Weekend update

Weekend update

Both Houses of Congress are on break this week for the Thanksgiving holiday.

We will be half way through the current Federal Benefits Open Season in the middle of this coming week. Open Season ends on December 14.

Believe or not, there was one more HHS final rule issued last Friday on top of three others discussed in Friday Stats and More. The Centers for Medicare and Medicaid Services “finalized a rule that is designed to increase the supply of lifesaving organs available for transplant in the United States by requiring that the organizations responsible for organ procurement be transparent in their performance, highlighting the best and worst performers, and requiring them to compete on their ability to successfully facilitate transplants.”

Healthcare Dive reports that even though COVID-19 hospitalizations have been surging in the our country at least the large hospital chains are weathering this COVID-19 storm better than the earlier surges this year.

Top executives from hospital chains Tenet and UHS said that’s because there aren’t as many unknowns as in the previous coronavirus surge earlier this year, speaking this week at Wolfe Research’s virtual healthcare conference.

“Yes, we are seeing increases across the country. Clearly that is what you read, but it’s not anywhere near where we’re not able to handle it,” Tenet CEO Ron Rittenmeyer said Wednesday.

Tenet has more facilities in Texas than any other state, and reports on the ground there paint a far more harrowing picture, though. Hospitals across the country say they are overrun, and some have had to halt or pare back on elective procedures to ensure they have enough staff and equipment to care for COVID-19 patients.

​For UHS’ acute care hospitals, the second wave around the July timeframe was much worse than what they’re experiencing today, CFO Steve Filton said Thursday — though UHS does have two hospitals, both in Texas, with record levels of COVID-19 patients.

The Wall Street Journal reports that

The billionaire Walton family that controls Walmart Inc. is among a group of investors backing a startup aiming to design at-home Covid-19 tests to sell for as little as $10 at the retail giant’s stores and elsewhere.

NowDiagnostics Inc., based 20 miles south of Walmart’s corporate headquarters, has filed requests for emergency authorization from the U.S. Food and Drug Administration for a Covid-19 antibody blood test, according to the Springdale, Ark., company.

It is also developing two at-home Covid-19 tests that would use a patient’s saliva and deliver results in minutes, said Chief Executive Kevin Clark. One of those would be an antigen test that looks for virus proteins to diagnose an active infection and the other an antibody test, which looks for an immune response that can signal a previous infection. None of the tests have been authorized by the FDA for use.

The Boston Globe offers this attention-grabbing quote (and more)

“The [COVID-19] virus is not likely to go away, maybe ever, but certainly not for a long time,” said Dr. Ashish Jha, dean of the Brown University School of Public Health. “But that said, we’re not going to be living like this forever, and in fact, I expect by springtime that things will start really getting much, much better [due to the Pfizer / BioNTech and Moderna vaccines]. And then it’ll continue to get better. And at some point, we will no longer feel like we’re living in the middle of a pandemic.”

Though experts varied on how quickly these things might happen, with some saying it could be summer before a shift toward normalcy begins, all agreed on the rough outline: As vaccination increases, major outbreaks will decrease in size and frequency and restrictions will gradually lift.

Our new normal will not be without its reminders of the pandemic, experts said. A high level of public health surveillance will be crucial to monitoring and preventing outbreaks. Taking a rapid test before eating out or starting work could well be part of our new normal. And because COVID-19 could recede at different times in different countries based on vaccine availability, travel screening and some level of international border restrictions could remain in place for years to come.

In this regard, the Wall Street Journal opines that “Even after a Covid-19 vaccine, changes to how we shop, dine, work out and entertain ourselves are likely to endure.”

As marketers of new technologies can tell you, the hardest part is getting people to adopt new ways of doing things. But this tendency also means that new innovations can be sticky: Once a habit is established, it’s not easily broken.

