Gen Xers and millennials say health care is a top priority for 2024 elections

By Lucy Peterson - As the 2024 presidential election quickly approaches, many are wondering what issues will be most important to voters, especially amongst millennials and Generation X. A new study by eHealth found that more than three quarters of respondents said that Medicare is one of their top three voting issues for 2024. Read Full Article…

HVBA Article Summary

1. Perception and Value: Over 75% of Gen Xers and millennials view the U.S. health care system positively, describing it as "good" or "excellent," while also expressing strong appreciation for Medicare, with 94% feeling entitled to its benefits in retirement.

2. Awareness Gap: Despite the positive sentiments towards Medicare, a significant knowledge gap exists, with only 30% of respondents aware that Medicare primarily serves those aged 65 and older. This lack of awareness is more pronounced among millennials, with only 28% knowledgeable about Medicare's intended purpose.

3. Concerns and Willingness to Act: Despite the value placed on Medicare, there are widespread concerns about its long-term sustainability, with 65% of respondents worrying about its future existence. Additionally, there's a lack of trust in elected officials to preserve the program. However, a substantial majority (84%) express a willingness to pay increased taxes to ensure Medicare's continuation, highlighting its importance as the population ages and health care becomes a top priority, particularly in upcoming elections.

ERISA Suit Filed Against Packaging Company 401(k) Plan

By Alex Ortolani - Product packager Sonoco Products Company, its board and benefits committee are the latest plan sponsor to be hit with a lawsuit alleging excessive participant fees in its 401(k) plan. Read Full Article…

HVBA Article Summary

1. Breach of Fiduciary Duty Allegation: The lawsuit, spearheaded by plan participant Daniel Steen, accuses defendants responsible for overseeing Sonoco Products Company's 401(k) plan of breaching fiduciary duty under ERISA. It alleges that by allowing Empower, the plan's recordkeeper, to charge excessive fees, they failed to act in the exclusive benefit of the plan and its participants, resulting in monetary losses.

2. Failure to Leverage Plan Size: Plaintiffs contend that the plan committee neglected to leverage the plan's substantial size to negotiate lower fees through a request for proposal from alternative recordkeepers. Despite Empower serving as the plan's recordkeeper throughout the class action period, from 2018 to 2022, the suit alleges a lack of competitive bidding for recordkeeping services at reasonable intervals, leading to overpayment for recordkeeping services.

3. Disparity in Fees: The lawsuit draws attention to the significant difference in per-participant fees between Sonoco's plan and comparable 401(k) plans, such as those of the Children’s Medical Center of Dallas and Ralph Lauren Corp. While fees for comparable plans range from $28 to $36 per participant, Sonoco's plan reportedly incurred a fee of $121 per participant, allegedly without plausible explanation for material service disparities. Plaintiffs aim to seek repayment for what they claim are millions of dollars in losses due to these purported excessive fees.

Ultraprocessed Foods an Independent Risk Factor for Poor Brain Health

By Megan Brooks - Consuming highly processed foods may be harmful to the aging brain, independent of other risk factors for adverse neurologic outcomes and adherence to recommended dietary patterns, new research suggests. Read Full Article…

HVBA Article Summary

1. Food Processing Impacts Brain Health: The study underscores the significance of food processing in relation to brain health. Increased consumption of ultraprocessed foods (UPFs) is associated with a higher risk of cognitive decline and stroke, while a higher intake of unprocessed or minimally processed foods may lower these risks. This highlights the importance of not just considering the type of food consumed but also how it is processed and handled.

2. Risk Factors and Protective Factors: Findings reveal a clear association between dietary habits and neurological health outcomes. A 10% increase in relative intake of UPFs correlates with a 16% higher risk for cognitive impairment and an 8% increased risk for stroke. Conversely, a higher intake of unprocessed or minimally processed foods is associated with a 12% lower risk for cognitive impairment and a 9% lower risk for stroke. These results emphasize the potential of dietary choices as both risk factors and protective factors for brain health.

3. Implications for Public Health Policy: The study prompts considerations for public health policies and dietary guidelines. Given the independent association of UPFs with adverse neurologic outcomes, beyond traditional dietary patterns, there's a call for inclusion of UPFs considerations in national and global dietary guidelines and public health strategies aimed at improving brain health. However, further research, including large prospective studies and randomized controlled trials, is needed to fully understand the mechanisms underlying these associations and to inform more targeted interventions.

