health would streamline decision-making and let each move faster,” Andrew Matzkin, a partner at the consulting firm Health Advances, told STAT.
Hospitals and insurers didn’t want you to see these prices. Here’s why. A report from The New York Times looks at the prices that different hospitals charge for medical procedures and how much various insurance companies are negotiating on behalf of their patients. In some cases, insured patients are getting prices that are higher than they would if they pretended to have no coverage at all.
Holes in reporting of breakthrough Covid cases hamper CDC response. Politico reports that the CDC is using outdated and unreliable data on coronavirus breakthrough infections to help make major decisions. Many states sending data to the CDC do not have the capacity to match patients’ hospital admission data with their immunization records.
A drug addiction risk algorithm and its grim toll on chronic pain sufferers. Is an algorithm that is central to how the U.S. is fighting the opioid crisis only making things worse? “A growing number of researchers believe that NarxCare and other screening tools like it are profoundly flawed,” according to an article in Wired, which cites a study that found 20 percent of patients flagged as doctor-shoppers to actually have cancer, which often requires seeing multiple specialists. “The AI that generates NarxCare’s Overdose Risk Score is, to many critics, even more unsettling.”
Private equity and health care delivery: Value-based payment as a guardrail? While private equity has increased in health care during the last decade, researchers and policymakers have expressed concern because “high-quality evidence on the influence of private equity ownership on health care delivery is limited, and often conflicting.” Yet the authors in a JAMA Network article contend that the pros and cons of value-based payment models relative to affordability, access, equity and quality should be considered more than they often are. “Value-based payment is often viewed as a mechanism to increase alignment between payers and delivery organizations, but it may also create better alignment with other groups involved in health care delivery, including investors,” they wrote.
Telehealth research snapshot. The University of Michigan Institute for Healthcare Policy & innovation’s Telehealth Research Incubator published a report examining access, costs, user experience and more. Key findings: “Telehealth use grew during COVID-19, but total care remains at the same level, suggesting that telehealth has largely been used as a substitute for in-person care. Nearly all specialties use telehealth, there is wide variation in use. Smaller and rural practices have lower rates of telehealth use,” the authors wrote. “Patients using direct-to-consumer telehealth are more likely to be female, be a nonelderly adult, live in an urban area, and have fewer comorbidities.”
Top 10 most expensive popular brand name drugs in the U.S. The most expensive medication, Humira, commands an average monthly price of $9,056 in GoodRx’s ranking. The least expensive? Latuda at $1,604. Five of the top 10 cost more $5,000 each. GoodRx, which aims to help consumers save money on health care, disclosed that it does not include insurance copayment or coinsurance payments in its calculations.
The social network for doctors is full of vaccine disinformation. CNBC details how vaccine misinformation is rampant on Doximity, a social media network specifically for doctors. Articles on the site about vaccines and masks have hundreds of comments, with plenty of physicians sharing debunked conspiracy theories. The company had an IPO in June and is worth $10 billion.
Will controversy over new Alzheimer’s drug spell the end for the FDA’s faster approval process? STAT reports accelerated pathway from prescription medication approval is under intense scrutiny after the FDA used it to greenlight Biogen’s controversial new Alzheimer’s drug, aducanumab, known by its brand name Aduhelm. The Office of the Inspector General at the Department of Health and Human Services recently announced it was looking into the approval process.
‘We’re in trouble’: Rural America can’t escape Delta. Politico reports that states “with low vaccination rates — including Louisiana, Alabama and Missouri, where rural transmission is occurring — are already battling sharp increases in new cases and hospitalizations attributable to the Delta variant.” Across the country, Biden health officials have for weeks worried internally about the low vaccine uptake in rural, conservative counties across the country.
Delta variant exposes two flaws that could undermine recovery. Paul Keckley opens with three “chilling” impacts of the Delta variant since the 1st of July: Soaring cases and hospitalizations, record high drops in the stock market and eroding consumer confidence. Those factors point to two flaws: the politics of science and the conundrum of mandates. “How the Delta variant is managed by state and federal public health leaders in concert with local hospitals and caregivers, how employers and school systems choose to influence vaccinations, and how media disable sensationalism in favor of science and common sense are keys to the normalcy we thought near just 30 days ago,” Keckley writes. “It might prove to be a blessing in disguise if these two flaws are addressed.”
Boldly evolving dentistry into whole-person care, part 1: Why dentistry lags in quality measurement. In this Forbes column, former Senator Bill Frist predicts that “over the next five years oral health increasingly will be integrated into whole-person care. And in parallel standardized quality and outcomes measures will be demanded. These quality outcomes — if known, accurately measured, and appropriately shared — could be used to continually improve quality and inform standards of care.” Why now? “The solo practitioner simply does not have a strong incentive to fastidiously track quality metrics. It adds a real administrative burden and cost onto a small practice with no financial benefit. In contrast, the newer and increasing number of dental service organizations (DSOs) are well positioned to push forward the quality agenda.”
Analysis of racial gaps in hospital care. The U.S. News & World Report examination of federal data reveals stark realities about the numbers of Black, Hispanic, Native American and Asian/Pacific Islander people and the common procedures they receive relative to the makeup of 1,400 hospitals’ communities. “When patients of different races tend to gravitate to different hospitals, minority patients – particularly Black patients – typically receive care at lower-quality hospitals,” is among the findings.
I was the architect of Operation Warp Speed. I have a message for all Americans. Former Health and Human Services Secretary Alex Azar in a New York Times opinion piece reiterates the non-partisan nature of both the coronavirus that causes COVID-19 and the vaccines developed to fight it. “The reluctance and even refusal of many Americans — including many of my fellow conservatives and Republicans — to get a Covid-19 vaccine is a frustrating irony for those of us who worked to expedite these vaccines,” Azar writes, adding that he “fully supports” the Biden administration’s efforts to persuade all unvaccinated Americans to get the shots. “Any claims that the vaccines are unsafe or ineffective, or that corners were cut are not true.”
The Last Smallpox Epidemic in Boston and the Vaccination Controversy, 1901–1903. This New England Journal of Medicine article from February of 2001 re-emerged on social media this week because of the striking similarities between the struggles with COVID-19 and the challenges experienced as the U.S. battled the smallpox epidemic, notably what was described then as “anti-vaccine heresy” versus “compulsory vaccination.”
First came the ransomware attacks, now come the lawsuits. Since the ransomware attack that shut down Colonial Pipeline, the organization is now facing a class-action lawsuit representing hundreds of gas stations that had to shut down. In this regard, Colonial Pipeline joins Target, Home Depot and others that have been sued for insufficient security after a ransomware attack—including Scripps Health, which was hit with a class-action suit in April of 2020. “The rise in lawsuits may mean companies and organizations that are hacked are no longer just on the hook for reimbursing people who had their data stolen,” the Washington Post reported. “They could now be liable for all kinds of damages that go well beyond a heightened risk of identity theft or credit card fraud.”
The little-known agency that’s trying to boil the ocean—a look at CMMI’s decade of trying to change Medicare and Medicaid. “What has been achieved?” Former Senator Bill Frist, MD, writes in Forbes. “Impressive figures capture the progress, including having launched 54 very different models that address a broad array of areas such as primary care, oncology, chronic kidney disease, and cardiovascular conditions. Nearly one million providers have participated, serving 26 million patients, leading the system-wide move to value-based care. Despite these remarkable numbers, only five of the 54 models delivered substantial financial savings. The majority have not saved money, and several are on pace to lose billions of dollars.” Frist delves into four lessons learned and examines the direction he expects CMMI to take moving into the future.
Accelerated approval, the path used to greenlight Biogen Alzheimer’s drug, has a checkered track record, critics say. STAT+ recounts the 2016 accelerated approval of Exondys 51 for childhood Duchenne muscular dystrophy. Sarepta Pharmaceutical has yet to conduct a randomized controlled trial to demonstrate effectiveness and while the deadline has passed, the drug remains available at a price of $300,000 a year. Will history repeat with Aduhelm?
Provisional life expectancy estimates for 2020. The CDC on July 21 published data showing that overall life expectancy in 2020 declined by 1.5 years in the U.S. since 2019. “Life expectancy at birth for males was 74.5 years in 2020, representing a decline of 1.8 years from 76.3 years in 2019. For females, life expectancy declined to 80.2 years, decreasing 1.2 years from 81.4 years in 2019,” the CDC wrote. “Between 2019 and 2020, life expectancy decreased by 3.0 years for the Hispanic population (81.8 to 78.8) (Figure 2). It decreased by 2.9 years for the non-Hispanic black population (74.7 to 71.8) and by 1.2 years for the non-Hispanic white population (78.8 to 77.6).”
Why aren’t the vaccines approved? Despite calls for the FDA to move the Pfizer, Moderna and J&J vaccines beyond their status of emergency use authorization, the agency has yet to issue formal approval. Until that happens, the military, schools and other organizations cannot require vaccination. “The strangest part of all this is that the FDA’s official position does not reflect its leaders’ actual views: They agree with the C.D.C. and other scientists that Americans should be getting vaccinated as soon as possible,” according to the New York Times.
Telehealth: A quarter-trillion-dollar post-COVID-19 reality? According to a new report from McKinsey, telehealth utilization has stabilized. After an initial spike to more than 32 percent of office and outpatient visits occurring via telehealth in April 2020, utilization levels have largely stabilized, ranging from 13 to 17 percent across all specialties.
How Biogen used an FDA back channel to win approval of its polarizing Alzheimer’s drug. In this STAT report, it’s revealed that Biogen executives mounted a secret campaign, code-named “Project Onyx,” to resurrect Aduhelm and convince the FDA to give it the green light. Central to this happening was the company’s relationship with the agency’s top regulator of Alzheimer’s drugs.
Federal speech rulings may embolden health care workers to call out safety issues. A recent decision by the First U.S. Circuit Court of Appeals could mean that hospitals and other employers will need to revise their policies barring workers from talking to the news media and posting on social media, Kaiser Health News reports.
Virtual care becomes a common cause in a divided Congress. Politico has the legislative outlook for telehealth and whether Medicare will make the temporary rules created during COVID to expand coverage permanent. The efforts have bipartisan support and Senator Brian Schatz (D-Hawaii) has introduced a bill that would permanently enshrine many of the COVID-era Medicare coverage and payment rules. It has attracted 59 co-sponsors.
Women, minorities remain underrepresented in biotech C-suites, on boards. According to a new analysis from Bedford Group/TRANSEARCH, just under 6 percent of biotech CEOs were women last year, and 14 percent of board members were women. The firm analyzed 225 biotech and pharmaceutical companies are listed on the Nasdaq, headquartered in the U.S. and have market caps of under $2 billion in coming to this conclusion.
Report: 70 percent of U.S. physicians are now employed by hospital systems and corporate entities. A new report from Avalere and the Physician Advocacy Institute paints a stark picture for the independent American physician. According to their data, 48,400 additional physicians left independent practice and became employees of hospitals or other corporate entities – 22,700 of that shift occurred after the onset of COVID-19. This represents a 12 percent growth in employed physicians in a two-year period.
