Friday Stats and More

Federal employment benefits

Friday Stats and More

David Ermer–COVID-19, Federal employment benefits, OPM–

Based on the CDC’s Cases in the U.S. website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 20th through 45th weeks of this year (beginning May 14 and ending November 11; using Thursday as the first day of the week in order to facilitate this weekly update):

That’s an eyepopper. 700,000 new cases in one week. Interestingly the CDC’s flu surveillance report as of November 7 continues to state that “Seasonal influenza activity in the United States remains low.” Twin epidemics of course would be worse.

The FEHBlog has noted that the new cases and deaths chart shows a flat line for new weekly deaths  because new cases greatly exceed new deaths. Accordingly here is a chart of new COVID-19 deaths over the same period (May 14 through November 11).

It’s worth adding that the highest number of weekly deaths occurred just before the start of this chart on May 14. Here a chart covering the period from April 2 through May 13, 2020.

Consequently, while new cases now are skyrocketing, current new weekly deaths (a weekly average of 5,473 over the past six weeks) are significantly lower than the above six week time frame (a weekly average of 10,408). That indicates to the FEHBlog that medical care is improving.

In other news —

  • Govexec.com offers Open Season decision making advice from the folks who write the Consumers’ Checkbook “Guide to Health Plans for Federal Employees.” While OPM with carrier input has made great strides in improving its FEHB plan comparison tool. the Checkbook Guide remains the gold standard in the FEHBlog’s opinion. The FEHBlog does purchase the Checkbook Guide and the price is around $11 for online access.
  • FedWeek provides more names on the Biden Administration OPM “landing team.” The FEHBlog is not familiar with any of them for what that’s worth.

Monday Roundup

David Ermer–COVID-19, Federal employment benefits, OPM, Uncategorized–
Photo by Sven Read on Unsplash

Well, the 2020 Federal Benefits Open Season starts next Monday, November 9. The FEHBlog has noticed that OPM has launched its Open Season 2020 website and Fedsmith.com has made available the FEHBlog favorite annual benefits administration letter, the description of significant FEHBP changes for 2021. There are a lot of interesting HMO plan changes to review.

The FEHBlog was looking for information about the virtual health fairs that OPM and FedPoint are sponsoring this year for federal employees and annuitants. It turns out that FedPoint is new name for Long Term Care Partners. FedPoint p/k/a LTCP administers the Federal Long Term Care Insurance Program. The company’s press release explains

FedPoint, which has more than 400 full-time employees and many part-time and contracted employees around the country, is a division of John Hancock Life & Health Insurance Company. The new name was chosen in part to reflect the platforms and service centers the company builds and manages, which function as key points where multiple stakeholders converge, interact, and transact business. Perhaps the most notable example is BENEFEDS, a proprietary online platform and call center built under the auspices of the U.S. Office of Personnel Management (OPM). Through BENEFEDS the company handles enrollment, billing, and customer support functions for enrollees in the large Federal Employees Dental and Vision Insurance Program (FEDVIP).

BENFEDS offers a website with information about 2020 Open Season virtual information offerings for FEDVIP and FEHBP customers. (BENFEDS understandably focuses on FEDVIP but if you click on any of the registration tabs you see that the information concerns the FEHBP, FEDVIP, and FSAFeds. NARFE’s Federal Benefits Institute also offers useful benefit webinars for active and retired Feds.

As tomorrow is the big day, the Centers for Disease Control is offering advice to voters on how to control the risk of contracting COVID-19 at polling places. The FEHBlog voted at a Montgomery County, Maryland, early voting center last Thursday and he found the process to be a well-oiled machine. Kudos.

Thursday Miscellany

David Ermer–COVID-19, Employee Wellness Programs, Federal employment benefits, SCOTUS, U.S. Healthcare–
Photo by Juliane Liebermann on Unsplash

The Senate Judiciary Committee sent Judge Amy Coney Barrett’s Supreme Court nomination to the Senate floor today. The Senate will confirm the nomination on Monday and Judge Barrett will be sworn in soon thereafter. Consequently, Judge Barrett will be sitting on Supreme Court bench when the Court hears the Affordable Care Act constitutionality case on November 10. The FEHBlog predicts a 9-0 decision in favor of the law’s constitutionality with the exception of the zeroed out individual mandate.

