Weekend update

U.S. Healthcare

Weekend update

David Ermer–AHRQ, Congress, COVID-19, Mental health care, Telehealth, U.S. Healthcare–
Lincoln Memorial in the Fall

The House of Representatives is on the campaign trail. The Senate will join them tomorrow after a confirmation vote on Judge Amy Coney Barrett’s nomination to the Supreme Court. Her nomination narrowly cleared a cloture vote at the Senate today. If you want to understand why the Supreme Court will not strike down the Affordable Care Act this term even with Judge Barrett on its illustrious bench, click here.

There is only one Congressional hearing this week — a Senate Commerce Committee hearing on Wednesday morning, October 28, about the federal internet liability shield. The witnesses will be the CEOs from Twitter, Alphabet/Google, and Facebook, large companies that currently benefit from this shield. Congress returns to its legislative business on November 16 following the Presidential and Congressional election on November 3.

Today, the Department of Health and Human Services shared news on how States and the District of Columbia will use the rapid COVID-19 BinaxNOW tests that the federal government purchased on their behalves. “HHS also provided all CLIA-certified nursing homes over 11 million rapid, point-of-care tests. The tests include the following FDA-authorized antigen diagnostic tests: Abbott BinaxNOW and either a Quidel Sofia 2 or Becton, Dickinson and Company (BD) Veritor™ Plus System instrument(s).”

The Washington Post’s Lily website offers an interview with a 14 year young lady, Anika Chebrolu, who was awarded a $25,000 prize “for her discovery: a compound that can bind to the coronavirus [COVID-19-, inhibiting its ability to infect people. She beat out nine other finalists — whose own projects ranged from a robotic glove to a device that detects invisible particles in water — to be named America’s top young scientist.” Ms. Chebrolu modestly explains that “my effort to find a spike protein binder isn’t unique in its methodology, and it may appear to be a drop in the ocean, but it adds to all these efforts and therefore is quite substantial.” Congratulations.

It’s also worth pointing out this Healthcare Dive article informing us that

Medical device funding hit a new high in the third quarter, growing 63% year on year to top $5 billion for the first time in CB Insights’ dataset. Investments in robotic surgery startups was a major driver of the increase. The analysts listed the progress of neuromodulation devices and Medtronic’s deals in diabetes and neurosurgery as other medical device highlights of the quarter.

The Mayo Clinic explains that “Robotic surgery, or robot-assisted surgery, allows doctors to perform many types of complex procedures with more precision, flexibility and control than is possible with conventional techniques. Robotic surgery is usually associated with minimally invasive surgery — procedures performed through tiny incisions.”

The International Modulation Society further explains that

Neuromodulation is technology that acts directly upon nerves. It is the alteration—or modulation—of nerve activity by delivering electrical or pharmaceutical agents directly to a target area.

Neuromodulation devices and treatments are life changing. They affect every area of the body and treat nearly every disease or symptom from headaches to tremors to spinal cord damage to urinary incontinence. With such a broad therapeutic scope, and significant ongoing improvements in biotechnology, it is not surprising that neuromodulation is poised as a major growth industry for the next decade.

Most frequently, people think of neuromodulation in the context of chronic pain relief, the most common indication. However, there are a plethora of neuromodulation applications, such as deep brain stimulation (DBS) treatment for Parkinson’s disease, sacral nerve stimulation for pelvic disorders and incontinence, and spinal cord stimulation for ischemic disorders (angina, peripheral vascular disease).

Cochlear implants to treat deafness, for example, are intermodulation devices.

The FEHBlog noticed on Twitter today that the HHS Agency for Healthcare Quality and Research has made available in the Apple Store and Google Play an app to help patients to develop questions for the doctor visits.