Eli Lilly CEO says drugmaker will keep looking for ways to cut insulin costs as Walmart debuts lower-price rival. David Ricks, CEO of Eli Lilly, told CNBC that the company welcomes Walmart’s efforts to lower the cost of insulin. On exploring their own low-cost insulin alternatives, Ricks said, “We always look at new solutions ourselves, and this is an interesting development and we’ll look at further options. If we can reach one more patient with more affordable insulin, we’re going to try to do that.”
The unlikely force shaping Amazon’s health plans: A veteran, doctor, and TV persona with big ideas for tech. STAT profiles Vin Gupta, Amazon’s chief medical officer of pandemic response. Gupta, with a background in global health and disease surveillance, is working on everything from diagnostics to public health communications at the tech giant.
New drug could cost the government as much as it spends on NASA. According to analysts quoted by The New York Times, Medicare and its enrollees will spend $5.8 billion to $29 billion on the new Alzheimer’s drug Aduhelm in a single year. NASA has a budget of $23 billion.
Obamacare ruling paves way for fixing flaws in biosimilar system. The Supreme Court upholding the ACA means the Biologics Price Competition and Innovation Act (BPCIA) will stand. Tucked into the ACA, BPCIA allows drugmakers get around hurdles like certain extensive clinical trials to market biosimilars—versions of biologics that mimic the originals. This ensures patients still have easier access to cheaper versions of some of the market’s most expensive therapies. However, experts say an adjustment is needed to ensure greater savings.
Hemmed in at home, nonprofit hospitals look for profits abroad. With the challenge of stagnant or declining revenues at home, three dozen of America’s elite hospitals and health systems are doing business overseas, Kaiser Health News reports.
We worked together to improve access to health care amid COVID-19. Here’s what we learned. In this op-ed for the Louisville Courier Journal, Andy Beshear, Governor of Kentucky; Steven J. Stack, MD, Kentucky Commissioner for Public Health; J. Nwando Olayiwola, MD, Humana Chief Health Equity Officer; and Kelly C. McCants, MD, Norton Healthcare executive director of the Institute for Health Equity write an op-ed about successful strategies they employed in vaccinating communities of color.
What if doctors are always watching, but never there? In this piece for Wired, Neil Singh, MD, a primary care physician in Brighton, England, and a senior teaching fellow at Brighton and Sussex Medical School, explains why he is hesitant about a future where remote patient monitoring is commonplace. “I worry what remote monitoring of patients will mean for a core but underappreciated job of a physician: namely, to bear witness,” Singh says.
The CEO of the Alzheimer’s Association on the approval of Aduhelm —and why critics should stop dwelling on the decision. In this interview with STAT, Harry Johns, CEO of Alzheimer’s Association, says that “dwelling on the approval” of Aduhelm is not “productive for those who can benefit from the treatment. He says that the “negative voices” criticizing the decision are “not pro-patient.”
For transgender people, finding mental health services that meet their needs is difficult. The 19th reports on the difficulties that transgender patients face when trying to obtain mental health services. “Even though you may find a therapist who is compassionate and wants to be helpful, they don’t have enough exposure to trans people, widely speaking,” said Jamison Green, past president of the World Professional Association of Transgender Health. “I do think a lot of people have become more culturally sensitive and less judgmental, but it doesn’t mean they have knowledge.”
Op-ed from Sachin Jain, MD: Health care needs a civil rights movement. In this article for Forbes, SCAN Health Plan CEO Sachin Jain, MD, writes about the need for a wholesale change and genuine reform in the way care is delivered. “We need bold leaders who will admit that our current system is an embarrassment,’ Jain writes.
Regeneron shareholders urged to boot board member over executive pay practices. According to STAT, “two prominent shareholder advisory firms are urging Regeneron Pharmaceuticals shareholders to remove a director who is on the compensation committee.” The firms argue that the director, George Sing, created an executive compensation platform that gives the shareholders no flexibility to remove CEO Leonard Schleifer and president and chief scientific officer George Yancopoulos if their job performance declines.
Why did One Medical buy Iora for $2.1 billion? Malay Gandhi, head of strategy at Benchling and a digital heath expert, talks about the decision by One Medical to buy Iora Health for $2.1 billion in an interview with Christina Farr, an investor with OMERS Ventures. “One Medical and Iora as a combined entity address nearly every segment and distribution model in primary care,” Ghandi says.
CEO pay rises to $12.7 million even as pandemic ravages economy. An annual analysis of CEO pay by the Associated Press and Equilar found the median compensation increased by 5.2 percent in 2020. Among the 342 S&P CEOs in the AP survey, the overall median rose to $12.7 million. According to the U.S. Bureau of Labor Statistics, median base salary for CEOs in the health care and social assistance industry ranked third, falling behind manufacturing and professional, scientific and technical services.
Why Apple and Google’s virus alert apps had limited success. When Apple and Google announced they were working together to create a smartphone-based system to track the virus, it seemed like a game changer. However, the collaboration hasn’t worked out quite like the two companies had hoped. The New York Times reports on why this venture has sputtered.
Doctors tell how to make the most of your telehealth visits. Kaiser Health News talked with doctors on telehealth and its usage going forward. The docs gave tips on the types of concerns that are best handled in person, and when video visits are most useful.
AHIP renames itself. America’s Health Insurance Plans (AHIP) announced that it will go simply by AHIP going forward. It also unveiled a new logo, which aims to convey a more modern, more inclusive and even more active AHIP, along with a new tagline.
Op-ed from former FDA commissioner Scott Gottlieb, MD: Beat tomorrow’s pandemic today. Former FDA Commissioner Scott Gottlieb, MD writes this op-ed for The Wall Street Journal on why it’s imperative health care industry stakeholders build up manufacturing capacity to scale up the production of vaccines and therapies before the next pandemic hits.
Buoyed by federal COVID aid, big hospital chains buy up competitors. Two sides of the provider coin were featured in articles this week. The New York Times reports how federal aid helped big health systems continue to acquire smaller hospitals. “Congress provided capital to hospitals that did not need it,” the Times quotes Zack Cooper, a Yale health economist. Rod Hochman, CEO of Providence, is quoted in this article defending consolidated health systems.
Shuttered hospitals, soaring COVID-19 deaths: Rural Black communities lose a lifeline in the century’s worst health crisis. On the flip side, STAT reports on the financial struggles of rural hospitals amid the COVID-19 pandemic. They report that a “record 19 rural hospitals closed in 2020, according to research from the University of North Carolina at Chapel Hill — more than in any other year.”
52 percent of insurers do not plan on raising rates. In a new survey from eHealth, 52 percent of insurers say they do not anticipate raising rates due to the COVID pandemic, 39 percent do anticipate raising rates, but no more than 5%. One-third are changing benefits, with most changes centered around telehealth and mental. health.
Click-and-mortar is a better model for health care. Jennifer Schneider, former president of Livongo along with Bob Kocher, founder of Lyra Health and partner at Venrock and Richard Lu, a medical student at Harvard wrote an op-ed in Tech Crunch about how the future of health care is a hybrid model called “click-and-mortar.” The authors say that this approach combines “the best elements of in-person and virtual care to deliver better outcomes more reliably and efficiently.”
Institutional resilience: The foundation for individual resilience, especially during COVID-19. Helen Riess, MD, Co-Founder and Chief Scientist, Empathetics and Associate Clinical Professor of Psychiatry at Harvard Medical School, writes an op-ed about the value of empathy in a resilient health care organization. “Institutional values of safety, access to accurate and caring information, human connection, and emphasis on mental health, are hallmarks of resilient organizations and will result in resilient individuals,” says Riess.
Racism derails Black men’s health, even as education levels rise. Racism affects Black men’s health and it is persistent, Kaiser Health News reports. “No matter how far you go in school, no matter what you accomplish, you’re still a Black man,” Derek Novacek, who a health disparities researcher said in an interview with Kaiser Health News. Black men have worse health than other groups when they are not educated and can’t catch up to their white peers when they are.
Health care strikes yield mixed returns for COVID-weary workers. Despite an increasing number of strikes during the pandemic, the number of new collective bargaining agreements in health care dropped by more than a third since the start of the pandemic, reaching 140 since March 2020, Bloomberg Law reports.
Blue Health insurers drop revenue rule that limited competition. The Blue Cross Blue Shield Association dropped a rule that limited competition among its member insurers, moving to implement a key aspect of an antitrust settlement the companies reached last year with customers, The Wall Street Journal reports. The settlement is still awaiting final approval from the federal judge presiding over the litigation.
Acknowledging its ‘white patriarchy’ and racist past, the AMA pledges to dismantle causes of health inequities. In an 83-page report on racial equity, the American Medical Association acknowledged its racist past including the ways it has excluded Black, brown, and Native physicians, espoused racism, and harmed people of color. “We cannot deny that AMA’s silence has … contributed to and had a negative impact on historically marginalized and minoritized communities,” the report says according to STAT.
Therapy on aisle 7: Retailers are entering the mental health market. CVS has added licensed clinical social workers trained in cognitive behavioral therapy to 13 locations in the Houston, Philadelphia and Tampa metro areas, according to The New York Times. The company plans to offer mental health assessments, referrals and counseling either in person or via telehealth. Walmart, Rite Aid and Walgreens are also offering mental health services.
Digital health startups are booming. Their customers are overwhelmed. According to a report in The Wall Street Journal, corporate-benefits executives are excited about the increasing amount of digital health technology that can lower costs and improve employees’ health. However, the activity has spawned a glut of startups pitching redundant or overpriced services. “Everybody’s excited because there’s so much damn money floating around. After Livongo got sold, everyone said, ‘Where’s my piece?’ Stuart Piltch, CEO of Cambridge Advisory Group, a health care consulting and data firm told WSJ.
New report recommends Americans select a primary care provider—or be assigned one. In a new report, the National Academies of Sciences, Engineering and Medicine recommends that all Americans select a primary care provider or be assigned one. It also calls on Medicare and Medicaid to shift money to primary care and away from the medical specialties. “High-quality primary care is the foundation of a robust health care system, and perhaps more importantly, it is the essential element for improving the health of the U.S. population,” the report concludes. “Yet, in large part because of chronic underinvestment, primary care in the United States is slowly dying.”
Half of voters say lowering the cost of prescription drugs should be a priority. A new poll from Morning Consult found that 50 percent of voters, including 55 percent of Democrats and 46 percent of Republicans, said passing legislation to lower drug costs should be a top priority for Congress. Almost 60 percent of voters say lowering health care costs should be a priority for Congress.
10 health system CEOs sign health care worker safety pledge.The list of signees includes Tomislav Mijaljevic, MD, CEO and President of Cleveland Clinic, Wright Lassiter, President and CEO of Henry Ford Health System, Marc Harrison, MD, President and CEO Intermountain Healthcare, Rod Hochman, MD, President & CEO of Providence, Laura Kaiser, President and CEO of SSM Health, and more.