On the COVID-19 front, Medscape reports as follows:

  • The Food and Drug Administration gave marketing approval to Gilead Science’s “remdesivir (Veklury) today as a treatment for hospitalized COVID-19 patients age 12 and up, making it the first and only approved treatment for the disease.”
  • The Centers for Disease Control updated its COVID-19 social distancing guidance: “Previously, the CDC cautioned against spending 15 minutes or longer in close proximity to an infected person, particularly in enclosed indoor spaces. In a new report published online October 21 in Morbidity and Mortality Weekly Report, however, investigators ‘determined that an individual who had a series of shorter contacts that over time added up to more than 15 minutes became infected.'”
  • Dr. Anthony Fauci predicts that “People will likely need to wear masks and follow social distancing guidelines through the end of 2021 and into 2022.”

Healthcare Dive informs us about four healthcare story lines that COVID-19 has overshadowed this year — — 1. Price transparency going strong; 2. Companies rush to go public; 3. Surprise billing efforts slow to a crawl, and 4. preference for healthcare at home. The FEHBlog is pleased to reflect that he has been discussing these matters and COVID-19 this year.

Govexec reports on the eight most important birthdays for federal employees from a federal employee retirement standpoint — the birthdays range from ages 50 to 72

The Society for Human Management provides a comprehensive update on employer and health plan sponsored wellness programs which is worth a gander.

Beckers Hospital Review alerts us that “Healthgrades named the recipients of its 2021 Specialty Excellence Awards Oct. 20, which include the top hospitals for critical care.” The article lists the 214 award winners by state.

Saturday October 24 is National Prescription Drug Take Back Day. “Check DEA’s official Take Back Day website for more information and to find year-round collection sites near you.”

Finally in a man bites dog story, the Wall Street Journal headlines tonight on its website that “Walmart sued the federal government in an attempt to strike a pre-emptive blow against what it said is an impending opioid-related civil lawsuit from the Justice Department.” Best defense, etc. The article notes that “Quicken Loans Inc. tried a similar tactic against the federal government in 2015 to avoid being pegged with mortgage fraud, but the Justice Department sued weeks later in a case Quicken settled last year.” The FEHBlog expects the same outcome with this lawsuit.

Tuesday Tidbits

David Ermer–COVID-19, Federal employment benefits, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

The FEHBlog did catch part of the LAN Summit today. The FEHBlog understands that recordings of the sessions will be available at no cost in the near future.

  • The LAN released a Healthcare Resiliency Framework which is particularly appropriate 2020.
  • The FEHBlog was impressed by a talk given by Alan Levine, the CEO of Ballad Health which was created by the 2018 merger of two rural health systems in southwestern Virginia and eastern Tennessee. This program caught the FEHBlog’s attention:

Ballad Health is implementing the Strong Starts/Strong Pregnancies Program to connect with the 300-member STRONG Accountable Care Community (ACC) it facilitated, which consists of churches, schools, employers, healthcare providers and social services agencies in the Appalachian Highlands. More than 6,000 babies are delivered each year in Ballad Health facilities, and beginning in 2021, Ballad Health and participating independent obstetricians in the region will provide assessments and screenings to help connect families with a community navigator who will work to make sure each child receives the strong start they deserve. This includes connecting families with the supports and services provided by the members of STRONG and other community partners.

Here are a couple of tidbits from the virtual HLTH Conference:

  • Fierce Healthcare reports that “In the months after Walgreens announced a $1 billion partnership with VillageMD to build hundreds of primary care clinics next to its retail pharmacy stores, there are still only a few locations in Houston. “But that will be changing quickly, said Walgreens’ co-Chief Operating Officer Alex Gourlay. “Within the next fiscal year, the company plans to have at least 40 locations open, Gourlay said, speaking at the HLTH 2020 virtual conference Monday. The company has previously said it expects to have at least 500 locations open within the next five years.”
  • Healthcare Dive reports that “Integrated health giant Kaiser Permanente said it intends to put a stronger focus on equity and inclusion in one of Greg Adams’ first major moves as CEO. The Oakland, California-based nonprofit plans to bring ethnicity and race factors into how it evaluates quality and care across the organization, Adams said Monday at the HLTH virtual conference. Kaiser’s board, which finished strategic planning in the middle of the pandemic, is still figuring out what that means in practice.” As a board we made the decision that we would own healthcare disparities for all care that we provide,” Adams said. “We haven’t quite figured out how we’re going to do that… [but] the point the board made is, owning it for a few conditions is not sufficient.”

