Tuesday Tidbits

U.S. Healthcare

Tuesday Tidbits

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

Today the Senate invoked cloture on the compromise FY 2021 continuing resolution (HR 8337) by an 82 to 6 vote. The Senate now is in a position to pass the legislation and send it to the President for signature before the end of this federal government fiscal year, tomorrow September 30.

The Wall Street Journal reports that House Speaker Nancy Pelosi and Treasury Secretary Stephen Mnuchin have resumed discussing a compromise COVID-19 relief bill. Their discussions will continue tomorrow.

Healthcare consulting company WillisTowersWatson released a new white paper about the impact of the COVID-19 public health emergency on healthcare spending in the U.S.

Health care plan sponsors may see an unprecedented decrease in year-over-year medical costs in 2020, as system capacity shifts and fear of contracting COVID-19 in medical settings drives a significant volume of foregone and deferred care. Significant uncertainties remain however, including the course of the pandemic, the availability of effective vaccines and treatments, and changes in the health care delivery system that could impact future health care costs.

Willis Towers Watson has evaluated a set of potential future care utilization scenarios contemplating a variety of patterns of infection and care return. Across our scenarios, 2021 costs to employer plans are expected to be slightly higher (0.5% to 5.0%) than the non-pandemic baseline projection. Nevertheless, when 2020 and 2021 are combined, all scenarios show cost reductions (–2.8% to –3.8%) relative to the non-pandemic baseline. The baseline comparison from which these estimates were developed reflects projected costs for 2020 and 2021 assuming the pandemic never occurred. Employers should consider these scenarios as they budget for and measure the performance of their health care plans in the upcoming year.

Speaking of COVID-19 vaccines, the National Institutes of Health today announced that based on a separate Phase I study, the COVID-19 vaccine being jointly developed by Moderna and NIH had a positive impact on 40 older adult volunteers. This vaccine currently is in the Phase III study with a younger cohort. The separate Phase I study found that “Overall, the researchers found that “the investigational vaccine was well-tolerated in this older age group. Importantly, the immune response to the vaccine seen in older volunteers was comparable to that seen in younger age groups.” NIH is proposing that the Phase III study be expanded to include a senior cohort.

In other tidbits

  • Beckers Hospital Review reports on “13 things to know about Aetna, Anthem, Cigna, Humana and UnitedHealthcare’s virtual care strategies.” The article reminds the FEHBlog that the current end date for the federal government’s COVID-19 public health emergency technically is October 23. In all likelihood HHS will extend the deadline for another ninety days to Inauguration Day.
  • Healthcare Dive reports that “HHS has sent the Office of Management and Budget an interim final rule, called Information Blocking and the ONC Health IT Certification Program: Extension of Compliance Dates and Timeframes in Response to the COVID-19 Public Health Emergency, received on Sept. 17. ONC declined to comment on the rule. But the title implies it will extend dates identified in the sweeping information blocking provisions — notably, the looming November compliance deadline for providers — and dates for the Conditions and Maintenance of Certification provisions requiring EHR platforms to be interoperable.”

Weekend Update

David Ermer–Congress, COVID-19, COVID-19 testing, Electronic health records, OPM, U.S. Healthcare–

The FEHBlog is back inside the Beltway after a relaxing week on the Jersey Shore.

Both Houses of Congress will be conducting legislative and committee work this week following Yom Kippur which occurs from sundown tonight until sundown tomorrow. The Senate must pass the compromise continuing resolution funding the federal government through December 11 no later than Wednesday September 30.

On September 30, the Senate Homeland Security and Governmental Affairs Committee will take up the nomination of Chad Wolf to be Secretary of Homeland Security. The Committee continues to defer action of the nomination of John Gibbs to be OPM Director.

Before long OPM will be publicizing the 2021 FEHBP government contribution. The September 1, 2020, OPM Benefit Administration Letter states that OPM will be taking this action in “early October” and early October starts this Thursday October 1. Thanks to Google Alerts, the FEHBlog ran across this Janesville (Wisc.) Gazette article reporting that an FEHB plan called MercyCare with only 80 enrollees understandably will be leaving the FEHB Program at the end of this year.