How Pfizer makes its COVID-19 vaccine. The New York Times has an in-depth look at the “complex manufacturing and testing process” of creating the Pfizer COVID-19 vaccine. The process takes 60 days and involves Pfizer facilities in three states. “Rarely do you work on something in the lab and go home and turn on your TV and see the top 10 headlines are about the thing that you were working on today,” said Katherine Calhoun, a scientist with Pfizer to The New York Times.
Health spending for 60-64 year olds would be lower under Medicare than under large employer plans. According to new analysis from Kaiser Family Foundation, lowering the age of Medicare eligibility from 65 to 60 would likely lead to lower revenues for hospitals, physicians, and providers who deliver care to 60-64 year olds. On the flipside, it would also “reduce health care spending for people who shift from large employer plans to Medicare, potentially saving money for people, employers, and the federal government in the form of reduced tax subsidies for employer coverage.”
Lloyd Dean: Our journey to one million COVID-19 vaccine doses. Lloyd Dean, CEO of CommonSpirit Health, shares his organization’s journey to administering one million COVID-19 vaccine doses in this LinkedIn post.
Every company is a tech company now. The disruption is just beginning. TIME has launched the TIME100 Most Influential Companies, which highlights companies that are shaping “our collective future, as well as the leaders who steer them.” The list includes Walgreens, Pfizer, BioNTech, CVS, Johnson & Johnson, Moderna, Illumina, and others in the health care industry.
States have a new COVID problem: Too much vaccine. This report from Politico reveals that many states are experiencing a challenge with too much vaccine supply. Several states are now administering fewer 75 percent of the doses they receive, according to the Centers for Disease Control and Prevention. One report found that 25 percent of people across Mississippi, Montana, North Dakota and Wyoming expressed reservations about being vaccinated.
Humana Health Plan overcharged Medicare by nearly $200 Million, federal audit finds. Kaiser Health News reports that a Humana health plan for seniors in Florida overcharged by $200 million in 2015 by overstating how sick some patients were, according to a new federal audit. Humana sharply disputed the findings of the audit.
Opinion: FTC’s challenge to Illumina’s vertical merger with Grail is all wrong. Joe Lonsdale, an entrepreneur and technology investor at 8VC, wrote an op-ed in STAT saying that the FTC’s arguments in trying to prevent the Illumina-Grail merger are wrong. “The FTC’s prosecutors don’t understand that a division of labor between R&D startups and large pharmaceutical companies is the lifeblood of biotechnology,” he writes.
Pfizer identifies fake COVID shots abroad as criminals exploit vaccine demand. The Wall Street Journal reports on how the pharma company has discovered counterfeit versions of its COVID-19 vaccine in Mexico and Poland. About 80 people at a clinic in Mexico received a fake vaccine going for about $1,000 a dose, according to the report.
A private-sector partnership to promote equitable vaccine delivery. Cheryl Pegus, MD, Walmart executive vice president of Health and Wellness, Kristin Russell, MD, Medical Director at Humana and William Shrank, MD, CMO at Humana authored an op-ed in JAMA about the partnership between the two companies in rolling out the COVID-19 vaccine in underserved communities. They say this effort thus far “demonstrates the power of private-sector partnerships brought together with speed to solve something as important as equitable distribution of vaccines during a pandemic.”
Underserved communities bear brunt of paused Johnson & Johnson rollout. The decision by federal health officials to recommend a pause in the use of Johnson & Johnson’s coronavirus vaccine will have an impact for transient and hard-to-reach populations, The Washington Post reports. The article details how the J&J pause has already impacted underserved communities in Ohio, Michigan, and Illinois.
When a cardiologist flagged the lack of diversity at premier medical journals, the silence was telling. Critics like cardiologist Raymond Givens, MD, say the troubling overall lack of diversity on editorial boards at prominent medical journals like JAMA and NEJM is one reason the issue of health inequities that shorten the lives of people of color have received less clinical and research attention than it should. “This deficit in diversity means there are tremendous blind spots. They don’t even know what they don’t know,” said Givens.
Biden campaigned on universal health coverage. Will his next big plan include a public option? 19th News reports that “White House officials have suggested that the next big legislative push, the details of which should be unveiled in the coming weeks, will include some kind of health insurance expansion.” However, it’s not clear if that means this will include a public option added to the ACA, which was a campaign promise from President Biden.
Medical device firms’ payments to doctors far outstripped those from pharma, study shows. According to a new study in Health Affairs, the medical device industry gave doctors consulting fees, lunches, lodging, and other incentive payments worth $904 million between 2014 and 2017. This is more than $80 million more than the pharmaceutical industry during the same time period. In particular, surgical specialists received seven times more money from device firms than drug vendors.
U.S. bet big on COVID vaccine manufacturer even as problems mounted. Emergent’s problems didn’t just start with the 15 million doses of the COVID-19 vaccine that had to be destroyed. The New York Times did an investigation of the company’s manufacturing practices at its Baltimore facility. This investigation revealed corporate culture that often ignored or deflected missteps and a government sponsor, the Biomedical Advanced Research and Development Authority, that acted more as a partner than a policeman.
Reinventing the Center for Medicare and Medicaid Innovation. Don Berwick, MD, former CMS administrator, and Rick Gilfillan, MD, former head of the Center for Medicare and Medicaid Innovation (CMMI), write an op-ed in JAMA about CMMI. They say it “has not yet become the engine that it could be for transforming the nation’s health care finance and delivery. To fulfill that potential, it needs to change, and HHS and CMS need to work more closely with CMMI to bring its lessons to much larger scale.”
Swan song for traditional employer-sponsored health insurance? David Nash, MD of Jefferson Health argues that “relentless escalation in health care costs and consolidations in the health care industry have increasingly rendered traditional employer-sponsored health insurance ‘unaffordable’ for millions of employers and their employees.” He offers a few alternatives that could transform the role of employers in the health care system.
‘All hands on deck’: When vaccinating Black people is a communal effort. In black communities in the South, lack doctors, Baptist preachers and respected community figures are trying to get people vaccinated. However, many structural problems such as a lack of access to broadband internet and a dearth of providers are making it harder to close the disparities in vaccination rates.
In U.S., an estimated 46 million cannot afford needed care. Approximately 18 percent of the U.S. population, or about 46 million people, report that if they needed access to quality health care today, they would be unable to pay for it. These results are based on a new study conducted by West Health and Gallup. Health care unaffordability runs considerably higher among Black adults (29 percent) and somewhat higher for Hispanic adults (21 percent) than for White adults (16 percent).
Building trust into telehealth. In this op-ed for Harvard Business Review, Alexa B. Kimball, MD, CEO and president of Harvard Medical Faculty Physicians and Nick Morgan, president and founder of Public Words, write that moving patient consultations to the virtual realm requires extra work by physicians in establishing trust with patients.
The saga of mishaps and miscommunications overshadowing AstraZeneca’s COVID vaccine. Top federal health officials accused AstraZenaca of highlighting in a press release overly positive data about the efficacy of its coronavirus vaccine. This is the latest mishap from the company regarding its COVID-19 vaccine, after they administered incorrect doses during clinical trials and kept U.S. regulators in the dark after pausing a trial entirely due to safety concerns. STAT outlined some of the key missteps and misfortunes that have tripped up the AstraZeneca COVID-19 vaccine.
A year fighting a global pandemic leaves US hospitals in shambles, new report finds. A new report from HHS’s Department Office of the Inspector General (OIG) paints a dire picture of the toll a year of treating a global pandemic has taken on the America’s health system and highlights the stress that operating in “survival mode” for such a lengthy period has caused those within it. HHS OIG surveyed 300 hospitals for the report and found long hours, more shifts, time away from family and increased responsibilities caused by the pandemic left staff “exhausted, mentally fatigued, and sometimes experiencing possible PTSD.
How to virtually become a doctor. A new generation of doctors is being trained virtually, The New York Times reports. Of the nation’s medical schools, three-quarters offered lectures virtually, according to a survey by the Association of American Medical Colleges, and 40 percent used virtual platforms to teach students how to interview patients about their symptoms and take their medical histories.
Why Trump and Republicans couldn’t kill Obamacare. An excerpt from The Ten Year War: Obamacare and the Unfinished Crusade for Universal Coverage by Jonathan Cohn, running in The Atlantic.
Clarify Health announces $115m Series C Funding. Clarify Health, an enterprise analytics company delivering real-world insights to health care organizations, announced it has raised $115 million in Series C funding. New investor, Insight Partners, led the round alongside Spark Capital, Concord Health Partners, and HWVP, with participation from the company’s largest investor, KKR, as well as Rivas Capital and Sigmas Group.
8 experts describe the day they realized COVID-19 was here to stay. STAT asked a range of people, including clinicians on the frontlines to virus watchers, vaccine makers, and public health specialists, to stalk about the moment last year when they realized we were in real trouble.
A $22,368 bill that dodged and weaved to find a gap in America’s health system. The New York Times shares the story of how one patient, who may or may not have had COVID, received a $22,367.81 bill. Because he was not given an official COVID diagnosis, he didn’t qualify for multiple federal health programs that would have paid for his care. He also 23 days away from qualifying for Medicare.
Vaccine hesitancy is not the problem among people of color. It’s vaccine access. Rep. Karen Bass, a Democrat who represents California’s 37th Congressional District, Marc Morial, president of the National Urban League, and Cheryl Grills, a clinical psychologist and professor at Loyola Marymount University in Los Angeles write an op-ed for The Washington Post about how access, not hesitancy, is the biggest challenge in getting people of color vaccinated.
Convalescent plasma strikes out as COVID-19 treatment. NPR reports that more than half a million Americans have received an experimental treatment for COVID-19 called convalescent plasma. But a year into the pandemic, it’s not clear who, if anyone, benefits from it.
Op-ed: Empathy is key to addressing minorities’ vaccine mistrust. In this op-ed for the Orlando Sentinel, Alric Simmonds, MD, chief health equity officer, chief medical officer and general surgeon at AdventHealth writes about the disparities that have emerged during the COVID-19 pandemic and why communities of color are less likely to trust the vaccine. He says that it is “incumbent upon the medical community and public to work toward better understanding, addressing and acknowledging the concerns that are contributing to the apprehension we are now seeing.”
The Trump administration quietly spent billions in hospital funds on Operation Warp Speed. STAT reports that Trump officials took $10 billion from a fund earmarked to help hospitals and health care providers impacted by COVID and used the money to bankroll Operation Warp Speed contracts.
Children’s Hospitals grapple with young COVID ‘long haulers’. While most of the 3 million children and young adults who have tested positive for COVID in the United States experience mild, if any, symptoms, some develop serious and potentially long-term problems. Kaiser Health News reports that clinicians are “increasingly hearing of children seeking help for different complications, such as fatigue, shortness of breath and loss of smell, that don’t go away.”
FDA analysis finds Johnson & Johnson vaccine works well. According to a new analysis posted by the FDA, Johnson & Johnson’s vaccine showed 86 percent efficacy against severe forms of COVID-19 in the United States, and 82 percent against severe disease in South Africa. Because this vaccine is only one shot, it will accelerate the speed in which people are vaccinated in the U.S. and the world.
