Midweek Update

U.S. Healthcare

Midweek Update

David Ermer–CMS, Congress, Medical / Rx research, NIH, Rx coverage, U.S. Healthcare–
Thanks to Alexandr Hovhannisyan for sharing their work on Unsplash.

From Capitol Hill, Roll Call reports, “House Republicans narrowly passed legislation Wednesday pairing nearly $4.8 trillion in deficit reduction measures with a debt limit increase into next year — a move they argue should force Democrats to finally negotiate conditions for raising the nation’s borrowing limit.” Time will tell.

Politico explains why and how prescription benefit managers are playing defense on Capitol Hill.

From the U.S. healthcare business front, Healthcare Dive informs us

  • “Kaiser Permanente is acquiring Geisinger Health and forming a new nonprofit to buy and operate other value-oriented nonprofit systems, the organizations announced Wednesday.
  • “The new nonprofit, Risant Health, will operate separately from Kaiser Permanente. Geisinger will become part of Risant but maintain its own name and mission, according to a press release.
  • “Geisinger president and CEO Jaewon Ryu will be CEO of Risant as the transaction closes, subject to regulatory review. Risant will have its headquarters in Washington, D.C.

Both Kaiser and Geisinger are FEHB plan carriers. Kaiser is the third largest carrier in the FEHB Program. Healthcare Dive adds

  • “Kaiser, which reported $95 billion in revenue in 2022, plans to spend $5 billion on Risant over the next five years and add five or six health systems to Risant over that period, according to reports.
  • “Kaufman Hall said recently it expects a “new wave of transaction activity” and a growing number of cross-regional partnerships.
  • “Pennsylvania-based Geisinger has ten hospital campuses and a health plan that covers more than 500,000 members. It has more than 25,000 employees. Both Geisinger and Kaiser reported operating losses last year, as supply and labor expenses rose.

Beckers Payer Issues tells us,

  • “Humana posted a 33 percent increase in profits year over year and added more than 500,000 Medicare Advantage members in the past year, according to its first-quarter earnings posted April 26. 
  • “We’ve had a strong start to the year, with our outperformance underpinned by strong membership growth and favorable inpatient utilization trends in our individual Medicare Advantage business,” CEO Bruce Broussard said. 
  • “The company posted $1.3 billion in net income in the first quarter of 2023, up from $930 million in the first quarter of 2022.”

From the public health front,

  • The National Cancer Institute released a bevy of research articles.
  • The FEHBlog ran across this helpful Johns Hopkins article about U.S infertility statistics,
    • “For the new study, Snow and Trent analyzed data on 53,764 women who participated in the federally supported National Survey of Family Growth (NSFG). While the survey did not ask explicitly about infertility, it contained questions about sexual activity, contraception and pregnancy that were not used in previous studies to estimate infertility rates. It also collected information about sociodemographic and healthcare factors.
    • “Based on the responses, the researchers concluded that the rate of infertility varied slightly from year to year, with a low from 2006 to 2010 of 5.8% and a high between 2017 to 2019 of 8.1%. However, these fluctuations are not considered statistically significant, and the team concluded that overall fertility rates did not significantly change during the study period.
    • “In particular populations, however, infertility rates were significantly higher than average compared with the general population. Women aged 40 to 44 were about 11 times more likely to be infertile than younger women, women who did not complete high school were twice as likely to be infertile as those with higher levels of education, non-Hispanic Black women were 44% more likely to be infertile than women of other races and women who had not recently received sexual health care were 61% more likely to be infertile. Unlike previous studies, the new data did not show a higher rate of infertility for Hispanic women.
  • MedPage Today offers an interview with Dr. Atul Gawande about the importance of palliative care.
  • Medscape identifies emerging cardiovascular disease risk factors.

From the Rx coverage front

Biopharma Dive reports

  • “The Food and Drug Administration has conditionally approved a new ALS medicine in a decision likely to influence how other experimental treatments for the nerve-destroying disease are tested and reviewed.
  • “The medicine, known until now as tofersen, is only for ALS patients who have a specific genetic mutation. Estimates cited by the FDA hold that this group accounts for less than 500 of the roughly 30,000 people in the U.S. with the disease.
  • “Until Tuesday, the few therapies that had secured FDA approval did so because they were shown to help patients live a bit better or a bit longer. Tofersen, which will be sold as Qalsody, is different. It failed the key clinical trial meant to demonstrate it can slow the functional decline associated with ALS, or amyotrophic lateral sclerosis.
  • “Rather, tofersen’s approval hinged on its ability to lower levels of “neurofilament light chain,” a protein that’s drawn increasing interest from ALS researchers. It’s the first ALS drug approved based on so-called “biomarker” data, setting a precedent that could provide another, perhaps faster path to market for some developers.

Biopharma Dive adds

  • “Roche’s new eye drug Vabysmo brought in nearly $500 million during the first quarter, the company said Wednesday. The more than 500% year-over-year sales increase outpaced all other of Roche’s medicines, surpassing top-sellers like the multiple sclerosis treatment Ocrevus and hemophilia therapy Hemlibra.
  • “Vabysmo’s market launch for age-related vision loss comes as one of the first treatments for the condition, Roche’s own Lucentis, faces copycat rivals, and another, Regeneron’s Eylea, could soon.
  • “The strong growth from Vabysmo helped propel a 9% increase in pharmaceutical division sales, which contrasted with a 3% decline in first quarter revenue for the overall business due to lower COVID-19 test sales.”

From the miscellany front —

  • Per the American Hospital Association, “The Centers for Medicare & Medicaid Services today announced changes to its enforcement process for the hospital price transparency rule. CMS said it will now automatically impose a civil monetary penalty if hospitals fail to submit a corrective action plan on time or fail to complete the CAP within 45 days. In addition, the agency will no longer issue a warning notice to hospitals that have not posted any machine-readable file or shoppable services list/price estimator tool, but will immediately ask the hospital to submit a CAP.”
  • The Office of Personnel Management announced
    • its OPM Data Strategy Fiscal Years 2023-2026, which lays out a vision to fully leverage OPM and agency human capital data, and to provide federal agencies, federal employees, and public users seamless access to OPM data products and services. In addition to the overarching strategy, OPM released a set of initial data dashboards to the updated OPM Data Portal at www.opm.gov/data, including FedScope datasets which can now be accessed at www.opm.gov/data/datasets. The OPM Data Portal is a redesigned OPM webpage providing increased access to OPM data products and services.
  • HIMSS posted a wrap-up page from last week’s conference.