While driving back from New Jersey the FEHBlog was musing about the uptick in COVID-19 cases. This musing reminded him to provide a link to this lengthy Wall Street Journal article published earlier this month about the “really diabolical” COVID-19 virus. WSJ articles on COVID-19 usually are accessible outside the paper’s paywall.

Taken on its own terms, SARS-CoV-2 is the infectious disease success of the past 100 years.

Almost unmatched in the annals of emerging human contagions, it has parlayed a few chance infections into a pandemic of around 27 million confirmed cases so far.

Doctors long expected the advent of such a virus, but even so, the shrewdness of the coronavirus caught many by surprise, and goes a long way to explaining how the world has struggled to contain it ever since.

“We underestimated it,” said Peter Piot , the head of the London School of Hygiene & Tropical Medicine and a co-discoverer of Ebola, who fell victim to the coronavirus himself in March.

In any event, looking forward, Healthline offers an update on the state of rapid COVID-19 testing.

In other news

  • Fierce Healthcare reports on UnitedHealthcare’s vision for a path forward on health reform. The study highlights the following policy priorities: 1. Universal coverage, 2. Improving affordability, 3. Enhancing the health experience, and 4. Boosting health outcomes.
  • Fierce Healthcare also provides insights into last week’s final rule creating a process for importing less expensive drugs from Canada. “HHS didn’t comment on whether Canada was on board with any re-importation proposals. The country has vociferously opposed national re-importation measures because of concerns it would dwindle their own drug supplies.” Time will tell. The FEHBlog is not a fan of this sort of drug importation.
  • Healthcare Dive reports that “Microsoft’s video platform, Teams, is integrating directly with electronic health records software to permit clinicians to launch telehealth visits from the EHR.” Microsoft’s first integration deal is with the largest EHR vendor Epic. This will facilitate direct telehealth visits between primary care providers and the patients.
  • Health Payer Intelligence discusses payer strategies for offering home healthcare / remote monitoring to members.

Friday Stats and More

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

Based on the CDC’s Cases in the U.S. website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 20th through 38th weeks of this year (beginning May 14 and ending September 23; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

For context take a look at this USA Today article on the three leading causes of death in the United States over the past 85 years (ending in 2018). COVID-19 will be taking over at least the spot for the third leading cause of death, which is currently held by accidental injuries.

In other news —

  • Forbes offers an update on Rite-Aid pharmacies and its prescription benefit manager. “Rite Aid said it will fully transition the PBM to Elixir in December and is “committed to becoming a dominant mid-market PBM, Rite Aid chief executive office Heyward Donigan said Thursday on the company’s second quarter earnings call.”
  • Benefits Pro (registration required) discusses the critical importance of educating employees about the advantages of health savings accounts. “Employers and financial advisors should discuss HSAs in the context of emergency savings and retirement planning, not just health care elections during annual enrollment.” The FEHBlog misses his ability to contribute to an HSA, an ability that he lost when he became Medicare eligible last year.
  • The Federal Times notes that Congress appears to be successfully convincing the Trump Administration to allow affected federal employees to opt out of the currently mandatory payroll tax deferral program. The article erroneously states that “The private sector does have the choice of whether to opt into the program, but feds and military members were automatically included.” Just like in the federal sector, it is the employer who makes the primary decision to participate in the payroll deferral program. It’s also the employer’s choice to allow employees to opt out of payroll deferral.
  • HHS’s Office for Civil Rights, which enforces the HIPAA Privacy and Security Rules took a big scalp today. “Premera Blue Cross (PBC) has agreed to pay $6.85 million to the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services (HHS) and to implement a corrective action plan to settle potential violations of the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security Rules related to a breach affecting over 10.4 million people. This resolution represents the second-largest payment to resolve a HIPAA investigation in OCR history. PBC operates in Washington and Alaska, and is the largest health plan in the Pacific Northwest, serving more than two million people.” The breach dates from the bad old days of 2014-15 when Anthem and OPM announced massive data breaches due to cyberattacker gaining deep access to company information systems.
  • ZDnet reports on recent cyberattack on an unidentified federal agency system. It’s worth reading because

[While] The name of the hacked federal agency, the date of the intrusion, or any details about the intruder, such as an industry codename or state affiliation, were not disclosed, CISA officially publish[ed] an in-depth incident response (IR) report detailing the intruder’s every step. The report, which ZDNet analyzed today, reveals how the intruder gained access to the federal agency’s internal networks through different channels, such as leveraging compromised credentials for Microsoft Office 365 (O365) accounts, domain administrator accounts, and credentials for the agency’s Pulse Secure VPN server.