On the healthcare survey and report front

The top 12 reasons for using telehealth, according to the 2020 survey, are listed below, with the 2019 ranking and percentages in parentheses:

  1. Convenience, 51 percent (1, 64 percent)
  2. Safety, 46 percent (12, 13 percent)
  3. Speed – ability to receive care quickly, 44 percent (2, 53 percent)
  4. Quality care, 30 percent (6, 25 percent)
  5. Condition covered by telehealth visit, 28 percent (7, 22 percent)
  6. Ease of access to health information, 27 percent (3, 34 percent)
  7. Convenient communication channels, 26 percent (4, 33 percent)
  8. Lower overall cost, 23 percent (5, 30 percent)
  9. Difficult to travel to medical office, 21 percent (7, 20 percent)
  10. Recommendation, 19 percent (7, 20 percent)
  11. Reputation, 19 percent (11, 14 percent)
  12. Past experience, 17 percent (9, 19 percent).
  • Health Payer Intelligence reports that

Around a third of Millennials [ages 24 – 39] have a behavioral health condition, emphasizing a greater need for behavioral healthcare options and coverage as well as a new approach to millennial member engagement, the latest Blue Cross Blue Shield Association (BCBSA) report revealed. * * * Not only do Millennials have a high percentage of behavioral health conditions but their rate of developing a behaioral health condition is rising by double digits. Over five years from 2014 through 2018, the prevalence of major depression rose by 43 percent, ADHD rose by 39 percentage percent, and psychotic disorders rose by 26 percent among Millennials.”

Thursday Miscellany

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

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

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

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

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

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

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

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

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

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

Tuesday Tidbits

David Ermer–Congress, COVID-19, OPM, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

The Hill reports “progress but not breakthroughs” as yet in the negotiation to achieve bipartisan agreement on a pre-election COVID-19 relief bill. The Speaker has agreed to continue negotiations past the 48 hour deadline that she set over the week. So both sides have set and withdrawn deadlines. That may be the clearest sign that progress is being made.

Federal News Network takes a deeper dive into last week’s FEHBP Open Season announcement from OPM. To recap “non-postal FEHBP participants will pay in 2021.

  • Self-only coverage: $4.67 more per biweekly pay period,
  • Self-plus-one coverage: $10.90 more per biweekly pay period,
  • Family coverage: $10.94 more per biweekly pay period.

It is interesting that the two other than self only options increased at the same level. This illustrates the small family size in the FEHBP. Furthermore,

[OPM Acting Director for Healthcare and Insurance Laurie] Bodenheimer described the premium rates OPM announced Wednesday as a “snapshot in time.” “These numbers are based on premiums for next year, along with what plans people are enrolled in right now,” she said. “It’s well known that during the open season people do choose different plans and coverage based on benefits or premiums or whatever is important to them. The end result is often that the overall premium increase is less than what we’re announcing today.”

That, my friend, is the benefit of FEHBP competition. The FEHBP/FEDVIP/FSAFeds Open Season runs from November 9 through December 14.

The open season for the Affordable Care Act’s marketplace begins on November 1. HHS released yesterday

a report showing the trend of lower premiums and increased issuer participation for HealthCare.gov will continue for 2021 year. The average premium for the second lowest cost silver plan (also called the benchmark plan) dropped by 2% for the 2021 coverage year and, when looking at states that are using HealthCare.gov in both 2020 and 2021, 22 more issuers will offer coverage in 2021, for a total of 181 issuers delivering more choice and competition for consumers.

The FEHBlog is happy to see that marketplace continues to mature and improve without the individual mandate.

On the COVID 19 front —

  • Healthcare Dive reports “About 20% of hospital executives surveyed by Kaufman Hall recently said they were ‘extremely concerned’ about their financial viability until an effective vaccine or treatment is available.”
  • A friend of the FEHBlog pointed out this helpful New York Times COVID-19 vaccination tracker.
  • NIH Director Dr. Francis Collins reports in his Director’s Blog that “findings [from two new studies] show that people who survive a COVID-19 infection continue to produce protective antibodies against key parts of the virus for at least three to four months after developing their first symptoms. In contrast, some other antibody types decline more quickly. The findings offer hope that people infected with the virus will have some lasting antibody protection against re-infection, though for how long still remains to be determined.”
  • NPR informs us that “Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness.” That has been the FEHBlog’s operating assumption. The principal researcher remarks that “”I do think this is good news, “but it does not make the coronavirus a benign illness.” No doubt about that.