How COVID-19 has tested the limits of hospitals and staff. Even as new cases in the United States have fallen since their peak in early January, almost three-quarters of the nation’s ICU beds were occupied over the week ending Feb. 18. The New York Times reports on how the virus has impacted the strain of ICUs throughout the country. “You don’t have time to really cry; you have to be strong for the next patient,” Lean Precilla, an intensive care unit nurse at Martin Luther King, Jr. Community Hospital, said to The Times.
More than 150 big-name CEOs endorse Biden’s COVID-19 relief plan. Notable CEOs, including Goldman Sachs’ David Solomon, BlackRock’s Larry Fink, Deutsche Bank Americas’ Christiana Riley, and Blackstone’s Steve Schwarzman, wrote a letter in support of President Biden’s COVID relief plan this week. The Business Roundtable, a group consisting of CEOs of the largest companies in America, also wrote a letter Tuesday supporting quick passage of a Covid relief bill.
Health care bore brunt of cyber-attacks in 2020. Health care and pharmaceutical companies dealt with the most cyberattacks of any industry sector in 2020 as hackers and criminals targeted companies looking for information on COVID-19 as well as vaccine development, according to a new report from cybersecurity research firm CrowdStrike.
Biden to nominate Brooks-LaSure to oversee CMS. President Biden plans to nominate Chiquita Brooks-LaSure, a health policy consultant, to the role of CMS administrator, STAT reports.
Survey: Adults more likely to get COVID-19 vaccine if they know someone who has gotten it already. According to a survey from Morning Consult, 67 percent of American adults who know someone who’s been vaccinated said they would get a COVID-19 shot, compared with 54 percent of those who don’t know a vaccinated person. Overall, 60 percent of U.S. adults said they’d get a COVID-19 vaccine if one were available to them, the survey found, with 24 percent saying they wouldn’t and 16 percent not yet expressing an opinion.
COVID response shows AI’s limits. AI companies focused on health care have attracted record investments during the pandemic, but how effective has the technology been in helping health care combat the pandemic? “Overall, the AI contribution to the pandemic has been minimal. All these models that predict things from retrospective data haven’t really changed the world,” Eric Topol, MD, of the Scripps Research Translational Institute, told Politico.
The new leader of 500 Women Scientists on finding community and supporting women of color in STEMM (Science, Technology, Engineering, Mathematics and Medicine). STAT interviewed Lauren Edwards, interim executive director of 500 Women Scientists, an organization that works to make science more equitable and inclusive, and to address the many forms of discrimination and oppression within it. “I would say to other women scientists, to have a community that is resilient and strong that can lift you through those times. Because I think, just the pursuit of so many careers, but especially STEMM, can break you down, if you don’t have that community,” Edwards said to STAT.
Lost on the frontline: Investigating 3,448 health care worker deaths. Guardian and Kaiser Health News put together an “interactive, public-facing database that aims to count and honor every U.S. health care worker – whether doctors or custodians, nursing home aides or paramedics – who has died after contracting the coronavirus on the job.”
Broad coalition of health industry groups calls for Obamacare expansion. America’s Health Insurance Plans, the American Medical Association, the American Hospital Association and a number of other industry groups are calling on the Biden administration to increase subsidies for the Affordable Care Act. They also asked the federal government to spend money helping people in plans offered by the insurance markets, an initiative that was cut back by the Trump administration.
Johnson & Johnson CEO says people may need annual COVID vaccine shots for the next several years. We may need an annual COVID-19 shot, just like seasonal flu shots, over the next several years, Johnson & Johnson CEO Alex Gorsky told CNBC. “Every time it mutates, it’s almost like another click of the dial so to speak where we can see another variant, another mutation that can have an impact on its ability to fend off antibodies or to have a different kind of response not only to a therapeutic but also to a vaccine,” Gorsky told CNBC.
CDC director says ‘bruises are going to take a long time to heal’ at agency. Of the loss in morale suffered at the CDC during Trump administration, new director Rochelle Walensky told STAT that “these bruises are going to take a long time to heal.” She said to STAT that she’s committed to doing the work necessary to help the agency recover, and has been meeting with senior leaders about how best to restore morale among the staff.
Health care unions find a voice in the pandemic. The New York Times reports that health care workers across the country are dissatisfied with their employers and government’s response to keeping them safe during the pandemic. “Dire staff shortages, inadequate and persistent supplies of protective equipment, limited testing for the virus and pressure to work even if they might be sick have left many workers turning to the unions as their only ally,” NYT reports. “We wouldn’t be alive today if we didn’t have the union,” said Elizabeth Lalasz, a Chicago public hospital nurse and steward for National Nurses United.
Hospitals suffer new wave of hacking attempts. The Wall Street Journal reports on the new threat of cyberattacks that hospitals are facing as they roll out the COVID-19 vaccine. According to the article, data reported to the U.S. Department of Health and Human Services shows that almost every month last year more than 1 million people were affected by data breaches at health care organizations.
Humana to join Cigna drug-buying group for some members. Humana announced this week that its joining a Cigna purchasing organization called Ascent Health Services, which will give it greater discounts from drugmakers, Bloomberg News reports. “This arrangement will help us leverage scale and buying power to extract deeper price discounts from drug manufacturers and advance affordability for our customers while at the same time preserve our ability to address their specific clinical needs,” Humana spokeswoman Kelley M. Murphy said to Bloomberg.
How data collection is posing new challenges in the COVID-19 vaccination effort. Across the country, vaccinations dashboards from the Centers for Disease Control and Prevention and the states show slightly different numbers about how many vaccines have been administered, STAT reports.
Help your team beat WFH burnout. As much as workforces that virtualized last year have survived largely because of video meetings, “burnout is at an all-time high,” according to a Harvard Business Review article that outlines 3 steps leaders can take now and as long after the pandemic as working remotely continues to be common.
Tracking President Joe Biden’s cabinet and appointees. Brookings Institution is monitoring “the diversity and pace” of Senate-confirmations and offering context by comparing it to Biden’s three predecessors: Presidents George W. Bush, Barack Obama and Donald Trump,” across the various departments including Health and Human Services.
How new leaders of federal agencies can set up a great front office. While McKinsey wrote this piece for federal government leaders, the lessons within can be applied to the private sector, such as optimal executive pairings, establishing principles for front-office teams, building trust and building a culture that welcomes new ideas.
Health officials confident Biden will deliver on promise of 100 million vaccines in 100 days. Anthony Fauci, MD, and Incoming CDC Director Rochelle Walensky, MD, both are confident that President Joe Biden will meet his goal to administer 100 million vaccinations in the first 100 days of the administration.
Welcome back to the global health stage, America. You have a lot of work to do. Kate Dodson, vice president for global health strategy at the United Nations Foundation, a nonprofit organization that acts as a strategic partner for the United Nations, welcomes the U.S. back to the World Health Organization with the inauguration of President Biden. She says the Biden administration should further show its commitment to solidarity with the world’s global health community by immediately signing onto the ACT Accelerator, a WHO-led global effort to enable equitable access to Covid-19 vaccines, treatments, and tests.
Merck loses bid for Supreme Court to revive $2.5 billion verdict. The Supreme Court denied a bid by Merck to revive a record verdict against Gilead Sciences Inc. in a dispute over a patent for a hepatitis C treatment.
Major health companies and trade groups suspend campaign contributions after Capitol riot. Among the organizations that have vowed to stop donating to politicians who supported overturning the election: PhRMA, the pharma trade group, Blue Cross Blue Shield Association (BCBSA), Amgen and Gilead Sciences, the biotech trade group BIO, the American Hospital Association, insurers Cigna and UnitedHealth Group, and the medical device manufacturer Boston Scientific. The actions that took place violate the values of our nation and the values held by America’s biopharmaceutical research companies,” Stephen Ubl, PhRMA’s president and CEO, said to STAT.
FDA fights for independence in Trump administration’s final days. There is a battle going on between the Department of Health and Human Services (HHS) and Food and Drug Administration (FDA) during the final days of the Trump administration. According to Politico, the FDA was blindsided Monday when HHS Secretary Alex Azar approved rules designed to reduce scrutiny of drugs and medical devices before they reach market. The two agencies have feuded over drug and vaccine authorizations central to the COVID-19 response.
Evaluation of internet-based crowdsourced fundraising to cover health costs in the United States. JAMA looked at the use of a popular fundraising platform to cover health care–related costs, the medical conditions involved with these fundraisers, and their geographic distribution in the US. Researchers found that between May 2010 through December 2018, more than $10 billion was sought through online medical fundraisers in the US, with more than $3 billion raised
A day in the life of a Navajo health worker. Elemental looks at an in-depth of the day and life of a Navajo health worker, Roxanna Yazzie, who is one of eight women helping run the health clinic in Navajo Mountain, a chapter of the Navajo Nation that straddles the border of Arizona and Utah.
The enduring importance of trust in the leadership of health care organizations. Sachin Jain, MD, CEO of Scan Group and Health Plan; Catherine Reinis Lucey, MD, Vice Dean for Education and Executive Vice Dean for the School of Medicine at the University of California, San Francisco (UCSF); and Francis Crosson, MD, Senior Fellow with the Kaiser Permanente Institute for Health Policy wrote an op-ed in JAMA extolling the importance of health care leaders at this time. They say it’s “vital to reassert, reaffirm, and simply accept that trust in the leadership of health care organizations, including integrated delivery systems, medical groups, health plans, and pharmaceutical companies.”
This is the health system that Biden inherits from Trump. The New York Times reports on the perilous state of rural hospitals coming out of the pandemic, as well as other providers that care for the poor and vulnerable. “The health care system lost a ton of money when people didn’t show up in March and April. It’s not clear it’s going to get that money back. I fully expect we’ll see a wave of providers go under, demand higher prices, and demand bailouts,” David Cutler, a health economist at Harvard told NYT. The policies that the Biden administration enacts when it comes into office in January will be crucial in shaping the long-term future of the health care system.
San Francisco board rebukes naming hospital for Facebook CEO. San Francisco city supervisors passed a resolution condemning San Francisco General Hospital for allowing itself to be named after Facebook CEO Mark Zuckerberg. While the action doesn’t require the hospital do anything, it aims to send a message that a public hospital that caters to the poor should not be for sale and bear the name of someone as controversial as Zuckerberg.
Tech’s hidden hand in the vaccine rollout. Technology companies such as Microsoft, IBM, Oracle, and Salesforce are working with governments and health agencies as part of a massive supply chain to manage the massive task of rapidly distributing the COVID-19 vaccines. “This supply chain is enormously complex, probably more complex than any I’ve seen — and I worked with the defense industry,” IBM VP Tim Paydos told Axios.
Intensive care beds are nearing capacity across the country, new data shows. More than a third of Americans live in areas where hospitals are running short of ICU beds, according to The New York Times. Examining data released by HHS, NYT found hospitals serving more than 100 million Americans reported having fewer than 15 percent of intensive care beds still available as of last week. This is before the Thanksgiving effect is set to take place.
Detailed data on AstraZeneca-Oxford COVID-19 vaccine show it has moderate efficacy. According to a published study in The Lancet, two standard doses of the COVID-19 vaccine produced by AstraZeneca and Oxford are 62 percent effective in preventing symptomatic illness. It may significantly reduce hospitalization from the disease.
