HEALTHCARE & GOVERNMENT
Oregon Will Be First State of Make Affordable Healthcare a Constitutional Right
November 8th, Oregonians voted to make the state the first in the nation to enshrine the right to affordable healthcare in its constitution. Ballot Measure 111 narrowly passed, with nearly 50.7% of voters in favor and 49.3% of voters opposed. The measure's long-term impact on Oregon healthcare is unclear because it doesn't prescribe how the state should ensure that everyone has affordable healthcare. Measure 111 amends the Oregon constitution by adding: "It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, clinically appropriate and affordable healthcare as a fundamental right." (https://oregoncapitalchronicle.com/2022/11/15/oregon-will-be-the-first-state-to-make-affordable-health-care-a-constitutional-right/)
82% Voters Want Federal Government to Extend Telehealth Flexibilities
82% of voters with employer-provided coverage think it is important for the federal government to extend the telehealth flexibilities that individuals received during the COVID-19 pandemic. This majority of voters is tripartisan: 95% Democrats, 77% independents, and 70% Republicans. (https://www.ahip.org/documents/Coverage-At-Work_telehealth-memo_final.pdf)
AHA Urges DEA to Release Regulation for Prescribing Controlled Substances Via Telehealth
The American Hospital Association has urged the Drug Enforcement Administration to release its proposed rules outlining a special registration process for prescribing medically necessary controlled substances via telehealth after the COVID-19 public health emergency; and to provide an interim plan to support continuity of care if the PHE expires before the rules are finalized; plus grant a permanent exception for separate registrations for practitioners in states that have medical licensing reciprocity requirements. "[T]here is growing concern that the pending expiration of the COVID-19 PHE and its associated waivers, combined with the lack of a special registration regulation, will leave providers in a position where they will need to cut services and leave patients without access to necessary treatment," AHA wrote. "With the expiration of the COVID-19 PHE currently scheduled for next year, this situation could come to pass as early as mid-January." (https://www.aha.org/news/headline/2022-12-01-aha-urges-dea-release-regulation-prescribing-controlled-substances-telehealth-after-covid-19-public)
HHS Issues Bulletin on Requirements Under HIPAA for Online Tracking Technologies
The HHS Office for Civil Rights has issued a bulletin to highlight the obligations of Health Insurance Portability and Accountability Act of 1996 on covered entities and business associates under the HIPAA Privacy, Security, and Breach Notification Rules when using online tracking technologies. These technologies, like Google Analytics or Meta Pixel, collect and analyze information about how internet users are interacting with a regulated entity's website or mobile application. Some regulated entities regularly share electronic protected health information (ePHI) with online tracking technology vendors and some may be doing so in a manner that violates the HIPAA Rules. The bulletin addresses potential impermissible disclosures of ePHI by HIPAA regulated entities to online technology tracking vendors and explains what tracking technologies are, how they are used, and what steps regulated entities must take to protect ePHI when using tracking technologies to comply with the HIPAA Rules. (https://www.hhs.gov/about/news/2022/12/01/hhs-office-for-civil-rights-issues-bulletin-on-requirements-under-hipaa-for-online-tracking-technologies.html)
Senators Intro Bill to Lower Prescription Costs for Seniors with Chronic Illnesses
Sens. Tom Carper (D-Del.) and Bill Cassidy (R-La.) recently introduced a bill that would allow people enrolled in the Program of All-Inclusive Care for the Elderly (PACE) to choose their prescription drug plan under Medicare Part D and save more in monthly medication costs. PACE enrollees are currently required to get their Medicare Part D-covered medications through the program. Joining another Medicare prescription drug plan means being unenrolled from PACE benefits. Carper and Cassidy's bill, the PACE Part D Choice Act, would allow PACE beneficiaries to enroll in stand-alone prescription drug plans not operated through the program. This would also make beneficiaries eligible for prescription drug plans subject to the $2,000 annual cap that was instituted by the Inflation Reduction Act earlier this year. The legislation, if passed, would require that PACE inform beneficiaries of their options for prescription drug plans outside of the program and help facilitate enrollment. (https://thehill.com/policy/healthcare/3738190-senators-introduce-bill-to-lower-prescription-costs-for-seniors-with-chronic-illnesses/)
COVID-19 NEWS & TRENDS
California COVID Cases, Hospitalizations Rising at Same Rate as Prior Surges
