Monday Roundup

Generative AI

Monday Roundup

David Ermer–AHRQ, CDC, FDA, Generative AI, Medical / Rx research, Obesity, Patient safety, SDOH, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC,

  • Tomorrow at 10 am, the House Oversight and Accountability Committee will mark up several bills including the FEHB provisions in the DRUG Act, HR 6283. It’s unfortunate that the Committee did not hold a hearing on this disruptive bill. The FEHBlog will be listening to the markup.
  • The Federal Times informs us,
    • “A pair of contracts designed to improve the quality of care in Tricare’s civilian medical networks will take effect Jan. 1, 2025, according to defense officials.
    • “The contracts are moving forward following a Jan. 31 decision in the U.S. Court of Federal Claims affirming the Defense Health Agency’s choice of TriWest Healthcare Alliance as the Tricare West Region’s new manager, denying a protest lodged by incumbent contractor Health Net Federal Services last year.  * * *
    • “Humana Government Business, the incumbent contractor for Tricare’s East Region, will continue in that role under a new deal worth up to $70.8 billion.The new contracts for the two regions have a potential combined value of $136 billion over nine years.”
  • MedTech Dive lets us know
    • “FDA panel recommends new standards for pulse oximeters amid bias concerns.
    • “Studies have found that pulse oximeters overestimated oxygen saturation in people with dark skin pigmentation, resulting in delayed care.”
  • and
    • “Hologic has received regulatory clearance to sell an artificial intelligence (AI)-enabled cervical cancer screening system in the U.S. 
    • “The product, the Genius Digital Diagnostics System, creates digital images of Pap test slides and uses an AI algorithm to identify cells that cytologists and pathologists should review.
    • “Hologic’s clearance, announced on Thursday, comes days after BD partnered with Techcyte to promote a digital, AI-enabled cervical cancer screening test that is yet to come to market.”

From the public health and medical research front,

  • Beckers Hospital Review tells us,
    • “Eli Lilly’s ingredient for Type 2 diabetes medication Mounjaro and its new weight loss drug, Zepbound, significantly lowered patients’ blood pressure by up to 10.6 mmHg, according to a new study published Feb. 5. 
    • “The study recruited about 500 adult patients with a body mass index at or more than 27, or the overweight range. Compared to a placebo, tirzepatide — the active pharmaceutical ingredient of Mounjaro and Zepbound — reduced blood pressure for participants taking 5, 10 and 15 milligrams each week. The patients were not diabetic and either had normal blood pressure or high blood pressure that was under control.” 
  • STAT News reports,
    • “Amgen is trying a unique strategy with its obesity drug candidate: testing whether it can wean patients toward lower or less frequent doses over time.
    • “Very early data hints that Amgen’s candidate, called MariTide, may provide longer-lasting weight loss than highly popular obesity drugs on the market like Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound. Amgen is already seeing if that means its drug could also be dosed differently from Novo and Lilly’s products, which are costly and expected to be taken consistently for life.
    • “In an ongoing Phase 2 trial, Amgen’s researchers will first titrate participants up on MariTide, but then after some time, see if the drug can still be effective when transitioning patients to a less intensive dosing regimen, executives said in an interview.
    • “Could there be an opportunity for an induction maintenance-type of strategy for a molecule like MariTide?” said Narimon Honarpour, senior vice president of global development at Amgen, referring to a strategy used for anti-inflammatory drugs in which high, rapid doses are given at the start and then lower or less frequent doses are used for maintenance in the long run.”
  • HHS’s Agency for Healthcare Research and Quality released a rapid evidence report about deprescribing to reduce medical harms in older adults.
    • “Deprescribing has emerged as a clinical practice to reduce polypharmacy and use of potentially inappropriate medications (PIMs) and serve as a mechanism for quality improvement and increased patient safety. The purpose of this rapid response is to summarize recent literature on the use of deprescribing to improve the safety of medication use among older adults (age ≥ 65 years).”
  • CBS News reports,
    • “Preterm and early-term births in the U.S. have increased from 2014 to 2022, raising risks to babies, according to new data from the Centers for Disease Control and Prevention.
    • “Data released Wednesday from the CDC’s National Center for Health Statistics shows the preterm birth rate — meaning delivery before 37 completed weeks of pregnancy — rose 12% during that time period, while early-term birth rates, at 37 to 38 completed weeks, rose 20%. 
    • “This is compared to full-term births, which are those delivered at 39 to 40 weeks.
    • “Using data from the National Vital Statistics System, the analysis only looks at singleton births, since multiple births like twins and triplets tend to be born at earlier gestational ages, the authors note.
    • “Gestational age is a strong predictor of short- and long-term morbidity and early mortality,” the authors write. “Births delivered preterm are at the greatest risk of adverse outcomes, but risk is also elevated for early-term compared with full-term births.”
  • MedCity News points out,
    • “Mayo Clinic has entered into a collaboration with TruLite Health — Mayo is helping the Phoenix-based startup develop its software platform designed to address providers’ clinical bias. The health system said it chose to collaborate with TruLite because of the platform’s potential to mitigate health inequities and enhance patient outcomes at the point of care.”
  • Per Fierce Healthcare,
    • “Artificial intelligence can help identify easy to miss patients who might be good candidates for a palliative or hospice care referral, a recent pilot at Mass General Brigham (MGB) revealed.
    • “The results of the findings were presented Friday at the Value-Based Payment Summit.
    • “Timely end-of-life care benefits patients. Patients and their families may also be more open to a conversation about goals of care during a hospital stay, MGB said in presentation slides shown to Fierce Healthcare.” 

From the U.S. healthcare business front,

  • Per BioPharma Dive,
    • “Novo Holdings, the controlling shareholder of Danish drugmaker Novo Nordisk, will buy contract manufacturer Catalent for $16.5 billion in a take-private deal the companies announced Monday.
    • “In a related transaction, Novo Nordisk has agreed pay its parent company $11 billion to take over three Catalent plants in Italy, Belgium and Indiana to help expand production of its GLP-1 drugs Ozempic and Wegovy. Demand for the latter, which is approved in the U.S. for treating obesity, has greatly exceeded supply, forcing Novo Nordisk to restrict access.
    • “Novo Nordisk and Catalent already work together at the three sites, which employ more than 3,000 staff.”
  • and
    • “On Monday, Johnson & Johnson said one of its most closely watched experimental medicines appears to have positive effects on two autoimmune diseases, providing further support to a drug that, by the company’s estimates, could eventually generate billions of dollars in annual sales.
    • “J&J didn’t release any data, but rather said the drug hit the main goals of a mid-stage clinical trial testing it in patients with Sjögren’s disease as well as a late-stage study focused on generalized myasthenia gravis, a rare condition known in short as gMG. The company plans to present more detailed results from both studies at upcoming medical meetings, and to engage with regulators about the path to approval in gMG.”
  • Per Healthcare Dive,
    • “Cano Health filed for Chapter 11 bankruptcy late Sunday, as the beleaguered primary care chain works to bolster its financials. 
    • “The filing is part of a restructuring support agreement with the majority of its lenders. Cano said it expects to emerge from restructuring during the second quarter this year, adding that the process will help it reduce debt and allow it to search for a strategic partner or buyer.
    • “Cano also announced it reached an agreement to receive $150 million in debtor-in-possession financing to fund its operations during restructuring.”
  • and
    • “Medicare Advantage rate changes proposed by regulators last week are upsetting Humana’s funding expectations for 2025.
    • “If finalized as proposed, the MA changes will lower Humana’s benchmark funding by around 160 basis points compared to a flat rate environment, the health insurer disclosed in a filing with the Securities and Exchange Commissionon Monday.
    • “The discrepancy is because the CMS didn’t factor in persistently elevated medical costs into how it calculates rates, Humana said. However, regulators could do so in the final rule. Despite the uncertainty, the insurer reaffirmed its earnings outlook for 2025.”
  • Per Fierce Healthcare,
    • “Rural providers feel financially stable, with most planning to expand existing service lines to increase revenue, a new survey has found (PDF).
    • “The survey was conducted by accounting firm Wipfli and reached 106 rural healthcare organizations across 26 states. Respondents included a mix of critical access hospitals, rural health clinics and others.
    • “Overall, most respondents are cautiously or completely optimistic about their financial viability. About 40% said their financial stability is higher than it was a year ago, and the portion of those who think they are in a better place than they were five years ago also rose compared to 2023. Despite challenges like high inflation, dwindling COVID-19 relief funds and flat reimbursement rates, growing optimism suggests rural providers learned how to manage unpredictability during the pandemic, the report said. * * *
    • Entering 2024, rural healthcare leaders are most concerned about revenue capture, digital capabilities and people management.
  • HR Morning offers nine tips on maximizing core health benefits.
  • The Society for Human Resource Management discusses best practices for hybrid work models.