During the pandemic, 10 years of consumer adoption of e-commerce was compressed into three months, according to a recent survey by McKinsey. Adoption has varied by age, since younger people were already more likely to shop—and do everything else—online. A survey just out from digital consultancy Mobiquity found a 47% increase in the number of baby boomers reporting they had ordered delivery from a restaurant through a website or app; a 193% increase in the number ordering groceries through a website or app; and a 469% increase in the number who had used telemedicine. Nearly 9 in 10 boomer respondents said they’ll continue to use such technologies even after the pandemic ends.

Count this boomer in.

Midweek update

Photo by Manasvita S on Unsplash

More good COVID-19 vaccine news today. The Wall Street Journal reports that following up on Monday’s favorable initial report on the phase three study of their COVID-19 vaccine, Pfizer and BioNTech announced the final report on that study.

Pfizer Inc. said it will ask health regulators to authorize its experimental Covid-19 vaccine within days, after reporting the shot was 95% effective in its pivotal study and showed signs of being safe. The company’s plans, announced Wednesday, mean the shot is on track to go into distribution by the end of the year, if the regulators permit.

Pfizer and BioNTech said that of the nearly 44,000 adults in the U.S. and in other countries who took part in the study, 170 developed Covid-19 with at least one symptom. Out of those, just eight had taken the vaccine, while 162 had received a placebo. The resulting 95% effectiveness rate puts the shot’s performance on par with shingles and measles vaccines. It is also consistent with last week’s peek at how it did in an analysis of the first 94 subjects to fall sick.

The infected subjects included 10 severe cases of Covid-19, with nine in the placebo group and one in the vaccine group. The vaccine was effective across different ages, races and ethnic groups, and it was more than 94% effective in adults over 65 years old, the companies said. About 42% of the trial participants are from racial or ethnic minority groups, while 41% are ages 56 to 85, the companies said.

Moreover, medical device manufacturer Lucira Health announced today that

Late yesterday the U.S. Food and Drug Administration (FDA) authorized the first prescription molecular diagnostic test for COVID-19 that can be performed entirely at home. The FDA issued an Emergency Use Authorization (EUA) to Lucira Health, Inc. for its single-use, user-friendly COVID-19 All-In-One Test Kit that can produce a positive or negative result at home within 30 minutes. Lucira’s test kit is differentiated by its simple ‘swab, stir and detect’ design. Clinical trials showed 100% of patients were successfully able to perform the Lucira test in about two minutes. That is significantly faster than labs which currently take two to seven days to generate similarly accurate test results. The Lucira™ COVID-19 All-In-One Test Kit is expected to be available to patients served by Sutter Health in Northern California, and Cleveland Clinic Florida in Miami-Ft. Lauderdale, in the near future. By early spring 2021, it is expected to be available nationally through health care providers.

Healthcare Dive indicates that the initial price for the test will be about $50.

Benefits Pro points us to a CIGNA report titled “Health and Wellness in Workplaces: What Works? ROI Analysis of Health and Wellness Interventions” which “is the largest global review of the impact of workplace wellness interventions, according to researchers.” Top line findings are that focused wellness programs deliver the greatest impact for employers and that mental health interventions yield the most significant return on the employer’s investment.

Fierce Healthcare reports that the American Medical Association’s House of Delegates is on the warpath against employer sponsored high deductible plans. “In 2010, about 25.3% of people were enrolled in a high-deductible plan, with that number rising to 40% in 2016.” The article overlooks the important fact that participating in such a plan is the key to opening a triple tax free health savings account.

Monday Roundup

Photo by Sven Read on Unsplash

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

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

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

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

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

Tuesday Tidbits

Photo by Patrick Fore on Unsplash

Federal News Network called the FEHBlog’s attention to the fact that the OPM Inspector General has released his annual report on top management challenges that OPM faces, a number of which as always concern the FEHBP.

The IRS yesterday released a boatload of 2021 tax information —

  • Rev. Proc. 2020-45 provides inflation-adjusted items for 2021. Of note the Society for Human Resource Management points out that

For 2021, the dollar limit for employee contributions to health flexible spending accounts (health FSAs), made pretax through salary reductions, remains unchanged at $2,750, the IRS announced on Oct. 27 when it issued Revenue Procedure 2020-45.