California is seeing a sustained rise in coronavirus cases and hospitalizations, with numbers climbing at the same alarming rate that the state experienced ahead of previous COVID-19 surges. Nearly a year to the day after the first case of the omicron variant in the U.S. was identified in a San Francisco resident, the daily number of newly reported cases in the state has climbed to 5,466, up 157% from a month earlier. More worryingly, new hospital admissions of patients with confirmed COVID are at 3,793, up 133% over the same period, according to health department data. (https://www.sfchronicle.com/health/article/Here-we-go-again-COVID-cases-and-17625055.php)
MEANWHILE, In California, Seniors Are Hit Hard as COVID Surges Across State: There has been a troubling spike in coronavirus-positive hospital admissions among seniors in the State, with Americans aged 65+ making up 92% of all deaths from the virus, according to data from the CDC. The jump in seniors in need of hospital care has been particularly dramatic. Rising hospitalization rates are a reason health officials are urging people, especially seniors, to get the updated COVID-19 booster shot and, if they test positive and are eligible, to access therapeutic drugs that likely will reduce the severity of any illness. Only 35% of California's vaccinated seniors age 65+ have received the updated booster since it became available in September. (https://www.latimes.com/california/story/2022-12-05/senior-california-covid-19-hospitalization-rates-spike)
Why Do Vaccinated People Represent Most COVID-19 Deaths Right Now?
The share of COVID-19 deaths among those who are vaccinated has risen. In fall 2021, about 3 in 10 adults dying of COVID-19 were vaccinated or boosted. But by January 2022, about 4 in 10 deaths were vaccinated or boosted. By April 2022, CDC data show that about 6 in 10 adults dying of COVID-19 were vaccinated or boosted, and that's remained true through at least August 2022 (the most recent month of data). There are several factors at play here, including a rising share of the population that is vaccinated, waning immune protection, and low uptake of boosters, and changes in immunity among the unvaccinated. New variants combined with a reduction in masking and other non-pharmaceutical interventions may also lead to more transmission, which can in turn lead to more deaths. Vaccinated people now make up the majority of the population - 79% of adults have completed at least the primary series. (https://www.kff.org/policy-watch/why-do-vaccinated-people-represent-most-covid-19-deaths-right-now/)
Why China's "Zero COVID" Policy is Likely to Fail
As the world watches the rare spectacle of protesters challenging China's authoritarian leadership over its increasingly perplexing "zero Covid" policy, people who study the disease see threats ahead for China and beyond. The zero Covid policy, which has kept cases and deaths in China to negligible numbers throughout the pandemic, seems doomed to fail in the face of the highly transmissible Omicron variant of the SARS-CoV-2 virus, they believe. But the Chinese leadership does not appear to be mapping a path to a safe exit ramp, leaving experts worried the country could see a tsunami of cases that would swamp its healthcare system if the national containment effort collapses. For example, Hong Kong similarly adopted a zero Covid policy, employing draconian quarantine, tracing, and testing policies to try to stop transmission of the virus. For more than two years, that system protected the city from the disease. But in the spring, Omicron breached Hong Kong, dramatically spiking the number of infections there. (https://www.statnews.com/2022/11/30/zero-covid-policy-china-no-exit-strategy/)
HEALTHCARE NEWS & TRENDS
2023: Several Macro-Level Trends Expected to Impact Employer Health & Well-being Initiatives
Every year, Business Group on Health creates "trends to watch" for the coming year. Each trend relates specifically to employer health and well-being strategy, yet often is impacted by broader factors such as the global economy, workforce trends, innovation, and the policy/regulatory environment. Factors currently affecting employers include labor shortages, the increased cost of healthcare, post-pandemic healthcare needs, global inflation, supply chain challenges, and regulatory compliance. They have all played a part in the development of Trends to Watch in 2023. (https://www.businessgrouphealth.org/resources/trends-to-watch-in-2023)
Amazon Announces New Virtual Healthcare Service to Treat Variety of Conditions
Amazon is expanding its healthcare offerings following its deal to buy One Medical, this time by opening a new virtual care option to help with common conditions like allergies, acne and hair loss. Amazon Clinic will allow patients in 32 states to message clinicians through a secure portal to seek personalized treatments and prescriptions for common conditions. Patients can seek birth control options and care for urinary tract infections, dandruff, migraines and more. The service does not yet accept insurance, but customers can use insurance to help pay for medications prescribed by a licensed clinician through the platform. (https://www.cnbc.com/2022/11/15/amazon-clinic-to-provide-virtual-healthcare-for-allergies-acne-and-more.html)