Monday Roundup

David Ermer–Congress, COVID-19, U.S. Healthcare–
Photo by Sven Read on Unsplash

The Wall Street Journal reports that Speaker Pelosi and Treasury Secretary Mnuchin continue to negotiate over another COVID-19 relief bill. “On Monday afternoon’s call with Democrats, Mrs. Pelosi said the two sides were still discussing how much money to provide state and local governments, child-care facilities and how to structure a national plan for testing and contact tracing of the virus.” The negotiations need to conclude soon if Congress is to have time to consider and pass the compromise bill before the national election which is two weeks from tomorrow.

Healthcare Dive offers a helpful overview of last week’s HLTH conference. Of note:

A slew of government agencies, including the Centers for Disease Control and Prevention, HHS and Operation Warp Speed, are working together to generate a vaccine distribution plan in tandem with private sector partners.

Plans for distribution are ongoing but shift as the frontrunners in the vaccine race do, experts say. Different vaccines require different processes. For example, there may be additional costs to store a coronavirus vaccine at cold temperatures, or because some of the candidates require two doses.

“All those things we’re working through to try and understand,” Alan Lotvin, president of CVS’ pharmacy benefit management arm Caremark, said Monday. “It’s going to be different for every vaccine.”

Walgreens, for example, is in regular conversations with five manufacturers in the last stages of clinical tests, the federal government and other retail partners to coordinate a distribution strategy, Gourlay said.

And CMS plans to release a rule before the end of the month for how Medicare will cover an eventual COVID-19 vaccine without cost-sharing, Verma said.

The Healthcare Dive article also discusses back to work technology presented at HLTH. In that regard, HR Daily advisor offers advice on how employers and managers can offer mental health guidance to their remote employees. For example,

Knowing that isolation is a big challenge, companies should look for ways to help their staff feel connected. “Working at home can prove challenging under the best of circumstances,” says Jeanne Hurlbert, PhD, President of Hurlbert Consulting. “Forming virtual work teams can help combat those challenges.”

“Teams can connect by phone or, ideally, through video conferencing, once or twice a day—and this can help to increase productivity. That allows them to provide instrumental support to each other,” Hurlbert adds. “And if your employees remain in the workplace, the same principles hold. The bonus? Our research shows that workers with more coworker connections enjoy higher job satisfaction.”

A friend of the FEHBlog shared this National Institutes of Health press release about “a groundbreaking study that will aim to address gaps in reaching communities most heavily affected by the opioid epidemic with proven, evidence-based interventions for opioid use disorder (OUD),” which as we have seen remains a national public health emergency.”

An estimated 1.6 million people had OUD in 2019; of these, only 18.1% received medication treatment for opioid misuse. To address this gap, in May 2019, the NIH announced plans to invest more than $350 million to support the multi-year HEALing Communities Study, a multi-site research study that will test the impact of an integrated set of evidence-based practices on reducing opioid-related overdose deaths by 40% in three years in communities hard-hit by the opioid crisis.

Study research sites include the University of Kentucky, Lexington; Boston Medical Center; Columbia University, New York City; and Ohio State University, Columbus. The study will track communities as they work to increase the number of individuals receiving medication-based treatment for OUD, increase treatment retention beyond six months, provide recovery support services, expand the distribution of naloxone, a medication to reverse opioid overdose, and reduce high-risk opioid prescribing.

Interesting.

Weekend update

David Ermer–Congress, COVID-19 vaccine, SCOTUS, U.S. Healthcare–

Note: The third time is charm. The correct version of OPM’s 2021 Non-Postal Nationwide / FFS Plan Premium chart is now linked to Friday’s note. Thanks readers.