Tuesday’s Tidbits

David Ermer–Congress, No Surprises Act, SDOH, U.S. Healthcare–
Photo by Patrick Fore on Unsplash

From Washington, DC

Fierce Healthcare reports

  • “Sens. Bernie Sanders, I-Vermont, and Bill Cassidy, R-Louisiana, reached a deal on new legislation that aims to increase access to generic drugs and impose transparency measures on pharmacy middlemen.
  • “The two senators, the new leaders of the powerful Senate Committee on Health, Education, Labor and Pensions (HELP), said the legislative package will “reform pharmacy benefit managers and expand the availability of low-cost generic drugs.”
  • “The committee will hold a hearing on May 2 to consider the legislative package, which includes four bills.”

Govexec adds

  • “Sen. Tammy Duckworth of Illinois, Reps. Gerry Connolly of Virginia, Eleanor Holmes Norton of Washington, D.C., and Debbie Wasserman Schultz of Florida, all Democrats, and Rep. Nancy Mace of South Carolina, a Republican, [introduced] the Family Building FEHB Fairness Act on Tuesday, marking National Infertility Awareness Week.
  • “Duckworth said the proposed legislation would cover other IVF-related costs and expand coverage to all the different forms of assisted reproductive technology. The most common type of assisted reproductive technology by far is IVF, but there is also gamete intrafallopian transfer, zygote intrafallopian transfer and frozen embryo transfer.” 

The FEHBlog expects that fertility coverage advocates will be pleased with FEHB carrier initiatives for 2025.

From the social determinants of health front —

  • Patient Engagement HIT informs us,
    • The different social determinants of health have different impacts on healthcare quality, utilization, and outcomes, with new Humana data showing that some SDOH are more closely related to poor care quality while others are more closely related to high healthcare utilization.
    • For other SDOH, like social isolation and limited access to transportation, patients experience both poor care quality and high acute care utilization, the JAMA Network Open report showed. * * *
    • This latest study looked at which SDOH have the biggest impact on health and well-being, as measured by care quality and acute care utilization, to better determine effective SDOH interventions going forward.

From the public health front

  • The All of Us Research Program celebrates National DNA Day!
  • Medscape reminds us that unexpected weight loss can be a health warning.
    • “Our study emphasizes the importance of weight loss even in relatively healthy individuals who are free from evident cardiovascular disease (CVD), dementia, physical disability, or life-limiting chronic illness,” first author Monira Hussain, MBBS, MPH, PhD, told Medscape Medical News.
    • “Clinicians should be aware that even minor weight loss of 5% or more in older adults without life-limiting illnesses can increase mortality risk,” Hussain said. “Regular monitoring of weight changes can help early identification of associated risks.”
    • The study was published online April 10 in JAMA Network Open.
  • STAT News tells us, “Consumers turning to melatonin gummies to get some help falling asleep might be getting a lot more help than they bargained for, according to a new study published Tuesday in the Journal of the American Medical Association.”
    • “However, one dietary supplement lobbying group argued that variability in strength of the gummies studied is to be expected, and is often purposefully done by manufacturers to ensure they do not degrade overtime and thereby run afoul of the FDA’s rules. Dietary supplements are required to demonstrate they contain 100% of the listed ingredient until their expiration date, and thus manufacturers will “put an overage in to start to be sure that six months from now that when that consumer buys the product, they’re still getting 100% of what’s on the label,” according to Steve Mister, the CEO of the Council for Responsible Nutrition.
    • “Mister conceded that he did share concerns about two of the products studied — one which included no melatonin and another that included more than 300% of the advertised amount. He maintained, however, that “there is … absolutely nothing in this study that should alarm consumers.”

From the U.S. healthcare business front

  • Fierce Healthcare relates, Health insurer “Centene Corporation posted $1.1 billion in profit for the first quarter of 2023, up from $849 million in earnings in the prior year quarter. The company’s revenue was also up year-over-year, reaching $38.9 billion compared to $37.2 billion in the first quarter of 2022. The numbers fall short of Wall Street analysts’ expectations on profit but exceed their predictions on revenue, according to analysts at Zacks Investment Research.”
  • Per Healthcare Dive,
    • “Tenet Healthcare, one of the largest for-profit hospital operators in the U.S., raised its forecast for full-year profit after posting growth in case volumes that boosted revenue and net income in the first quarter.
    • “The company said on Tuesday that quarterly profit climbed 2.9% from a year earlier to $143 million, beating an earlier forecast that net income would range between $90 million and $125 million in the period..
    • “The earnings results also beat Wall Street revenue estimates, according to SVB Securities analysts. Tenet logged $5 billion in revenue, a 5.8% increase compared to the first quarter of 2022.”
  • Per MedTech Dive,
    • “Labcorp on Tuesday reported a 10% increase in its base business revenue in the first quarter and said the proposed spinoff of its clinical development unit would be completed as expected at mid-year.
    • “The company’s base business benefited from an agreement to manage laboratories for the Ascension health system, Labcorp said. That relationship contributed about 4% of Labcorp’s organic growth in the first quarter, CEO Adam Schechter said on the company’s earnings call.
    • “Labcorp is now managing laboratories in nearly 100 Ascension hospitals, Schechter said. The partnership, established early last year, covers Ascension hospital-based labs in 10 states.”

Axios updates us with developments from the No Surprises Act front.

“What we’re watching: Lawmakers in the House and Senate said they’re planning to conduct oversight of the law, with Republicans focusing on how the Biden administration is implementing it.

  • “Senate health committee ranking member Bill Cassidy (R-La.) noted that “the courts continue to toss out the way that the administration has implemented [the law]. So, oversight hearings, we’re going to have some discussions in the HELP Committee. I think that’s all appropriate.”
  • “A federal judge in Texas has ruled in favor of providers in two of the lawsuits.
  • “Florida Republican Rep. Vern Buchanan, chair of the Ways and Means Health Subcommittee, said the committee would hold a hearing on the topic in June. A GOP committee aide said “the hearing schedule was fluid,” but given the bipartisan interest, “this is a strong potential topic” for a hearing.

“Yes, but: When asked, lawmakers weren’t sure what Congress might be able to do to fix providers’ issues, though some are open to new legislation.”

The FEHBlog is on record favoring that the Administration’s approach to implementing the law in a way that controls healthcare spending.

