Simplicity is a virtue.

From Washington, DC,

• The Senate is in session this week on Capitol Hill this week (following the Jewish holiday Yom Kippur. which begins at a sundown Sunday) for Committee business and floor voting.

• The American Hospital Association News tells us,
  • “The Centers for Disease Control and Prevention is seeking public input on how data intermediaries, such as health information exchanges and other data-sharing entities, can support secure, scalable, standards-based public health data exchange. Comments submitted for the request for information will be used to evaluate ways to improve interoperability, reduce reporting burdens and enhance the timeliness and usefulness of data for public health while protecting privacy.
  • “CDC said the effort builds on its data modernization initiatives and seeks feedback on how intermediaries can help address ongoing challenges related to data silos and information sharing across the healthcare and public sectors. Comments are due by Nov. 20.”

From the judicial front,

• Beckers Payer Issues reports,
  • “Several HCA Healthcare-affiliated hospitals in Texas filed a lawsuit Sept. 11 against Pennsylvania insurer Independence Blue Cross over alleged claim denials.
  • “The plaintiffs include Methodist Healthcare System of San Antonio, St. David’s HealthCare, HCA Houston Healthcare North Cypress, The Woman’s Hospital of Texas and HCA Houston Healthcare Medical Center — all tied to Nashville, Tenn.-based HCA Healthcare.
  • “The lawsuit, filed in a Pennsylvania federal court, argued the insurer needed to reimburse these hospitals under the BlueCard Program, which allows members of one Blue Cross Blue Shield Association licensee plan to receive covered care access in another licensee’s service area. In this case, the hospitals contract with BCBS Texas. The complaint also said IBX represented the hospitals as “in network.”
  • “The complaint said IBX owes the hospitals at least $345,319 under the agreements. The lawsuit outlines alternative legal theories, such as “implied-in-fact contract,” to challenge IBX’s reimbursement approach, as well.”

• The Wall Street Journal relates,
  • “Michelle Fennell was sitting at her desk when her right eye started feeling heavy. Suddenly, it was blurry and her peripheral vision waned. It felt like she was looking through a fishbowl; she could see straight ahead but not to her right or down. 
  • “Two weeks later, a doctor diagnosed Fennell, 53 years old, with nonarteritic anterior ischemic optic neuropathy, or NAION, a condition that leads to sudden, often permanent vision loss.
  • “The doctor asked what medicines she was taking. “He said right away, stop taking Ozempic,” to protect her remaining vision, said Fennell, who started taking the drug to treat her Type 2 diabetes six months prior. “I was shocked.” 
  • “Some emerging scientific research points to an increased risk for patients taking certain GLP-1s to develop NAION. But the evidence is mixed, and not clear enough to say whether or how the drugs cause the condition, doctors and researchers said.
  • “Fennell is one of dozens of people suing Novo, maker of the popular weight-loss and diabetes drugs Wegovy and Ozempic, claiming the medication caused this side effect. There are also a similar but smaller number of lawsuits against Eli Lilly, maker of Zepbound. Both companies are fighting the litigation, saying there isn’t enough evidence to support the idea that drugs are to blame.”

From the public health and medical / Rx research front,

• The Hill reports,
  • “Doctors in Texas say they have seen an increasing number of otherwise healthy young men coming in on the brink of organ failure. 
  • “The health care practitioners told Texas Monthly they believe the culprit is CKDu, or chronic kidney disease of unknown origin, an unexplained form of kidney disease that can quickly turn deadly.
  • The disease has also been called Mesoamerican Nephropathy, a reference to the region it’s more typically found in, Central America. It’s also been identified in Sri Lanka. Researchers are now concerned it is growing in the United States, especially among agricultural workers and laborers. 
  • People with CKDu don’t have the classic risk factors of kidney disease, like hypertension or diabetes. Most people affected by the disease are Latino men ages 20 to 60. Often, they work under extreme conditions.

• The Washington Post relates,
  • “The reported success of an experimental drug that uses messenger RNA to deliver personalized skin cancer vaccines could herald a wave of new treatments that harness the potent technology for a range of cancers, researchers say.
  • “Drugmakers Moderna and Merck this summer announced that a cancer vaccine, intismeran autogene, had succeeded in a Phase 3 clinical trial in preventing the recurrence of melanoma, a result experts celebrated as a breakthrough for mRNA-based cancer treatments. 
  • “Trials investigating mRNA vaccines for lung cancer, pancreatic cancer and other diseases are already underway. They use the same approach as intismeran that might once have seemed like science fiction: analyzing a tumor sample to create a vaccine customized to target its specific mutations, so each patient receives a unique drug for their cancer.
  • “Some of these treatments are still years or decades from fruition, if they prove to be effective, but researchers said the still-nascent field of mRNA vaccines could eventually transform our approach to cancer care.
  • “It is not too far-fetched to consider that in the future, when one is diagnosed with cancer, part of your specimen is going to go to the pathologist, who’s going to confirm the cancer [diagnosis],” said Dan Costin, director of the White Plains Hospital Center for Cancer Care in New York and a lead investigator in an mRNA lung cancer vaccine trial. “And the other part will be going to a laboratory where they will be preparing a special vaccine.”