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity policy front,

  • The Wall Street Journal reported on Wednesday,
    • “The U.S. government said it had disrupted a uniquely dangerous and potentially life-threatening Chinese hacking operation that hijacked hundreds of infected routers and used them to covertly target American and allied critical infrastructure networks.
    • “Senior officials described the operation in unusually blunt terms as part of an evolving and increasingly worrisome campaign by Beijing to get a foothold in U.S. computer networks responsible for everything from safe drinking water to aviation traffic so it could detonate, at a moment’s notice, damaging cyberattacks during a future conflict, including over Taiwan.
    • “Wednesday’s announcement was part of an effort by senior Biden administration officials to underscore what Federal Bureau of Investigation Director Christopher Wray called the “apocalyptic scenarios” animating their fears about China’s advanced and well-resourced hacking prowess. Western intelligence officials say its skill and sophistication has accelerated over the past decade. Officials have grown particularly alarmed at Beijing’s interest in infiltrating U.S. critical infrastructure networks, which they say poses an unrivaled cybersecurity challenge.”
  • Here’s Cybersecurity Dive’s story on this chilling development.
    • “The FBI and Department of Justice disclosed Wednesday a court-authorized disruption of a botnet linked to the Volt Typhoon threat campaign from 2023, which Wray noted during his testimony. The hackers installed KV Botnet malware on hundreds of small office/home office routers in the U.S., in a plan to target critical infrastructure providers through the compromised hosts. * * *
    • “Volt Typhoon is very focused on targeting U.S. critical infrastructure by staying below the radar, and works hard to reduce the signatures we use to hunt them across networks,” Sandra Joyce, VP, Mandiant Intelligence, Google Cloud, said in a statement. “They are making use of compromised systems to blend in with normal network activity and constantly change the source of their activity.”
  • Cyberscoop adds,
    • “Any federal agency running Ivanti Connect Secure or Ivanti Policy Secure devices must disconnect them from their networks before midnight Friday [February 2], the United States’s top civilian cyber defense agency said Wednesday amid reports the vulnerable devices are being targeted by espionage operations linked to China. 
    • “Last month, CISA warned that the vulnerable Ivanti devices were subject to “widespread exploitation of vulnerabilities by multiple threat actors.” On Wednesday, the agency issued new instructions for how to update and bring those devices back online. 
    • “A CISA spokesperson did not immediately respond to a question about how many instances of Ivanti’s affected product are present in federal networks. * * *
    • “Chinese hackers appear to be exploiting the Ivanti vulnerabilities to carry out espionage. Researchers with Google’s Mandiant wrote in a blog post Wednesday that they’d identified “broad exploitation activity” by suspected Chinese-linked espionage hackers they track as “UNC5221,” as well as other uncategorized attackers.” 
  • and
    • “The Office of the National Cyber Director has work to do to improve the implementation of President Joe Biden’s national cybersecurity strategy, according to a watchdog report.
    • The Government Accountability Office said in a report released Thursday that the national cybersecurity strategy lacks performance measures and estimated costs, which the watchdog believes is essential for a national strategy.
    • “The GAO said that “neither the strategy nor the implementation plan included outcome-oriented performance measures for the initiatives or for the overall objectives of the strategy to gauge success.” The initiatives outlined in the implementation planinclude milestones and expected completion dates, but lacked assessments in “the extent to which the initiatives are achieving outcome-oriented objectives” like information sharing or updated federal cyber defenses, GAO said.
    • “ONCD staff told the GAO said it wasn’t actually feasible to develop outcome-oriented measures, simply because those measures do not yet exist in the broader cybersecurity field. “They acknowledged the value of having meaningful outcome-oriented performance measures to assess cybersecurity effectiveness but stated that such measures do not currently exist in the cybersecurity field in general,” the GAO wrote.”
  • On Wednesday Cybersecurity Dive tells us,
    • The Biden administration came out forcefully this week against a congressional effort to undo the U.S. Securities and Exchange Commission’s recently adopted rule requiring public companies to disclose cybersecurity incidents.
    • President Joe Biden would veto the joint resolution, S.J. Res. 50, if it comes to his desk, the administration said Wednesday in a policy statement.
    • The legislation to disapprove the SEC’s authority to require companies to quickly disclose material cyber incidents and describe how they manage cyberthreats in annual reports was introduced by Republican senators in November alongside a companion resolution by House Republicans.
  • Federal News Network offers an interview with “Kirsten Moncada, OPM’s chief privacy officer and a longtime federal privacy expert, [who remarked that] the rise of AI tools in government is sure to create more work for privacy officials across the government.”

From the cybersecurity vulnerabilities and breaches front,

  • Cybersecurity Dive informs us
    • “An identity-based attack Cloudflare previously declared contained and unimpactful turned out to be quite the opposite. The threat actor that intruded Cloudflare’s Okta environment in mid-October regained access to some of the content delivery network’s systems in mid-November, the company said Thursday in a blog post.
    • “The threat actor used one access token and three service account credentials Cloudflare failed to rotate after the environment was compromised by an early October attack against Okta, the company said. The Okta incident ultimately exposed data on all of the single sign-on provider’s customer support system clients.
    • “We want to emphasize to our customers that no Cloudflare customer data or systems were impacted by this event,” CEO Matthew Prince, CTO John Graham-Cumming and CSO Grant Bourzikas said in the blog post.”
  • Dark Reading points out,
    • “Security researchers have sounded the alarm on a new cyberattack campaign using cracked copies of popular software products to distribute a backdoor to macOS users.
    • “What makes the campaign different from numerous others that have employed a similar tactic — such as one reported just earlier this month involving Chinese websites — is its sheer scale and its novel, multistage payload delivery technique. Also noteworthy is the threat actor’s use of cracked macOS apps with titles that are of likely interest to business users, so organizations that don’t restrict what users download can be at risk as well.
    • “Kaspersky was the first to discover and report on the Activator macOS backdoor in January 2024. A subsequent analysis of the malicious activity by SentinelOne has showed the malware to be “running rife through torrents of macOS apps,” according to the security vendor.”
  • On Wednesday, the Cybersecurity and Infrastructure Security Agency (CISA) announced “New Software Updates and Mitigations to Defend Against Exploitation of Ivanti Connect Secure and Policy Secure Gateways.”
  • CISA added a known exploited vulnerability to its catalog on January 31 and another later the same day.

From the ransomware front,

  • Security Week discuses why the ransomware threat continues to grow.
    • “The volume of ransomware attacks is not a constant and can be affected by many short term factors (take downs, criminal retirements, retooling, etcetera). 2022 showed a reduction, and some commentators suggested that the tide was turning against ransomware. 2023 has demonstrated this was a false dawn, with more than twice the number of victims in 2023 compared to 2022. 
    • “Anyone who believes ransomware will go away doesn’t understand the nature of criminality. Extortion has and always will be a primary criminal business plan. The current Delinea report demonstrates that the delivery of extortion can be fine-tuned (the evolution from encryption to data exfiltration), but the purpose remains the same, and the incidence will continue to increase.
    • “The success of this business plan is demonstrated by an increase in the number of victims who have paid the ransom — up from 68% to 76% (and remember that is 76% of a higher number of victims). What cannot be measured is the effect of cyberinsurance on ransomware delivery and response. Some commentators believe that attackers look for victims with cyberinsurance, and the report notes, “One reason for the willingness to pay may be the rise of cyberinsurance.”
  • Bleeping Computer’s The Week in Ransomware returns this week.
    • “Attacks on hospitals continued this week, with ransomware operations disrupting patient care as they force organization to respond to cyberattacks.
    • “While many, like LockBit, claim to have policies in place to avoid encryping hospitals, we continue to see affiliates targeting healthcare with complete disregard to the disruption they are causing patients in trying to receive care.”

From the cybersecurity defenses front,

  • TechTarget identifies “sixteen common types of cyberattacks and how to prevent them.”
  • CISA announced,
    • “CISA and the Federal Bureau of Investigation (FBI) published guidance on Security Design Improvements for SOHO Device Manufacturers as a part of the new Secure by Design (SbD) Alert series that focuses on how manufacturers should shift the burden of security away from customers by integrating security into product design and development.
    • “This third publication in CISA’s SbD Alert series examines how manufacturers can eliminate the path threat actors—particularly the People’s Republic of China (PRC)-sponsored Volt Typhoon group—are taking to compromise small office/home office (SOHO) routers.” 
  • An ISACA expert writes about “Navigating the Treacherous Waters of IT Risk: The MOVEit Transfer Exploit as a Case Study.”

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity policy front,

  • Cybersecurity Dive points out five cybersecurity trends to watch this year.
  • Dark Reading informs us,
    • Following the Securities and Exchange Commission’s X account, formerly known as Twitter, compromise on Jan. 9, two Senators have issued a statement calling the hack “inexcusable” and urging the Inspector General of the US Securities and Exchange Commission (SEC) to investigate the regulator’s failure to have basic multifactor authentication (MFA) protections in place.
    • “Additionally, a hack resulting in the publication of material information for investors could have significant impacts on the stability of the financial system and trust in public markets, including potential market manipulation,” Senators Ron Wyden, D-Ore., and Cynthia Lummis, R-Wyo. said in a statement. “We urge you to investigate the agency’s practices related to the use of MFA, and in particular, phishing-resistant MFA, to identify any remaining security gaps that must be addressed.” * * *
    • “Not only should the agency have enabled MFA, but it should have secured its accounts with phishing-resistant hardware tokens, commonly known as security keys, which are the gold standard for account cybersecurity,” the letter to the SEC Inspector General said, adding the agency was warned in 2023 about its “poor cybersecurity.”
    • “The letter added a shot at the regulator’s increasingly rigorous oversight of enterprise cybersecurity.
    • “The SEC’s failure to follow cybersecurity best practices is inexcusable, particularly given the agency’s new requirements for cybersecurity disclosure,” the Senators wrote.”
  • Cyberscoop reports
    • “Over-classification, a lack of policy guidance, and tensions between private sector cybersecurity firms are continuing to hamper federal government efforts to share cybersecurity threat information, according to a report released Friday by the U.S. intelligence community’s top watchdog. 
    • “Friday’s report, released by the Office of the Inspector General of the Intelligence Community, concludes that while federal agencies have broadly improved their ability to share threat information and defensive mitigations, long-standing policy and technical concerns are providing barriers to rapid information sharing. 
    • “The IG’s report examines how relevant federal agencies shared cyber threat information and defensive measures over the past two years through a framework created by the Cybersecurity Information Sharing Act of 2015. The report finds that the “policies, procedures, and guidelines” for sharing information are “sufficient” to carry out the requirements of the legislation and noted that “sharing has improved” in the last two years.
    • “However, a section on barriers to sharing information among federal entities describes a set of familiar issues — to cyber pros at least — that has long been a rallying cry for improvement, including failures to be more forthcoming in sharing threat information with private sector entities.”
  • and
    • “As dozens of states race to establish standards for how their agencies use AI to increase efficiency and streamline public-facing services, researchers at the National Institute of Standards and Technology found that artificial intelligence systems, which rely on large amounts of data to perform tasks, can malfunction when exposed to untrustworthy data, according to a report published last week.
    • “The report, part of a broader effort by the institute to support the development of trustworthy AI, found that cyber criminals can deliberately confuse or “poison” AI systems to make them malfunction by exposing them to bad data. And what’s more, according to the study, there’s no one-size-fits-all defense that developers or cybersecurity experts can implement to protect AI systems.”
  • The Wall Street Journal adds,
    • “U.S. intelligence authorities are using AI to pick up on the presence of hackers trying to infiltrate and attack American critical infrastructure—and identifying signs of hackers using AI themselves in the attacks.
    • “At a conference Tuesday, cybersecurity leaders discussed burgeoning aspects of AI use by hackers—as well as by law enforcement. Rob Joyce, cybersecurity director at the National Security Agency, said machine learning and artificial intelligence are helping cybersecurity investigators track digital incursions that would otherwise be very difficult to see. 
    • “Specifically, Chinese hackers are targeting U.S. transportation networks, pipelines and ports using stealthy techniques that blend in with normal activity on infrastructure networks, Joyce said, speaking at Fordham University in New York.
    • “These methods are “really dangerous” as their aim is societal disruption, as opposed to financial gain or espionage, Joyce said. The hackers don’t use malware that common security tools can pick up, he added.” 