The limit also applies to limited-purpose FSAs that are restricted to dental and vision care services, which can be used in tandem with health savings accounts (HSAs).

For health FSA plans that permit the carryover of unused amounts, the maximum carryover amount for 2021 is $550, an increase of $50 from the original 2020 carryover limit.

  • IRS Notice 2020-79 provides inflation-adjustments “affecting dollar limitations for 401(k), pension plans and other retirement-related items for tax year 2021. The contribution limit for employees who participate in 401(k), 403(b), most 457 plans, and the federal government’s Thrift Savings Plan remains unchanged at $19,500.”

Medscape reports that

Eli Lilly announced it will halt its ACTIV-3 trial evaluating the antibody bamlanivimab in combination with remdesivir for people hospitalized with COVID-19, after new evidence regarding efficacy emerged. The new data from the National Institutes of Health suggest that the experimental neutralizing antibody therapy does not offer significant clinical benefit for people with more advanced COVID-19 illness, according to a company statement. Eli Lilly also announced it plans to continue its other trials evaluating the antibody, including those assessing a potential role in treating people in the earlier stages of COVID-19.

A friend of the FEHBlog called his attention to this interesting NCQA publication on social determinants of health. Check it out.

Health Affairs provides a useful perspective on low value care in the age of COVID-19. In short,

There is the chance to use surveys or qualitative methods to compare the diverse harms experienced by patients who did and did not receive a low-value service because of the COVID-19 pandemic. It will be important to examine harms both across and within potentially high-risk or vulnerable subpopulations, as the distribution of harms may differ by demographics, social determinants, and presence of comorbid illnesses.

And to close the loop, the Senate confirmed Judge Amy Coney Barrett to be an Associate Justice of the U.S. Supreme Court last evening, and Justice Barrett was sworn in soon thereafter. The Senate has joined the House of Representatives on the campaign trail.

Thursday Miscellany

Photo by Juliane Liebermann on Unsplash

Because OPM’s press release links to 2020 premiums, here are OPM’s charts for

OPM also distributed this interesting chart comparing nationwide fee for service plan and local HMO plan premium increases for 2021.

FEHB plans post benefit change information on their respective websites before OPM does next month. Blue Cross FEP and Kaiser, among others already have done so.

On the pharmacy / PBM front —

  • Fierce Healthcare reports on Cigna CEO David Cordani’s talk at the HLTH Conference yesterday and Drug Channels discusses the improving relationship between Prime Therapeutics and Cigna’s PBM Express Scripts.
  • Fierce Healthcare also reports on the HLTH Conference talk by Jim Peters, Rite Aid’s chief operating officer, speaking at the HTLH 2020 virtual conference. It appears that Rite Aid is looking to pull the Health Hub page out of CVS Health’s playbook.

Today, the American Hospital Association’s lawyers argued before a three judge panel that the U.S. Court of Appeals for the D.C. Circuit should reverse the District Court’s decision upholding an HHS rule requiring to post payer-negotiated rates for popular hospital services. The AHA’s lawyer wants to place this burden on the health plans. A friend of the FEHBlog told him that the oral argument was “wild.” Unfortunately, the FEHBlog’s MacBook Air could only get through five minutes of the online argument. In any event Fierce Healthcare reports that the oral argument did not go well for the AHA’s lawyers. “The judges, all of which were appointed by Democratic presidents, were skeptical of the AHA’s argument that HHS doesn’t have the authority to implement the rule.” The appellate court will release a decision in three months or so.

Federal News Network reports that OPM is creating a new federal pay locality for Des Moines Iowa and expanding the Los Angeles pay locality to include Long Beach California. The change affects 3,800 Iowa employees and 1860 California employees. However, “Trump’s federal pay plans for 2021 may also complicate matters. The president proposed a 1% across-the-board pay raise for federal employees next year. To date, he hasn’t proposed any locality pay adjustments, and Congress hasn’t suggested it will step in and pass its own raise for federal workers, meaning employees in Iowa and California may not see a change in 2021.”