Monday Roundup

David Ermer–ACA, CMS, Medicare, OPM, Rx coverage, Telehealth, U.S. Healthcare–
Photo by Sven Read on Unsplash

From Washington, DC —

  • The Wall Street Journal reports, “Weight-loss drugmakers are lobbying Congress to grant them access to a monster payday for their blockbuster treatments: Medicare coverage.” At last Thursday’s carrier conference, OPM pointed out a related advantage of the Medicare Part D EGWPs that the FEHBP will offer next year. Although the weight loss drugs may not be on the Medicare formulary, those drugs would be made available to FEHB annuitants via the Plan’s formulary, which can gap-fill the Medicare formulary.
  • CMS announced that the updated MMSE Section 111 GHP User Guide version 6.8 has been posted to the GHP User Guide page on CMS.gov. Refer to Chapter 1 for a summary of updates.”
  • Per Health Payer Intelligence, AHIP launched a marketing campaign targeting Pharma’s prescription drug pricing. “The payer organization stated that prescription drug pricing is out of control and explained health insurance’s role in reducing the impact.”
  • The Department of Health and Human Services proposed a rule to extend ACA marketplace, Basic Health Program, Medicaid, and CHIP coverages to 580,000 DACA recipients.

From the healthcare spending and plan design fronts

  • Fierce Healthcare informs us,
    • “About a year ago, Elevance Health launched a pilot program to offer digital concierge care to members who were recovering from COVID-19 infections.
    • “Since then, the insurer has expanded that initiative to offer concierge care management to members with a number of chronic conditions, including Crohn’s disease, cancer and diabetes. Anthony Nguyen, M.D., the chief clinical officer at Elevance, told Fierce Healthcare that the program was born from a desire to be “more engaging with our members.”
    • “The challenge for not only the programs that we have, the traditional ones, as well as others in the market, is that it’s not personalized,” Nguyen said. “It is not tailored to an ‘n’ of one.”
    • “Greater personalization was built into the foundation of the program, he said. For example, concierge care deploys a nurse matching tool that connects members with a clinician who is likely to connect and resonate well with them, improving the care journey.”
  • and
    • “Healthcare spending declined dramatically in 2020 thanks to the COVID-19 pandemic, but expenditures rebounded the following year, according to new data from the Health Care Cost Institute.
    • “The group released its annual look at cost and utilization trends last week, which found the average health spending for people with employer-sponsored coverage reached $6,457, up 15% from the 2020 average of $5,630. Spending declined by 4% in 2020 as utilization decreased, the researchers said.
    • “John Hargraves, director of data strategy at HCCI, told Fierce Healthcare that the 2020 data are an aberration in the long-term spending trends, which had grown steadily prior to the pandemic.
    • “It’s almost like 2020 is a missing data point in the long-term growth in the healthcare spending and use patterns that we’ve noted,” Hargraves said.”

From the telehealth and fraud waste and abuse fronts, the HHS Inspector General made available a “toolkit intended to assist public and private sector partners—such as Medicare Advantage plan sponsors, private health plans, State Medicaid Fraud Control Units, and other Federal health care agencies—in analyzing their own telehealth claims data to assess program integrity risks in their programs.”

Weekend update

David Ermer–CDC, Congress, COVID-19 vaccine, U.S. Healthcare–
Photo by Michele Orallo on Unsplash

From Capitol Hill, the House of Representatives and the Senate will be in session this week for Committee business and floor voting.

From the Omicron and siblings front, Scientific American discusses how often people should receive the Covid vaccine.

  • “The bivalent booster now available in the U.S. came out in September 2022. It was formulated to cover the COVID-causing virus’s Omicron strains BA.4 and BA.5 and the original strains from 2020. After an initial wave of people received the booster in the fall and early winter, the rate of vaccinations has dropped.
  • “A number of fully vaccinated and boosted people would like another booster for additional protection, Schaffner says, but a much larger population has not yet received any booster at all. Only 16.7 percent of the U.S. population(about 55 million people) have had the latest one—far fewer than officials had hoped. “That’s clearly been a source of considerable disappointment to everyone in public health,” Schaffner says. “The current public health thrust is not to give people an additional booster but to get people to take the firstbivalent booster.”
  • “The CDC says it continues to monitor emerging data but maintains its recommendation of one updated COVID vaccine for eligible people aged six months and older. “Too few people, particularly those who are older and at high risk for severe COVID-19, have taken advantage of getting an updated COVID-19 vaccine. And we encourage eligible individuals to speak with their health care provider and consider receiving one,” says CDC representative Kristen Nordlund.”

From the U.S. healthcare business front —

  • Medscape considers whether doctors will start retiring en masse soon.
    • “The double whammy of pandemic burnout and the aging of baby boomer physicians has, indeed, the makings of some scary headlines. A recent surveyby Elsevier Health predicts that up to 75% of healthcare workers will leave the profession by 2025. And a 2020 study conducted by the Association of American Medical Colleges (AAMC) projected a shortfall of up to 139,000 physicians by 2033.
    • “We’ve paid a lot of attention to physician retirement,” says Michael Dill, AAMC’s director of workforce studies. “It’s a significant concern in terms of whether we have an adequate supply of physicians in the US to meet our nation’s medical care needs. Anyone who thinks otherwise is incorrect.”
  • Revcycle Intelligence discusses healthcare mergers and acquisitions that occurred in the first quarter of 2023.
    • “Healthcare merger and acquisition activity generated $12.4 billion in the first quarter of 2023, marking a significant year-over-year increase, according to a Kaufman Hall report.
    • “The M&A Quarterly Activity Report revealed there were 15 transactions in Q1 2023, down only slightly from the post-pandemic high of 17 in Q4 2022. The number of transactions increased compared to Q1 2022, when 12 deals were announced.
    • “The seller or smaller party had an average revenue of $827 million in Q1 2023, falling below the average size of $852 million in Q4 2022. One mega-merger was announced in Q1 2023—a transaction where the smaller party has an annual revenue exceeding $1 billion. This year’s mega-merger was between New Mexico-based Presbyterian Health Services and Iowa-based UnityPoint Health.”