From the cybersecurity vulnerabilities and breaches front,

  • Cybersecurity Dive tells us,
    • Mortgage lender loanDepot is responding to a cyberattack that led the company to take some of its IT systems offline, the California-based company said Monday. 
    • “Though our investigation is ongoing, at this time, the company has determined that the unauthorized third-party activity included access to certain company systems and the encryption of data,” the company said Monday in filing with the Securities and Exchange Commission. “In response, the company shut down certain systems and continues to implement measures to secure its business operations, bring systems back online and respond to the incident.”
    • A spokesperson for the non-bank mortgage lender declined to say how or when the threat actor gained access to its systems and if it’s received an extortion demand or paid a ransom.
  • and
    • “Distributed denial of service attacks hit an all-time high in 2023, more than doubling year over year in the fourth quarter, Cloudflare said Tuesday in a threat report.
    • “The record high year for DDoS attacks coincided with mass exploits of the novel zero-day vulnerability HTTP/2 Rapid Reset, which threat actors used to launch DDoS attacks that broke records during the third quarter of 2023.
    • “Cloudflare said it was mitigating about 201 million requests per second at the peak of the series of HTTP/2 vulnerability attacks.
    • “Massive DDoS attacks require significantly fewer capabilities, resources and time, according to Omer Yoachimik, senior product manager of DDoS protection and security reporting at Cloudflare.”
  • The Cybersecurity and Infrastructure Security Agency (CISA) let us know on January 11,
    • “Cisco released a security advisory to address a vulnerability (CVE-2024-20272) in Cisco Unity Connection. A cyber threat actor could exploit this vulnerability to take control of an affected system.
    • “CISA encourages users and administrators to review the Cisco Unity Connection Unauthenticated Arbitrary File Upload Vulnerability advisory and apply the necessary updates.”
  • CISA added six known exploited vulnerabilities to its catalog on January 8, one more on January 10, and another one on the same day.

From the ransomware front,

  • Per Cybersecurity Dive,
    • “Almost 5,200 organizations were hit by ransomware attacks in 2023, Rapid7 said in a Friday blog post, pulling research from public disclosures and incident data from its managed detection and response team.
    • “In reality, we believe that number was actually higher because it doesn’t account for the many attacks that likely went unreported,” Christiaan Beek, senior director of threat analytics at Rapid7, said in the report.
    • “Rapid7 didn’t provide numbers for 2022, but research from other firms concludes the number of ransomware attacks is rising. There were twice as many ransomware attacks in the second half of 2023, compared to the latter half of 2022, according to BlackFog.”
  • Security Week reports,
    • “Over the weekend, the LockBit ransomware gang claimed responsibility for a November 2023 cyberattack on the hospital system Capital Health.
    • “In December, Capital Health announced that it fell victim to a cyberattack that resulted in network outages and that it immediately launched an investigation, informed law enforcement, and started the restoration process.
    • “At this time, all services are available at our facilities, all systems have been restored, and all operations have returned to normal,” the organization said in an incident notification.
    • “According to the LockBit ransomware gang, only data exfiltration occurred.
    • “We purposely didn’t encrypt this hospital so as not to interfere with patient care,” the gang notes on its Tor-based leak site.
    • “The ransomware group says it stole more than 10 million files from the healthcare organization, which allegedly includes medical confidentiality data.”
  • Here’s a link to Bleeping Computer’s latest Week in Ransomware.

From the cybersecurity defenses front,

  • Federal New Network identifies five steps for building an adaptable, dynamic zero trust architecture within federal agencies.
  • Security Boulevard considers how to recover after failing a cybersecurity audit.

Friday Factoids

David Ermer–ACA, CDC, Congress, COVID-19, Generative AI, Medical / Rx research, Rx coverage, SDOH, U.S. Healthcare–
Photo by Sincerely Media on Unsplash

From Washington, DC

  • Roll Call reports,
    • “Speaker Mike Johnson reiterated support Friday for the fiscal 2024 spending agreement he negotiated in the face of opposition from members of the House Freedom Caucus, who’ve been lobbying him to toss the deal. 
    • “Johnson, R-La., told reporters that while he is seeking feedback from across his conference, he is committed to the “strong” deal he negotiated with Senate Majority Leader Charles E. Schumer, D-N.Y.
    • “Our topline agreement remains; we are getting our next steps together, and we are working toward a robust appropriations process,” he said.”  * * *
    • “Next week, Congress will face a more pressing Jan. 19 spending deadline for agencies covered under four of the 12 annual appropriations bills. Schumer took the first procedural step needed for a stopgap spending bill Thursday, filing cloture on the motion to proceed to a shell vehicle. 
    • “The Senate’s continuing resolution is expected to last until March, sources familiar with the talks say. But while Johnson has said he is “not ruling out” the need for another continuing resolution, he has not yet said definitively whether or not he would support one. 
    • “And that stopgap measure will be essential to keep the government open, as Senate Appropriations Chair Patty Murray, D-Wash., and House Appropriations Chairwoman Kay Granger, R-Texas, are continuing to negotiate over the final subcommittee allocations, also known as 302(b)s. 
    • “Negotiators will need about a month to wrap up their work after those allocations are finalized, House Appropriations ranking member Rosa DeLauro, D-Conn., said Friday. “
  • Govexec tells us,
    • “The Office of Personnel Management made some of its best progress at reducing the number of pending retirement applications from federal workers last year, reducing the backlog by 34% in 2023 and breaking multiple recent records in the process.
    • “Long a source of frustration for the governmental HR agency, lawmakers and retirees alike, OPM’s inventory of pending retirement claims has been plagued by delays due to the still largely paper-based nature of federal employment records, staffing issues and other challenges. The COVID-19 pandemic exacerbated many of these issues, as the backlog climbed to a high of more than 36,000 pending claims in March 2022.
    • “But OPM moved on multiple fronts last year to improve the process. The agency released its long-awaited IT strategic plan, which includes plans to develop a “digital retirement system,” complete with electronic records and an online retirement application process.
    • “And officials launched a series of short-term fixes aimed at shoring up the current system, including a guide for retirees to follow as they navigate the retirement process, as well as staffing up and coordinating more actively with federal agencies to prepare for the annual wave of new retirement claims that occurs between January and March.”
  • Federal News Network informs us,
    • “The Postal Service says its competitive package business is growing, following its busy year-end holiday season.
    • “USPS says it delivered 130 million more packages in the “peak” first quarter of fiscal 2024, a nearly 7% increase, compared to the same period last year.
    • “USPS delivered more than 1.9 billion packages in the first quarter of fiscal 2023, which covers October through the end of December.
    • “Postmaster General Louis DeJoy, in a video message to employees, said growing the package business is the key to turning around the Postal Service’s long-term financial problems.”
  • KFF analyzes the Food and Drug Administration’s recent decision to allow Florida to import prescription drugs from Canada.
  • Per Fierce Healthcare, AHIP, among others, expressed opposition to the provision in the proposed 2025 Notice of Benefit and Payment Parameters Notice, reducing the number of non-standardized plans that an Affordable Care Act plan carrier can offer from four to two.
    • “AHIP is particularly concerned about the impact of non-standardized plan limits on issuers’ ability to offer broad networks for consumers that want access to a variety of providers and specialists, which is often a key factor in plan selection for those with chronic health conditions,” the lobbying group wrote in comments on the proposed rule.”
  • The U.S. Preventive Services Task Force offers a report on its 2023 accomplishments.