Thursday Miscellany

David Ermer–Congress, Medicare, U.S. Healthcare–
Photo by Juliane Liebermann on Unsplash

The Wall Street Journal reports today that the Blue Cross Blue Shield Association (BCBSA) has reached with class plaintiffs’ counsel a tentative settlement agreement in a employer and individual consumer class action alleging anti-trust law violations among Blue Cross licensees that was filed in 2012. The settlement which includes $2.7 billion in payments and BCBSA operational changes intended to increase competition among Blue Cross licensees. The agreement is pending approval by the Blue Cross licensees and an Alabama federal court judge.

BCBSA also is facing a similar class action brought by a class of healthcare providers. The Journal report indicates that this case is headed to litigation. If you can’t access the Journal article due to its paywall (which is worth the investment in the FEHBlog’s humble opinion), Becker’s Hospital Review summarizes the settlement here.

Somewhat ironically, according to this Health Payer Intelligence report, the House of Representatives earlier this week passed a bill to repeal a law passed in 1945 that exempts health insurers from certain federal anti-competitive regulations.

The President issued an executive order today discussing his healthcare strategy and warning Congress that Health and Human Services will act to end healthcare surprise billing if Congress fails to pass its own surprise billing law by the end of the year. HHS issued a press release about the following agency actions taken today to implement the President’s strategy:

  • Issued a final rule from the Food and Drug Administration to open the first-ever pathway for states to use to safely import prescription drugs to lower patients drug costs.
  • Solicited private-sector proposals, as called for in the President’s July executive order, on allowing Americans to get lower-cost FDA-approved drugs and insulins from American pharmacies via importation and reimportation.
  • Released the 2021 Medicare Advantage and Medicare Part D Premium landscape, showing that average 2021 premiums for Medicare Advantage plans are expected to decline 34.2 percent from 2017 while plan choice, benefits, and enrollment continue to increase, and that Part D premiums will be down 12 percent from 2017, with over 1,600 drug plans offering insulin at no more than $35 per month.
  • Issued a notice of proposed rulemaking from the Health Resources and Services Administration to pass on steep discounts at community health centers on insulin and epinephrine to Americans who are uninsured or have high cost-sharing, including the nearly 3 million health center patients with diabetes.

The Society for Human Resource Management compares the Presidential candidate’s health plan coverage proposals here.

Last month the FEHBlog noted that GoodRx, the prescription drug discounter, was planning an initial public offering. Fierce Healthcare reports that

GoodRx raised $1.1 billion in its initial public offering after pricing its deal well above its expected price range. The GoodRx IPO began trading Wednesday at $46 per share, 39% above its $33 per share offering price. GoodRx stock rose above $49 per share in early afternoon action, Investors.com reported. That boosted the consumer healthcare technology firm’s market cap to about $12.7 billion.

Whoa Nelly.

Friday Stats and More

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

Based on the CDC’s Cases in the U.S. website, here is the FEHBlog’s chart of new weekly COVID-19 cases and deaths over the 20th through 37th weeks of this year (beginning May 14 and ending September 16; using Thursday as the first day of the week in order to facilitate this weekly update):

and here is the CDC’s latest overall weekly hospitalization rate chart for COVID-19:

Because the FEHBlog does look at his charts which are intended to show trends, he realized that new deaths chart is flat because new cases greatly exceed new deaths. Accordingly here is a chart of new COVID-19 deaths over the same period (May 14 through September 16 (basically four months).

In other COVID-19 news:

  • The Wall Street Journal reports “

U.S. hospitals expect to be better prepared if a second wave of Covid-19 cases hits in coming months, doctors and administrators say, after gaining a better understanding how to triage patients, which drugs to use and what supplies are needed. When the new coronavirus first struck, beds filled up at record speed, ventilators were in short supply and proven treatments were scant. Since then, doctors say, they have developed a better understanding of who needs a ventilator and how quickly a patient can be discharged, and studies have pointed to a few drugs like the antiviral remdesivir and the steroid dexamethasone that can help

The FEHBlog heartily agrees that the country is better prepared but he believes that the Journal is assuming facts not in evidence when it speaks about a second wave because we really are still in the first wave.