On the COVID-19 front

  • The NIH Director Dr. Francis Collins has an encouraging post today about COVID-19 vaccine development.
  • The Wall Street Journal reports that Johnson & Johnson put a pause on their Phase III vaccine trial in order to investigate an unexpected illness in a participant. The FEHBlog is pleased to read about occasional pauses like this because it shows that the trial system is working.
  • CNN Health reports that “there were 20% more deaths than would normally be expected from March 1 through August 1 in the United States — with Covid-19 officially accounting for about two-thirds of them, according to new research published Monday in the medical journal JAMA.” COVID-19 is one bad disease.
  • A friend of the FEHBlog called to his attention the fact that on October 8, 2020, the Department of Health and Human Services renewed the nationwide public health emergency for the opioid crisis. It is surprising to the FEHBlog that the first such declaration was made only three years ago.
  • This lead the FEHBlog to discover that on October 2, 2020, HHS also renewed the nationwide COVID-19 public health emergency through January 21, 2021. This act extends the CARES Act COVID-19 testing mandate on health plans at least through that date.

Finally Federal News Network reports that “Social Security recipients will get a modest 1.3% cost-of living-increase in 2021, but that might be small comfort amid worries about the coronavirus and its consequences for older people. The increase amounts to $20 a month for the average retired worker, according to estimates released Tuesday by the Social Security Administration. That’s a little less than this year’s 1.6% cost-of-living adjustment, or COLA. The COLA affects the personal finances of about 1 in 5 Americans, including Social Security recipients, disabled veterans and federal retirees, some 70 million people in all.”

Weekend update

David Ermer–Congress, COVID-19, Federal employment benefits, Medicare, U.S. Healthcare–
Thanks to ACK15 for sharing their work on Unsplash.

Congress does not plan to hold votes this week. The Senate Judiciary Committee begins Judge Amy Coney Barrett’s Supreme Court nomination confirmation hearing tomorrow.

Fox Business brings us up to date on the COVID-19 relief bill negotiations, and Federal News Network outlines new federal employment bills to watch.

This week the HLTH conference will virtually occur. Healthcare Dive describes five conference highlights.

On the afternoon of Tuesday October 13, the HCP-LAN will hold its virtual summit meeting. The FEHBlog has enjoyed these summits and, in contrast to HLTH, there’s no charge to attend. “The 2020 LAN Virtual Summit will center around how value-based payment models and the larger health care system have adapted to become more responsive and resilient in the wake of the public health emergency.”

On Thursday October 15, the Medicare Open Season begins. This is time when Medicare beneficiaries can enroll in or switch Medicare Advantage and Part D plans. The Open Season end on December 7.

Hopefully this week also will spotlight OPM’s 2020 Open Season announcement.

In recent news —

  • Health Payer Intelligence discusses a PriceWaterhouseCoopers report on strategies that health plans are implementing to control prescription benefit costs.
  • The Wall Street Journal considers “Lessons for the Next Pandemic—Act Very, Very Quickly / Scientists and public-health leaders are working on new ways to find infections before they spread; smarter lung scans and screening blood samples.” It’s never too early to start evaluating and planning.
  • The Federal Times reports on the virtual ceremony held to honor the federal employees who received the 2020 SAMMIE awards. SAMMIE is short for Samuel J. Heyman Service to America Medals. Congratulations SAMMIE winners.
  • NPR reports that

When developing a vaccine, scientists have a few strategies to try. They can take a piece or component of the bacteria and use that to trigger an immune response in a person. They can kill the pathogen and use its corpse as the vaccine. Or they can take a live pathogen and weaken it in the lab.

The latter are called “live, attenuated vaccines,” and over the past century, scientists have noticed something peculiar about these vaccines: They seem to offer some protection, not just from the targeted disease, but also against many different diseases, including respiratory infections.

COVID-19, of course, is a respiratory infection.