From the public health and medical research front,

  • Becker’s Hospital Review provides three updates on the predominant Omicron strain JN.1.
    • “Disease severity: New findings from a study led by researchers at the Ohio State University indicate BA.2.86 and its close relative, JN.1, may be linked to an increase in disease severity. The research focused on mutations in the spike protein of BA.2.86 and found it can infect human cells that line the lower lung, which is a feature linked to severe symptoms. Researchers emphasized additional research is needed to confirm the findings, since the study used pseudoviruses. 
    • “But from our past experience, we know that infectivity in human epithelial cell lines provides very important information,” Shan-Lu Liu, MD, Ph.D., senior study author and virology professor at OSU, said in a news release. “The concern is whether or not this variant, as well as its descendants including JN.1, will have an increased tendency to infect human lung epithelial cells similar to the parental virus that launched the pandemic in 2020.” 
    • “In late December, the WHO classified JN.1 as a “variant of interest” due to its rapid spread. At the time, the agency said the overall risk to public health posed by the strain remains low, since updated vaccines continue to offer protection against severe illness. The CDC published its latest update on JN.1 Jan. 5, stating, “At this time, there is no evidence JN.1 causes more severe disease.” 
  • The Centers for Disease Control points out,
    • “As seasonal flu activity remains elevated nationally, CDC is tracking when, where and what influenza viruses are spreading and their impact on the public’s health. So far this season, the most commonly reported influenza viruses are type A(H1N1) and type B viruses. According to CDC research, this could mean more severe outcomes among people who are hospitalized with flu.”
  • Here’s a link to the CDC’s latest Fluview report.
    • “Seasonal influenza activity remains elevated in most parts of the country.
    • “After several weeks of increases in key flu indicators, a single week of decrease has been noted.  CDC will continue to monitor for a second period of increased influenza activity that often occurs after the winter holidays.
    • “Outpatient respiratory illness has been above baseline1 nationally since November and is above baseline in all 10 HHS Regions.
    • “The number of weekly flu hospital admissions decreased slightly.”
  • The CDC also announced,
    • “On October 23, 2023, the Centers for Disease Control and Prevention (CDC) issued Health Alert Network (HAN) Health Advisory 499 to provide guidance for prioritization of nirsevimab given the limited supply. Nirsevimab (Beyfortus, Sanofi and AstraZeneca) is a long-acting monoclonal antibody immunization recommended for preventing RSV-associated lower respiratory tract disease in young children.
    • Given the recent increase in nirsevimab supply and the manufacturers’ plan to release an additional 230,000 doses in January, the CDC advises healthcare providers to return to recommendations put forward by the CDC and the Advisory Committee on Immunization Practices (ACIP) on the use of nirsevimab in young children. Infants and children recommended to receive nirsevimab should be immunized as quickly as possible. Healthcare providers should not reserve nirsevimab doses for infants born later in the season when RSV circulation and risk for exposure to RSV may be lower. RSV activity remains elevated nationwide and is continuing to increase in many parts of the country, though decreased activity has been observed in the Southeast.” 
  • Fierce Healthcare reports,
    • “Though prescriptions for antiviral influenza medications have declined somewhat since 2023, perhaps indicating that the United States might be less encumbered by the flu than in recent record-breaking years, healthcare providers still find themselves battling a surge above historic norms, according to data by the Evernorth Research Institute.
    • “Researchers there examined pharmacy claims for more than 32 million people during current and past flu seasons and found an increasing prevalence of antiviral medication prescriptions since Thanksgiving 2023, though that’s tapered off slightly recently. More individuals experience flu symptoms severe enough to send them to physicians’ offices for prescriptions, and most of many of those forced to do so did not get the flu vaccination. Evernorth, a Cigna subsidiary, tries to develop cost-effective delivery systems for pharmacy benefits.
    • “Urvashi Patel, M.D., vice president of the Evernorth Research Institute, told Fierce Healthcare in an email that “since the shift to remote work from the pandemic, many employees who used to get their flu vaccines at the office are no longer able to. This may change as more workers continue to return to the office, but it’s likely a contributor to lower vaccination rates.”
  • The Wall Street Journal shares an employee’s favorable experience with the powerful weight loss drug Mounjaro.
  • Health Day provides the following study notes:
    • “U.S. doctors are prescribing antifungal creams to patients with skin complaints at rates so high they could be contributing to the rise of drug-resistant infections, new research shows.
    • “These are “severe antimicrobial-resistant superficial fungal infections, which have recently been detected in the United States,” noted a team led by Jeremy Gold, a researcher at the U.S. Centers for Disease Control and Prevention.
    • “One of the biggest emerging threats: Drug-resistant forms of ringworm (a form of dermatophytosis).”

From the U.S. healthcare business front,

  • Healthcare Dive reports,
    • “UnitedHealth was slammed with medical costs as it closed out 2023. The health insurance behemoth still managed to exceed Wall Street’s financial expectations.
    • “UnitedHealth posted a medical loss ratio of 85% in the fourth quarter — its highest MLR since the COVID-19 pandemic began early 2020.
    • “MLR is a metric of how much payers shell out to cover their members’ medical expenses. Payers tried to shake the effects of higher medical costs all last year as patients who delayed healthcare during the pandemic returned to doctor’s offices.
    • “The bulk of higher costs in the fourth quarter was driven by more seniors using outpatient services, a trend that first appeared in the second quarter of 2023, said UnitedHealth CEO Andrew Witty on a Friday morning call with investors.”
  • Beckers Hospital Review offers an interview with Mayo Health System President “Prathibha Varkey, MBBS, [who] is excited about the future of healthcare,” and an analysis of nurse practitioner pay by specialty.
  • The Washington Post offers an interview with the American Medical Association President Jesse Ehrenfeld, MD.
  • Mercer Consulting offers guidance on network strategies to optimize patient care and save while its sister company, Oliver Wyman, peers into the crystal ball concerning the state of healthcare in 2035.
  • Beckers Payer Issues offers a look at ten updates to the 2024 Medicare Advantage landscape.
  • MedCity News discusses seven JP Morgan Conference news items that you don’t want to miss.
  • BioPharma Dive poses five questions facing the pharmaceutical industry this year. “Many drugmakers hope to compete with Novo and Lilly in obesity, while others seek to win oncology’s next era. Meanwhile, a contentious drug pricing law looms.”
  • Drug Channels shares a guest post titled “Repairing the Patient Journey: How Pharma Can Fix the Obvious–and Not So Obvious–Breaking Points of Nonadherence.”
  • The Wall Street Journal reports,
    • “CVS Health plans to close dozens of pharmacies inside Target stores at a time when pharmacy chains are struggling to grow retail profits.
    • “CVS will close the pharmacies between February and April this year, said a company spokeswoman. The closures are part of CVS’s efforts to pare down its retail footprint “based on our evaluation of changes in population, consumer buying patterns and future health needs,” she said. * * *
    • “CVS has operated pharmacies inside Target stores since late 2015 when it bought the business from the retailer for around $1.9 billion. It has pharmacies in around 1,800 of Target’s more than 1,950 U.S. stores. A Target spokeswoman declined to comment. The latest round of closures account for a small percentage of CVS’s pharmacies at Target stores.” 
  • Per Fierce Healthcare,
    • “Artificial intelligence was dominating CES 2024 this week. From assistive speech tools to pet wearables to AI-enabled pillows to prevent snoring, the majority of companies exhibiting at CES boasted the use of the technology as part of their products.
    • “Digital health companies at the show also are putting AI to use from Intuition Robotics’ AI-enabled ElliQ care companion robot to hearing eyewear.
    • “Amid all this hype, entrepreneur and investor Mark Cuban believes AI will be transformative for healthcare.
    • “There are two types of companies in the world — those who are great at AI and everyone else and either you know how to use it to your advantage or you’re in trouble,” he said during a digital health panel at CES on Thursday.
    • “He added, “I don’t think it will be dominated by five or six big models. I think there will be millions of models. I think we’ll find every company will have a model, every vertical will have its own model, individuals will have their own models, doctors have their own models, and trying to get to the point where it’s more democratic so that specific verticals will be used within healthcare is going to be an evolution and I don’t think we’ve figured all that out.”
  • Healthcare Dive adds
    • “Generative artificial intelligence can be used to pull social determinants of health data, like housing or employment status, from clinician notes to identify patients who need additional support, according to a new study.
    • “Large language models trained by researchers could identify 93.8% of patients with adverse social determinants of health, while official diagnostic codes include that data in only 2% of cases. 
    • “The finely tuned models were also less likely than OpenAI’s GPT-4 to change their determination when demographic information like race or gender was added. Algorithmic bias is a major concern for AI use in healthcare, amid fears the technology could worsen health inequities.” 

Tuesday Tidbits

David Ermer–FDA, Federal employment benefits, Generative AI, Medical / Rx research, Mental health care, Rx coverage, Telehealth, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

From Washington, DC,

  • The U.S. Census Bureau informs us,
    • “[T]he U.S. population [was projected to be] 335,893,238 on New Year’s Day, an annual increase of 1,759,535 or 0.53%.
    • “In January 2024, the United States is expected to experience a birth every 9.0 seconds and one death every 9.5 seconds. Meanwhile, net international migration is expected to add one person to the U.S. population every 28.3 seconds. The combination of births, deaths and net international migration increases the U.S. population by one person every 24.2 seconds.
    • “The projected world population on Jan. 1, 2024, is 8,019,876,189, up 75,162,541 (0.95%) from New Year’s Day 2023. During January 2024, 4.3 births and 2.0 deaths are expected worldwide every second.”
  • The Internal Revenue Service released the Employers’ Tax Guide to Fringe Benefits for use in 2024.
  • Federal News Network discusses four ways federal pay practices have changed for 2024.
  • The Food and Drug Administration accounts for its recent actions.