Psychiatry is revealing the potential — and pitfalls — of telehealth. COVID-19 has forced specialties to adjust to a virtual health care world, reports researchers Vidit N. Munshi and Ipsit V. Vahia, MD in Harvard Business Review. They say the “experiences in psychiatry and other early-adopting fields provide a roadmap for how hospital systems can move forward.”
Some COVID-19 traveling nurses are making $8,000 a week. The COVID-19 surge cases this fall has turned hospital staffing into a national bidding war, with hospitals willing to pay exorbitant wages to secure the nurses they need, Dallas News reports.
Sanford Health’s merger with Utah system is shelved in wake of CEO’s face mask controversy. Sanford Health is shelving plans to merge with Intermountain Healthcare of Utah, reports Twin Cities Pioneer Press. This comes after the departure of Sanford’s longtime CEO Kelby Krabbenhoft last week after he made controversial remarks on not wearing a mask.
FDA moving historically fast in approving vaccines. Not fast enough for the White House. According to Politico, President Donald Trump and his deputies are admonishing Food and Drug Administration Commissioner Stephen Hahn for not moving faster to authorize promising coronavirus vaccines from Pfizer and Moderna. The United Kingdom became the first Western country to authorize a COVID vaccine.
Hospital CEOs are ready to distribute the vaccines. The CEOs of OhioHealth and Atrium Health told CNBC that they are ready to distribute the vaccines once they are approved by the FDA. “We have refrigeration units that can store up on Day One 300,000 vials. We also are training staff as we speak,” Atrium Health CEO Eugene Woods said.
Cheryl Pegus, MD tapped to lead Walmart’s health care efforts. Big congratulations are in order for Cambia Health Solution’s president of consumer health solutions and chief medical officer, Cheryl Pegus, MD, on getting tapped as Walmart’s executive vice president of Health & Wellness. In her role, Pegus will oversee health and wellness efforts at the company’s 4,700 pharmacies, more than 3,400 Vision Centers, its Walmart Health centers, and through its digital health capabilities and Walmart Insurance Services.
See Dr. Pegus and others in this webcast: Accelerating Future Care Delivery Models
PPE is still a major problem as hospitalizations surge. The lack of personal protective equipment (PPE) is still a recurring problem as COVID hospitalizations surge across the country. Bonnie Castillo, executive director of the National Nurses United group, told PBS NewsHour that “after all the calls for additional PPE and that protective gear, nurses still don’t have it.”
Data show hospitalized Covid-19 patients are surviving at higher rates, but surge in cases could roll back gains. According to a new report from STAT, patients hospitalized with COVID-19 are surviving at higher rates than in the early days of the pandemic. The average length of stay declined from 10.5 days in March to 4.6 days in September. However, experts say that a new surge in cases will overwhelm hospitals and make these numbers worse, as what’s already happening in a number of states.
Former Congresswomen calls for bipartisan health care reform. Rep. Donna Christensen, MD, who served U.S. House of Representatives for nine terms and was the first female physician to serve as a member in the history of the U.S. Congress, wrote an op-ed saying that that the likelihood of a President Biden and a Republican Senate means political leaders should focus on “commonsense, bipartisan policies that will benefit health care consumers across the country.”
Top hospitals charging patients up to 1,800% more for services than they actually cost: study. The 100 most expensive hospitals in the United States charge between $1,129 and $1,808 for every $100 of their costs, according to a study by National Nurses United.
Hospital CEO says he had COVID and doesn’t need a mask. His staff are appalled. Sanford Health CEO Kelby Krabbenhoft told his employees he will not be wearing a mask because he has already had COVID. The move received backlash from his employees, including a nurse who told CNN, “We are supposed to be leaders in the community. How can we be taken seriously when this is our CEO?”
The Vaccines Will Probably Work. Making Them Fast Will Be the Hard Part. Pfizer and Moderna have estimated they will have 45 million doses, or enough to vaccinate 22.5 million Americans, by January. But scaling these vaccines for the hundreds of millions that will need them will be challenging. “If that was an aspiration — of 300 million by the end of the year — I would say that was the biggest challenge that we had,” Paul Mango, deputy chief of staff for policy at the Department of Health and Human Services, told The New York Times.
Government-Funded Scientists Laid the Groundwork for Billion-Dollar Vaccines. The vaccines, which will likely be the first to get FDA approval, rely heavily on two fundamental discoveries that emerged from federally funded research, according to Kaiser Health News. “This is the people’s vaccine,” corporate critic Peter Maybarduk, director of Public Citizen’s Access to Medicines program, said to KHN. “Federal scientists helped invent it and taxpayers are funding its development. … It should belong to humanity.”
10 Leadership Lessons from Covid Field Hospitals. Executives at two emergency field hospitals, the NHS Nightingale London and Boston Hope Hospital, share their observations of 10 leadership behaviors in Harvard Business Review “that served to empower, encourage, and support leaders across professions as they stepped up to address the uncertainties they were facing.”
Interoperability: an untapped tool in America’s fight against Covid-19. In this op-ed for STAT, Humana CEO Bruce Broussard argues that in order to fight flu season and the COVID-19 pandemic, the health care industry must successfully “leverage data and technology to track its spread and treat individual patients.” He argues that rules must be enforced around ensuring EHR systems are interoperable with each and across the health system, including public health surveillance systems.
‘We’re being left behind’: Rural hospitals can’t afford ultra-cold freezers to store the leading Covid-19 vaccine. While large hospitals purchase expensive ultra-cold freezers to store the first approved Covid-19 vaccine, rural hospitals say can’t afford these “high-end units, meaning health workers and residents in those communities may have difficulty getting the shots,” according to a STAT News report.
Biden Plan to Lower Medicare Eligibility Age to 60 Faces Hostility From Hospitals. One of President-elect Biden’s proposals would face stiff resistance from hospital industry leaders. “Hospitals are very aware about generous commercial rates being replaced by lower Medicare rates,” Chris Pope, a senior fellow with the conservative Manhattan Institute, said to Kaiser Health News.
New data looks at racial inequities in COVID-19 screenings, hospitalizations and mortality. A new study in Health Affairs from researchers at the Medical College of Wisconsin found that after adjustment for demographics and comorbidities, Blacks and Hispanics were more than three times more likely to screen positive and two times more likely to be hospitalized relative to Whites, Moreover, Hispanics were two times more likely to die than Whites.
With the election still not decided, this week we are including some of Health Evolution’s most-read pieces on crisis leadership.
CEOs share leadership advice for managing through a crisis. What does it take to lead during a crisis or in today’s reality multiple crises? Scan Group and Health Plan CEO Sachin Jain, MD, EmblemHealth CEO Karen Ignagni, Banner Health CEO Peter Fine, and Alice Chen, MD, Deputy Secretary for Policy and Planning and Chief of Clinical Affairs, California Health and Human Services Agency share their experience and insights. It begins with honoring the humanity of the workforce.
CEOs are divided on speaking out in polarizing times. Given the opposing political viewpoints and policies at stake in this election, not to mention emotions running high, CEOs and other leaders may be tempted to take a stand publicly. But should they? Umass Memorial Health Care CEO Eric Dickson, MD, Tufts Medical Center CEO Michael Apkon, MD, HealthEdge CEO Stephen Krupa and John Figueroa, with the Pepperdine Graziadio Business School, has been the CEO of Genoa Healthcare, Apria Healthcare Group and Omnicare have differing points of on the answer to that question.
Why leaders with humility, integrity and compassion matter more now than ever. Health Evolution Executive Chairman David Brailer, MD, compared Northwell Health CEO Michael Dowling’s book “leading Through a Pandemic,” with Bob Woodward’s “Rage” and found that “these books, when read together, reveal and define the critical essence of leadership and show why leaders have real and consequential impacts on our society and lives … These books bring into sharp focus three foundational and enduring underpinnings of leadership – the structural steel of leadership, if you will: humility, integrity and compassion.”
And now from around the internet:
A look at how health care ballot questions fared. In California, voters shot down Proposition 23, which would have required chronic-dialysis clinics to have an on-site physician when patients are treated, report data on infections and get permission from the state before closing clinics. Oklahoma voters decided against a plan to take annual funds from a tobacco company settlement and let lawmakers use it to fund Medicaid programs. Here are the results of a few health care specific ballot proposals.
Medicare Fines Half of Hospitals for Readmitting Too Many Patients. Nearly half the nation’s hospitals, many of which are still wrestling with the financial fallout of the unexpected coronavirus, will get lower payments for all Medicare patients because of their history of readmitting patients, federal records show, according to Kaiser Health News.
Centene CEO Michael Neidorff makes a bold prediction on the supreme court’s ACA case. “I don’t believe when push comes to shove, they want to put all of these people at the height of the pandemic on the streets with no insurance,” Neidorff told analysts on an earnings call, according to Forbes. “At one point, I thought it would be 7-2 when Justice Ginsburg was still around and others. I said it could go to 6-3. It could still be 5-4.” Centene provides individual ACA coverage to more than 2.2 million Americans across more than 20 states.
A Chance to Expand Medicaid Rallies Democrats in Crucial North Carolina. In battleground state North Carolina, The New York Times reports, “Democrats believe they have a chance of gaining control of the State Legislature for the first time in a decade, which would make it possible to expand Medicaid to cover half-a-million more low-income adults here after years of Republican resistance.” Democrats say this is a motivating issue for their base and potential voters who have sat out previous elections.
Historic vaccine race meets harsh reality. Pfizer’s latest admission that it won’t reach a self-imposed deadline on its vaccine efficacy shows that vaccine development is a long, complicated process that doesn’t stick to political deadlines, Politico reports. “All timelines assume that we have a vaccine that is actually shown to work and is safe before the end of the year,” said Peter Hotez, a virologist and dean of the National School of Tropical Medicine at the Baylor College of Medicine. “But we still have no guarantee.”
Read more: With public trust in COVID vaccines fading, CEOs must be trust amplifiers
Stressed about the election? You’re not alone. How to stay calm ahead of Nov. 3. Here are some helpful tips on how to get over any election-related anxiety.
COVID-19’s real death toll is much worse, CDC says. A new study from researchers at the CDC finds that the real death toll of COVID-19 is closer to 300,000, rather than the 220,000-plus that has been reported in the public. The tally includes not only deaths known to have been directly caused by the coronavirus, but also roughly 100,000 fatalities that are indirectly related and would not have occurred if not for the virus.
Opinion piece: Medicare should break an old rule for digital therapeutics. Andrey Ostrovsky, MD, former chief medical officer for the Center for Medicaid and CHIP Services, penned an opinion piece for STAT arguing CMS needs to make a change to make digital therapeutics more available to Medicare beneficiaries.
Telehealth and the barber shop. Politico looks at a unique pilot program run by researchers at Cedars-Sinai Medical Center in Los Angeles. The research effort involves having pharmacists and a virtual blood pressure kit got into barbershops to address the burden heart disease places on Black men. “We felt that establishing a rapport [and] meeting [patients] on their ‘own turf’ was essential,” said C. Adair Blyler, a Cedars-Sinai Medical Center pharmacist.