From the fraud, waste, and abuse front, Fierce Healthcare reports

  • “Eighteen people, some of them practicing medical doctors, were criminally charged with participating in healthcare fraud schemes that exploited the COVID-19 pandemic and allegedly raked in $490 million.
  • “The schemes resulted from false billings to federal programs and theft from federally funded pandemic programs, according to the Department of Justice in a news release.
  • “In the widespread fraud takedown, federal authorities also targeted suppliers of COVID-19 over-the-counter tests who exploited federal partners by shipping tests to patients who did not want or need them. And the feds went after individuals who filed fraudulent claims to the Provider Relief Fund (PRF) and the manufacturers and distributors of fake COVID-19 vaccination record cards.
  • T”wo of the most significant criminal cases in this latest sweep were filed by federal prosecutors in the Central District of California.
  • “Dr. Anthony Hao Dinh allegedly bilked the federal government out of $150 million and he used these fraud proceeds for high-risk options trading, losing over $100 million, according to the Justice Department in an announcement on April 20.

From the healthy living front

  • The Wall Street Journal tells us,
    • “An ounce of prevention may be worth a pound of cure, but medical schools have traditionally given little weight to instruction on how to help patients live healthier lives.
    • “The future could look different as schools and residency training programs have begun to embrace a field known as lifestyle medicine, weaving teaching on nutrition, exercise and other healthy behaviors into the core curriculum of medical education. This new push aims to provide doctors with tools to tackle chronic but often preventable conditions such as heart disease, stroke and diabetes that affect six in ten adults in the U.S.
    • “Incorporating lifestyle medicine into medical-school curricula can resolve the inadequacies that exist in preparing physicians for the growing challenge of chronic disease,” says Jennifer Trilk, professor of biomedical sciences and director of lifestyle-medicine programs at the University of South Carolina School of Medicine Greenville, which in 2017 became the first medical school in the U.S. to incorporate more than 80 hours of lifestyle-medicine training over four years of undergraduate education.”
  • NPR Shots offers an explanation of “Unraveling a hidden cause of [female] UTIs — plus how to prevent them.
  • Fortune Well explains why “a diet rich in certain foods may help protect against miscarriage, new research says. Here’s what to eat—and avoid—if you’re pregnant or trying to conceive.

Friday Factoids

David Ermer–CDC, Congress, COVID-19, End of the PHE, NE, Federal employment benefits, SCOTUS, U.S. Healthcare–
Photo by Sincerely Media on Unsplash

From the end of the PHE front, the CDC’s daily Covid tracker continues to point down; flu activity remains low nationally, and OPM released its end of PHE guidance for FEHB carriers yesterday.

From the post-Dobbs front, the Wall Street Journal reports,

  • “The Supreme Court on Friday allowed the widely used abortion pill mifepristone to remain on the market indefinitely, granting emergency requests from the Biden administration and the brand-name manufacturer of the drug.
  • “The high court blocked the effect of a lower-court order that was poised to limit access to the pill, which is used in more than half of U.S. abortions. The Supreme Court’s action wasn’t a decision on the merits of the case; instead, the justices were deciding whether the pill could remain available during a continuing legal challenge brought by antiabortion groups.
  • “The court’s order was unsigned and provided no reasoning, as is typical in emergency actions. But it indicated that FDA-approved access to mifepristone would remain until litigation concludes in the lower courts and the Supreme Court itself has an opportunity to review those decisions—a timeline that likely will take many months.”

From the U.S. healthcare business front —

  • STAT News informs us,
    • Patient volumes are back in a big way, at least for the country’s largest for-profit hospital operator.
    • HCA Healthcare beat Wall Street’s expectations of profitability in the first quarter of 2023, as more people flocked to HCA’s hospitals, surgery centers, and physician clinics. Inpatient admissions, all types of surgeries, and emergency room visits were each up significantly in the first quarter of this year, compared with the same period last year, when the Omicron variant of the coronavirus stymied a lot of patient care.
  • The American Hospital Association adds,
    • Financial reserves play an important role for not-for-profit hospitals and health systems in ensuring that they can continue to serve their communities in the face of challenging operational and financial headwinds, according to a new report prepared for the AHA by Kaufman Hall. The report explains how financial reserves enable struggling not-for-profit hospitals and health systems to make needed investments, borrow at affordable interest rates, cover operating expenses and remain available to their communities as surging labor and supply costs, investment losses and other challenges persist. 

From Capitol Hill, STAT News reports,

  • Amid a scramble to assemble a health care policy package in the Senate, a pair of key senators have significantly changed a proposal to cap insulin costs.
  • The new legislation by Senate Diabetes Caucus co-chairs Sens. Jeanne Shaheen (D-N.H.) and Susan Collins (R-Maine) would cap insured patients’ insulin costs at $35 per month for at least one insulin of each type and dosage form, and require pharmacy benefit managers to pass through rebates they collect from insulin manufacturers to the insurance plans that employ them.
  • The legislation also includes several provisions related to biosimilar policy. The bill would create a new, expedited pathway for the Food and Drug Administration to consider biosimilars that would be alternatives to biologics without adequate competition and would allow Medicare drug plans to put biosimilars on their formularies as soon as they come on the market.
  • That is a major shift from the version of the bill that the senators released last year, which was structured differently around offering incentives to get drug manufacturers to voluntarily lower the prices of insulin.

Politico discusses a bipartisan bill to shift some Medicare coverage to home.

From the miscellany front, Healthcare Dive offers a potpourri of wrap-up stories on the HIMSS conference that ended yesterday.

    Thursday Miscellany

    David Ermer–Congress, Medical / Rx research, OPM, Rx coverage, Telehealth, U.S. Healthcare–

    Today was the belated second day of the OPM AHIP FEHB carrier conference. We learned this afternoon:

    • OPM has requested contractor proposals for its Postal Service Health Benefits Program (PSHBP) enrollment system.
    • OPM has created a new Carrier Connect system to receive PSHBP applications and benefit and rate proposals from carriers.
    • The new system will be available to receive PSHBP applications beginning June 26, 2023, and ending August 31, 2023, for the inaugural PSHBP year 2025.
    • OPM will release decisions on those applications in November 2023.
    • All cross-over enrollments to the PSHBP will become effective on January 1, 2025.

    OPM also discussed its well-received initiative to allow FEHB carriers to offer integrated Medicare Part D prescription drug plans for 2024. These Part D EGWPs will be features of all PSHB plans beginning in 2025.

    From Capitol Hill, Politico reports

    • “President Joe Biden immediately rejected Kevin McCarthy‘s opening debt-limit proposal, but it prompted movement elsewhere: A growing number of House Democrats want party leaders to restart negotiations.
    • “The party is still firmly behind Biden and Senate Majority Leader Chuck Schumer, who declared the speaker’s pitch dead on arrival in the upper chamber, in the position that Congress should raise the debt ceiling without any conditions. But a growing contingent of Democrats are acknowledging that Biden’s blanket refusal to engage with McCarthy may need to change — especially if House Republicans manage to pass their bill as planned next week.”