To compensate for this inconvenience, the FEHBlog has attached his treasured actual maximum FEHB government contribution chart 2016-2021. If a plan’s premium is below the maximum government contribution, prescribed by 5 USC Sec. 8906, then plan annual premium increase is covered by the government contribution increase. If, however, the plan’s premium is above the maximum government contribution, the “shield” typically vanishes. As a result, the “above the max” plan’s annual premium changes are quite visible to the member. The maximum government contribution helps tamp down premium increases in this competitive program. The purpose of the chart is to illustrate the fact that the CPI-U is a useful proxy for maximum government contribution changes.

Onto the Weekend Update

The Senate is open for voting and committee work this week. On Thursday morning, the Senate Judiciary Committee will vote on Judge Amy Coney Barrett’s Supreme Court nomination. The House remains on the campaign trail although, according to the Hill, the Speaker has warned the Administration that she will stop negotiating a pre-election COVID-19 relief bill unless a compromise is reached early this week. Turnabout is fair play.

On the COVID-19 vaccine front —

Alex Gorsky, chief executive of Johnson & Johnson, remains upbeat about the possibility of a COVID-19 vaccine arriving as early as this year, despite the health care giant suspending a late-stage clinical trial for one of its own candidates after a patient fell ill this week. “If you just look at the sheer number of compounds that are in development right now, there is a very good probability that late this year or early next year, we will have options for vaccines.”

  • The Department of Health and Human Services announced on Friday that “agreements with CVS and Walgreens to provide and administer COVID-19 vaccines to residents of long-term care facilities (LTCF) nationwide with no out-of-pocket costs.” “The pandemic has inflicted a devastating toll on America’s nursing home residents,” said Centers for Medicare and Medicaid Services Administrator Seema Verma. “That’s why the Trump Administration has taken unprecedented action to protect them in every possible way. This effort will ensure they are at the front of the line for the COVID vaccine and will bring their grueling trial to a close as swiftly as possible.”

On Saturday, according to CNN, the President signed into law a Congressionally approved bill that converts the national suicide hotlines ten digit number 1-800-273-8255 (TALK) to a three digit number 988. The Federal Communications Commission has ordered voice service providers to make the new three digit number available to subscribers by July 16, 2022.

The Centers for Medicare and Medicaid Services released the result of a Medicare beneficiary survey on the impact of COVID-19. It’s a survey of interest to FEHB plans because there is a large cadre of Medicare prime annuitants enrolled in their plans.

21% of Medicare beneficiaries report forgoing non-coronavirus disease 2019 (COVID-19) care due to the pandemic, and nearly all – 98% – of beneficiaries have taken preventative measures to keep themselves safe from the virus.

According to the survey, the most common type of forgone care because of the pandemic was dental care (43%), followed by regular check-up (36%), treatment for ongoing condition (36%), and diagnostic or medical screening test (32%). The most common reason cited for forgoing care was not wanting to risk being at a medical facility (45%).

“An infographic with a snapshot of the survey results is here.  A link to the public use file detailing the survey results is here.”

On the other side of the aging spectrum the Wall Street Journal reports on millennials agreeing to marry in part so that one partner can access the other partner’s employer sponsored health insurance. This has been happening for a long time. What’s interesting to the FEHBlog is that employer sponsored plans, not ACA marketplace plans , are viewed as the life raft.

Tuesday Tidbits

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

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

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

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

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

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

On the COVID-19 front

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

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

Monday Roundup

David Ermer–COVID-19, HIPAA Privacy and Security Rules, U.S. Healthcare–

The Wall Street Journal reports today that

Photo by Sven Read on Unsplash

“Public-health experts increasingly agree—including critics of the Great Barrington Declaration—that the broad, months long lockdowns imposed in March may be too unpopular to sustain [again]. Experts who backed lockdowns in the spring now worry another round of the same type could backfire if the public ceases to comply.

Even proponents of more lockdowns are generally pushing for briefer, more targeted closures, dubbed circuit-breakers, in which governments would shut specific businesses for two or three weeks, such as bars, restaurants and possibly universities. Other institutions that appear to be lower risk—including day cares, elementary schools and outdoor facilities—could remain open.