The nasal flu vaccine, in contrast to the injection, is a “live, attenuate vaccine.” However, it is only available to certain age groups. The Centers For Disease Control explains “The nasal spray flu vaccine is approved for use in healthy non-pregnant individuals, 2 years through 49 years old. People with certain medical conditions should not receive the nasal spray flu vaccine.” Of course, this is a conversation to hold with your doctor if you are eligible for the nasal flu vaccine.

Monday Round-up

David Ermer–Federal employment benefits, Mental health care, OPM, U.S. Healthcare–
Photo by Sven Read on Unsplash

For fun, the FEHBlog went down the OPM.gov rabbit hole to find the dates on which the the following year’s FEHB and FEDVIP premiums were announced. Since 2004 (the FEHBlog could not find the 2009 and 2010 press releases), the announcement was made eleven times in September and four times in October. The latest date was October 7 in 2014. Since that date the release dates range from September 28 (in 2015 and 2018) to October 7. So OPM has not set a new record yet.

In this regard, the Society for Human Resources Management reports today that

Employers expect a moderate health plan cost increase next year of 4.4 percent, on average, compared to this year, according to early results from HR consultancy Mercer’s National Survey of Employer-Sponsored Health Plans 2020.

The increase, based on 1,113 employer responses since early July, is marginally lower than a recent forecast by the nonprofit Business Group on Health, which in August expected a 5.3 percent increase in health plan premiums for 2021. But Mercer’s projection is within the broad range of 4 percent to 10 percent forecast by consultancy PwC’s Health Research Institute over the summer.

Mercer projects that 2020 will end with a 3.3 percent health benefit cost increase, which is still largely in line with the average annual cost growth over the past several years. Still, health benefit cost growth is now far outpacing the consumer price index and wage growth, both of which have slowed significantly.

The President, who returned to the White House from Walter Reed National Military Medical Center this evening, signed an executive order on Saturday. The executive order concerns “Saving Lives Through Increased Support For Mental- and Behavioral-Health Needs. It establishes a “Coronavirus Mental Health Working Group (Working Group) is hereby established to facilitate an ‘all-of-government’ response to the mental-health conditions induced or exacerbated by the pandemic, including issues related to suicide prevention. The Working Group will be co-chaired by the Secretary of Health and Human Services, or his designee, and the Assistant to the President for Domestic Policy, or her designee.”

It’s a bit of surprise to the FEHBlog that as Federal News Network reports the federal government has not yet given affected employees the option to decline the Administration’s temporary payroll tax deferral.

Happy New Fiscal Year

David Ermer–COVID-19, COVID-19 testing, COVID-19 vaccine, Federal employment benefits, HIPAA Privacy and Security Rules, OPM–

Today, October 1, 2020, is the beginning of the new 2021 federal fiscal year and the fourth calendar quarter of 2020. Federal News Network reports that the President signed the compromise continuing resolution into law at 1 am this morning. The federal government is now funded through December 11, 2020.

The Washington Post reminds us that

Most federal employees [became] eligible Thursday [October 1] for paid parental leave, a benefit valued at about $1 billion a year and one of the most significant expansions of their benefits since the creation of unpaid parental leave more than 25 years ago. The new entitlement will allow employees to take paid time off for part or all of 12 weeks over a 12-month period, effective with births, adoptions or foster placements that occur Thursday and after. Previously, employees could take 12 weeks of unpaid time available under the Family and Medical Leave Act.

On the COVID-19 front —

  • The Wall Street Journal provides operational background on the current Phase III COVID-19 vaccine trials.
  • The Department of Health and Human Services announced an agreement with the Rockefeller Foundation “to identify and share effective approaches for using rapid point-of-care (POC) antigen tests to screen for COVID-19 in communities, with a focus on safely reopening K-12 schools. The partnership establishes a pilot program with select cities and states in The Rockefeller Foundation’s Testing Solutions Group (TSG), a network of public officials devoted to rapidly scaling COVID-19 testing, tracing, and tracking in their communities.”
  • STAT News discusses the somber connection between diabetes and COVID-19.

Data from the U.S. Centers for Disease Control and Prevention show more than three-quarters of people who died from Covid-19 had at least one preexisting condition. Overall, diabetes was noted as an underlying condition for approximately 4 in 10 patients. Among people younger than 65 who died from the infection, about half had diabetes.

