Tuesday Tidbits

Photo by Patrick Fore on Unsplash

From Washington, DC

  • The Medicare open enrollment period ends on Thursday, December 7. The Federal Benefits Open Season ends next Monday, December 11. While the Affordable Care Act open enrollment period continues into next month, December 15 is the last day to enroll if you want your coverage to begin on January 1, 2024.
  • FEHB open season changes take effect on January 1, 2024, for annuitants and on January 14, 2024, for federal employees. January 14 is the beginning of the first pay period in 2024.
  • Govexec tells us,
    • “In a memo to agency heads on Friday, OPM Associate Director for Workforce Policy and Innovation Veronica Hinton announced that the government’s HR agency had added shared certification functionality to the agency-facing portion of USAJOBS through a tool called Talent Pools.
    • “The Office of Personnel Management is proud to announce a new USAJOBS feature, Talent Pools, to ‘advertise’ available shared certificates of candidates across government,” Hinton wrote. “These certificates, issued under delegated examining procedures through the Competitive Service Act or an OPM-run cross government hiring action, contain candidates who have applied to an open announcement, have been assessed and are available for agencies’ consideration.”
    • “Hinton argued that the new feature should be a boon to agency hiring managers and job applicants alike by removing unnecessary and often duplicative red tape.”
  • Federal News Network informs us,
    • “Federal employees working in cyber now have a way to develop skills, while also seeing what it’s like to work at another agency.
    • “In the hopes of boosting retention of cyber employees, the Office of Personnel Management launched a new platform Monday for agencies to advertise openings in the cyber workforce rotation program.
    • “The rotation program lets agencies offer temporary assignments to federal employees who are currently working in IT, cyber or cyber-related positions in government. Eligible employees can apply for and work at a different agency for between six months and one year before returning to their home agency.
    • “The cyber rotations will advance career opportunities and support employee engagement, satisfaction and retention,” OPM said.”
  • The U.S. Preventive Services Task Force released two draft recommendation statements for public comment.
    • “Grade B — The USPSTF recommends exercise interventions to prevent falls in community-dwelling adults age 65 years or older who are at increased risk for falls.
    • Grade C — The USPSTF recommends that clinicians individualize the decision to offer multifactorial interventions to prevent falls to community-dwelling adults age 65 years or older who are at increased risk for falls. Existing evidence indicates that the overall net benefit of routinely offering multifactorial interventions to prevent falls is small. When determining whether this service is appropriate for an individual, patients and clinicians should consider the balance of benefits and harms based on the circumstances of prior falls, presence of comorbid medical conditions, and the patient’s values and preferences.”
    • The public comment period on the draft recommendation statements and the related draft evidence reviews ends on January 8, 2024. These recommendations would continue the current grades for these recommendations, last issued in 2018.

From the public health and medical research front,

  • Per Beckers Hospital Review,
    • “Leapfrog is winding down 2023 by recognizing 132 hospitals with its Top Hospital Award, a distinction for hospitals that demonstrate the highest performance in the U.S. on quality and patient safety. 
    • “Awarded hospitals are divided into four groups: general hospitals (34), children’s hospitals (8), rural hospitals (15) and teaching hospitals (75). Methodologies for the awards in each category can be found here. Seventeen more hospitals were awarded this year compared to last.”
    • The article lists all 132 recognized hospitals by state.
  • and
    • United Health Foundation released its 2023 America’s Health Rankings Dec. 5, which analyzes the overall health of the 50 states and this year identifies a record-high and rising prevalence of chronic conditions. 
    • For the 2023 rankings, UHF analyzed 87 measures across five categories of health: social and economic factors, physical environment, behaviors, clinical care and health outcomes. This year, eight chronic conditions — arthritis, depression, diabetes, asthma, cancer, cardiovascular diseases, chronic obstructive pulmonary disease and chronic kidney disease — reached their highest levels since America’s Health Rankings began tracking these measures in 1990. 
  • STAT News reports,
    • “Given the widespread acceptance that the current flu vaccines could use improvement, are mRNA shots the answer? As the scientific world waits for published data on which to formulate conclusions, STAT spoke to influenza and vaccine experts who see some significant benefits of applying mRNA technology to the production of flu vaccine — but also some serious challenges mRNA manufacturers will face breaking into this already crowded market.” 
    • In short, it’s messy.

From the U.S. healthcare business front,

  • The Wall Street Journal reports,
    • “CVS Health, the nation’s largest drugstore chain, will move away from the complex formulas used to set the prices of the prescription drugs it sells, shifting to a simpler model that could upend how American pharmacies are paid. 
    • “Under the plan, CVS’s roughly 9,500 retail pharmacies will get reimbursed by pharmacy-benefit managers and other payers based on the amount that CVS paid for the drugs, in addition to a limited markup and a flat fee to cover the services involved in handling and dispensing the prescriptions. Today, pharmacies are generally paid using complex measures that aren’t directly based on what they spent to purchase specific drugs.
    • “A similar payment model, sometimes known as “cost plus,” has been promoted by entrepreneur Mark Cuban’s eponymous pharmacy company, among others, which have said it brings greater clarity and accountability to drug pricing.  * * *
    • “The company will call the payment model CostVantage. When it starts rolling out next year, the new prices will first become available to consumers paying cash for their prescriptions using an array of drug discount cards. 
    • “In 2025, the setup will be incorporated into CVS pharmacies’ contracts with pharmacy-benefit managers covering drugs paid for under employer plans.
    • “CVS will also introduce a new option for clients of its PBM, CVS Caremark, that will work in tandem with the new retail pharmacy-payment scheme. The new PBM product, called TrueCost, will be based on the net cost of drugs with defined fee structures, the company said. Employers and other clients will have the choice to use it or not.”
  • Fierce Healthcare adds,
    • “After spending nearly $20 billion to pick up Signify Health and Oak Street Health this year, CVS rebranded its health services business to “CVS Healthspire” as it plots its long-term growth strategy.
    • “During the Forbes Healthcare Summit in New York City on Monday, CVS chief executive officer Karen Lynch said Healthspire will encompass CVS’ pharmacy services business, its care delivery assets, including home health company Signify Health and Medicare-focused primary care player Oak Street Health, as well as its new Cordavis operation. Cordavis is a new segment CVS launched in August that aims to work with drugmakers to bring additional biosimilars to market.”
  • BioPharma Dive points out,
    • “Johnson & Johnson expects its pharmaceuticals division will bring to market 20 new therapies for cancer, immune and neurological diseases by 2030, an outlook that underpins the industry giant’s forecast for sales growth of between 5% and 7% through the end of the decade.
    • “Seven of those anticipated drugs have the potential to earn more than $5 billion each in peak annual sales, J&J said Tuesday as part of a business review held three months after the company split off its consumer division. The separation left J&J slimmer, but focused on its higher-margin pharmaceuticals and medical device businesses.
  • Per Healthcare Dive,
    • “Next year is set to be another “make or break” year for nonprofit hospitals as they continue to weather staffing shortages and heightened inflation, according to a report from credit ratings agency Fitch Ratings released on Tuesday.
    • “The outlook for the sector is still “deteriorating” — a rating that’s been in place since August 2022. Fitch does not forecast credit downgrades en masse in the coming year. However, downgrades and negative outlooks will likely continue to outpace upgrades and positive outlooks.
    • “The single largest differentiator in performance will be hospitals’ ability to attract and retain staff in a hypercompetitive landscape, said Kevin Holloran, Fitch senior director and sector head, in a statement.”