New drug effective in treating COVID. Researchers from Brigham and Women’s Hospital in Boston published a study in JAMA that Rheumatoid arthritis drug rug tocilizumab is associated with a lower mortality rate among critically ill patients. However, the researchers warn the findings are “susceptible to unmeasured confounding, and further research from randomized clinical trials is needed.”
Uncovering health IT biases. Analytics tools are perpetuating racial imbalances in health care, a STAT investigation found. Multiple algorithms used across the country to target medical services to patients unwittingly infuse racial bias into decision-making about who should receive stepped-up care. In one case examined by STAT, an algorithm scored a white patient four times higher than a Black patient with very similar health problems, giving the white patient priority for services.
How to make vaccines trustworthy. With COVID-19 vaccine skepticism rising, according to recent polls, Heidi Larson, anthropologist and founder of the Vaccine Confidence Project, is working to combat a rising tide of misinformation. The New York Times profiled Larson and her work, as she explained how the health community must work to regain the trust of a vaccine skeptical public.
Major medical groups defend foreign national physicians. The American Hospital Association, American Medical Association and four other medical groups recently sent a joint letter to Acting Secretary of Homeland Security Chad Wolf requesting that J-1 physicians—those participating in graduate medical education programs or training at schools of medicine in the U.S.—be excluded from a proposed rule that would limit how long foreign nationals can remain in the country.
Merger finalized. Atrium Health and Wake Forest Baptist Health, including Wake Forest School of Medicine, officially merged as a single enterprise, Atrium Health announced late last week. The new system projected $11.5 billion in combined net revenue.
Kamala’s history with the drug and hospital industry. The New York Times looks at how Senator Kamala Harris, the Democratic nominee for Vice President, took on the health care industry in California when she was the state’s attorney general. Harris oversaw multimillion-dollar settlements with Quest Diagnostics and McKesson, who had been accused by whistleblowers of Medicaid fraud. She also joined the Justice Department lawsuit that stopped two of the nation’s largest health insurers, Anthem and Cigna.
Investing in safety-net innovation to address COVID-19. Alice Chen, MD, deputy secretary for policy and planning and director of clinical affairs for the California Health and Human Services Agency and Urmimala Sarkar MD, professor of medicine at the University of California, San Francisco (UCSF) in the Division of General Internal Medicine, outlined recommendations in Health Affairs to ensure safety-net health systems can adapt to and beyond the COVID-19 pandemic.
Read more from Chen: CEOs share leadership advice for COVID-19 crisis
Insulin is not quite the price of water. Insulin prices are more than eight times higher in the United States than in 32 high-income comparison nations combined, according to a new RAND Corporation study. According to the analysis, the average price per unit across all types of insulin in the United States was $98.70, which is a fraction of what other countries pay.
A vaccine lab network. CEPI, an international public-private partnership dedicated to aiding the production of vaccines that can stem global epidemics, said it was establishing uniform testing procedures in five labs around the world that will enable like-for-like comparisons between COVID-19 vaccine candidates.
Keck named CEO of BCBSA. The Blue Cross Blue Shield Association announced this week that Kim A. Keck will be BCBSA’s new president and chief executive officer and a member of the Board of Directors, effective Jan. 4, 2021. Keck is currently president and chief executive officer of Blue Cross & Blue Shield of Rhode Island (BCBSRI).
Scott Gottlieb warns of ‘more aggressive’ COVID-19 spread in fall and winter. With COVID-19 deaths around the globe passing 1 million, former FDA commissioner Scott Gottlieb, MD, told CNBC that schools and businesses reopening and people becoming more complacent are creating conditions that place the U.S. on the verge of its “most dangerous season.” Whereas Gottlieb also pointed to the progress in treating infected people and therapeutics, the threat is a “resurgence in infections that dwarfs the other waves we’ve had.”
Fortune published its Change the World 2020 list. Among the 51 companies to be honored are health care enterprises including: the Vaccine Makers, Abbott Laboratories, BD, Centene , ChenMed, Henry Schein, Medtronic, Merck, Ping An Insurance and Regeneron. The list also features companies serving the health care industry, notably Alphabet, Microsoft, Salesforce and Walmart. “We tried to build ChenMed to have a deep purpose but it’s nice to be noticed,” said Chris Chen, MD, CEO, ChenMed.
UnitedHealth reportedly buys Amazon PillPack rival. In what appears to be the latest acquisition in the online pharmacy sector, the insurer is buying DivvyDose, a startup that focuses on delivering medications to people with chronic conditions. Though neither UnitedHealth nor DivvyDose officially confirmed the arrangement as of our publication time, Bloomberg on September 23, 2020 reported that the two organizations were holding discussions about a deal.
Trump administration, pharma talks fall apart. The Trump administration nearly reached an agreement late last month on a plan to lower drug price before the talks broke down. According to The New York Times, Mark Meadows, President Trump’s chief of staff, insisted the drug makers pay for $100 cash cards that would be mailed to seniors before November. Pharma CEOs didn’t want to be part of what they believed was an 11th hour political stunt. Priscilla VanderVeer, the vice president of public affairs at PhRMA, said: “One-time savings cards will neither provide lasting help, nor advance the fundamental reforms necessary to help seniors better afford their medicines.”
FDA drafts COVID-19 vaccine guidelines. The U.S. Food and Drug Administration is set to draft guidelines that would require a COVID-19 vaccine to meet rigorous standards to gain a speedy clearance for use, according to a report in The Wall Street Journal. One standard that’s certain to be included is a vaccine would have to be 50 percent more effective than a placebo. A new poll from Axios found that 60 percent of Americans were not very or not at all likely to get the first wave of vaccines when they’re made available.
Affordable Care Act hangs in the balance with Supreme Court. The Supreme Court is ruling on the Affordable Care Act in November. With the passing of Ruth Bader Ginsburg, there is a concern from Democrats that if the law is struck down insurers could once again deny service based on pre-existing medical conditions. One potential pre-existing condition for 6 million Americans and counting? Coronavirus.
Hilferty to retire. Daniel Hilferty, president and CEO of Independence Health Group, is retiring at the end of this year, the company said Tuesday. Hilferty will join us on Oct. 8, 2020 for an executive briefing, Bold Approaches for Consumer Engagement in a New World.
Gates doesn’t hold back. In a wide-ranging interview with STAT News, Bill Gates, famous public health philanthropist and founder of Microsoft, didn’t hold back on America’s response to the COVID-19 pandemic. He said that the response has been a “mismanaged situation every step of the way.” He was particularly critical of the FDA Commissioner, Stephen Hahn, MD, for asserting incorrect findings from a Mayo Clinic study on convalescent plasma. “The head of the FDA got up and said it was a 35% death reduction where it’s not even a 3% reduction based on just a tiny little subset that was nonstatistical. This is unheard of,” Gates said. The Gates Foundation released a report this week that stated the pandemic has stalled 20 years of progress in vaccine coverage.
No trust in pharma and FDA. Speaking of the FDA, a new Axios-Ipsos poll found that the agency, as well as the pharma industry, has a lot of work to do to gain public trust. According to Axios, less than 10% of Americans have a great deal of trust in the FDA or pharmaceutical companies to look out for their interests. Only 35% of Americans have a fair amount of trust in pharma and less than half in the FDA. On the somewhat positive side for pharma, the industry’s positive ranking in the Gallup poll went up 7% to 34%–but they are still the second worst behind…the federal government.
Updates in the uninsured. A new report from the CDC reveals that the rate of uninsured rose from 2018 to 2019 from 9.4 percent to 10.3 percent. The uninsured rate for non-elderly adults (those aged 18 to 64) was 14.7 percent, up from 13.3 percent in 2018. With the pandemic leaving many unemployed, the number is sure to rise in 2020. While estimates have been made, the damage won’t be known for quite some time. Centene, one of the largest health plans for Affordable Care Act exchanges and Medicaid managed care marketplaces, announced this week it onboarded 1.1 million new members from the end of March through August.
Urban hospitals face closure. While it’s been well established that rural hospitals have been closing at a quickening pace over the past two decades, urban hospitals may face a similar fate, NPR reports. Experts say the economic damage inflicted by the COVID-19 pandemic on safety net hospitals will linger. “We’ve had three hospital closures in the last year or so, all of them Black neighborhoods,” says David Ansell, MD, senior vice president for community health equity at Rush University Medical Center, a teaching hospital on Chicago’s West Side, told NPR.
Microsoft and Nuance announce new partnership. The two companies announced a partnership, with Nuance’s ambient clinical intelligence (ACI) solution will be integrated into Microsoft Teams to scale virtual consults aimed at increasing physician wellness and providing better patient health outcomes.
Vaccine developers promise safety first. With the COVID-19 vaccination process getting politicized thanks to the Presidential election, leaders at nine biopharmaceutical companies issued a letter early this week pledging to fully vet their COVID-19 candidate vaccines before asking for federal approval to market them. The companies that signed the letter were AstraZeneca, Johnson & Johnson, Moderna Inc., Novavax Inc., Merck, Sanofi and GlaxoSmithKline, and Pfizer Inc, which is developing a vaccine with BioNTech, another signatory.
Rural health care plan draws skepticism. Last week, HHS released the Rural Action Plan, which aims to address the challenges facing rural communities related to issues such as emerging health disparities, chronic disease burden, high rates of maternal mortality and limited access to mental health services. It has been met with skepticism by rural health advocates. “They tinker around the edges,” Tommy Barnhart, former president of the National Rural Health Association, said to Kaiser Health News. He noted to the site that “there’s a lot of political hype” about rural heatlh that has happened under President Donald Trump, as well as previous presidents.
Anthem, Cigna both losers in legal ruling. The executives of Anthem and Cigna are finding out that when it comes to corporate legal battles, there isn’t always a winner and a loser. In the case of the two giant insurance companies, which have been engaged in a long battle over their failed merger attempt in 2017, they’re both losers. A Delaware Chancery Court ruled that neither company was entitled to recover any damages after they failed to complete their proposed $54 billion merger. “Neither side can recover from the other. Each must deal independently with the consequences of their costly and ill-fated attempt to merge,” the ruling read.
A costly incision. Greg Neal, the former CEO of Bristol Regional Medical Center in Bristol, Tennessee, was asked to resign last week after he participated in a surgical procedure, even though he is not a licensed physician. “Recently, at the invitation of a surgeon, I entered an operating room to observe a surgical case and to support our surgical team, as many health system and hospital CEOs do throughout the nation. As the case began, the surgeon asked if I would like to make the initial incision for this surgical procedure. I regret I did so,” Neal wrote in his resignation letter.
Topol to Hahn: Tell the truth or resign. Eric Topol, MD, the Founder and Director of the Scripps Research Translational Institute, wrote a letter to FDA Commissioner Stephen Hahn, MD, imploring him Hahn to either be truthful about proposed COVID-19 therapeutics or resign from his position. Topol calls out Hahn for authorizing the use of hydroxychloroquine for treating COVID-19 patients, which President Trump touted as a “miracle drug.” Topol says the drug had no meaningful supportive evidence to support it as a COVID-19 therapeutic. He also says Hahn lied about data surrounding convalescent plasma.