    A Senate Finance Committee press release informs us, “Senate Finance Committee Ranking Member Mike Crapo (R-Idaho) and Chair Ron Wyden (D-Oregon) released a bipartisan framework that the Committee will use to pursue legislative solutions to modernize and enhance federal prescription drug programs, with the goal of reducing drug costs for patients and taxpayers.”

    STAT News adds, “A legislative package of mostly drug pricing policies is coming together in the Senate, and these policies were not expected to be part of it, four drug lobbyists said. It seems to be an effort by Finance Chair Ron Wyden (D-Ore.) to play catch-up, in an effort to be included in the package that Senate Majority Leader Chuck Schumer is pulling together.”

    Also from Washington DC —

    • STAT News tells us
      • “President Biden will nominate oncologist Monica Bertagnolli, director of the National Cancer Institute, to lead the National Institutes of Health, three people familiar with the White House’s plans told STAT.
      • “Bertagnolli last fall became the first woman to direct NCI, the largest of the NIH’s 27 departments, amid the president’s efforts to relaunch the Cancer Moonshot with the goal of halving cancer deaths and vastly curbing new cases.”
    • The U.S. Preventive Services Task Force is making progress in reevaluating the incomplete grade given to screening for partner violence or abuse of older and vulnerable adults.
    • Health Leaders Media points out
      • “CMS recently released the fiscal year 2024 inpatient prospective payment system proposed rule, and with it came the annual proposed ICD-10-CM diagnosis code changes which include new codes to enhance the tracking and progression of Parkinson’s disease and more reimbursement for certain social determinates of health (SDOH).
      • “The proposed rule includes 395 additions, 12 revisions, and 25 deletions to the ICD-10-CM diagnosis code set. If finalized, these changes will take effect October 1.
      • “Of the 395 new ICD-10-CM codes, 123 of them are external cause codes to capture accidents and injuries. CMS also proposes 36 new codes for osteoporosis with current pathological pelvic fracture.”

    In studies news

    • Health Affairs informs us
      • “Hospitals must disclose their cash prices, commercial negotiated rates, and chargemaster prices for seventy common, shoppable services under the hospital price transparency rule. Examining prices reported by 2,379 hospitals as of September 9, 2022, we found that a given hospital’s cash prices and commercial negotiated rates both tended to reflect a predetermined and consistent percentage discount from its chargemaster prices. On average, cash prices and commercial negotiated rates were 64 percent and 58 percent of the corresponding chargemaster prices for the same procedures at the same hospital and in the same service setting, respectively. Cash prices were lower than the median commercial negotiated rates in 47 percent of instances, and most likely so at hospitals with government or nonprofit ownership, located outside of metropolitan areas, or located in counties with relatively high uninsurance rates or low median household incomes. Hospitals with stronger market power were most likely to offer cash prices below their median negotiated rates, whereas hospitals in areas where insurers had stronger market power were less likely to do so.”
    • The All of Us Program offers its research roundup.

    From the U.S. healthcare business front, Fierce Healthcare reports

    • “Express Scripts is rolling out new programs that aim to better support independent pharmacies in rural areas.
    • “The pharmacy benefit management giant said Thursday that the IndependentRx Initiative is designed to build on a slew of recently announced updates to its model that put a focus on greater transparency. The PBM said it will boost reimbursement to independent pharmacies that are the only location within 10 or more miles of an Express Scripts customer.
    • “This includes growing incentive-based programs that pay for performance, such as when a pharmacy dispenses 90-day prescriptions to improve medication adherence.
    • “The PBM added that these pharmacies will have greater opportunities to participate in its retail pharmacy network.”

    From the telehealth front, mhealth Intelligence observes

    • “Published in the American Journal of Drug and Alcohol Abuse, new data shows that patient retention rates following the implementation of telehealth for opioid use disorder (OUD) treatment were higher than those for in-person care.
    • “According to the Centers for Disease Control and Prevention (CDC), about 2.7 million people in the US have OUD, and overdoses appeared to have increased during the COVID-19 pandemic.
    • “However, the pandemic allowed physicians to explore new methods of providing care, including telehealth. To assess the efficacy of treating OUD through telehealth, a digital provider of medication-assisted treatment (MAT), Ophelia Health, conducted a study that assessed patient 180-day and 365-day retention rates.”

    From the miscellany front

    • The Wall Street Journal offers its occasional Future of Healthcare series.
    • Kaiser Family Foundation provides a resource to answer “Key Questions About Implementation of the Medicare Drug Price Negotiation Program.”
    • Here’s a final HIMSS report from the last day of the conference.

    Midweek Update

    David Ermer–Congress, Electronic health records, HSA, No Surprises Act, Rx coverage, U.S. Healthcare–
    Thanks to Alexandr Hovhannisyan for sharing their work on Unsplash.

    From Washington, DC —

    Roll Call brings us up to date on the debt ceiling issue. “House Republicans unveiled legislation Wednesday to pair their favored spending cuts and energy and regulatory policies with a debt limit increase lasting through early next year.” “Measure viewed as a ‘conversation starter’ with government cash crunch seen as early as June.”

    The Wall Street Journal informs us that the U.S. Supreme Court extended its stay of an injunction restricting sales of an abortion pill from midnight tonight to midnight Friday.

    • “The justices have three primary options. They could grant the emergency requests and leave mifepristone on the market indefinitely during litigation, which could preserve the status quo for many months. They could leave the pill in place temporarily and agree to review the case in full, even though lower courts aren’t done reviewing it. Or they could deny the emergency appeals outright.” 

    As anticipated, Health Affairs Forefront has posted here and here helpful articles explaining the final 2024 Notice of Benefit and Payment Parameters released earlier this week.