“The opinion of public health experts is changing very rapidly,” said Jayanta Bhattacharya, a professor of medicine at Stanford University, who is one of the co-authors of the Great Barrington Declaration. “In March, I felt alone. [Now] I think there are a very large number of public health experts, epidemiologists, and doctors who oppose further lockdowns.”

That’s a consensus that the FEHBlog can support.

Fierce Healthcare reports from the HLTH Conference on Humana CEO Bruce Broussard’s talk on how he adjusted his leadership style to the COVID-19 public health emergency. “He said that a virtual work environment has forced him to be much more “intentional” in his leadership approach, which meant adopting new strategies to reach workers and being more thoughtful about how he approaches communicating with Humana’s employees. * * * In addition,Broussard said he believes COVID-19 is putting a spotlight on the value of taking a whole-person approach to care. Having flexible access to a number of different services at home was crucial for the insurer’s largely-Medicare Advantage member base, who were at high risk from complications if they caught the virus. Broussard said he doesn’t foresee the momentum toward those options going away once COVID-19 is under control.

Today, the FEHBlog ran across another interesting conference which is being held later this week — American Healthcare Information Management Association (“AHIMA”) 20. The FEHBlog, who is an AHIMA member, purchased access to this virtual conference. The conference runs from October 14 to October 17.

A related organization, the Workgroup for Electronic Data Interchange (WEDI) holds its virtual annual conference from October 20 to 22. WEDI focuses on the HIPAA standard transactions while AHIMA focuses on the HIPAA-coded data included in those transactions. It is the umbrella law that piques this lawyers interest among other things.

Weekend update

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

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

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

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

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

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

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

In recent news —

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

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

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

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

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

Thursday Miscellany

David Ermer–COVID-19, OPM, Telehealth, U.S. Healthcare–
Photo by Juliane Liebermann on Unsplash

Well, this year’s FEHBP / FEDVIP Open Season announcement will be the latest in recorded history as the FEHBlog found on opm.gov that the past champion turtle was the Open Season announcement issued on October 7. OPM did send out its second Benefit Administration Letter on the Open Season today but that’s not the same thing as announcing 2021 premium changes. What’s particularly odd is that OPM usually settles all of the FEHBP premium negotiations by mid-August. What possibly could be the reason for this hold up? The FEHBlog hopes that this is not the new normal as the ongoing delay impairs FEHBP competition.

In an example of good corporate citizenship, Forbes reports today that

The large hospital operator HCA Healthcare Thursday said it will “return, or repay early” about $6 billion in federal stimulus money from the Coronavirus Aid, Relief, and Economic Security Act, known as CARES. HCA, one of the nation’s biggest hospital operators, has been performing well financially and earlier this year reported a profit of more than $800 million in its second quarter thanks to CARES Act funds.

In other business news, Fierce Healthcare reports that

[Telehealth vendor] Amwell’s stock climbed 38% Wednesday just three weeks after raising an outsized initial public offering of $742 million. Investor interest in Amwell was fueled by speculation that insurer UnitedHealth may buy the telehealth giant, according to healthcare analysts, Business Insider reporter Blake Dodge reported.

The article adds that “UnitedHealth Group also is reportedly in talks to buy online pharmacy DivvyDose that would put the insurer in direct competition with Amazon’s PillPack.” Interesting moves.

On the COVID-19 front today, the Wall Street Journal confirmed by its investigational reporting, at least to the FEHBlog’s satisfaction, that the COVID-19 virus was spreading across our country months before the mid-March commencement of the great hunkering down. “While the country was still looking outward [in January and February 2020, researchers now believe the earliest infections in many states came mostly from travel within the U.S.” This reminds me of the course of the Great Influenza in 1918 according to J.M. Barry’s Great Influenza book. Again, the difference between then and now is 100 years of medical advances. The FEHBlog continues to have faith in the U.S. healthcare system as well as the common sense of the American people.