Digital health investments continue. This past week was a financially lucrative one for companies in the digital health and telemedicine space. First, Amwell Health, a telemedicine provider, announced it is filing an initial public offering (IPO) with a $100 million concurrent financial boost from Google’s cloud division. The next day, Lyra Health, which offers mental health benefits via a mobile app, announced a $110M series D round, which puts its valuation at more than $1 billion. The company plans to use the funding to expand its teletherapy service.
Report: Behavioral Health: In Need of Innovation and Care Integration. While behavioral health conversations have historically been carried out by specialists and centered on drugs and psychiatrists, today’s decision makers are engaging in more progressive and impactful discussions about innovation–from prevention and diagnosis to proactive vs. reactive intervention and treatment.
Teva vs. federal prosecutors. The U.S. Justice Department charged Teva Pharmaceutical, a company based in Israel, on Tuesday with conspiring with competitors to raise prices for generic drugs. The company’s CEO, Kare Schultz, told Bloomberg said Teva is prepared to fight the criminal charges. “It’s hard to admit to a crime you didn’t commit,” Schultz said on why they didn’t settle with the government.
Yale’s new COVID test approved by FDA. A saliva-based laboratory diagnostic test developed by researchers at the Yale School of Public Health to determine whether someone is infected with the novel coronavirus has been granted an emergency use authorization by the U.S. Food and Drug Administration (FDA). In a recent Health Evolution executive briefing, Yale New Haven Health CEO Marna Borgstrom said the test could be a “game changer.” Former FDA chief Scott Gottlieb, MD, said the test could be rolled out in a widespread fashion.
Public health IT overhaul coming? According to a report in Politico, the Trump administration has plans to revamp how state and local health departments and providers report public health data to the government. The CIO of HHS, who oversaw that effort, abruptly resigned last week after a difficult rollout of a new coronavirus reporting system for hospitals.
The rate of uninsured hasn’t changed…yet. New research from the Commonwealth Fund found that in the first half of 2020, the adult uninsured rate was 12.5 percent. In addition, 9.5 percent of adults were insured but had a gap in coverage in the past year and 21.3 percent were underinsured. This is statistically unchanged from 2018. Moreover, there was no statistically significant change in coverage inadequacy between the months leading up to the pandemic and the months that followed. However, that’s certain to change, the report states. The Urban Institute estimates that this employment disruption will leave 3.5 million more people uninsured by the end of the year.
Cecilia Health gets funding. Cecelia Health, a technology-enabled diabetes and other chronic disease management company, announced today it has completed a $13 million Series B funding round.
Kamala Harris’ health care policy positions. Democratic Presidential candidate Joe Biden selected California Senator Kamala Harris as his running mate. What should health care CEOs know about her policy positions on the industry? Modern Healthcare has a breakdown of where she stands.
Study reveals effectiveness of PPE in hospitals. A new study from researchers at St Francis Hospital, The Heart Center in Roslyn, New York, reveals that PPE has kept health care workers safe from contracting COVID-19. The study, published in JAMA Internal Medicine, found that comparing the prevalence of antibodies among hospital employees with the rate reported by the State of New York for the general public on Long Island, hospital employees had a significantly lower positive rate. Hospital employees are required to wear a N95 mask, isolation gown, and gloves. “Given that health care workers in hospitals are exposed to a much higher density of the virus, this is strong evidence that current PPE practices are protective, easing health care workers’ concern and psychological distress,” the authors conclude.
Microaggressions against doctors of color. The New York Times profiled a number of Black doctors who shared their experiences with racism while in the field. “I’m the only African-American female physician faculty member in my department, and that creates this feeling of not having a support system to speak up when something happens to you,” said Adaira Landry, MD, an emergency resident physician in Brigham & Women’s Hospital in Boston. Landry and three other physicians wrote a paper in Annals of Internal Medicine about microaggressions in medicine.
Prescription politics. STAT News looked at 23 of the biggest drug makers and the two major trade associations, PhRMA and BIO, and how much they’ve donated to politicians during the COVID-19 pandemic. Of note, 23 of the 25 drug companies or trade group PACs in STAT’s survey contributed to Sen. Mitch McConnell, the Republican majority leader seeking reelection in 2020. McConnell raked more in cash than any other lawmaker.
Teladoc and Livongo merge in $18.5 billion deal. The digital health companies announced the deal on Wednesday morning. They will operate under the name Teladoc Health and combine Teladoc’s platform with Livongo’s technologies for treating patients with chronic diseases, STAT reports.
Related webcast: Late last week Health Evolution interviewed Livongo CEO Zane Burke. Watch the on-demand discussion.
Is the pandemic an opportunity to reimagine capitalism? Harvard Professor Rebecca M. Henderson contends that executives and enterprises have both “a moral duty” and an “economic interest” in working toward healthy institutions that keep capitalism free and fair. “We can learn from the horrors of the pandemic. We don’t need to go back to ‘normal.’ We need to find a way to balance the energy of the free market with the power of competent, responsive government. Together, they can help us build a more just and sustainable world.”
The U.S. Centers for Disease Control and Prevention this week said it is expecting an outbreak of Acute Flaccid Myelitis. The life-threatening neurologic condition affects mostly children. “It will be circulating at the same time as flu and other infectious diseases including COVID-19 and could be another outbreak for clinicians, parents, and children to deal with,” CDC Director Robert Redfield, MD, said during a briefing. “Since CDC began surveillance for AFM in 2014, a national outbreak has occurred every other year during August through November.”
Big pharma vs. The White House. Last week, President Trump signed an executive order that would aim to lower the price of prescription drugs. As a result, pharma industry representatives have scrapped a meeting scheduled for this week with the President, according to Politico. Two pharma industry trade groups, PhRMA and BIO, were reluctant to send representatives from their member companies because the executive order included a rule that would have Medicare not pay more for Part B prescription drugs or biological products than the most-favored-nation price. Trump said the pharma industry had a month to find a better option than that rule.
Personnel news. Walgreens CEO Stefano Pessina will step down as CEO and become executive chairman once the drugstore chain finds a replacement for him. Good Shepherd Health Care System in Oregon has chosen Brian Sims as its next president and CEO. The American Hospital Association (AHA) Board of Trustees selected Wright L. Lassiter, III, president and CEO of Henry Ford Health System in Detroit, Mich., as its chair-elect designate.
Join Lassiter and others in our upcoming Executive Briefing, “Confronting Racial Disparities and the Drivers of Health During COVID-19″ on August 4th at 1:30 pm EST.
How has the CEO job changed? McKinsey has issued a new report on how the CEO role is changing amid the pandemic. They boil it down to four major shifts:
-Unlocking bolder aspirations
-Elevating their “to be” list to the same level as “to do” in their operating models
-Fully embracing stakeholder capitalism
-Harnessing the full power of their CEO peer networks
Mayo Clinic named best hospital. For the 5th straight year, Mayo Clinic was named by U.S. News and World Report as the best hospital in the U.S. For the report, U.S. News analyzes data from nearly 5,000 medical centers and survey responses from more than 30,000 physicians to rank hospitals in 16 adult specialties including cancer, cardiology, diabetes, rheumatology and more
COVID-19 cases much higher than reported, CDC says. The Centers for Disease Control and Prevention (CDC) released data this week that suggests the number of people infected with COVID-19 is six to 24 times higher than reported. For most sites, CDC says it is likely that greater than 10 times more SARS-CoV-2 infections occurred than the number of reported COVID-19 cases. “These data continue to show that the number of people who have been infected with the virus that causes Covid-19 far exceeds the number of reported cases,” Fiona Havers, MD, a COVID researcher said to The New York Times. “Many of these people likely had no symptoms or mild illness and may have had no idea that they were infected.”
Intermountain CEO Marc Harrison shared a list of the seven lessons the Utah-based health system is learning while providing care during the pandemic with Harvard Business Review. 1. Harness technology more aggressively 2. Emphasize prevention 3. Eliminate racial disparities in care 4. Integrate mental health and primary care 5. Accelerate innovation 6. Partner up and 7. High health care costs are untenable and must be addressed.
Digital pharmacies see funding increase. Digital pharmacies are seeing funding opportunities spurred on by the COVID-19 pandemic. Last week alone, New York City-based Medly Pharmacy got a $100 million series B funding, NowRx, based in Mountain View, California, raised $20 million and TruePill, based out of Hayward, California, raised $25 million.
Beyond telehealth: The New era of consumer directed virtual care. “Today, the question is not whether telehealth will play a substantial role going forward, but rather how virtual care will reinvent our experience, and the role that health systems and physicians will play in that change,” Livongo Executive Chairman Glen Tullman wrote on LinkedIn. Tullman adds that consumer directed care encompasses digital health tools with deep maching learning and data science. “Where necessary and appropriate, telehealth can be used as a step-up in the care continuum where an office visit is not required.”
A better way to scale COVID-19 testing. Nikhil Bhojwani and Atul Gawande write in Harvard Business Review that testing broad populations, aka “Assurance Testing,” is necessary to reopening but requires more scale than medical testing. They propose an online marketplace for that very purpose.
“The reality of organizing testing today is that test sites and buyers are local,” Bhojwani and Gawande explain. “But a marketplace with broad civic participation that ties local needs to national capacity would allow buyers of tests of any size, testing labs, and testing site operators to discover and contract with each other.”
AMID COVID-19 resurgence, fewer deaths. Dr. Fauci explains why. It’s obvious that we are not going in the right direction. When one tries to open up, even among Governors and Mayors abiding by the guidelines, among some, not all, there’s an all-or-none phenomenon where you’re either on lockdown or the devil may care,” said Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases. Fauci cited three reasons: those initially getting diagnosed are approximately 15 years younger than people diagnosed in the spring and data has thus far illustrated that for young people the disease is less fatal; nursing homes have begun practice more effective measures to protect people, but the ratio could change to reveal a higher death rate. “We may be seeing a delay,” Fauci added. “So, be careful. As the weeks go by, we may be seeing the uptick of deaths.”
Hundreds of public health groups decry politicization of CDC. Nearly 350 public health organizations wrote a letter to HHS Secretary Alex Azar expressing frustration that the CDC has been undermined and politicized. They say the CDC has been underfunded and the broad scope of its work remains critical. They called on Azar to be more public in his defense on the role of the CDC in fighting the COVID-19 pandemic. “It is a scientific organization that functions best as an apolitical agency trusted to guide the strategy of our nation to be healthier and safer. We must amplify the unfettered voice of CDC, not stifle it,” the authors of the letter wrote to Azar.
COVID-19 studies are off course, report says. STAT News and Applied XL, a Newlab Venture Studio company conducted an analysis of the 1,200 clinical trials aimed at testing treatment and prevention strategies against COVID-19. They found that one in six focused on malaria drugs hydroxychloroquine or chloroquine, which have no benefit in hospitalized patients. Robert Califf, MD, the head of clinical policy and strategy at Verily Life Sciences and Google Health and a former commissioner of the FDA, tells STAT that “too often studies are too small to answer questions, lack real control groups, and put too much emphasis on a few potential treatments.”