From the public health and medical research front,

  • Medscape explains the other health conditions, besides diabetes and obesity, that GLP-1 drugs might treat. It’s an impressive list.
  • STAT News reports,
    • “Reducing or eliminating alcohol consumption reduces the risk of developing oral cavity and esophagus cancers, according to a special report from the International Agency for Research on Cancer. But more data are needed to conclude whether the same is true for several other cancer types, including colorectal, breast, and liver cancer.
    • “Even so, it is likely that reducing or ceasing to drink alcohol will lessen the risk of these cancers, said Farhad Islami, a cancer epidemiologist at the American Cancer Society and an author of the report. “Given that many of these cancers have similar mechanistic pathways, we think we will see a similar association with reduction or cessation,” he said. “That’s why we recommend more studies, so we can have stronger evidence.”
  • BioPharma Dive points out ten clinical trials that are worth watching in the first half of 2024.

From the U.S. healthcare business front,

  • Healthcare Dive tells us,
    • “BJC HealthCare and Saint Luke’s Health System closed their merger on Monday, about seven months after the Missouri-based systems announced plans to combine.The combined organization will operate under the BJC HealthCare brand in its eastern region, serving St. Louis and southern Illinois. The Kansas City region will retain the Saint Luke’s brand name. The new system has a combined workforce of 44,000 employees, according to a Tuesday announcement.”
  • MedTech Dive notes,
    • “Roche reached an agreement to acquire LumiraDx’s point-of-care testing technology, the companies announced on Dec. 29.
    • “Roche will pay $295 million upfront and an additional amount up to $55 million to fund Lumira’s point-of-care technology platform business until the acquisition closes. 
    • “The acquisition comes as Lumira faces a potential delisting amid declining revenue.”
  • Health Payer Intelligence identifies trends in health insurer strategies for 2024. “In 2024, payer strategies will include improving health equity partnerships, differentiating their Medicare Advantage plans, and offering care navigation.”
  • Healthcare IT News offers an interview with “[t]wo investment bankers discuss the players in the telehealth sector, the main financial backers, the dynamics between venture capital and private equity, and more.
  • Beckers Hospital Review tells us,
    • “Feeling blue? Your employer might have an AI app for that, The Wall Street Journal reported Dec. 27. 
    • “Workplaces increasingly are offering employees access to digital mental health tools, including AI chatbots meant to mimic therapists and wellness apps that diagnose mental health conditions, the report said. Over the summer, a survey of 457 U.S. companies conducted by professional services company WTW found that about one-third offer a “digital therapeutic” for mental health support. Another 15% were considering adding one by 2025. 
    • “The capabilities and goals of these services vary. Amazon gives employees free access to the app Twill, which uses AI to track users’ moods and create “personalized mental-health plan(s).” A construction workers’ union in Ohio will begin offering access to Wysa, a self-described “emotionally intelligent” AI chatbot that encourages users to “vent or just talk through negative thoughts and emotions” and “let it help you cope with pandemic anxiety and lockdowns.” 

Monday Roundup

David Ermer–Congress, Generative AI, Medical / Rx research, No Surprises Act, SDOH, Telehealth, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC,

  • The New York Times reports,
    • “The prospects for passing legislation to speed military aid to Ukraine this year are fading, as Republicans balk at striking a quick deal on immigration policy changes they have demanded in exchange for allowing the bill to move forward.
    • “After a weekend of intensive bipartisan border talks yielded progress but no breakthrough, Senator Chuck Schumer, Democrat of New York and the majority leader, acknowledged on Monday that negotiators were still far from completing a deal.
    • “It’s going to take some more time to get it done,” he said on the Senate floor on Monday afternoon, laying out plans for the week that made no mention of any votes on the aid package for Ukraine.”
  • Govexec tells us that “The Senate on Monday voted 50-11 to confirm former Maryland Gov. Martin O’Malley as commissioner of the Social Security Administration, ending a drought of more than two years in which the embattled agency lacked a permanent leader at the helm.”
  • Fierce Healthcare informs us,
    • “The Biden administration on Monday released amended fees related to independent dispute resolution under the No Surprises Act.
    • “In the amended final rule, CMS said it will instead set an administrative fee of $115 for disputes that are subject to the rule. A separate rule, which is up for comment until Jan. 2, adjusts the fees for disputes initiated after Jan. 1, 2025. * * *
    • “In addition, CMS outlined ranges for certified IDR entity fees, which the arbiters charge for determinations. Under the rule, the agency finalized a range of between $200 and $840 for a single determination and between $268 and $1,173 for batch rulings.
    • “These fees are also set annually, and IDRs can request to update them once each year, which the feds must approve.”
    • The rule takes effect on January 20, 2023.

From the public health and medical research front,

  • STAT News points out,
    • “As more data emerges that obesity drugs like Wegovy can reduce complications from heart and kidney problems as well, scientists have been wondering whether these benefits are driven by weight loss alone or also by other mechanisms.
    • “A new study suggests that one possible contributor is the drugs’ ability to reduce inflammation independent of weight loss.
    • “In mice experiments, scientists found that the treatments, known as GLP-1-based drugs, acted through the brain to reduce inflammation throughout the body. This was over a short period of time before the mice lost weight, according to the study, published Monday in Cell Metabolism.
    • “Though the researchers only studied mice, and didn’t look at how much the reduced inflammation translates to actual health benefits, they detailed a previously unknown mechanism of GLP-1 drugs that may help explain their effects on organs throughout the body.
    • “This is a new model for the anti-inflammatory actions of GLP-1” drugs, said Daniel Drucker, senior author of the study and a senior scientist at the Lunenfeld-Tanenbaum Research Institute.”
  • JAMA Pediatrics provides good news:
    • “Question  Is maternal influenza vaccination during pregnancy associated with a reduction in influenza-associated hospitalizations and emergency department (ED) visits in infants younger than 6 months?
    • “Findings  In this case-control study of 3764 infants younger than 6 months, maternal vaccination was associated with a reduction in influenza-associated hospitalizations and ED visits in infants. Vaccine effectiveness was highest among hospitalized infants, those younger than 3 months, and those born to mothers vaccinated in the third trimester.
    • “Meaning  The findings in this study indicate that maternal influenza vaccination during pregnancy provided important protection for the infant in the first few months of life before infants are eligible for vaccination.”
  • The American Medical Association shares what doctors wish their patients knew about social drivers of health.

From the U.S. healthcare business front,

  • Bloomberg reports
    • “We’re seeing wide price variation even in the same hospitals on the same day based upon the negotiated prices by the differing health insurance carriers or health plans,” said Cynthia Fisher, founder and chairman of the philanthropic group Patient Rights Advocate, , which provides free price data for nearly all of the more than 6,000 hospitals in the US. “For the employers, this is eye-opening.”
    • “Patient Rights Advocate on Dec. 11 introduced a hospital pricing search tool for the public. The organization pointed to prices for an injection of cancer drug Rituximab at Rush University Medical Center in Chicago that ranged from $899.33 for the Cigna Basic/Premier medical plan for Rush employees administered through Allegiance Benefit Plan Management Inc. by the Cigna Group, to $9,260.13 for the Cigna One Health HMO.
    • “If they’re able to offer it at a tenth of the price, why should one employer pay 10 times more?” Fisher said.
    • “Cigna didn’t respond to a request for comment, and a spokesman for Rush said the hospital wasn’t “in a position to speak to something that specific so rapidly.”
    • “Being able to easily compare prices will protect health plans from billing errors and fraud by hospitals and insurers, Fisher said. “The employers and unions that design health plans will be able to benefit from being well-informed about their choices and decisions to seek the best quality of care at the lowest possible prices,” she said.
  • Beckers Hospital Review identifies the thirteen out of twenty most popular prescription drugs that are in shortage and the 25 largest health systems by number of physicians.
  • Healthcare IT News calls attention to the fact that “Now that telemedicine is mainstream, artificial intelligence is helping healthcare providers with imperatives such as patient triage. Early results are promising.”
  • According to Reuters,
    • “High cost, logistical issues and the prospect of potential treatment advances are holding back adoption of the first gene therapies for hemophilia, experts said this week during the American Society of Hematology’s (ASH) annual meeting.
    • “Experimental options discussed at the San Diego meeting included personalized treatments and next-generation gene therapies, many still in the earliest stages of testing.”
  • Benefits Pro lets us know about a “Cigna report [that] outlines the benefits, challenges of value-based care. The Cigna paper suggests that physicians, patients, and health plans tend to recognize the good aspects of VBC, but that change has been slow nonetheless in the private sector.”
  • Per Fierce Healthcare,
    • “Kroger is piloting value-based primary care clinics as it joins a growing list of retailers looking to cash in on the booming sector of senior-focused medical care.
    • “The grocery chain has teamed up with Better Health Group, a provider network, to shift some of its in-store clinics, called The Little Clinic, into primary care centers for seniors, in addition to offering regular services.
    • “Better Health Group is rolling out the value-based model at eight of Kroger’s Altanta-area stores.
    • “The clinics today provide a full range of services from your acute, convenient care to primary care-like functions. About 60% of patients that we see in the clinic don’t have an assigned or designated primary care provider. So, there’s a huge opportunity just in general to serve patients and provide longitudinal care,” said Jim Kirby, chief commercial officer for Kroger Health, in an interview with Fierce Healthcare.”