  • Medscape offers an MD’s perspective on the leading COVID-19 vaccine candidates.
  • The Wall Street Journal reports that the Centers for Disease Control withdrew last month’s highly criticized advice that people who had contact with asymptomatic COVID-19 patients don’t need a COVID-19 test. “The Sept. 18 updated recommendation now says that close contacts of a person with a confirmed Covid-19 infection need a test even in the absence of symptoms. The changes were described as a clarification, rather than a revision, on the CDC website.”
  • Speaking of COVID-19 testing, Mercer Consulting offers advice on how to cover COVID-19 testing which Congress made unnecessarily complicated.

In other news,

  • Govexec.com reports that “House Democrats are preparing to vote [next week] on a six-week stopgap spending bill that would keep agencies open through Dec. 11, according to Democratic aide.” From reading the article, it looks like the continuing resolution which is not fully backed will be enacted thereby avoiding what would be the craziest government shutdown in American history.
  • Speaking of criticism, Fierce Healthcare reports that “the American Academy of Family Physicians, which represents about 135,000 physicians, said the recommendations miss the mark and skew toward virtual-only telehealth vendors and large medical systems with established telehealth infrastructure. The task force’s report doesn’t address the needs of independent practices that need guidance, support and payment advocacy, wrote Stephanie Quinn, AAFP senior vice president of advocacy, practice advancement and policy in a blog post Tuesday.” The most encouraging tele heath acceleration that the FEHBlog witnessed during the great hunker down is patients holding telehealth visits with their own doctors. That FEHBlog agrees with AAFP that this trend that should be strongly encouraged.
  • Healthcare Dive reports that “Privately insured patients pay 247% more at hospitals on average than Medicare patients for the same care, according to a new study by nonprofit think tank RAND. The study, based on 2018 data, shows the gap is increasing from 2017 and 2016, which saw disparities of 230% and 224%, respectively. If private payers had paid Medicare rates over the three-year study period, they would have saved $19.7 billion, RAND determined. The study could provide fodder for proponents of a government-run public option, a key tenet of Democratic presidential nominee Joe Biden’s healthcare agenda, which — like Medicare — would negotiate prices with hospitals and other providers.

Hey, Healthcare Dive, in contrast to health plans which do negotiate with healthcare providers Medicare imposes prices on providers. Government price fixing leads to disparities like this and it’s far from a good thing.

Thursday Miscellany

David Ermer–CDC, Congress, COVID-19, COVID-19 testing, COVID-19 vaccine, U.S. Healthcare–
Photo by Juliane Liebermann on Unsplash

The FEHBlog heard on a webinar today that the House of Representatives will be releasing their FY 2021 continuing resolution tomorrow. That resolution according to press reports will be acceptable to the Senate and the White House. The FEHBlog will keep an eye out.

In COVID-19 news

  • Fierce Pharma reports that “Moderna reached human testing for its COVID-19 vaccine candidate in record time, and now with its phase 3 trial moving right along, the company is expecting efficacy data in November—likely after Pfizer and BioNTech, but before everyone else.”
  • Fierce Healthcare reports that “CVS Health is planning to double the number of its drive-thru testing sites by mid-October, the healthcare giant announced on Thursday [September 17]. CVS intends to add more than 2,000 sites at its pharmacies in the next several weeks, bringing its total to more than 4,000 nationwide. The new locations will be opened in waves, beginning with 400 new sites opening on Friday. CVS currently offers testing in 33 states and the District of Columbia.”
  • Medscape reports that “Eli Lilly and Co said on Wednesday interim trial data showed its experimental monoclonal antibody treatment reduced the need for hospitalization and emergency room visits for patients with moderate COVID-19. The company said it will discuss the interim results, which have not yet been reviewed by outside experts, with global regulators. A Lilly spokeswoman said discussions with the U.S. Food and Drug Administration are expected to range from additional clinical trials to the possibility of an emergency use authorization.”