• Medscape tells us,
  • “GLP-1 medicines for weight loss do cause some muscle loss, but current research suggests this is usually a normal part of losing weight and not unique to these drugs. The debate is really about how careful we should be in older or already frail people.
  • What happens to muscle with GLP-1 weight loss?
    • GLP-1 drugs (like semaglutide and tirzepatide) lead to large weight loss; about one-quarter to one‑third of that loss is “lean mass,” which includes muscle, organs, water, and bone, not just muscle alone.1When researchers adjust for the non‑muscle parts of fat tissue, the estimated lean loss with semaglutide drops from 39% of total weight lost to about 30%.2 Studies of people losing similar amounts of weight with bariatric surgery show a very wide range of lean‑mass loss (about 12–44%), so GLP‑1 drugs do not appear to cause an unusual or “extra harmful” pattern compared with other ways of losing weight.1 Importantly, in trials where people lost a lot of weight on GLP‑1s, physical function and mobility usually improved, even though some lean mass was lost.
  • Who might need extra caution?
    • Experts agree most typical middle‑aged adults with obesity are not becoming frail from GLP‑1 treatment.1 Concern is higher for: –
      • Older adults, especially over 60 –
      • Post‑menopausal women – P
      • People with sarcopenic obesity (high fat, low muscle) or other illnesses (heart disease, fatty liver, sleep apnea, major weight cycling)1
    • In these groups, losing too much muscle could worsen balance, strength, and fracture risk.

• Health Day informs us,
  • “Getting enough sleep is important for your health — but the type of sleep you get may matter, too.
  • “A team led by Jingsong Luo of Peking University in China tracked more than 95,000 adults who wore wrist monitors for seven days and nights, measuring REM, deep sleep and light sleep.
  • “Over the next nine years, they checked health records for links to more than 1,000 different diseases.
  • “The result: More REM sleep was linked to a lower risk of 83 diseases, including heart failure, dementia, Parkinson’s, Alzheimer’s and multiple sclerosis.
  • “More deep sleep was tied to lower risk of seven conditions, including type 2 diabetes, major depression and sleep apnea.
  • “REM sleep is when most dreaming happens, while deep sleep is the most restorative stage.
  • “The findings also underscore the importance of getting six to eight hours of sleep a night.”

From the U.S. healthcare business front,

• Beckers Clinical Leadership discusses better ways for our health system to handle chronic illnesses.
  • “[A]dvances – nutritional interventions, bioelectronic medicine, robotics, community-based care – are not isolated innovations. Together, they represent a strategy to reduce the burden of chronic disease on the more than 190 million Americans living with it today. When prevention works, the cost of care comes down. When communities are healthier, demand for expensive interventions falls.
  • “The path forward is clear, even if it isn’t easy. Chronic disease will not be tamed by any single breakthrough. It will be tamed by a sustained, systemwide commitment to prevention – investing in food, technology, relationships and community before a patient ever needs a hospital bed. Every health system, payer and policymaker should be asking the same question we ask ourselves: are we doing everything we can to keep people healthy before they need us? That is where the opportunity is. And that is where we intend to lead.”

• Beckers Payer Issues relates,
  • “Marisa Rogers, MD, has left her role as chief medical officer for Oak Street Health, CVS Health’s primary care company for older adults.
  • “We built our clinical teams, invested in our leaders, advanced our care model, improved quality, and navigated more change and transformation than I could have imagined,” Dr. Rogers said in a Sept. 18 LinkedIn post. “I’m proud of what we accomplished together and even more grateful for the people I shared it with.”

• Healthcare Dive reports,
  • “Almost 12 million Americans can’t access telehealth services because they don’t have enough broadband to support a reliable virtual care connection, according to new research published Friday in JAMA Health Forum.
  • “The majority of impacted individuals live in rural areas, highlighting how inadequate infrastructure and pricey broadband subscription rates are preventing traditionally underserved Americans from getting virtual access to primary, specialty and emergency care, researchers with the University of Vermont said.
  • “Affordability, low digital literacy, inadequate technology and a lack of availability of telehealth services are also hindering telehealth access.’