Monday Roundup

David Ermer–CDC, Congress, COVID vaccine mandate, Generative AI, Rx coverage, SCOTUS, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC,

  • The U.S. Supreme Court granted the federal government’s request to direct three U.S. Courts of Appeals to vacate decisions they made in cases involving the federal government employee Covid vaccine mandate on the ground that the President had withdrawn the mandate. In short, the Court held that the cases are moot.
  • Bloomberg reports,
    • “Employer groups are lining up behind legislation headed to the House floor that would prevent medical groups owned by hospitals from charging more for services than private providers. 
    • “The Lower Costs, More Transparency Act (H.R. 5378) includes provisions that would require “site-neutral” payments for drug administration in off-campus hospital outpatient departments. The measure, which has bipartisan support, could come to a vote in the House as early as Monday. 
    • “Although the measure only applies to Medicare, employers say site-neutral payments could spill over to reduce costs for commercial plans. They argue the additional fees hospital-owned practices are charging aren’t necessary for services that can be safely performed in a doctor’s office, while hospitals counter that the legislation will lead to reduced oversight and lower quality of care.” * * *
    • The American Hospital Association blasted site neutral proposals.
  • P.S. The House of Representatives passed H.R. 5378 by a bipartisan 320-71 vote.
  • According to a press release, “AHIP is pleased to announce the appointment of Mike Tuffin as its next President and CEO, effective January 8, 2024. Tuffin returns to AHIP having served as its Executive Vice President for Public Affairs from 2003 to 2012. He succeeds Julie Simon Miller, AHIP’s General Counsel, who has served as Interim CEO since September 2023.” Good luck.
  • The Sequoia Project is releasing five new TEFCA resources. TEFCA will be the long-overdue backbone for connecting the country’s various electronic health record networks.
  • Mercer Consulting discusses Rx legislative activity to watch in 2024.

From the public health front,

  • Beckers Hospital Review tells us,
    • “Data from the CDC and anecdotal reports form hospital officials suggest respiratory syncytial virus infections have peaked in the U.S., allaying concerns that the nation could see simultaneous surges of COVID-19, flu and RSV.
    • “We think we’re near the peak of RSV season or will be in the next week or so,” CDC Director Mandy Cohen, MD, told NBC News in a Dec. 1 report. 
    • “National data aligns with that forecast. Weekly emergency department visits for RSV had been on the rise since September. Now, they may be coming down again, CDC data indicates. There were 22,321 ED visits for RSV for the week ending Dec. 2, the latest for which data are available. That’s down from 23,500 in the previous week. PCR test positivity rates also fell slightly to 11.7 from 12.7 in the previous week.” 
  • The Washington Post adds,
    • “Up to 5.4 million people in the United States already have been sick with the flu this fall, according to data compiled by the Centers for Disease Control and Prevention. The agency also estimates that flu has caused as many as 55,000 hospitalizations and 4,600 deaths from Oct. 1 through Dec. 2.
    • “As flu season progresses, usually peaking between December and February, the CDC plans to update its tally of flu-related cases weekly. The flu, or influenza, is a highly contagious respiratory infection caused by viruses that spread from person to person, often via droplets expelled through coughing or sneezing.
    • “The flu, like colds and other respiratory illnesses, is more common in cold weather as people tend to spend more time indoors, where viruses can pass more easily from person to person. Also, health experts believe the flu virus survives better in cold weather and cold, dry air weakens people’s resistance.”
  • The CDC has posted the latest COVID statistics.
  • The AP reports,
    • “Health officials on Friday released the first nationally representative estimate of how many U.S. adults have chronic fatigue syndrome: 3.3 million.
    • “The Centers for Disease Control and Prevention’s number is larger than previous studies have suggested, and is likely boosted by some of the patients with long COVID. The condition clearly “is not a rare illness,” said the CDC’s Dr. Elizabeth Unger, one of the report’s co-authors. 
    • “Chronic fatigue is characterized by at least six months of severe exhaustion not helped by bed rest. Patients also report pain, brain fog and other symptoms that can get worse after exercise, work or other activity. There is no cure, and no blood test or scan to enable a quick diagnosis.”
  • Beckers Hospital Review informs us,
    • “Patients taking Novo Nordisk’s weight loss drug Wegovy in 2021 and 2022 were three times more likely to continue taking the medication a year later compared to older weight loss therapies, according to a study published Dec. 6 in Obesity. 
    • “Researchers from Cleveland Clinic evaluated about 1,000 EHRs between January 2015 and July 2023 among patients who were taking anti-obesity medications. The EHRs were collected from a large health system in Ohio and Florida. 
    • “The weight loss drug with the highest adherence was Wegovy (semaglutide), with 40% of Wegovy patients still filling prescriptions after a year. In comparison, the adherence of orlistat, liraglutide, naltrexone-bupropion and phentermine-topiramate after 12 months ranged between 0% and 19%.” 
  • The American Medical Association lets us know what doctors wish their patients knew about pickleball injuries.

From the U.S. healthcare business front,

  • MedCity News identifies five trends shaping healthcare business strategies for 2024.
    • M&A
    • Generative AI
    • Workforce Challenges
    • Outsourcing
    • Affordability
  • Per Fierce Healthcare and because many FEHB plans offer global coverage
    • “More than half of global health insurers are expecting significant increases in healthcare costs over the next several years, according to a new report.
    • “Analysts at advisory firm WTW surveyed 266 insurers across 66 countries and found that 58% are bracing for “higher or significantly higher” cost increases in the three upcoming years. The report found that global medical costs increased by 10.7% in 2023, a record high and up from a 7.4% increase in 2022.
    • “The average cost trend insurers expect is 9.9% next year, which accounts for variations in rates between regions. For example, the estimated rate of cost increases decreased from 10.9% in 2023 to 9.3% in 2024, while it’s projected to rise from 11.3% in 2023 to 12.1% in 2024 in the Middle East and Africa, according to the report.”
  • Fierce Healthcare also reports,
    • “Healthcare technology giant Epic is leveraging its massive clinical research database, with data on 226 million patients, to develop a next-generation decision support tool for clinicians.
    • “Elevance Health, formerly Anthem and the nation’s second-largest insurer, leverages its clinical data platform, called Health OS, and artificial intelligence to help providers close gaps in care and reduce burdensome paperwork, according to CEO Gail Boudreaux.
    • “The insurer’s goal is to break down data silos and integrate data on patients’ physical, mental and social health into a longitudinal patient record within electronic health record (EHR) systems, Boudreaux said during the Forbes Healthcare Summit this week in New York City.”
  • Beckers Hospital Review identifies the eight most influential drugs approved by the FDA this year, according to GoodRx, while the Institute for Clinical and Economic Review (ICER)
    • “published its latest report on Unsupported Price Increases (UPI) of prescription drugs in the United States. Among the top 10 drugs with net price increases in 2022 that had substantial effects on US spending, ICER determined that eight lacked adequate new evidence to support any price increase. The analysis also found that one of three Medicare Part B drugs with high list price increases in 2021 lacked adequate supporting new evidence, directly raising annual out-of-pocket expenses for Medicare patients by up to $680 per year.”
  • Beckers Payer Issues offers seven prior authorization updates.
  • Beckers Hospital Review identifies nine hospitals already cleared to administer the new CRISPR treatment for sickle cell anemia that FDA approved last week. Also, “[re]ad more about the treatment and experts’ reactions here.” 

Cybersecurity Saturday

David Ermer–Cybersecurity, Generative AI–

From the cybersecurity policy front,

  • FedScoop tells us,
    • “A new bipartisan House bill aims to bolster the U.S. cybersecurity workforce by creating two training programs within the federal government, building on companion legislation introduced in the Senate earlier this year.
    • “The Federal Cybersecurity Workforce Expansion Act, co-sponsored by Reps. Chrissy Houlahan, D-Pa., and Mike Gallagher, R-Wis., would establish a cybersecurity registered apprenticeship program in the Cybersecurity and Infrastructure Security Agency and a Department of Veterans Affairs pilot program that would provide cybersecurity training to veterans.
  • The Cybersecurity and Infrastructure Security Agency (“CISA”) announced,
    • “In the fast-paced world of cybersecurity, staying ahead of threats is essential. And while security is without a doubt a priority for businesses of all sizes, it is easy to feel overwhelmed by all the information available. At CISA, we have been diligently developing a solution aimed at simplifying the way our partners and potential collaborators understand their cyber risk and prioritize their investments, ensuring they can quickly navigate this complexity with ease. Our focus has been on making the process of working with us more intuitive and user-friendly so that every organization can spend more time meeting business goals and less time sifting through cybersecurity resources. We believe this approach will be especially helpful for smaller to medium sized stakeholders with fewer resources, who need help prioritizing actions to help them to reduce the likelihood and impact of damaging intrusions.
    • “In early 2024, we look forward to launching a new way for organizations to understand their cyber risk and receive targeted, straightforward guidance built around our Cybersecurity Performance Goals. This new tool is called ReadySetCyber. While we’re not quite ready to unveil all the details just yet, we are excited to share a glimpse of what’s on the horizon.”
    • That glimpse is available here.
  • The Wall Street Journal reports,
    • “A cyberattack that disrupts everyday life in the U.S. will likely cost more than the insurance industry can afford to cover, requiring government intervention, insurers and brokers said.
    • “The idea of a federal backstop to help insurers cope in the event of a catastrophic cyberattack has been examined by the government in recent years, but has gained momentum with tandem efforts at the Treasury Department, the Office of the National Cyber Director and the Cybersecurity and Infrastructure Security Agency over the past year. Government officials and the insurance industry plan to meet in April to work out exactly what such a program would look like.
    • “Federal support in the event of a catastrophic attack would undoubtedly be necessary, said John Keogh, president and chief operating officer of insurer Chubb.
    • “While the industry could absorb a major natural disaster, the effects of a cyberattack on a similar scale would quickly overwhelm its capacity to cover losses.”