Progress. Also a Centers for Disease Control study has confirmed an earlier Wall Street Journal report that widespread flu immunization plus continued use of social measures to prevent the spread of COVID-19 , e.g., social distancing, mask wearing, etc, should lead to an easy flu season in the United States this winter.

In other news, Healthcare Dive provides health insurer CEO insights on 2021. “Though there’s significant uncertainty around the future of the insurance industry, many remarks can be summed up in a line from Cigna CEO David Cordani: ‘We feel bullish on 2021.’ And despite the major role of government in regulating healthcare, most officials seemed agnostic on the presidential election looming in less than two months.” That is certainly encouraging.

Midweek update

David Ermer–Congress, COVID-19 vaccine, Telehealth, U.S. Healthcare–
Photo by Manasvita S on Unsplash

The Federal Times and Govexec.com report that the Senate Homeland Security and Governmental Affairs Committee postponed voting this morning on John Gibbs’ nomination to be Office of Personnel Management Director. Federal employee organizations have publicly opposed his nomination.

It occurs to the FEHBlog that OPM has not had a long acting director since Ambassador John Berry who served in that role for President Obama’s entire first term. Before Mr. Berry the OPM Directors usually lasted one Presidential term. So for the past eight years OPM has mirrored the Washington Football Team’s approach to head coaches and quarterbacks.

Healthcare Dive reports that

Cigna is rebranding its growing health services segment, including pharmacy benefit manager Express Scripts, as Evernorth, the Connecticut-based payer announced Wednesday. The new umbrella brand will encompass Express Scripts, specialty pharmacy Accredo, medical benefit manager Evicore and Cigna’s other health service product lines starting in the third quarter. The rebranding, which has been in the works for months pre-pandemic, is the next evolution of the Cigna-Express Scripts tie-up completed in late 2018, as the combined entity looks to spur more interest in its products from third parties in the industry.

The late U.S. Navy Admiral and Arctic explorer Robert Peary would be pleased.

Healthcare Dive also reports that

  • “CVS Health has struck a deal with Apple to give temporary free access for the health giant’s clients, customers and employees to Apple’s new subscription fitness service.
  • Beneficiaries enrolled in Aetna’s commercial or CVS Caremark’s prescription plans will be offered a free one-year subscription to the feature, called Apple Fitness+. A free two-month subscription will be offered to CVS Pharmacy ExtraCare members and all CVS employees after the service is launched, per Tuesday {September 15]’s release.
  • The announcement coincided with Apple’s unveiling of the subscription service, which offers virtual fitness classes. The tech giant on Tuesday also released the latest model of its Apple Watch, which includes a new blood oxygen level tracker.”

The National Committee for Quality Assurance released yesterday the final report of its Task Force on Telehealth. Here are the task force’s recommendations:

Policymakers should make permanent the following specific COVID-19 policy changes:

Lifting geographic restrictions and limitations on originating sites. Allowing telehealth for various types of clinicians and conditions. Acknowledging, as many states now do, that telehealth visits can meet requirements for establishing a clinician/patient relationship if the encounter meets appropriate care standards or unless careful analysis demonstrates that, in specific situations, a previous in-person relationship is necessary. Eliminating unnecessary restrictions on telehealth across state lines.

Policymakers should look closely at the effect of expanding prescribing authority to telehealth, as authorized by the PHE. They should evaluate what policies and guidelines could be applied to virtual prescribing to ensure patient safety and avoid adverse outcomes.

Policymakers should fully reinstate enforcement of Health Insurance Portability and Accountability Act (HIPAA) patient privacy protections that was suspended at the start of the public health emergency.

The Department of Health and Human Services and the Defense Department announced their COVID-19 vaccine distribution strategy today.

The strategic overview lays out four tasks necessary for the COVID-19 vaccine program:

  • Engage with state, tribal, territorial, and local partners, other stakeholders, and the public to communicate public health information around the vaccine and promote vaccine confidence and uptake.
  • Distribute vaccines immediately upon granting of Emergency Use Authorization/ Biologics License Application, using a transparently developed, phased allocation methodology and CDC has made vaccine recommendations.
  • Ensure safe administration of the vaccine and availability of administration supplies.
  • Monitor necessary data from the vaccination program through an information technology (IT) system capable of supporting and tracking distribution, administration, and other necessary data.

