CDC to undergo overhaul in response to COVID-19 misteps
CDC Director Rochelle Walensky announced that the agency will be undergoing an overhaul and reform due to failed responses to COVID-19. Dr. Walensky said the C.D.C.’s future depended on whether it could absorb the lessons of the last few years, during which much of the public lost trust in the agency’s ability to handle a pandemic that has killed more than 1 million Americans. “This is our watershed moment. We must pivot,” she said. Her admission of the agency’s failings came after she received the findings of an examination she ordered in April amid scathing criticism of the C.D.C.’s performance. The report itself was not released; an agency official said it was not yet finished but would be made public soon. This could have a major impact on CDC’s future and the functioning of the public health agencies CDC supports. Several reports have called for fundamental changes and investments in public health capacity, however very little is being said in terms of the needed evidence base for public health practice – namely public health systems and services research (PHSSR).
Inflation Reduction Act requires the federal government to negotiate some prescription drug prices
President Biden signed the Inflation Reduction Act into law, creating several new programs and actions for reducing health care costs for consumers. The legislation for the first time requires the HHS Secretary to negotiate prices for some top-selling drugs covered in Medicare. It also requires drug companies to pay rebates if prices rise faster than inflation for drugs used by Medicare beneficiaries. And it caps out-of-pocket drug spending for beneficiaries in Medicare Part D at $2,000 annually. This is a major change in Medicare’s purchasing power and health services research has a tremendous opportunity to prospectively evaluate its impact – both intended and unintended consequences.
OSTP released guidance to make federally funded research freely available
The White House Office of Science and Technology Policy (OSTP) updated U.S. policy guidance to make the results of taxpayer-supported research immediately available to the American public at no cost. In a memorandum to federal departments and agencies, Dr. Alondra Nelson, the head of OSTP, delivered guidance for agencies to update their public access policies as soon as possible to make publications and research funded by taxpayers publicly accessible, without an embargo or cost. All agencies will fully implement updated policies, including ending the optional 12-month embargo, no later than December 31, 2025.
CMS offers roadmap for connecting children with complex medical conditions to Medicaid services
The Centers for Medicare and Medicaid Services (CMS) unveiled guidance on a new Medicaid health home benefit for children with medically complex conditions. This new optional benefit helps state Medicaid programs provide Medicaid-eligible children who have medically complex conditions with person-centered care management, care coordination, and patient and family support. CMS anticipates that the new benefit will help these children receive the care they need, including across state lines. Children with medically complex conditions — including serious health concerns like cerebral palsy, cystic fibrosis, blood diseases, and mental health conditions that can severely impact a child's ability to function — often require tremendous care coordination and highly specialized treatment. Finding needed services often requires traveling well beyond a family's home, and often care is only available for these children out-of-state. The new health home services are expected to give these children and their families help in coordinating and managing care. In related news, AcademyHealth is proud to be a partner in the new Coordinating Center for Children with Medical Complexity.
Administration released final rules for surprise billing enactment
The Departments of Health and Human Services, Labor, and the Treasury issued a new series of rules on a range of topics regarding implementation of the No Surprises Act (NSA). Among other topics, the rules address the NSA’s application to plans without a network or with a closed network, international pickup by air ambulance companies, emergency services provided in a behavioral health crisis facility, and notices.
Doctors are becoming politically vocal post-Dobbs
Red state lawmakers rushing to pass new abortion restrictions are being stymied by an unexpected political force — OB-GYNs. These physicians — many of whom have never before mobilized politically — are banding together in the wake of the Supreme Court overturning Roe v. Wade, lobbying state lawmakers, testifying before committees, forming PACs, and launching online campaigns against proposed abortion restrictions. Legislators who are themselves physicians are using their medical backgrounds to persuade colleagues to scale back some of the more restrictive and punitive portions of anti-abortion laws being considered. While physicians have long frequented state capitols, lawmakers and lobbyists said the level of advocacy from the medical community since the Dobbs decision in June is unprecedented. AcademyHealth is hosting a webinar for our organizational affiliates featuring Medicaid Medical Directors discussing the potential impacts of Dobbs on state Medicaid programs.
CHIPS and Science Act signed into law, establishing a National Secure Data Service
President Biden signed the CHIPS and Science Act into law, which included a provision that established a National Secure Data Service (NSDS) demonstration program at the National Science Foundation. The NSDS will encourage government and research partners to organize, analyze, and use information in support of evidence-informed decision-making to improve society while protecting the privacy of individuals and businesses.
CMS considers mandating quality compliance reporting for Medicaid and CHIP
CMS is proposing a rule that would establish the requirements for mandatory annual State reporting of the Core Set of Children’s Health Care Quality Measures for Medicaid and Children’s Health Insurance Program (CHIP), the behavioral health measures on the Core Set of Adult Health Care Quality Measures for Medicaid, and the Core Sets of Health Home Quality Measures for Medicaid. The effort to improve reporting is intended to promote consistency in the quality of care for beneficiaries and identify health disparities. Comments are due to CMS by October 21, 2022.
NCHS announced US life expectancy dropped by nearly two years in 2020
The National Center for Health Statistics (NCHS) at CDC released their annual life tables for 2020, where they found that life expectancy in the US dropped by nearly two years in the first year of the COVID-19 pandemic, largely due to deaths related to the pandemic and a rise in overdose deaths. For the country overall, life expectancy was 77 years, down from 78.8 in 2019. Hawaii had the highest life expectance at 80.7 years while Mississippi had the lowest at 71.9 years.
What I’m reading:
Sadly, misinformation and disinformation have become an increasing component of our public discourse and too little is known about effective strategies to combat misinformation in social media. So this recent study on “inoculation” was particularly intriguing. The investigators conducted seven experiments with nearly 30,000 participants to test whether short “inoculation videos” increases ability to identify manipulation techniques.
The American Hospital Association released a report finding that pandemic-driven deferred care has led to hospitals treating sicker patients. The pandemic led to communities entering quarantines and avoided non-emergency health care, which led to patients that eventually entering the health care system with higher acuity. These patients now require longer hospitalizations and more intensive treatments, putting further strain on the health system.
The Office of the National Coordinator for Health Information Technology (ONC) published a report on electronic public health reporting in 2019, and found that before the pandemic began less than one in five primary care physicians electronically exchanged health information with public health agencies. Approximately a quarter of physicians nationally did not know whether their practice electronically exchanged patient health information with PHAs.
If you missed our 2022 Health Datapalooza and National Health Policy Conference, then you may not have heard Commissioner Robert Califf’s as the opening keynote outlining the priorities for the FDA. So here is a nice piece about them in Science.
Doctors Mieres and McCulloch wrote in Medpage Today about the importance of human connection in the practice of medicine, and the need to reimagine medicine as a communal and relationship-minded enterprise. They call for practitioners to practice a more radical empathy with patients in order to gain their trust and fundamentally overhaul how we provide care. For example, they suggest the idea of a medical school class that teaches would-be physicians not only how to have good bedside manner but also how to share their own stories of hardship and loss, and how to open up about their own failings and successes.
And for fun, I hope you enjoy this list of tips on upping your odds for getting your article accepted for publication.