    From the U.S. healthcare business front —

    • Beckers Payer Issues tells us,
      • Elevance Health posted double-digit revenue growth and beat investor expectations in the first quarter of 2023, according to the company’s earnings report published April 19.
      • “Elevance Health is off to a strong start in 2023, driven by our continued focus on whole health and advancing health beyond healthcare,” President and CEO Gail Boudreaux said.
    • Beckers Hospital Review adds,
      • Mark Cuban is creating an independent pharmacy network to “serve patients more widely” after pitching the idea to local pharmacy owners in February. 
      • Mark Cuban Cost Plus Drug Co. has operated as a mail-order, online pharmacy since January 2022, but with its latest endeavor, the business is looking to expand access to its portfolio of more than 1,000 prescription drugs.
      • The collaboration between independent pharmacies and Cost Plus Drugs includes a “Team Cuban Card,” which acts like an insurance card at pharmacy checkouts. 
      • Independent pharmacists interested in partnering with Cost Plus Drugs were asked to complete an interest form with the company detailing the type of pharmacy they run and how patients access the services offered. So far, Cost Plus Drugs has 36 affiliate locations, with five in Florida, seven in Indiana, six in New Jersey and 18 in Texas. The company said it will add new sites every month.
      • This is part of a larger movement to prevent more local pharmacy closures, Mr. Cuban told Becker’s. 
    • STAT News reports
      • Because Johnson & Johnson is the largest healthcare company in the world, its financial fortunes tend to be a bellwether for the industry at large. And parsing J&J’s positive results from the last quarter, released yesterday, analysts see hope that the pharmaceutical business is in good shape despite a difficult macroeconomic environment.

    From the HIMSS conference —

    • Med City News shares a conference presentation by “Glen Tullman — CEO of care navigation company Transcarent, as well as former CEO of Allscripts and Livongo. Mr. Tullman discussed what he thinks the future of healthcare will look like during the HIMSS conference in Chicago. He laid out five predictions, including an increased focus on consumer expectations and more investment in AI.”
    • Fierce Healthcare points out
      • Companies like Best Buy and VillageMD are disrupting the traditional healthcare industry by bringing a more consumer-centric approach to providing medical services.
      • During a keynote address Wednesday morning at HIMSS23, executives at these so-called “disrupters” shared their vision for the future of care delivery.
    • You will find HIMSS links to its sessions here and here.

    From the Rx and medical test coverage front —

    • The Institute for Clinical and Economic Research issued a white paper
      • Evaluating Best Practices and Potential Reforms for White Bagging, Brown Bagging, and Site of Service Policies that Seek to Address High Markup in Drug Prices
        • — White bagging, brown bagging, and site of service policies developed by payers can reduce significant markup costs for clinician-administered drugs but have sparked concerns and legislative action related to their impact on patients and providers —
        • — White paper evaluating best practices and potential policy reforms was informed by input from a diverse set of hospitals, provider groups, and payers.
    • Medscape delves into the debate over the optimal time period for using weight loss drugs.
    • The Wall Street Journal examines new blood tests that offer early detection of cancers and Alzheimer’s Disease.
      • “Questions include who should be getting them, and what patients should do about positive results.”

    From the miscellany front —

    • Fierce Healthcare informs us, as the FEHBlog expected,
      • The federal No Surprises Act “appears” to be effectively protecting patients from the most frequent sources of unexpected medical bills, though several coverage gaps such as those relating to ground ambulance services are still leaving some patients with hefty bills, according to a new qualitative report.
      • To get a read on the consumer protection legislation after a full year of implementation, researchers from the Urban Institute and Georgetown University’s Center on Health Insurance Reforms, with backing from the Robert Wood Johnson Foundation, interviewed 32 regulators and stakeholders representing consumers, payers, hospitals, billing companies and other relevant industry subsectors.
      • These informants “largely agreed that consumers are being well protected from surprise balance bills covered under the law,” researchers wrote in the report.
    • Health Payer Intelligence notes
      • Many consumers would be interested in a type of account that was like a health savings account (HSA) in its construction but able to be attached to plans other than high deductible health plans (HDHPs), a survey from Employee Benefit Research Institute (EBRI) stated.
      • “We decided to test enrollee interest in a new type of health account similar to an HSA. Like an HSA, the new health account could be funded by both workers and employers, could be invested in the stock market, and would be portable from job to job. Earnings would grow tax free, and contributions would be capped,” the EBRI researchers explained.
      • “Unlike an HSA, this new health account would not have to be paired with a high-deductible health plan; it could be paired with any health plan.”
    • “AHIP released the latest version of its comprehensive, biennial report, Health Coverage: State-to-State 2023, which analyzes health coverage and health insurance provider industry employment for all 50 states and the District of Columbia.”

    Tuesday’s Tidbits

    David Ermer–COVID-19, COVID-19 vaccine, Electronic health records, FDA, Federal employment benefits, Rx coverage, U.S. Healthcare–
    Photo by Patrick Fore on Unsplash

    From the public health front

    The Wall Street Journal reports

    • Americans seeking messenger RNA vaccines for Covid-19 for the first time will get one, updated shot targeting both the Omicron variant and the original strain of the virus under new moves rolled out Tuesday by federal health officials. 
    • The Food and Drug Administration also authorized a second booster of the updated shots for people at high risk of Covid-19, specifically people 65 years and older or people who have weak immune systems.
    • The agency’s actions mark the latest tweaks to Covid-19 vaccines, and could be followed up by further efforts to simplify the complicated vaccination regimen, perhaps by enshrining plans for a once-a-year shot for most people.
    • “The agency believes that this approach will help encourage future vaccination,” said Dr. Peter Marks, head of the FDA’s division that oversees vaccines. “Covid-19 continues to be a very real risk for many people, and we encourage individuals to consider staying current with vaccination.”

    The U.S. Preventive Services Task Force maintained its I or incomplete grade for “visual skin examination by a clinician to screen for skin cancer in adolescents and adults.” In other words, USPSTF concluded that the current evidence is insufficient to assess the balance of benefits and harms of this screening examination.

    The Department of Health and Human Services made available a readout from the Secretary’s roundtable on Black maternal health.

    • One critical action the Administration has taken to move the needle was implementing the state option to extend Medicaid’s postpartum coverage from two months to twelve months, a lifesaving opportunity made possible by President Biden’s American Rescue Plan (ARP) and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023), which President Biden signed into law earlier this year. So far, 31 states and DC have signed on. Congresswoman Robin Kelly – who also sponsors the MOMMA’s Act, which aims to prevent maternal mortality – helped champion this extension. 
    • Participants who lead community organizations helped shine a light on what effective, scalable solutions can look like, and the outcomes speak for themselves.
    • Jennie Joseph shared that by removing barriers to care for women at higher risk for maternal mortality and morbidity, her organization has never had a mother or baby die in 25 years, and of the 1,200 patients served since 2020, only five babies were born premature.
    • Aza Nedhari remarked that her organization’s Home Visitation Program, which provides expectant and new parents with culturally congruent comprehensive home visiting services during pregnancy and postpartum, has supported over 2,000 families and has facilitated a zero percent mortality rate since 2015.