[Moreover,] Juliana Chan, director of the Hong Kong Institute of Diabetes and Obesity, said the pandemic has intertwined with and exposed two other widespread problems: diabetes and disparities triggered by social determinants of health.

“What we are seeing is nothing new, but it is really just on a massive and global scale,” she said in an interview. “I hope that there is something positive out of this, that people understand that we are hit by three epidemics.”

  • The U.S. Department of Labor issued additional FAQs “regarding the need to report employees’ in-patient hospitalizations and fatalities resulting from work-related cases of the coronavirus.”

Because October is National Cybersecurity Awareness Month, the FEHBlog wishes to point out this Health IT Security report that

From October 2019 to July 2020, Microsoft data shows hackers have rapidly improved the sophistication and increased the frequency of cyberattacks. And when it comes to incident response engagements, ransomware attacks were the most common cause. The report follows reports that the Universal Health Services health system is currently recovering from what appears to be one of the biggest ransomware attacks in recent history. Further, nearly a dozen healthcare entities in the past month have either faced similar incidents or saw their data leaked online by ransomware threat actors.

Weekend update

David Ermer–Congress, COVID-19, Federal employment benefits, Medicare, OPM–
Photo by Dane Deaner on Unsplash

Greetings from North Beach, NJ. The FEHBlog will be writing from outside the Beltway for the coming week.

Both Houses of Congress are is session for committee and legislative business this coming week. The House Rules Committee will consider the FY 2021 continuing resolution tomorrow.

The FEHBlog noticed that last week the President nominated OPM’s Acting / Deputy Director Michael Rigas to fill permanently fill his other and more important acting position, Deputy Director for Management at the Office of Management and Budget. It’s too bad that Mr. Rigas was not nominated for OPM Director back in 2017. He certainly has impressed people in the Trump Administration.

The Federal News Network reports that

“Due to the ongoing management challenges that the COVID-19 pandemic presents for our workforce, the Government Managers Coalition believes the federal government would benefit from the establishment of a [permanent] emergency leave transfer program (ELTP) both as a management tool and as a means by which to support our workforce,” the organizations said in a recent letter to Michael Rigas, acting director of the Office of Personnel Management. “An ELTP would be a novel solution, especially for employees with caregiving responsibilities affected by school and daycare closures.” Under an emergency leave transfer program, federal employees can donate unused annual leave to their colleagues who are adversely impacted by a major disaster. Employees who are impacted by a national emergency can apply in writing to become recipients of the donated leave.

This is a good idea for other large and even mid-sized employers.

In other news

  • The Wall Street Journal reports that

When enough people become immune such that the whole community is protected, it’s called herd immunity. Herd immunity can sometimes occur naturally from survivors of the disease within a population, but often not without many deaths. Covid-19 has so far killed close to 200,000 people in the U.S. Epidemiologists believe only a small percentage of the nation has been infected and developed some level of immunity. The introduction of a vaccine can be the quickest, safest way of creating herd immunity, since people can develop immunity without getting the disease.

According to the Great Influenza, the world’s population eventually achieved herd immunity from the 1918 influenza, by a mild first wave of the virus and millions upon millions of deaths from the second wave. Of course, there was no vaccine for the great influenza one hundred years ago.

  • Healthcare Dive informs us that “One year after the first Walmart Health location opened in Dallas, Georgia, the retail giant is moving forward with nationwide expansion of its health superstores.” The FEHBlog is intrigued by Walmart’s healthcare actions.
  • Last week, the Centers for Medicare and Medicaid Services announced that “it has finalized the End-Stage Renal Disease (ESRD) Treatment Choices (ETC) Model (fact sheet), to improve or maintain the quality of care and reduce Medicare expenditures for patients with chronic kidney disease. The ETC Model delivers on President Trump’s Advancing Kidney Health Executive Order and encourages an increased use of home dialysis and kidney transplants to help improve the quality of life of Medicare beneficiaries with ESRD. The ETC Model will impact approximately 30 percent of kidney care providers and will be implemented on January 1, 2021 at an estimated savings of $23 million over five and a half years.”

