October 23, 2019 | From frying pan to fire?

October 23, 2019

INDUSTRY NEWS

Surprise billing: From frying pan to fire?

Attempts to resolve the “surprise billing” problem have turned into a battle between providers and insurers. More than 100 physician organizations signed on to a letter urging Congress not to turn more power over to health insurers. “We are highly concerned that the rate-setting provisions in current bills further shift marketplace leverage to health insurers at the expense of providers,” the letter stated. “The health insurance market is already heavily consolidated, which can result in artificially low payment rates and anticompetitive harms to both consumers and providers of care.” (Fierce Healthcare; letter)

“Stunning” pharma payments to doctors now commonplace

Back in 2013, ProPublica exposed a “stunning” development in the pharmaceutical industry’s courtship of doctors: In just four years, one doctor had earned $1 million giving promotional talks and consulting for drug companies; 21 others had made more than $500,000. Six years later, despite scrutiny from prosecutors, academics and the media, ProPublica reports that such high earnings have become commonplace. Investigators found more than 700 doctors who were paid more than a million dollars by drug and medical device companies. (ProPublica)

INNOVATION & TRANSFORMATION

Another wearable will detect AFib

Fitbit and the Bristol-Myers Squibb-Pfizer Alliance are working together to develop educational content for individuals at increased risk for atrial fibrillation. Once the FDA clears Fitbit’s atrial fibrillation detection feature, it will be working with the pharmas to develop content. It’s been over a year since Apple announced plans for a smartwatch that would be outfitted with FDA-cleared ECG sensors and detection software, and other digital health and wearable companies are following suit. (MobiHealth News)

CONSUMERS & PROVIDERS

Race, ethnicity lead to diabetes readmit rates

Researchers writing in JAMA Network Open found that “statistically significant and policy-relevant ethnic/racial differences exist in 30-day all-cause hospital readmissions, particularly among black adults with diabetes.” In the retrospective analysis of over 270,000 Medicare beneficiaries with diabetes, racial and ethnic differences seemed to prevail as factors significantly associated with risk for hospital readmission. (JAMA Network Open)

Preventing falls can lead to disability

Hospitals’ hyperfocus fall prevention has produced an “epidemic of immobility,” Kaiser Health News reports. “Older patients face staggering rates of disability after hospitalizations,” said Dr. Kenneth Covinsky, a geriatrician and researcher at the University of California-San Francisco. One-third of patients age 70 and older leave the hospital more disabled than when they arrived. It doesn’t take much to change this: Older patients who walk just 275 steps a day in the hospital show lower rates of 30-day readmission. Another issue: Hospitals are required to report falls, but they don’t typically track patient movement. (Kaiser Health News)

NEW & NOTED

Rethink those steroid injections: Research published last week in Radiology suggests that knee and hip steroid injections may accelerate joint damage in some patients with osteoarthritis. This points to the need for better-informed consent. “Critical considerations about the complications should be part of the patient consent, which is currently not the case right now,” says senior author Ali Guermazi, MD, PhD, chief of radiology at the Veterans Affairs Boston Healthcare System. (Medscape Medical News; Radiology)

Medicare for What? Support for Medicare for All may be waning. The Wall Street Journal cites two reasons: First, Sens. Elizabeth Warren and Bernie Sanders have yet to provide specifics on the financial costs to voters. Second, the plethora of other Democratic health proposals complicates messaging; many voters still don’t understand what specific plans would do. (Wall Street Journal)

DeSalvo heads to Google: Google has hired ex-Obama administration official Karen DeSalvo as its first chief health officer. DeSalvo, a well-respected healthcare executive and public health expert, was the acting assistant secretary for health and ran the Office of the National Coordinator. (Healthcare Dive)

MULTI-MEDIA

Topol: Time for docs to organize, speak out

Many doctors feel despair about their appalling working conditions and deteriorating doctor-patient relationships. But there have been no protest marches, no social media campaigns. Why aren’t physicians organizing? That’s what Eric J. Topol, MD, asks in his New Yorker essay, “Why Doctors Should Organize” and discusses in his podcast, Medicine and the Machine. (podcast; New Yorker)

MARKETVOICES...QUOTES WORTH READING

“The patient-physician relationship must be the center, the principal objective. In the medical world, we are largely beholden to our overlord, the administrator, whereas in the rest of the professions, that’s not the case. […] Most of the time, the bean counters are not physicians. The performance metrics of those with physician leadership show that to be an advantage. Nonetheless, we’re in a peculiar situation where doctors have become essentially subservient to administrators whose principal interest is to deliver the financial goods, and that’s a problem.”—Eric J. Topol, on the podcast Medicine and the Machine