The FEHBlog was wondering today whether any progress has been made in the COVID-19 relief bill negotiations. CNET has the answer. Not much. But you never know in an election year.

Finally Forbes reports

According to the results of the Envoy Return to Work Survey that was released today, 73% of Americans are afraid of putting their personal health and safety at risk by returning to the workplace, with 75% saying they would consider quitting their jobs if the Covid-19 prevention measures by employers were inadequate or inappropriate. Workers in the business or tech services are more likely to consider leaving their job than those in the construction, manufacturing, retail or service industries. * * *

Their concerns notwithstanding, 90 percent of workers miss their workplace. Most miss their friends and teammates (47%), perks such as lunch and snacks (36%), and small talk at the coffee machine or water cooler (31%). Slightly more workers — 94% of those polled — said they want to spend at least one day a week in the office.

The survey indicates that some employers need to do a better job ensuring that the workplace is safe to come back. Of those who returned to their place of employment, 42% said they experienced preventive measures that were either ineffective or not enforced, including six-foot distancing measures (25%), mask requirements (21%), and hand washing requirements (18%).

What a crazy year.

Friday Stats and More

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.

Tuesday Tidbits

Photo by Patrick Fore on Unsplash

The Hill reports that

House Democrats reached a deal with Republicans on legislation to avert a government shutdown after rekindling talks over disputed farm assistance, with a vote planned as soon as Tuesday night [/ tonight]. Speaker Nancy Pelosi (D-Calif.) said in a statement that Democrats had reached an agreement to add nearly $8 billion in nutrition assistance for low-income children and families in exchange for “accountability” in assistance for farmers sought by the Trump administration.

Yippee. Duly predicted by the FEHBlog.

The Wall Street Journal reports‘ that

U.S. health regulators have drafted guidelines that would require a Covid-19 vaccine to meet rigorous standards to gain clearance for use, according to people familiar with the matter. Among the proposed requirements is that a coronavirus shot reduce the rate of infections by 50% compared with placebo, which the regulators have already required for a regular approval of any Covid-19 vaccines. The Food and Drug Administration (FDA) submitted the draft plan for review last week to Secretary of Health and Human Services Alex Azar, according to the people. The White House Office of Management and Budget is also reviewing the plan, the people said.

Rigorous. Good. People are more likely to trust vaccines that have been subjected to rigorous standards. A

Speaking of the FDA, that agency today “announced it is launching the Digital Health Center of Excellence within the Center for Devices and Radiological Health (CDRH). The launch of the Digital Health Center of Excellence is an important step in furthering the agency’s overarching dedication to the advancement of digital health technology, including mobile health devices, Software as a Medical Device (SaMD), wearables when used as a medical device, and technologies used to study medical products.” Good move.

The Centers for Medicare and Medicaid Services announced today “that it will expand the Medicare Prior Authorization Model for Repetitive, Scheduled Non-Emergent Ambulance Transport (RSNAT) nationwide. The model has saved Medicare about $650 million over four years while preserving quality of care and access to essential services. * * * [Today’s] Second Interim Evaluation Report * * * found that the model reduced RSNAT service use by 63% and RSNAT expenditures by 72% among beneficiaries with end stage renal disease and/or severe pressure ulcers during the first four years of the model. This decrease in RSNAT service expenditures, in turn, caused a total decrease of Medicare fee-for-service (FFS) expenditures of 2% (about $650 million over four years). The report did not find evidence that the model adversely affected quality of care.” It’s good news that CMS has found a way to reduce the cost of this service which is important to Medicare beneficiaries,

Weekend Update

President James Monroe painted by Samuel Morse

Both Houses of Congress will be holding committee meetings and floor votes this week. A House Oversight and Reform subcommittee is holding a hearing on the Postal Service tomorrow, September 14. The Senate Homeland Security and Governmental Affairs Committee will vote on whether to advance John Gibbs nomination to be OPM Director on Wednesday September 16. The FEHBlog will be on the lookout for more news on FY 2021 continuing resolution.