    From the obesity treatment front

    Healthcare Dive tells us.

    • Telehealth giant Teladoc Health is expanding its physician-based care product for employers to weight management and prediabetes, as interest explodes in drugs meant for diabetes control that are being more frequently prescribed for weight loss, resulting in nationwide shortages.
    • The medications, called GLP-1 drugs, include Novo Nordisk’s Ozempic, which has been at the center of a national conversation about health, weight loss and medication access as more people, especially celebrities, use the drug to lose weight.
    • The provider-based program, which includes access to a Teladoc-employed doctor for a personalized care plan, along with daily coaching with digital tools, will become available for diabetes prevention and weight management in the third quarter, the company told Healthcare Dive.

    Beckers Payer Issues adds.

    • UnitedHealth Group CEO Andrew Witty told investors [last week] it is “good news” that there are innovations being made in weight management. 
    • “We need to get focused on the facts and reality of this marketplace. We need to really be clear about which patients really do benefit from these medicines and make sure we properly understand how they’re going to use those medicines,” Mr. Witty said. “So there’s a lot still to learn, I think, as these things progress through their final phases.”

    From the interoperability front

    • HIMSS reports on its sessions held today.
    • The American Hospital Association relates.
      • About 84% of hospitals had posted a machine-readable file containing rate information by the end of first-quarter 2023, up from 65% the previous quarter, according to a report released today by Turquoise Health. The report also found that 183 commercial health insurers representing over 95% of U.S. commercially insured lives were publishing machine-readable files of their in-network negotiated rates and out-of-network allowed amounts, up from 68 in July 2022.

    From the U.S. healthcare business front

    • The Wall Street Journal reports
      • Hospitals are joining the gig economy. 
      • Some of the nation’s largest hospital systems including Providence and Advocate Health are using apps similar to ride-hailing technology to attract scarce nurses. An app from ShiftKey lets workers bid for shifts. Another, CareRev, helps hospitals adjust pay to match supply, lowering rates for popular shifts and raising them to entice nurses to work overnight or holidays.
      • The embrace of gig work puts hospitals in more direct competition with the temporary-staffing agencies that siphoned away nurses during the pandemic. The apps help extend hospitals’ labor pool beyond their employees to other local nurses who value the highly flexible schedules of gig work. 
      • The shift is among many ways hospitals are revamping hiring, schedules and pay to give nurses more control and to fill staffing gaps created by persistent labor shortages. Vacancies are straining many hospitals’ operations despite recent hiring gains at hospitals and reports of softer demand from some temporary-staffing companies.
    • Healthcare Dive informs us
      • Pharmacists are arguing they should play a more active role in care teams by being allowed to practice the full scope of their license, according to comments at the HIMSS conference in Chicago.
      • Nearly half of U.S. counties have shortages of primary care providers, with just one of those doctors for every 1,500 people, while 61% of those counties have a high volume of retail pharmacy locations that could help make up the deficit, according to new data from health IT network Surescripts.
      • But pharmacists at HIMSS say they need access to a greater range of medical data to get there.
    • OPM held a session on this topic on the first day of its FEHB carrier conference on March 29.
    • Beckers Payer Issues reports
      • CVS Health has named Brian Kane as executive vice president and president of Aetna, effective September 1.
      • Mr. Kane will report directly to CVS President and CEO Karen Lynch. He is replacing Daniel Finke, who is stepping down for health reasons, according to an April 17 news release.

    From the tidbits/miscellany department

    • The National Association of Letter Carriers calls attention to the fact that the Postal Service has issued Postal Service Health Benefits Program fact sheets for Postal employees and annuitants.
    • The Drug Channels blog makes ten predictions about how the Inflation Reduction Act will impact market access and drug channels.
    • Govexec predicts expanded childcare options and higher pay for childcare workers based on an executive order that the President signed today.

    Monday Roundup

    David Ermer–ACA, CDC, CMS, FDA, Medical / Rx research, Rx coverage, U.S. Healthcare–
    Photo by Sven Read on Unsplash

    The HIMSS conference is being held this week in Chicago. The HIMSS organization is providing the publich with morning and afternoon session updates.

    From the regulatory front, the Department of Health and Human Services released the final 2024 Notice of Benefit and Payment Parameters which is applicable to qualified health plans in the marketplaces.

    From the US healthcare business front

    • Healthcare Dive reports
      • Hospital and health system merger and acquisition activity remained consistent in the first quarter of 2023 with 15 healthcare industry transactions, a slight drop from 17 in the fourth quarter of 2022, according to a new report from hospital consultancy Kaufman Hall. The 15 transactions comprised $12.4 billion in total transacted revenue, down from the high of $12.7 billion in 2018.
      • Mergers and acquisitions are trending toward cross-regional partnerships, and the size of the smaller party in mergers is increasing to between $250 million and $750 million in annual revenue, according to the report.
      • Realignment of for-profit health system portfolios continued in the first quarter of 2023, particularly for high financial and operational performing health systems.
    • AHIP issued a report finding that hospital markups on specialty drugs cost patients thousands of dollars.
    • Beckers Hospital CFO Reports identifies 22 US hospitals that are cutting care.
    • Beckers Payer Issues informs us that
      • UnitedHealthcare’s plans to implement a gold-card program in 2024 might cut another 10 percent of its prior authorization volumes on top of a 20 percent reduction that will roll out this summer, UnitedHealthcare CEO Brian Thompson said during UnitedHealth Group’s April 14 earnings call, which was transcribed by Seeking Alpha.
      • The payer plans to implement the national gold-card program in early 2024 for care provider groups that meet eligibility requirements, according to a March 29 company news release. The gold-card status applies for most UnitedHealthcare members across commercial, Medicare Advantage and Medicaid. 
      • Qualifying care provider groups “will follow a simple notification process for most procedure codes rather than the prior authorization process,” according to the release. 

    From the public health front, Medpage Today reports

    • Chronic pain continued to affect more than one in five U.S. adults, new CDC survey data showed.
    • During 2021, an estimated 51.6 million adults (20.9%) had chronic pain lasting 3 months or longer, and 17.1 million (6.9%) had high-impact chronic pain — pain severe enough to restrict daily activities — reported S. Michaela Rikard, PhD, of the CDC’s National Center for Injury Prevention and Control, and co-authors.
    • Pain prevalence was higher in adults who were American Indian or Alaska Native, who identified as bisexual, or who were divorced or separated, the researchers said in Morbidity and Mortality Weekly Report.