Federal News Network helpfully has created an online payroll deferral calculator for this federal employees and military members who are subject to this COVID-19 relief action.

Monday Roundup

David Ermer–Congress, COVID-19, COVID-19 testing, COVID-19 vaccine, Rx coverage, Telehealth, U.S. Healthcare–
Photo by Sven Read on Unsplash

Becker’s Health IT offers 20 bold health IT predictions for the next five years. Here are the FEHBlog’s favorites:

1. Joel Klein, MD. Senior Vice President and CIO of University of Maryland Medical System (Baltimore): I think at least half of all healthcare in America will be virtual within five years. There are two barriers:

• Payers. They might pay less but if they pay enough, it will be enough. If we can figure out how to solve emergency department visits with widespread, cost effective on-demand care, that will make a difference.
• ‘But I want to see my doctor.’ That might be true for some things, but the convenience factor (especially for tertiary care… especially for millennials…) once you really start doing it overwhelms most of the physical presence upsides.

Edward Lee, MD. CIO of The Permanente Federation (Oakland, Calif.): In five years, physicians will no longer need to manually document their notes into the EHR. Instead, artificial intelligence will capture all the pertinent information from the patient-physician encounter. This will enable physicians to spend quality time with their patients instead of worrying about writing their notes or placing orders in a computer system. Joy and meaning for physicians will increase, physician burnout will decrease, and above all, patient care will improve.

Michael Pfeffer, MD. Assistant Vice Chancellor and CIO of UCLA Health: Health IT will enable each patient to have a unified, interactive view of their health information regardless of place of care or type of clinical data (i.e. phenotypic, genomic, imaging). AI-based apps will help make sense of their data, taking into account social determinants of health and potential health disparities to improve health equity and health literacy. This intelligence will be paired with personal health preferences and data on health provider quality, access, pricing and satisfaction to help patients make truly informed decisions about their care.

Fierce Biotech reports that “Just under a week after it stopped its key phase 3 pandemic vaccine test [due to a safety concern], AstraZeneca and the University of Oxford have been given the green light to restart in the U.K.” What’s more

While AZ and Oxford have been highlighted as [COVID-19 vaccine] race leaders, so too have Pfizer and BioNTech, which said they now want to boost their phase 2/3 trial for one of their five mRNA vaccines, BNT162b2, from around 30,000 to 44,000.

Also over the weekend, the companies said they have asked the FDA for the extra participants in order to include a broader patient population and with plans to include adolescents as young as 16 and people with chronic, stable HIV (human immunodeficiency viruses), hepatitis C or hepatitis B infection to “provide additional safety and efficacy data.”

It said it’s on track to hit its original target of 30,000 patients this week; despite wanting more people, Pfizer said in a statement that it was still on course to deliver data by the end of next month.

CVS Health announced last week that in response to demand created by children returning to school, it has made “children age 12 years and older eligible for testing at the more than 2,000 test sites located at select CVS Pharmacy drive-thru testing locations, starting last Friday, September 11.”

In other news

  • The Washington Post reports that commuting in the Washington DC metropolitan area may not be back to normal until next summer.

Some 430 employers representing about 275,000 workers in the greater-Washington region — stretching from Baltimore to Richmond — participated in the survey conducted Aug. 10 to 28. Their responses offer a snapshot of what companies are thinking as they weigh resuming in-office operations.
A clear majority of Washington-area employers said they are adopting a phased approach to returning to the office, although many said they remain uncertain about the timing of that return. A third of the region’s employers said they don’t know whether they will have their workers back on site by next summer.

  • Govexec.com reports that “The Office of Personnel Management issued a proposed rule [today] that would enable federal agencies to appoint employees in STEM jobs, or positions on temporary or new projects or organizations, for a decade. OPM said the change would give agencies more flexibility when tackling long-term science, technology, engineering and mathematics projects and other non-permanent work. Current regulations require agencies to get special permission from OPM to keep any term employee on staff for longer than four years.” The public comment deadline is November 10, 2020.
  • The House Oversight and Reform subcommittee on government operations held a postal update hearing today. It turns out that the subcommittee’s objective was to be to call the Postmaster General’s qualifications into question. A bipartisan Postal Service Board of Governors selects the Postmaster General, rather than following the usual Presidential appointment followed by Senate confirmation route.