Tuesday Tidbits

David Ermer–AHRQ, CDC, Congress, COVID-19, COVID-19 vaccine, Federal employment benefits, OPM, Telehealth–

The U.S. Office of Personnel Management released its first of four Benefit Administration letters for the upcoming Federal Benefits Open Season which which will run from Monday, November 9, 2020 through Monday, December 14, 2020. Here are links to the BAL, a sample email to employees and a Venn diagram displaying the interlocking aspects of the health, dental, vision, and flexible benefits programs that participate in this Open Season. The FEHBlog expects that COVID-19 public health emergency will tamp down the traditional Open Season health fairs. It will be an interesting experiment to see whether this change impacts the volume of plan changes one way or the other.

In anticipation of FDA approval of COVID-19 vaccine(s), an expert panel formed by the National Academies of Science has issued for public comment draft recommendations for staging an equitable distribution of the vaccines according to a STAT News report. A public hearing on the draft recommendations is scheduled for tomorrow. This report then goes to the Centers for Disease Control which has an Advisory Committee on Immunization Practices. The staging offered in the recommendations makes sense to the FEHBlog, e.g., first responders first etc.

The Wall Street Journal reports that Americans should add strong ventiliation to the Covid-19 prevention toolbox along with mask, social distancing, etc.

After urging steps like handwashing, masking and social distancing, researchers say proper ventilation indoors should join the list of necessary measures. Health scientists and mechanical engineers have started issuing recommendations to schools and businesses that wish to reopen for how often indoor air needs to be replaced, as well as guidelines for the fans, filters and other equipment needed to meet the goals.

There’s a recently renovated office building near the FEHBlog’s offices in downtown DC that has a big outside sign stating that its ventilation services are tops and known to be anti-COVID. The FEHBlog will retry to remember to post a picture of the sign later this week.

Becker’s Health IT discusses a Centers for Medicare and Medicaid Services proposed rule issued yesterday. “The Medicare Coverage of Innovative Technology proposed rule would speed up the FDA approval process for Medicare coverage of new medical technologies. * * * Often referred to as the “valley of death,” for innovative medical tech products, the lag time between the FDA’s approval and Medicare establishing coverage prevents seniors from accessing these new technologies during the coverage determination process.” Ouch.

Speaking of innovation, Econtalk podcast host and economist Russ Roberts speaks this week with author Matt Ridley about his fascinating book titled “How Innovation Works.” Check it out.

In other news

  • EHR Intelligence reports “Following vote in the House of Representatives to remove the bill prohibiting the use of federal funds for the adoption of a national patient identifier (NPI), the Premier Healthcare Alliance and the Patient ID Coalition call on the US Senate to also lift the ban.” Good luck.
  • FYI, here’s a link to Treasury Secretary’s Steven Mnuchin’s testimony before the COVID-19 subcommittee of the House Oversight and Reform Committee. The federal employee press does not suggest that fireworks exploded at the hearing.
  • The Department of Health and Human Services announced today that “The Federal Communications Commission (FCC), HHS, and U.S. Department of Agriculture (USDA) today announced that they have signed a Memorandum of Understanding to work together on the Rural Telehealth Initiative, a joint effort to collaborate and share information to address health disparities, resolve service provider challenges, and promote broadband services and technology to rural areas in America.” Perhaps another silver lining in the COVID-19 cloud.
  • And then another. The HHS Agency for Healthcare Research and Quality explains that

There is evidence that people who receive longer-term treatment with medications for addiction treatment (MAT) have better outcomes. But, keeping people with OUD on MAT is challenging. Now, the COVID-19 pandemic may be making retention of patients in MAT even more difficult.

Fortunately, we can report some good news that should help us fight the opioids epidemic even as we try to maintain safe distance. It appears that people with OUD will stay in treatment when given support remotely as they do in person—a major benefit that appears to be emerging during the COVID pandemic.

Tuesday Tidbits

David Ermer–Federal employment benefits, Medicare, Rx coverage, Telehealth–

The U.S. Office of Personnel Management today announced the companies that were awarded FEDVIP contracts for a seven year term beginning January 1, 2021. OPM added two new dental carriers — UnitedHealthCare (nationwide) and HealthPartners (regional) for a total of twelve dental carriers. OPM added one new vision carrier — MetLife (all vision plans are nationwide) — for a total of five vision carriers beginning next year.

