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.
As this list will be updated frequently, please email suggestions to Gabriel Perna.
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.