Midweek Update

David Ermer–CDC, COVID-19, HIPAA Privacy and Security Rules, Telehealth, U.S. Healthcare–
Photo by Maria Teneva on Unsplash

The Blue Cross Blue Shield Association has a new president and CEO effective January 4, 2021 — Kim A. Keck. Ms. Keck, who will be the first woman to hold this position, is currently president and CEO of Blue Cross of Rhode Island. She worked for Aetna for 28 years. Of course, she succeeds Scott Serota. Congratulations, Ms. Keck.

Congratulations as well to the 2020 winners of the Nobel Prize in Chemistry, Emmanuelle Charpentier of the Max Planck Institute in Berlin and Jennifer Doudna of the University of California, Berkley, for their work in developing “genetic scissors” known as CRISPR-Cas9 “that can cut DNA at a precise location, allowing scientists to make specific changes to specific genes.” NPR explains that

“Once in a long time, an advance comes along that utterly transforms an entire field and does so very rapidly,” says Francis Collins, director of the National Institutes of Health, which has long supported Doudna’s research. “You cannot walk into a molecular biology laboratory today, working on virtually any organism, where CRISPR-Cas9 is not playing a role in the ability to understand how life works and how disease happens. It’s just that powerful.”

In other good news Precision Vaccinations reports that

The CDC researchers noted in the Morbidity and Mortality Weekly Report published on October 2, 2020, that during the 2019-20 flu season, 61.2 percent of surveyed pregnant women received the flu vaccine, which was 7.5 percentage points higher than the previous flu season. In addition, 56.6 percent of the women received the Tdap vaccine during pregnancy, and 40.3 percent received both vaccines. The percentage of women receiving both vaccines significantly increased from 35 percent just one year ago.

These increases were driven by increased vaccination coverage among Black and Hispanic women and those of other races reported the CDC. The CDC authors stated: “Racial disparities in vaccination coverage could decrease further with consistent provider offers or referrals for vaccination, in combination with culturally competent conversations with patients.” Specifically, this data found approximately 20 percent of pregnant women reported not receiving a provider recommendation for these vaccinations.

On the COVID-19 front, STAT News informs us that Eli Lilly reports good results with its synthetic antibody treatments for COVID-19. Lilly is seek emergency authorization use approval from the Food and Drug Administration as it continues to clinical trials on the treatments.

In other news —

The Department of Health and Human Services (“HHS”) announced today that

Surgeon General VADM Jerome M. Adams, M.D., M.P.H., issued a Call to Action urging Americans to recognize and address hypertension control as a national, public health priority. The Surgeon General’s Call to Action to Control Hypertension provides strategies for those on the frontlines of health care and public health to address this costly, dangerous and far too common chronic health condition.

According to Fierce Healthcare, Express Scripts has added new tools to its digital formulary that address “women’s health needs, tobacco cessation, muscle and joint pain, caregiver care and COVID-19 workplace support. The formulary’s goal is to assist employers and other plan sponsors in finding the digital health solutions that best fit their worker’s needs, and which have been vetted by experts at Express Scripts for key concerns like effectiveness, value, user experience and security.”

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Doctors and consumers expect to use virtual care more often after COVID-19 than they did before, according to a new survey from telehealth vendor Amwell, hinting at the long-term potential of the virtual care model in healthcare. Prior to the pandemic, the majority of virtual visits were for on-demand urgent care. But this year, the volume of virtual specialty and scheduled visits outpaced urgent care, suggesting telehealth is becoming normalized across more fields and use cases. Only about 21% of consumers had a virtual visit for on-demand urgent care visit this year. By comparison, 54% had a scheduled visits with their primary care physician.

HHS’s Office for Civil Rights announced another HIPAA scalping of a healthcare provider that failed to provide individual access to their medical record, a top OCR priority at this time. “Dignity Health, doing business as St. Joseph’s Hospital and Medical Center (“SJHMC”), has agreed to take corrective actions and pay $160,000 to settle a potential violation of the HIPAA Privacy Rule’s right of access provision. SJHMC, based in Phoenix, Arizona, is a large, acute care hospital with several hospital-based clinics that provide a wide range of health, social, and support services.”