Thursday Miscellany

David Ermer–Congress, COVID-19 testing, COVID-19 vaccine, U.S. Healthcare–
Photo by Juliane Liebermann on Unsplash

The Wall Street Journal reports that the entire Senate Republican caucus, with the exception of Sen. Rand Paul, voted for the scaled down $500 billion (is that an oxymoron?) COVID-19 relief bill, but the bill failed to receive the 60 votes necessary for cloture because the Democratic caucus lined up in opposition. So we have another political issue for the election.

Thankfully, the Congress and the White House have agreed on a continuing resolution to fund the federal government into the new federal fiscal year. The House will be holding votes next week so the FEHBlog expects that the House will pass the continuing resolution and then peace out for the campaign trail. The Senate will hang around as long as it can to approve more nominations. Following the election Congress will hold a lame duck session at which point another COVID-19 relief bill is likely to be enacted.

In healthcare news —

  • The National Academies of Sciences has a detailed web page about social determinants of health that is worth a look.
  • Humana has launched value based hearth surgery and shoulder replacement programs. “””The value-based care models are part of a portfolio of payment bundles created by Humana including a Maternity Episode-of-care Model and an Oncology Model of Care. Humana also offers a Hospital Incentive Program for acute care inpatient admissions. About 2.4 million MA members and 115,000 commercial members are enrolled in value-based models, Humana has said.”
  • Fierce Biotech reports that quick, inexpensive saliva based COVID-19 tests are being piloted at Heathrow Airport in London, England. Send the tests over here.
  • The Wall Street Journal informs us that “health experts say it’s increasingly likely that several [COVID-19] vaccines could pass muster in clinical trials and become available in phases over a period of weeks and months.”

The Centers for Disease Control and Prevention sent documents last week to state officials that lay out various scenarios, including availability of a limited number of doses of two vaccines by the end of October with more doses by the end of the year. The CDC document doesn’t name the two vaccines that could become available but describes characteristics that match those of the vaccines from Pfizer and Moderna.

Experts say multiple vaccines will be needed because no single company can make enough for the whole world. Several companies have signed contracts with the federal government to supply at least 100 million doses of each vaccine in the U.S., and are planning to produce larger global supplies.

Progress.

Tuesday Tidbits

David Ermer–Congress, U.S. Healthcare–

Photo by Patrick Fore on Unsplash

The President’s latest OPM Director nominee John Gibbs will receive a confirmation hearing before the Senate Homeland Security and Governmental Affairs Committee on Wednesday September 9, 2020, at 3:30 pm ET.

In other Senate news, the Majority Leader Mitch McConnell is working his caucus to gain support for a scaled down COVID-19 relief bill according to the Hill. “The GOP proposal includes a $300 per week federal unemployment benefit, another round of Paycheck Protection Program (PPP) funding, $105 billion for schools and an additional $16 billion for coronavirus testing.” “’It’s something I hope 53 Republican senators vote yes on,’ said Sen. Ron Johnson (R-Wis.), adding that Treasury Secretary Steven Mnuchin ‘accommodated’ some of his concerns about the initial GOP bill.”

As for healthcare tidbits:

  • The Centers for Disease Control has posted an extensive set of FAQs on this year flu vaccination program. For example

Q. Are there delays in the availability of flu vaccine?

A. Currently, vaccine manufacturers are not reporting any significant delays in distributing flu vaccine this season. Because a record number of flu vaccine doses are being manufactured this year, the time to produce and distribute them will be longer. CDC will continue to provide weekly updates on total flu vaccine doses distributed throughout the 2020-2021 flu season. Use the VaccineFinder to find out where to get vaccinated near you.

EHR data collected during a patient visit can be leveraged to develop an EHR registry of patients with excessive alcohol use that can be optimized and updated in real-time, Kaiser Permanente researchers reported in the Journal of Medical Internet Research. An EHR registry consisting of patient data could medical professionals address specific high-risk patients. In this case, researchers can utilize the registry to assess alcohol use and recovery methods. Although alcohol abuse is a significant problem in the US, there were no current EHR-integrated registries that assessed these issues.

That was an important gap to fill. It’s good to see the government’s investment in EHR’s paying off.