The Centers for Medicare and Medicaid Services announced an initiative to “transform rural health.” Healthcare Dive explains

CMS’s new payment model for rural hospitals and accountable care organizations that will use upfront and capitated payments. Participating facilities will be able to waive cost-sharing for Medicare Part B services, provide transportation for beneficiaries and expand telehealth services, among other flexibilities.

The Community Health Access and Rural Transformation model has two tracks, one of which is focused on ACOs. In the other track, $75 million will be provided to lead organizations in 15 rural communities, which will be announced early next year with a planned start of the model next summer.

The lead organizations, which can be state Medicaid agencies, local health departments or academic medical centers, among others, will receive $2 million after being accepted and another $3 million in upfront funding as the model progresses.

Fierce Healthcare discusses Teladoc’s acquisition of Livongo which was announced Wednesday August 5. “The combination of two of the largest publicly-traded virtual care companies announced Wednesday will create a health technology giant just as the demand for virtual care soars.” However,

Both companies’ stock dropped Wednesday after news of the deal broke. Teladoc’s stock was down 15% and Livongo’s stock also fell by 14%. As of Thursday, both companies’ stock was still trading lower.

Analysts say the total deal price of $158.99 per share represents a 10% premium over Livongo stock’s record closing price of $144.53 as of Aug. 5, leading to the market pushback on the high valuation.

The Drug Channels blog offers its useful annual update “on pricing at five of the largest pharmaceutical manufacturers—Eli Lilly, Janssen, Merck, Novartis, and Sanofi.” Drug Channels finds that

Average discounts from [prescription drug manufacturer] list prices have been deepening.Merck’s average discount rate went from -41% in 2016 to -44% in 2019, while Lilly’s rate went from -50% to -57%. We estimate that in 2019, the total value of gross-to-net reductions for brand-name drugs was $175 billion. That figure has doubled over the past six years.

In other encouraging news, STAT News tells us about an experimental drug to treat coronaviruses like COVID-19.

A research team at the University of California, San Francisco, has synthesized a molecule that they say is among the most potent anti-coronavirus compounds tested in a lab to date. Called nanobodies because they are about a quarter of the size of antibodies found in people and most other animals, these molecules can nestle into the nooks and crannies of proteins to block viruses from attaching to and infecting cells.
The lab-made one created by the UCSF team is so stable it can be converted into a dry powder and aerosolized, meaning it would be much easier to administer than Covid-19 treatments being developed using human monoclonal antibodies. While the work is still very preliminary, the goal is to deliver the synthetic nanobody via simple inhaled sprays to the nose or lungs, allowing it to potentially be self-administered and used prophylactically against Covid-19 — if it’s shown safe and effective in both animal tests and clinical trials.

Let’s go. This my friends is the difference between 1918 and 2020. We must have faith in medical research.

Finally the FEHBlog’s favorite podcast EconTalk provided a timely insight into Shakespeare’s Romeo and Juliet in this week’s episode. Journalist and author Ben Cohen talked about his book, The Hot Hand, with EconTalk host Russ Roberts. The Hot Hand concerns streaks. and Shakespeare wrote three of his most popular plays, including Romeo and Juliet, from 1605-1606 when London was suffering from the plague. What’s more,

The reason why Romeo doesn’t know that Juliet has taken this potion and that she is simply sleeping and not actually dead is because this whole harebrained scheme had not been explained to him because he never gets the [explantory] letter [that a messenger was tasked to bring him].

So, if you think about it, it’s really a bonkers plot line. The flyer says, ‘I will–Juliet, take this sleeping potion, it will knock you out. Your family will think you’re dead. When they think you’re dead, Romeo is going to come back and he’s going to sweep you away and take you and live happily ever after.’

Now, this is the stuff that like you wouldn’t even see on a reality show or some terrible soap opera now. And yet, it’s our most famous love story.

And so, why does it fall apart? She takes the sleeping potion, right? She gets knocked out. Her family thinks she’s dead. Romeo comes back and sees her in the open crypt. All of the crazy stuff [Romeo and then Juliet committing suicide] actually turns out–where the whole scheme falls apart–is simply on getting a letter to Romeo. And it falls apart because the plague is sweeping through and the messenger gets stuck in quarantine.

So, all of this is the plague.

Now that’s a 1605 twist that rings true nearly 400 years later.