    From the Rx coverage front, the Institute for Clincical and Economic Research released a Final Evidence Report on Lecanemab for Alzheimer’s Disease.

    • — Independent appraisal committee voted that currently available evidence is not adequate to demonstrate a net health benefit for lecanemab when compared to supportive care —
    • — Using best estimates from current data, ICER analyses suggest lecanemab would achieve common thresholds for cost-effectiveness if priced between $8,900 – $21,500 per year —
    • — Manufacturers should release all patient-level data to help patients, clinicians, researchers, and regulators understand more about the link between amyloid reduction and cognitive outcomes

    Lecanemab is an FDA approved drug that the CDC is considering for Medicare coverage beyond clinical testing. The VA has agreed to cover FDA marketing label uses for the drug in its patient population which overlaps with FEHBP.

    From the medical research front, a National Institutes of Health study outlines “opportunities to achieve President Biden’s Cancer Moonshot goal of reducing cancer death rates in the United States. Accelerated progress is needed to achieve Cancer Moonshot goal of cutting the age-adjusted cancer death rate by at least 50% over 25 years, NIH study says.”

    • The study was conducted by researchers in NCI’s Division of Cancer Epidemiology and Genetics, the Center for Cancer Research, and their collaborators, using data from NCI’s Surveillance, Epidemiology, and End Results (SEER) Program and the Centers for Disease Control and Prevention’s National Center for Health Statistics. The researchers examined trends in age-standardized cancer incidence, survival, and mortality rates from 2000 to 2019 for all cancers combined, as well as for the six cancers that together account for 57% of cancer deaths: lung, colorectal, pancreatic, breast, prostate, and liver. They then projected the overall cancer death rate in 2047 based on the assumption that current trends would continue.
    • According to their analysis, because of decreasing cancer incidence and improvements in survival, age-adjusted death rates from all cancers combined declined by 1.4% per year from 2000 to 2015 and by 2.3% per year from 2016 to 2019. These declines reflect substantial reductions in deaths from lung cancer (-4.7% per year during 2014–2019), as well as colorectal cancer (-2.0% per year during 2010–2019) and breast cancer (-1.2% per year during 2013–2019).
    • Trends in prostate, pancreatic, and liver cancer death rates have been less promising. Death rates from prostate cancer had declined strongly (-3.4% per year during 2000–2013), but the decline has slowed (to -0.6% per year during 2013–2019). Death rates from pancreatic cancer have been increasing (0.2% per year during 2006–2019). Death rates from liver cancer, which had been increasing for decades, recently began to decline (-0.5% per year during 2016–2019). Death rates from all other cancer types combined have declined (-1.7% per year during 2016–2019).

    Weekend Update

    David Ermer–Congress, End of the PHE, NE, Medical / Rx research, OPM, U.S. Healthcare–
    Photo by Michele Orallo on Unsplash

    The Senate and the House of Representatives return to Washington, DC for Committee business and floor voting tomorrow.

    On Thursday, April 20, OPM will hold the postponed second day of the OPM AHIP FEHB Carrier Conference. Of course, the FEHBlog will be in attendance.

    Federal News Network tells us

    • “Just 19 of the 74 agencies in the 2022 Best Places to Work in the Federal Government rankings either held steady or improved their employee engagement score.
    • “But among many declining trends in the Partnership for Public Service’s results, some agencies still managed to shine.
    • “When we look at these averages, I think it’s so much more powerful when we pull apart and look at the variation across government and within agencies,” said Max Stier, the Partnership’s president and CEO, at a Best Places to Work ceremony Wednesday.”

    From the regulatory front, the Department of Health and Human Services announced its plan to continue PREP Act liability protections related to Covid testing, preventive services and treatments well beyond May 11.

    From the U.S. healthcare business front

    • Beckers Payer Issues lists 100 things to know about the Blue Cross Blue Shield system.
    • The Wall Street Journal reports “Merck & Co. said it agreed to acquire Prometheus Biosciences Inc. for $10.8 billion, a push into the lucrative market for immune-disease treatments.”
    • Healthcare Dive discusses the financial condition of non-profit hospitals.

    From the medical research front, The Wall Street Journal informs us

    • “Moderna Inc. and Merck & Co.’s cancer vaccine helped prevent relapse for melanoma patients, results from a midstage trial showed, demonstrating progress in the pursuit of shots to ward off cancer by jump-starting the immune system. 
    • “About 79% of high-risk melanoma patients who got the personalized vaccine and Merck’s immunotherapy Keytruda were alive and cancer-free at 18 months, compared with about 62% of patients who received immunotherapy alone, researchers said Sunday. The 157-person trial offers some of the strongest evidence yet that such vaccines could benefit cancer patients. 
    • “I am fairly encouraged that this will open up a whole new set of trials,” said Jeffrey Weber, the senior investigator on the trial and deputy director of the Perlmutter Cancer Center at NYU Langone Health.”

    From the artificial intelligence front, NPR discusses efforts to use AI to improve a volunteer driven app for the visually impaired called Be My Eyes.

    • “Hans Jørgen Wiberg, a Danish furniture craftsman, created the app after he got tired of calling his friends and family to ask for help identifying things. (Wiberg is visually impaired.) He spent a couple years developing it, and the app launched in 2015. 
    • “But eight years later, there’s a twist. As artificial intelligence, or AI, becomes more accessible, app creators are experimenting with an AI version using tech as well as human volunteers. Be My Eyes CEO Mike Buckley says the argument for AI is that it can do things people cannot. 
    • “What if the AI ingested every service manual of every consumer product ever?,” says Buckley. “And so you could tap into the AI and say, ‘How do I hook up my Sony stereo?'” Furthermore, Buckley says, “we took a picture of our refrigerator and it not only told us what all the ingredients were but it told us what we could make for dinner.”

    Nifty.

    Fortune Well identifies “The five best supplements for healthy aging, according to a longevity expert.” The article notes “If you’ve ever walked down the supplement aisle in a pharmacy, you’ve seen the overwhelming abundance of options available for your medicine cabinet. According to the 2022 Council on Responsible Nutrition Consumer Survey on Dietary Supplements, 75% of Americans use dietary supplements, most on a regular basis.” By the way, the five best are

    • Calcium for bone strength
    • Vitamin D for immunity and bone strength
    • Probiotics for gut health
    • Magnesium for mood, and
    • Multivitamins to cover the bases.