Medicare could have saved $1.6B with same E&M facility rates

More than $1.6 billion could have been saved by Medicare and its beneficiaries if they have been charged the same payment rate for the same evaluation and management services at provider-based facilities as charged at freestanding facilities, according to a new report from the HHS Office of Inspector General. The findings, based on an analysis of $3.95 billion E&M payments at provider-based facilities in eight states between 2010 and 2017, suggest beneficiaries could have saved more by only making one cost-sharing payment instead of two, and the amount would have been lower based on the rate in freestanding facilities.

   

Research published in JAMA Network Open found that the number of pediatric admissions each quarter with a primary diagnosis of COVID-19 or multisystem inflammatory syndrome in children during the first 15 months of the pandemic was twice as high as for influenza during the two years before the pandemic. Findings were based on 1,561 US children diagnosed with influenza from April 2018 to March 2020 and 1,959 children diagnosed with SARS-CoV-2 infection or MIS-C from April 2020 to June 2021.

   

Researchers developed a technique called dual immune/solid organ transplant, or DISOT, for transplanting kidneys and stem cells from the same donor into young patients, which removes the possibility that the recipient will experience immune rejection of their transplanted organ and negates the need for immunosuppressive drugs. Findings published in The New England Journal of Medicine showed that three children with a rare genetic disease called Schimke immuno-osseous dysplasia, an immune disorder, have successfully undergone the procedure.

   

At least 90% of infants and children with cow's milk allergy tolerated extensively hydrolyzed whey-protein formula and most adverse events were mild, according to a study published in Pediatric Allergy and Immunology. Data showed that weight and length gain aligned with normal growth patterns established by the World Health Organization.

   

A study involving children with Kawasaki disease found that cases of KD across the US fell and remained low during periods of COVID-19-related masking, school closure, and reduced circulation of respiratory viruses and air pollution. Researchers also highlighted in JAMA Network Open that KD in San Diego rebounded in the spring of 2021, coincident with lifting of mask mandates.

   

Sumitomo Pharma Oncology's candidate TP-3654 was granted the FDA's orphan drug designation as a potential treatment for myelofibrosis. The investigational oral inhibitor that targets PIM kinases is currently being tested in a Phase 1/2 trial to determine its pharmacodynamics, pharmacokinetics, safety and tolerability in patients who have intermediate- or high-risk primary or secondary myelofibrosis at various sites in the US and Japan.

   

The FDA approved a supplemental New Drug Application for Zulresso, or brexanolone, that allows expanded use of the drug in patients aged 15 years old and older with postpartum depression. Brexanolone was approved previously for adults aged 18 years old and older.

   

About 4 in 10 American workers responding to a Willis Towers Watson poll said they have deferred or canceled a medical procedure over the past year, with 25% and 23% citing unaffordability and cost uncertainty, respectively, as their main reason for delaying care. Out of more than 9,600 respondents, 33% of workers who were struggling to pay for care said the deferrals have made their health worse.

   

The Commonwealth Fund's 2022 Scorecard on State Health System Performance found 2020 brought record rises in deaths related to drug overdoses and alcohol use, with many states seeing increases of more than 20% since the COVID-19 pandemic began. It's the first time the report has incorporated seven COVID-19-related metrics, including hospital and ICU capacity, state vaccination rates and excess mortality. States that had high rankings in previous reports generally performed well throughout the pandemic, but the report noted access to health care services decreased in all states during the acute phase because health care workers exposed to the virus entered isolation and facilities targeted resources toward patients with COVID-19 who were critically ill.

   

A new guidance from the HHS Health Sector Cybersecurity Coordination Sector recommends that health systems conduct regular assessments of their security posture, monitor networks and software consistently to spot weak spots, and make plans to respond and recover after incidents. To safeguard protected health information, the guidance also recommends that health information managers regularly examine gaps in security controls, define critical metrics for security, and put individual departments and managers in charge to prevent specific risks.

   

A bipartisan group of senators is calling on the CMS to develop a community-based palliative care demonstration project. The model would provide palliative care whenever and wherever a patient needs it and include a full range of interdisciplinary care.

   

Would you like to improve COVID-19 vaccine uptake in your community? Learn how to apply patient counseling techniques, integrate evidence-based strategies and evaluate the latest safety and efficacy data on COVID-19 vaccines with The NP's Role in COVID-19 Vaccine Confidence: Part 3 in the AANP CE Center. Enroll in this on-demand webinar today and earn 2.0 contact hours of continuing education credit (0.5 of which may be applied toward pharmacology).