Mark Cuban Cost Plus Drugs Adds 82 Drugs to Portfolio
Mark Cuban's online pharmacy now offers nearly 1,000 generics after adding 82 drugs to its repertoire, the company said Nov. 21. The latest additions to Cost Plus Drugs include deferasirox, a generic for iron reducer Jadenu. Jadenu typically costs $2,332.80, but the generic tablet costs $15 at Cost Plus Drugs - making for the company's second biggest price reduction. Budesonide, a steroid used to treat Crohn's disease and asthma, usually costs $159.83, but is $18.47 at the online pharmacy. To date, Mark Cuban Cost Plus Drugs Co. has more than 1 million customers, has partnered with a payer and a pharmacy benefit manager, and plans to enter the brand-name drug business in 2023. (https://www.beckershospitalreview.com/pharmacy/mark-cuban-cost-plus-drugs-adds-82-drugs-to-portfolio.html)
CVS Tries Out Remote System to Help Fill Prescriptions
CVS Health Corp. is testing a system that allows pharmacists to process prescriptions in part remotely, a move it said could improve store working conditions and the experience for customers as the company grapples with a shortage of pharmacists. CVS has equipped roughly 8,000 of its 9,000+ U.S. drugstores with technology that allows pharmacists to review and enter prescription information remotely while still meeting patient-privacy requirements. About 400 of CVS's 30,000 pharmacists are currently helping prepare prescriptions either at central locations, from their homes or in stores other than where medications will be dispensed, the company said. The largest U.S. pharmacy chain by revenue said its initiative, which began this past summer in Arizona, will lighten the workload for store pharmacists and free them up to provide customers with a wider range of services, such as vaccinations and health screenings. (https://www.wsj.com/articles/cvs-tries-out-remote-system-to-help-fill-prescriptions-11670108339?mod=hp_lead_pos5)
Elon Musk Says Brain Implant Startup Neuralink Should Be Ready for Human Testing in 6 Months
Elon Musk's startup Neuralink Corp. should be ready to test its technology on humans in six months, the entrepreneur said last week during a live-streamed update about progress the company has made with its brain-implant technology. Neuralink has submitted most of its paperwork to the FDA, which oversees medical devices, including neural implants, Mr. Musk said. In 2019, he said the company planned to seek the FDA's approval for human testing and predicted it could begin as soon as 2020. "We are now confident that the Neuralink device is ready for humans, so timing is a function of working through the FDA approval process," Elon tweeted during the event. The company wants to be able to help restore vision and enable people with severe disabilities to move and communicate by decoding brain activity. Eventually, Neuralink wants to open clinics where patients could get a device implanted into their brains by their surgical robots, which the company also showcased at the event. The robot surgeon will thread Neuralink's tiny proprietary electrodes, or brain-signal recording wires, into the brain. Elon showed a video of "telepathic typing" monkey, which has a Neuralink brain implant. The animal wasn't typing into a keyboard, but was able to move a cursor to images of letters. (https://www.wsj.com/articles/elon-musks-neuralink-set-to-show-and-tell-latest-brain-computer-advances-at-event-11669785946?mod=article_inline)
Black & Hispanic Adults Have Greater Prevalence of Hypertension: Study
In a recent study, adult Mexican Americans and non-Hispanic Blacks in the U.S. had an overall greater prevalence of hypertension, obesity, and diabetes mellitus compared with white and Asian adults. The study also showed that few adults reported an ideal diet, highlighting the need for primary care providers to talk to patients about nutrition, Stephanie M. Lopez-Neyman, a PhD candidate in the department of nutrition sciences at Texas Woman's University, told Healio. (https://www.healio.com/news/primary-care/20221122/racial-disparities-present-in-cardiovascular-cardiometabolic-disease-risk-factors)
WHO Renames Monkeypox as 'MPOX'
Monkeypox disease now has a new name: mpox. The World Health Organization recently announced the long-awaited change, saying the disease's original name plays into "racist and stigmatizing language." But it will take time to replace a term that has been used for decades. The first human monkeypox case was recorded in 1970. The virus was initially detected years earlier, in captive monkeys. "Both names will be used simultaneously for one year while 'monkeypox' is phased out," WHO said.