Negotiations between the White House and the pharmaceutical manufacturers have failed because the President signed and made public his most favored nation pricing executive order today. The order requires the Secretary of Health and Human Services to implement most favored nation pricing pilot programs for Medicare Parts B and D drugs. The HHS Secretary will select the drugs to be included in the pilots. Action on the Part B pilot must begin immediately. “The model[s] would test whether, for patients who require pharmaceutical treatment, paying no more than the most-favored-nation price would mitigate poor clinical outcomes and increased expenditures associated with high drug costs.” The Hill reports that “The pharmaceutical industry quickly blasted the surprise move and raised the idea of suing to stop it.”.

A friend of the FEHBlog shared this link to a Governing article on how President James Monroe prevented a yellow fever epidemic when he was governor of Virginia 200 years ago. Governing observes “Over the last few months, there have been countless news stories about the 1918 Spanish flu pandemic and the 1793 yellow fever outbreak in Philadelphia. We know about these stories because the disease spread and thousands of lives were lost. But the outbreak of 1800 is the example we should remember [because of President Monroe’s actions].” Far be it from the FEHBlog who has read and discussed the Great Influenza to overlook President Monroe’s actions.

Midweek update

OPM Director Nominee John Gibbs (Senate video / Federal Times)

The Senate Homeland Security and Governmental Affairs Committee held a confirmation hearing for OPM Director nominee John Gibbs this afternoon. Here’s are links to Mr. Gibbs’ testimony and a Federal News Network article on the hearing. The Committee will vote on whether to advance Mr. Gibbs’ nomination to the full Senate at a business meeting scheduled for next Wednesday October 16.

The Senate Health Education Labor and Pensions Committee heard testimony today from the NIH Director Dr. Francis Collins and the U.S. Surgeon General Vice Admiral Jerome Adams on the topic of vaccines. U.S. News and World Report highlights an important segment of Dr. Collins’s appearance before the Committee.

AstraZeneca announced on Tuesday that its late-stage [COVID-19] vaccine study was being put on hold due to a “potentially unexplained illness” in one of the participants.

“With an abundance of caution at a time like this, you put a clinical hold, you investigate carefully to see if anybody else who received that vaccine, or any other vaccines, might have had a similar finding of a spinal cord problem,” Collins said.

Those who are concerned about the safety of the approval process should be reassured by the development, Collins said. “If it turns out that that is a real consequence of this vaccine and can be shown to be cause and effect then all the doses that are currently being manufactured for that will be thrown away because we do not want to issue something that is not safe,” Collins said. He added that the U.S. is investing in six vaccine candidates “because of the expectation that they won’t all work, although it would be lovely if they did.”

AstraZeneca was one of the nine drugmakers to pledge on Tuesday to uphold standards for science and safety in their pursuit of a coronavirus vaccine.

Healthcare Finance reports on America’s Health Insurance Plan comments on how health insurers can aid the COVID-19 vaccine distribution process. For example,

Insurers can use their member data to help identify which people meet the criteria to be eligible for the vaccine, according to the best available evidence. Outreach efforts must adhere to patient privacy requirements, AHIP said.

Insurers can coordinate across partners such as public health officials for data sharing regarding their members’ vaccine status, encouraging data to be shared with state or regional databases (Immunization Information Systems).

“Health insurance providers play an important role ensuring that people receive the vaccines that are recommended for them, and have experience conducting outreach to their members to inform them of the vaccines that are recommended for them and how they can get them,” AHIP said. This may include reminders to ensure they receive multiple doses of a vaccine when needed.”

The Health Affairs Blog experts offer five recommendations on how to better integrate telehealth with primary care.