From the cybersecurity vulnerabilities and breaches front,

  • Cybersecurity Dive points out last Monday,
    • A cyberattack targeting Fidelity National Financial led to disruptions across its services, including title insurance and mortgage transactions, after it was forced to block access to certain systems, the company said last week in a filing with the Securities and Exchange Commission. 
    • An investigation showed an unauthorized third party gained access to some of its systems and stole certain credentials, the company said.
    • The threat group known as AlphV/BlackCat claimed responsibility for the attack, according to security researcher Dominic Alvieri.
  • CISA added two more known exploited vulnerabilities to its catalog on November 30, 2023, and removed one on December 1, 2023.

From the ransomware front, here’s a link to the latest Bleeping Computer’s Week in Ransomware.

From the cybersecurity defenses front,

  • Technopedia identifies the top nine cybersecurity trends for 2024.
  • Cybersecurity Dive informs us,
    • “Technology like generative AI can address some key security challenges confronting organizations, but professionals that overemphasize those capabilities miss the fundamental need to put people and their unique talents first.
    • “Security is a people issue,” Amazon CSO Stephen Schmidt said Monday during a presentation at AWS re: Invent in Las Vegas. “Computers don’t attack each other. People are behind every single adversarial action that happens out there.”
    • “For Schmidt, winning in security is akin to playing chess — focusing on the board, how the pieces move and interact — while practicing psychology. Security professionals need to understand the human elements at play, including their own tendencies and opponents’ motivations.
    • “You’re not playing just one chess match,” Schmidt said. “You are playing dozens or hundreds of games at the same time, because you have a variety of adversaries with different motivations who are going after you.”
    • “This cybersecurity scrum can feel overwhelming, but many defenders view generative AI as an ally that can automate repetitive tasks. Cybersecurity vendors across the landscape have released security tools infused with the technology, and more are in the pipeline.”
  • Tech Republic adds that Open AI first released ChatGPT on November 30, 2022. The site explains how the technology has evolved.

Monday Roundup

David Ermer–CMS, Congress, FDA, Federal employment benefits, Generative AI, Medical / Rx research, Medicare, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC,

  • Roll Call offers a preview of Congress’s actions over the next month, after which point the first session of this 118th Congress will come to a close.
  • Bloomberg provides an update on ongoing efforts to revamp the Nation’s organ transplant system. Here are the highlights:
    • “First contract bid solicitations from HHS expected this fall, and
    • “Multiple vendors to run transplant system for first time.”
  • The Centers for Medicare and Medicaid Services published in today’s Federal Register corrections to its Section 111 reporting civil monetary penalty rule which was issued on October 11, 2023. CMS asserts that the corrections fix “typographical and technical errors in the final rule, and it does not make substantive changes to the policies or the implementing regulations that were adopted in the final rule.”
  • The Department of Health and Human Services announced,
    • “As part of the inaugural meeting of the White House Council on Supply Chain Resilience, President Biden and Secretary of Health and Human Services Xavier Becerra today announced new efforts to bolster the domestic supply chain for essential medicines and medical countermeasures.
    • “President Biden will issue a Presidential Determination broadening HHS’ authorities under Title III of the Defense Production Act (DPA) to enable investment in domestic manufacturing of essential medicines, medical countermeasures, and other critical inputs that have been deemed by the President as essential to the national defense. In addition, HHS will designate a new Supply Chain Resilience and Shortage Coordinator for efforts to strengthen the resilience of critical medical product and food supply chains, and to address related shortages.”
  • The Food and Drug Administration announced,
    • “approv[ing] Ogsiveo (nirogacestat) tablets for adult patients with progressing desmoid tumors who require systemic treatment. Ogsiveo is the first drug to be approved for the treatment of patients with desmoid tumors, a rare subtype of soft tissue sarcomas.
    • “Desmoid tumors are non-cancerous but can be locally aggressive. The tumors may invade into surrounding structures and organs, resulting in pain, issues with being able to move, and decreased quality of life. Although surgical removal has historically been the treatment of choice, there is a high risk that the tumor will return or that other health challenges will occur after removal; therefore, systemic therapies (cancer treatment targeting the entire body) are being increasingly evaluated in clinical trials.” 
  • The HHS Inspector General concluded that “The Risk of Misuse and Diversion of Buprenorphine for Opioid Use Disorder in Medicare Part D Continues to Appear Low: 2022.”
  • Govexec tells us,
    • “The U.S. Postal Service is planning to hire just 10,000 temporary employees during the current holiday season as part of a new approach that management has acknowledged comes with some risks. 
    • “The seasonal hiring marks a 64% reduction from the employees brought on in 2022 during what USPS calls its “peak season” when the agency made 28,000 temporary hires. The agency had said it would bring on just 20,000 seasonal workers that year, but a recent USPS inspector general report found it reached a higher tally. 
    • “This will mark the second consecutive year in which the Postal Service significantly reduces its seasonal hiring. In 2021, USPS added 45,000 non-permanent staff for the holiday rush. Postmaster General Louis DeJoy has said additions to the permanent, career workforce has lessened the need for such a surge. In the last two years, the agency has converted 150,000 employees from part-time workers to full-time, career personnel.”
  • Federal News Network informs us,
    • “Participants in [OPM’s] Thrift Savings Plan felt less content with the TSP this year, according to the latest results of the Federal Retirement Thrift Investment Board’s annual satisfaction survey.
    • “Currently, 82% of TSP participants are satisfied with the plan, compared with an 87% satisfaction rate in 2022, the board’s survey of tens of thousands of TSP participants showed.
    • “The slumping satisfaction scores may not come as a surprise after the TSP’s tumultuous transition to a new recordkeeper in June 2022. The 2023 survey, conducted between March and May of this year, was the first time the major update was reflected in the annual participant satisfaction survey.”

From the public health and medical research front,

  • Precision Vaccinations points out,
    • “The World Health Organization (WHO) today reported that the multi-country mpox outbreak continues at a low transmission level in the European Region and the Americas.
    • “The 30th WHO Situation Report, published on November 25, 2023, offers insights regarding the latest epidemiology and a particular focus on the ongoing and evolving epidemiology of mpox in the Democratic Republic of the Congo (DRC).
    • “The WHO confirmed that from January 2022 through October 31, 2023, a cumulative total of 91,788 laboratory-confirmed cases of mpox, including 167 deaths, have been reported from 116 countries/territories/areas.
    • “The countries that have reported the highest cumulative number of mpox cases are the United States (30,771), Brazil (10,967), and Spain (7,647).”
  • Healio notes,
    • “Eating disorder claims in the United States rose 65% as a percentage of all medical claims over the last 5 years, according to a report from FAIR Health, a health care claims repository.
    • “Researchers at FAIR Health evaluated more than 43 billion private health care claims records to investigate trends in eating disorders from 2018 to 2022 based on regional and national levels, demographic and socioeconomic factors and other health conditions. * * *
    • “Key takeaways:
      • “Patients aged 14 to 18 years accounted for most eating disorder claims in 2022.
      • “Overall, 72% of patients with eating disorders were diagnosed with at least one co-occurring mental illness.”
  • Beckers Hospital Review lets us know,
    • “Eli Lilly’s Mounjaro helped patients lose weight more effectively than Novo Nordisk’s Ozempic, according to a preprint study that included more than 40,000 patients. 
    • “The research evaluated 41,223 EHRs of overweight or obese patients taking Mounjaro (tirzepatide) or Ozempic (semaglutide) for Type 2 diabetes. The cohort was restricted to patients with available weight data and those who had not received a glucagon-like peptide-1 receptor agonist prior to May 2022.
    • “Although about 77% of the patients took Ozempic, those who took Mounjaro “were significantly more likely to achieve 5%, 10% and 15% weight loss and experience larger reductions in weight at 3, 6, and 12 months,” the study found.
    • “Truveta, a healthcare data company that collects EHR information from more than 30 systems, conducted the research. It is the first real-world comparative effectiveness study between Mounjaro and Ozempic, Truveta said in a Nov. 27 news release.” 
  • STAT News reports,
    • “The inflammation-targeting therapy Dupixent succeeded in a Phase 3 trial in patients with the chronic lung disease COPD, its developers said Monday, results that could propel the blockbuster medicine into a massive new market.
    • “Dupixent, which is jointly developed by Sanofi and Regeneron Pharmaceuticals, has already racked up approvals for several indications, including asthma, atopic dermatitis, and eosinophilic esophagitis. If approved for COPD, it would be the first biologic treatment for the condition.
    • “The trial, dubbed Notus, was the second Phase 3 trial for Dupixent in COPD, with the companies announcing similarly positive results from the Boreas trial earlier this year. The full data from Boreas were published in the New England Journal of Medicine.”

From the U.S. healthcare business front,

  • Employee Benefit News offers tips on PBM contracting.
  • Per Fierce Healthcare,
    • “Mark Cuban Cost Plus Drug Company has inked its latest partnership, joining forces with Expion Health to address the rising cost of specialty drugs.
    • “Cost Plus Drugs’ pricing model will integrate into Expion’s dynamic pricing technology, harnessing the power of both for speciality medications. Expion’s tool and Cost Plus Drugs’ approach together “equips payers with a sophisticated tool for navigating this modern landscape,” the companies said in the announcement.”
  • and
    • “Ayble Health, a digital health platform for patients with chronic gastrointestinal conditions, has announced a new collaboration with the Mayo Clinic.
    • “Ayble is working with the Mayo Clinic Complex Care Program to offer a hybrid care model that matches patients with the appropriate virtual and in-person care based on acuity and need.
    • “By matching the right care for a patient at the right time, the two hope to improve outcomes and costs for digestive diseases. The collaboration is available for large employers and health plans.” 
  • MedCity News calls to our attention,
    • “AI startup Hoppr teamed up with AWS to launch a new foundation model to help bring more generative AI solutions into medical imaging, the companies announced on Sunday at RSNA 2023, the annual radiology and medical imaging conference in Chicago.
    • “The new product, named Grace, is a B2B model designed to help application developers build better AI solutions for medical images — and to build them more quickly. Along with the launch of Grace, Hoppr also announced that it received “a multi-million dollar investment” from Health2047, the American Medical Association’s venture studio.”
  • Per Healthcare Dive,
  • “Advocate Health’s financial performance dipped in the third quarter despite rising patient volumes as the major nonprofit health system navigated higher expenses and declining investment returns.
  • “The operator reported a nine-month operating income of $79.4 million, down from the $85.7 million Advocate recorded through the first half of the year.
  • “Advocate’s investment income also took a hit, falling more than a third from midyear. Overall, the nonprofit’s bottom line dropped to $721.2 million, 28% lower than midyear. * * *
  • “Formed out of a merger between Illinois-based Advocate Aurora Health and North Carolina-based Atrium Health last year, the health system is comprised of three divisions: Advocate Aurora Health, Atrium Health’s Charlotte-Mecklenburg Hospital Authority and Atrium Health Wake Forest Baptist. Together, the divisions operate more than a thousand care sites, including 67 hospitals.”