MEANWHILE, U.K. Analysis Shows One Dose of MPOX Vaccine Yields Strong Protection: Researchers at the U.K. Health Security Agency estimated that one dose of the mpox vaccine was 78% effective at protecting against infection 14 or more days after vaccination. The findings bolster the case that the vaccination drive has helped combat this year's global outbreak of mpox. (https://www.statnews.com/2022/11/22/u-k-analysis-shows-one-dose-of-monkeypox-vaccine-yields-strong-protection/)
VillageMD Acquires Summit Health-CityMD, Creating One of the Largest Independent Provider Groups in the U.S.
VillageMD has entered a definitive agreement to acquire Summit Health-CityMD, a leading provider of primary, specialty and urgent care. The transaction is valued at approximately $8.9 billion with investments from Walgreens Boots Alliance and an affiliate of Evernorth, a subsidiary of Cigna Corporation. Together, VillageMD and Summit Health-CityMD will create a multi-payor platform to deliver quality, affordable care for all patients. Together, they will have 680+ provider locations in 26 markets. (https://newsroom.cigna.com/VillageMD-Acquires-Summit-Health-CityMD)
Why Doesn't the U.S. Have At-Home Flu Tests?
Flu season is underway. RSV is putting record numbers of children in hospitals. And health professionals are gearing up for another Covid winter. With so many potential viruses in play, it would be helpful if Americans had a way to distinguish between different ailments at home. And when it comes to the flu in particular, at-home testing could help telehealth doctors decide when it makes sense to prescribe treatments like Tamiflu, which need to be started within two days of onset of symptoms. Yet no at-home flu tests are available for purchase in the U.S. That's not for lack of technology - the rapid antigen flu tests at the doctor's office are "virtually identical" to the Covid tests already in people's homes, according to Zoë McLaren, associate professor of public policy at the University of Maryland Baltimore County who studies health policies for infectious disease epidemics. Rather, the issue comes down to historical hangups - and the need to find digital fixes to address them. (https://www.statnews.com/2022/11/22/why-doesnt-the-u-s-have-at-home-flu-tests/)
HEALTHCARE WORKFORCE NEWS
The "Great Remote Work Mismatch"
Many Americans got used to the flexibility that remote work granted them during the pandemic, but fewer employers are willing to grant it to them, The Washington Post reported Nov. 27. Work-from-home employees are increasingly being called into the office. And remote work listings are decreasing, though the number of people seeking them out is rising - which makes them more and more elusive. Remote work listings peaked in March, with 21% of LinkedIn's job postings offering the option. In October, 15% of listings on LinkedIn offered remote work. Despite this, 50% of job applications submitted on LinkedIn are for remote positions, according to data from the site.
"It's the 'great remote work mismatch,'" Rand Ghayad, head of economics and global labor markets at LinkedIn, told the Post. "In the past, labor mismatches have been about skills. Now we're seeing a different kind of mismatch, where workers are looking for jobs that offer certain attributes - like the ability to work remotely - that employers aren't willing to offer."
There are nearly two job openings for each applicant for on-site positions, but there are two applicants for each remote position on LinkedIn, making the supply-and-demand gap for on-site workers four times as high as it is for remote work, Mr. Ghayad said. There is a "tug of war" between what employees want, on more than one front - wage increases, signing bonuses, work-from-home privileges - and what employers want to give, which signals a shifting labor market, according to the Post. (https://www.beckershospitalreview.com/workforce/the-great-remote-work-mismatch.html)
A Work-From-Home Culture Takes Root in California
According to new data from the U.S. Census Bureau, working from home for some portion of the week has become the new normal for a large segment of Californians. A recent survey found that about 20% California adults lived in households in which at least one person had telecommuted or worked from home five or more days the prior week. About 33% of California adults lived in households in which someone had worked from home at least one day the previous week. Even as pandemic lockdowns fade into memory, Covid-19 has transformed California's workplace culture in ways researchers say will reverberate well beyond 2022. The data shows high-income employees with college degrees are more likely to have access to this hybrid work model, while lower-income employees stay the course with on-site responsibilities and daily commutes. At a basic level, that means low-wage workers will continue to shoulder greater risks of infection and serious illness as new covid variants sweep through job sites, alongside seasonal waves of flu and other respiratory viruses. (https://californiahealthline.org/multimedia/a-work-from-home-culture-takes-root-in-california/)