What will be the impact of ONC’s interoperability rules? As part of the 21st Century Cures Act, ONC published rules regarding a standardized application programming interface (API) infrastructure on May 1, aiming to help usher in a new era of interoperability in health care. While many parts of the new rule won’t take effect for 24 to 36 months, researchers published a framework in Health Affairs for immediate and future measurement of stakeholder behavior in three domains: individual-level data access, bulk-data access, and information blocking. They conclude that ONC’s rules take a “significant steps toward interoperability, but there are many ways in which long-term policy goals and desired behaviors might still not materialize.”
Insurers moving into dental coverage. According to a new study from West Health Partners, health insurers are far more interested in offering dental benefits now than they were two years ago. In talking with 100+ health plan executives, West Health found the percentage of health insurers offering dental insurance products has risen substantially, from 68 percent in 2018 to 80 percent today, and the percentage offering adult dental benefits has more than doubled to 48 percent.
Where telehealth falls short. David Blumenthal, MD, President of the Commonwealth Fund, writes in Harvard Business Review that while telehealth use has surged during the pandemic, he isn’t convinced that this transformation will lead to a “whole new kind of doctor–patient relationship.” He explains that when compared to in-person visits, telehealth falls short in building trust between doctors and patients.
More financial woes for hospitals, per AHA. A new report from the American Hospital Assocation has estimated the total losses for the nation’s hospitals and health systems to be at least $323.1 billion in 2020 thanks to COVID-19. Also, Definitive Healthcare released an analysis that reveals 40% of providers are at risk of closure due to pandemic-related financial implications.
Cost of Remdesivir. The first COVID-19 drug will be sold for $3,120 per treatment course to hospitals for treatment of patients with private insurance, according to the Department of Health and Human Services and Gilead Sciences, the drug’s manufacturer.
5 issues to focus on post COVID. Global law firm Dentons and ReviveHealth shared a list of the five post-COVID issues that provider organizations will have to focus on. Those issues are as follows:
Johns Hopkins shifting 30% of visits to telemedicine full time. Paul Rothman, MD, Dean of the Medical Faculty at Johns Hopkins University and CEO of Johns Hopkins Medicine, said at the OurCrowd Pandemic Innovation Conference this week that after the pandemic is over, 30% of visits will be done via telehealth. “Telehealth gives us the ability to reach out where we didn’t before. We are an international healthcare provider, and it grants us access to patients who didn’t want to travel,” Rothman said at the conference.
Cigna, Oscar Health team up. A pair of health insurance companies – Cigna, based in Bloomfield, CT and Oscar Health, based in New York City – are teaming up to offer small businesses “Cigna + Oscar.” This will be a health insurance product for small businesses, available in Atlanta and in the San Francisco Bay Area and across Tennessee, effective Q4 2020. The fully-insured health plans available through Cigna + Oscar include no charge, 24/7 virtual doctor visits, $3 drug co-pays and are designed to fit the budgets of small businesses. A survey commissioned by Cigna + Oscar reveals 50% of small businesses are considering or unsure about changing their health insurer heading into 2021.
Gilead makes a move in oncology. While Gilead Sciences, out of Foster City, California, is in focus these days because of its work on COVID-19, the pharma company has made a move in oncology. Gilead announced that it was acquiring a 49.9% equity interest in Pionyr Immunotherapeutics for $275 million and exclusive option to buy the rest of the company. “The agreement represents important progress as we continue to build out Gilead’s presence in immuno-oncology with innovative and complementary approaches. We look forward to seeing the programs advance with the goal of developing new therapies that will improve the treatment of cancer,” says Daniel O’Day, chairman and CEO of Gilead.
AHA, others speak out on end to discrimination protection. The Trump administration rolled back Obama-era regulations that prohibited discrimination based on gender identity and the termination of a pregnancy. The American Hospital Association (AHA) and American Medical Association publicly disagreed with the move. “Hospitals and health systems value every individual we have the privilege of serving, regardless of race, religion, national origin, sexual orientation or gender identity. That is why we urged the administration to not move forward with changes to non-discrimination protections,” AHA President Rick Pollack said in a statement.
Senators ask for permanent change to telehealth expansion. Senator Brian Schatz, D-Hawaii, wrote a letter to Senate Leader, Mitch McConnell, R-Kentucky, and Minority Leader, Chuck Schumer, D-New York urging them to expand telehealth access permanently. The letter was signed by 30 Senators, both Democrats and Republicans.
“Congress should expand access to telehealth services on a permanent basis so that telehealth remains an option for all Medicare beneficiaries both now and after the pandemic. Doing so would assure patients that their care will not be interrupted when the pandemic ends. It would also provide certainty to health care providers that the costs to prepare for and use telehealth would be a sound long-term investment,” they write in the letter.
Providers estimating a long wait until pre-COVID revenue levels. A new survey of health systems and medical groups shines a light on how long it could take until things return to normal. More than 40% of health care systems and 36% of medical groups are forecasting it will be at least a year before revenues return to pre-COVID levels, according to a survey from the American Medical Group Association (AMGA). Nearly 23% of health care systems and 28% of medical groups said it’s still unknown when their revenues will return to normal.
“The financial risks are real, and we have heard that several groups have already run through their reserves,” AMGA President and CEO Jerry Penso, MD, said in a statement. “This pandemic has changed the expense makeup for providers, who now are funding new PPE and telehealth infrastructure costs while simultaneously dealing with significant revenue losses.”
Health Disparities are multidimensional. Data from the Centers for Disease and Control and Prevention (CDC) shows that COVID-19 disproportionately affects African American communities. One recent study showed that counties across the nation that are predominantly black account for over half of coronavirus cases in the U.S. and nearly 60% of deaths. Hollings Cancer Center researcher Chanita Hughes-Halbert conducted two recent health disparity studies that showed the importance of effective strategies for chronic disease prevention and management for male minority prostate cancer patients as well as male veterans who have experienced various health issues.
“COVID-19 is showing all of the ways in which racial and ethnic minorities and individuals from other medically underserved groups are disadvantaged. In addition to having health-related risk factors for COVID-19, racial minorities are likely to be particularly vulnerable to the adverse economic impact of COVID-19,” Hughes-Halbert said.
Amwell files for an IPO. Less than a month after raising almost $200 million in the middle of the COVID-19 pandemic, virtual health company Amwell is about to go public, according to CNBC. With the pandemic forcing patients to get virtual care, Amwell told CNBC last month that it’s seen a 1,000% increase in visits, and closer to 3,000% to 4,000% in some places
The high cost of COVID-19. According to a report from Wakely, a health care actuarial consultant, the estimated cost of the pandemic to insurers could reach up to $546.6 billion over a two-year period. Members of private insurers out of pocket expenses could be between $2.8 billion and $48.6 billion of the costs, the study found. The rates vary because there are different potential rates of infection, estimates in the cost of treatment and a range of deferred care costs.
More health care leaders speak out on George Floyd/diversity and inclusion. A trio of health care leaders have spoken out about the issues of racial injustice and inequality surrounding George Floyd’s death. Livongo CEO Glen Tullman writes in LinkedIn about the importance of committing to actions, not just words, in the wake of these events.
“Create a healthy and open dialogue on racial injustices. Donate money, no matter the amount, to advocacy organizations or volunteer with local grass roots organizations that fight for justice and equal rights. And most importantly, do your part by exercising your right to vote. We must stand together in this opportunity,” Tullman writes.
Rod Hochman, CEO of Providence, also writes about a commitment actions on LinkedIn. He shares seven actions health care organizations can take to address the racial disparities that exist in health and health care in America. This includes mobilizing COVID-19 resources for people of color before the next wave hits, go beyond usual outreach to minority communities, advocate for primary care for all, get out the vote, promote the census, support safety net programs and accelerate diversity and inclusion programs.
Ramon Sequeira, President of Takeda Pharmaceuticals U.S.A., Inc., shared her reflections in LinkedIn . She says the company must “take immediate steps to ensure everyone has equal access to our medicines and support programs.” She also says the company needs to find ways to “hire, train and communicate more purposefully to encourage both diversity and inclusion.”
Health care CEOs speak out on George Floyd protests. CEOs are publicly commenting in regard to the death of George Floyd at the hands of the police and the subsequent protests that have occurred across the country as a result. Some CEOs are addressing the larger issues at hand, while others communicated directly to their employees and the business community at large.
Merck CEO Kenneth Frazier told CNBC that “what the African American community sees in that videotape is that this African American man, who could be me or any other African American man, is being treated as less than human.” Frazier says leaders in the business community can be a “unifying force” and have the ability to create jobs and new opportunities for minorities.
Teladoc Health CEO Jason Gorevic writes on LinkedIn that these kinds of moments make him keenly aware of his responsibility as a business leader and CEO: “to foster an inclusive environment.” He says he sent a communication to employees this week reaffirming its commitment to an inclusive environment. “Emotions are rightly running high for everyone in America right now,” he adds. “Like many of our colleagues, I feel the weight of what’s upon us. In times like these, we all look for reassurance and understanding from the communities that matter most to us, including our workplace.”
Cedars-Sinai Health System CEO Tom Priselac also wrote on LinkedIn about the events in Minnesota. He says the events are a “stark reminder of the inequities that African-Americans and other people of color still face in our country.” He continues that while those who engaged in violent protests in Los Angeles should be held accountable, those acts by a small amount of people should not overshadow “the peaceful yet strong protests of thousands earlier in the day.”
Also speaking out were various medical association groups. The American Medical Association described police brutality of minorities a public health issue. AMA President, Patrice Harris, MD and Board Chair, Jesse Ehrenfeld, MD, released a joint statement urging health organizations to “take up the mantle of intolerance for police brutality and racism.” The American Hospital Association said hospitals have an important role to play in the wellbeing of their communities. “As we’ve seen in the pandemic, communities of color have been disproportionately affected, both in infection rates and economic impact,” Rich Pollack, president and CEO of the AHA, said in a statement.
Telehealth: A $250 billion opportunity? McKinsey & Company released a report saying up to $250 billion of current US health care spend could potentially be virtualized. The authors note that since COVID-19, providers have rapidly scaled telehealth solutions and nearly half of U.S. consumers have used it (up from 11 percent in 2019). However, the opportunity of telehealth is not inevitable. “This shift is not inevitable. It will require new ways of working for a broad set of providers, step-change improvements in information exchange, and broadening access and integration of technology,” according to McKinsey.
Racial disparity in COVID-19 patients. A new study in Health Affairs reveals that African Americans had 2.7 times the odds of hospitalization from COVID-19 compared to non-Hispanic white patients. Researchers examined 1,052 COVID-19 patients at Sutter Health, a large integrated health care system in northern California, to measure potential disparities. “African Americans continue to bear a disproportionate burden of chronic disease, with pronounced disparities in type 2 diabetes, congestive heart failure, and hypertension. There are concerns that existing racial and ethnic disparities will be exacerbated and compounded by COVID-19,” writes the study’s authors.