Happy Thanksgiving!

David Ermer–Congress, COVID-19 testing, Federal employment benefits, Generative AI, Medical / Rx research, OPM, U.S. Healthcare–
Photo by Priscilla Du Preez 🇨🇦 on Unsplash

Following this post, The FEHBlog will reappear on Saturday for Cybersecurity Saturday. The FEHBlog wishes his readers a Happy Thanksgiving.

From Washington DC

  • Thanks to Bloomberg, the FEHBlog learned about this Congressional Research Service report on FY 2024 USPS Appropriations. To wit,
    • “On September 30, 2023, Congress passed the Continuing Appropriations Act, 2024 and Other Extensions Act (H.R. 5860; P.L. 118-15), which provides continuing FY2024 appropriations to federal agencies through November 17,
    • “Section 126 of the act increases the rate of funding for the Office of Personnel Management (OPM) to approximately $219.1 million, which is about $28.3 million above its FY2023 funding.
    • “The additional OPM funding is provided for the implementation of the Postal Service Health Benefits Program (PSHBP), a new health benefit program for eligible postal employees and retirees. Under the PSRA, OPM is required to establish and administer the PSHBP.”
  • FEHBlog note — The Postal Service also is on the financial hook for funding implementation of the PSHBP.
  • STAT News reports,
    • “Senate Democrats, led by Sen. Bernie Sanders (I-Vt.), on Tuesday mounted a public pressure campaign to get the executives of Merck, Johnson & Johnson, and Bristol Myers Squibb to testify in a January hearing on why the United States pays more for prescription drugs than other countries.
    • “All three companies have sued the Biden administration over the new Medicare drug price negotiation that congressional Democrats passed last year. Bristol Myers Squibb’s blood thinner Eliquis; Johnson & Johnson’s blood thinner Xarelto, anti-inflammatory medicine Stelara, and blood cancer treatment Imbruvica; and Merck’s diabetes drug Januvia were selected as part of the first 10 drugs to go through the negotiation process.
    • “It’s unclear whether the executives will agree to testify at the hearing, which is titled “Why “Does the United States Pay, By Far, The Highest Prices In The World For Prescription Drugs?” Sanders also put out a fundraising email just before the letter was announced, with the subject line: “The greed of the pharmaceutical industry is out of control.” It featured an op-ed he wrote for the Guardian Monday.”

In FEHB Open Season and federal retirement news,

  • Fedweek provides Reg Jones’ observations on FEHBP and Medicare Parts A and B. The Federal Times offers articles titled “A Procrastinator’s Checklist for Choosing Open Season Benefits” and “What’s driving rate hikes for federal employee health premiums?”
  • The second Federal Times article is a topic that the FEHBlog follows throughout the year. In that regard, Mercer Consulting released the following survey findings last week:
    • “Mercer, a business of Marsh McLennan (NYSE: MMC), released the findings of its 2023 National Survey of Employer-Sponsored Health Plans, which found the average per-employee cost of employer-sponsored health insurance rose by 5.2% in 2023 to reach $15,797. * * *
    • “In 2022, cost rose by 3.2%, well below general inflation, which averaged 8% that year. Because healthcare providers typically have multi-year contracts with health plans, employers did not feel the full brunt of inflation last year. “Rather, inflation-driven cost increases are phasing in as contracts are renewed,” says Sunit Patel, Chief Health Actuary, Mercer. The survey shows employers project another sharp increase of 5.2% for 2024.
    • “It may take another couple of years for price increases stemming from higher healthcare sector wages and medical supply costs to be felt across all health plans,” Mr. Patel says.
    • “At the same time, inflation is only one factor behind this year’s higher cost increases. In 2023, spending on prescription drugs rose sharply. “While the effects of inflation may be relatively short-lived, new and ongoing developments in the pharmaceutical market seem likely to have a longer-term impact on health benefit cost.”
  • The Federal Times adds,
    • “Federal employees’ retirement applications take almost twice as long to process when they contain errors, leading to further delays in processing and dispensing annuities, according to a watchdog report published Monday.
    • “The Office of Personnel Management’s inspector general found that “healthy” application packages took on average 53 days to process, and “unhealthy” ones containing errors took more than 108 days, according to a random sample of applications the inspector general studied.
    • “That discrepancy needs be reflected in the data OPM reports monthly to accurately monitor whether retirement processing is improving, the IG report said.
    • “The lack of transparency for healthy versus unhealthy ‘incomplete’ application packages limits the quality of information being provided to external parties as the main cause for why Retirement Services has not met its goal for processing retirement application packages within 60 days,” according to the report.”

From the public health and medical research front,

  • Beckers Clinical Leadership tells us,
    • “Hospital and public health officials are urging people to take precautions and be mindful of where they seek care to limit capacity strain on emergency departments as respiratory virus activity heats up heading into the holiday season. 
    • “Since early September, COVID-19 metrics had mostly been trending downward or remained flat. Now they are on the rise again, though they remain far below levels seen in previous surges. There were 16,239 new admissions for the week ending Nov. 11, up 8.6% from the previous week. 
    • “Meanwhile, most of the country is seeing an uptick of flu and respiratory syncytial virus cases. Hospitalizations associated with the two infections are also ticking up, particularly among children and older adults. 
    • “The more concerning thing is the severity of some of the illness,” Hany Atallah, MD, chief medical officer Jackson Memorial Hospital in Miami, told ABC affiliate WPLG. “And we are also seeing some patients come in with more than one viral infection, so they may have RSV and flu, for example. We’re constantly trying to follow the science and encourage people to get vaccines.” 
  • The Wall Street Journal points out,
    • “Ozempic, Wegovy and their counterparts have exploded in popularity over the past year, earning billions for the drugs’ makers, transforming the American approach to weight-loss, and sparking widespread cultural discussion in a country that is already obsessed with weight. 
    • “That conversation lands on Thanksgiving tables this week, where some people say the drugs have boosted their confidence around food, and others say they are worried about facing questions about what they’re eating, what they’re not eating, and changes in their appearance.
    • “It’s a hot topic, and people have a lot of judgments,” says Dr. Gauri Khurana, a psychiatrist in private practice in New York City and a clinical instructor at Yale University who has prescribed the medications and helped patients manage them. * * *
    • “Doctors advise people to listen to their bodies—not their family members—when it comes to serving sizes. A balanced plate that gives priority to protein and high-fiber foods over carbohydrates and fatty foods, which tend to sit in the stomach and exacerbate the medication’s effects of delayed gastric emptying, can help patients avoid filling up too quickly or feeling nauseous.”
  • The New York Times reports,
    • “Just in time for the holiday season, the Biden administration is offering Americans a fresh round of free at-home coronavirus tests through the Postal Service.
    • “The administration revived the dormant program in September, announcing then that households could order four free tests through a federal website, covidtests.gov.
    • “Beginning Monday, households may order an additional four tests. Households that have not placed an order since the program resumed can submit two orders, for eight tests in total.”
  • The University of Minnesota informs us,
    • “A new survey of 158 hospital executives, conducted by the Sepsis Alliance, found that 90% see antimicrobial resistance (AMR) as a threat, and 88% think the problem is getting worse. The survey, conducted by Sage Growth Partners on behalf of the Sepsis Alliance, also dug into executives’ views on other related AMR issues. An 11-page report on the findings was published on the Sepsis Alliance websiteon November 17.
    • “Another top concern is the public’s lack of knowledge about AMR, with 59% of executives saying that public education of clinicians as well as patients is the largest barrier to antibiotic stewardship. Respondents recommend public service announcements covering the need for early treatment, the importance of completing treatment, and storing the drugs properly.”

From the U.S. healthcare business front,

  • Healthcare Dive asks “Where are all the nurses? Hospitals, advocates disagree on crisis; Hospitals and nursing unions disagree about what’s driving sluggish application rates for open registered nurse positions — a lack of qualified candidates or a lack of interest.”
  • BioPharma Dive notes,
    • “Roche’s Genentech unit is partnering with computing giant Nvidia in a multiyear deal that highlights the pharmaceutical industry’s growing hopes of using artificial intelligence to speed up the process of designing and developing new drugs. 
    • “By collaborating with Nvidia, Genentech expects to “significantly enhance” its existing AI research and potentially improve on the chip designer’s own software, such as its “BioNemo” platform for drug discovery. 
    • “Our teams will be continuously exchanging expertise on the advancement of science and the state-of-the-art methods emerging in accelerated computing, AI and simulation across this entire drug discovery process,” said Kimberly Powell, vice president of healthcare at Nvidia, in a briefing with reporters.”