RecommendationsRepresentative Open-Text Survey Responses
Harmonize the reimbursement criteria “Some insurance companies are paying less than in-person visits for telehealth visits from Day 1. Small practices, like usual, have been left to themselves for the most part.”“Primary care is extremely challenging with the constant change in protocols, the uncertainty and enormously confusing insurance schemes.”
Create billing codes or payment models for the additional work required to offer telehealth “Insurance companies not reimbursing telephone visits at a rate that supports the level of work done on a telephone visit.”“Elderly patients have no access or are unable to access virtual – more work, have to teach them how to take BP, some hard of hearing, etc.”“I am more stressed out doing telehealth, as we spend time to fix internet, video, and voice. There are calling issues, so it’s more time consuming.”
Provide coverage for at-home monitoring devices “I need blood pressure cuffs and glucometers covered by insurance for home monitoring.” “I will do tele health… provided patients have equipment.”“Patients lack thermometers, blood pressure cuffs, and pulse oximeters.”
Incentivize the development of and access to, patient- and provider-centered telehealth technology “Telehealth information technology platform is NOT user friendly.”“Difficult to properly diagnose with telehealth. Have been using photos from patients to supplement but still not really sufficient.”“Our patients are low-income with language barriers. Requiring third party interpreter by speaker phone takes extra time and reduces quality of care.”
Review, revise, and communicate telehealth malpractice policies  “I am not going to practice telehealth; it is not reliable and may increase malpractice cases.”“I’m very concerned about being sued for managing the patients over telehealth especially since many are requesting opioids.”“Malpractice premiums are a major barrier for telehealth.”

Source: Authors’ analyses of data from surveys administered to primary care providers in New York City from April to July 2020.

Happy Labor Day!

Photo by Karl Magnuson on Unsplash

The FEHBlog drove from New Haven, CT, to Bethesda, MD, today with a stop in Long Island. Traffic was quite cooperative. This trip allowed the FEHBlog to listen to this week’s Econtalk episode in which Econtalk host Russ Roberts interviewed leadership expert Margaret Heffernan about her new book “Uncharted — How to Navigate the Future.” “The central thesis of her book is that while the future may be unpredictable, that doesn’t mean you can’t prepare for it. And smart organizations and people can learn how to do it.” Here’s a valuable nub from the conversation:

I remember–oh, I don’t know, probably 2010 to 2012–having a number of arguments with my husband about when the next banking crash would be. And it suddenly struck me, this was just a stupid argument. Right? Because neither of us knew. No little economic fairy had sprinkled gold dust on us.

And, I said, ‘Okay, let’s ask a different question. Let’s ask the question: If there is another banking crash, or when there is another banking crash, what will we wish we had been doing right now?’ And, we thought through that in some pretty gritty detail about where we would want our investments to be, where we would want to be, what resources we would want to have. And so we slightly changed some of the things we were doing. We accelerated some things. We put other things on hold. And, what it did is it left us feeling, ‘Okay, we don’t know what the future is, but we think we’ve placed ourselves in a reasonably robust context.’ And actually that’s pretty much all we can do.

Accordingly, time would be better spent on thinking about how to restructure healthcare in the post pandemic world or how to better deal with a similar pandemic in the future and not on trying to figure out when this particular pandemic will end. Of course, everyone should work together toward the end of the current pandemic as it eventually will end.

The FEHBlog noticed for example that the benefit consulting firm Willis Towers Watson is holding a virtual conference later this month on resetting health and other employee benefits for the post-pandemic world. The conference website links to already available articles on this important topic.

What’s more with respect to getting current job done, the Wall Street Journal reports this weekend,

FDA [r]egulators authorized [last week] a new test developed by Fluidigm that uses saliva rather than a nasal swab. The clinical study associated with Fluidigm’s submission to the FDA demonstrated 100% agreement between the saliva results and paired nasopharyngeal samples. Fluidigm’s test returns results in several hours. Meanwhile, OraSure Technologies is developing a nasal-swab test that is potentially suitable for at-home use and could be ready this fall. * * * Thanks to health care innovation, a return to normalcy for the United States might just be in the cards in the months ahead.

Amen to that.