Prior authorization inpatient claim denial rate by payer type

By Andrew Cass - Kodiak Solutions said in a May 21 report that if payers used consistent criteria for making prior authorization/preficiation claim denials, the denial rates would be similar across all payer categories. Read Full Article…

HVBA Article Summary

1. Identify and Standardize Criteria: To mitigate varying denial rates across payer categories, there's a need for standardization in the criteria used for prior authorization determinations. Providers should advocate for clearer, consistent guidelines to ensure equitable treatment of patients regardless of their insurance type.

2. Utilize Advanced Analytics: Healthcare providers can leverage sophisticated analytics software, like Kodiak's revenue cycle analytics, to track and analyze denial patterns over time. By understanding these trends, providers can proactively address issues, refine their authorization processes, and minimize denials.

3. Enhance Collaboration with Payers: Establishing collaborative relationships with payers is crucial. By engaging in open dialogue and sharing data insights, providers and payers can work together to streamline authorization processes, reduce denials, and ultimately improve patient care and financial outcomes.

Lifestyle-Dementia Links Persist Regardless of Risk Genes, French Study Shows

By Judy George - Lifestyle and other dementia risk factors were linked with cognitive changes independently of genetic risks for Alzheimer's disease, a French prospective study found. Read Full Article…

HVBA Article Summary

1. Lifestyle Factors Influence Dementia Risk: A study conducted across three French cities involving over 5,000 participants revealed that lower scores on the Lifestyle for Brain (LIBRA) health risk scale at baseline were associated with subsequent cognitive decline and dementia incidence. This association persisted regardless of APOE4 or other genetic factors, suggesting that lifestyle modifications could mitigate dementia risk.

2. Impact of LIBRA Scores on Dementia Risk: The hazard ratio for dementia increased with each 1-point change in LIBRA scores, with a higher risk observed in APOE4 carriers compared to non-carriers. This indicates that lifestyle factors assessed by the LIBRA score, such as diet, exercise, cognitive activities, smoking, and alcohol consumption, play a significant role in dementia development independent of genetic susceptibility.

3. Precision Prevention and Public Health Implications: The findings underscore the importance of targeted prevention strategies that address modifiable risk factors for dementia. Public health initiatives aimed at promoting healthy lifestyles could potentially delay or slow the onset of dementia, offering a promising avenue for dementia prevention, especially among individuals with genetic predispositions like APOE4 carriers.

Ozempic Protects Kidneys, Boosts Survival in Diabetes Patients With CKD

By Crystal Phend - For people with type 2 diabetes and chronic kidney disease (CKD), semaglutide (Ozempic) reduced the risk of major kidney events and death from cardiovascular causes, the phase III FLOW trial showed. Read Full Article…

HVBA Article Summary

1. Reduction in Composite Endpoint: Adding the GLP-1 receptor agonist to standard care resulted in a significant 24% reduction in the primary composite endpoint compared to placebo. This endpoint included dialysis, kidney transplantation, a significant decline in estimated glomerular filtration rate (eGFR), or death from kidney-related or cardiovascular causes.

2. Number Needed to Treat (NNT): The NNT over 3 years to prevent one such event was 20, highlighting the clinical efficacy of the intervention in reducing adverse kidney and cardiovascular outcomes among high-risk patients.

3. Safety and Efficacy: The FLOW trial demonstrated both the safety and efficacy of semaglutide, with statistically significant reductions in kidney-specific components of the primary outcome, cardiovascular mortality, major cardiovascular events, and all-cause mortality. The trial also emphasized the potential for combination therapy, suggesting a role for semaglutide alongside other proven therapies for type 2 diabetes and chronic kidney disease, such as RAS inhibition, SGLT2 inhibition, and mineralocorticoid-receptor antagonism.

(Another) Fiduciary Breach Asserted in TPA Healthcare Claims Processing

By Nevin E. Adams, JD - The plaintiffs here—W.W. Grainger, Inc.; W.W. Grainger, Inc. Group Benefit Plan I; W.W. Grainger, Inc. Group Benefit Plan II; and W.W. Grainger, Inc. Group Benefit Plan III—are both the plan sponsor and benefit plans impacted by the actions of defendant Aetna Life Insurance Company. Read Full Article…

HVBA Article Summary

1. Abuse of Authority and Enrichment: The lawsuit alleges that Aetna, entrusted with a fiduciary duty under ERISA to manage claims with care and prudence, abused its authority for self-enrichment. By taking money from Grainger under the guise of claims administration, Aetna purportedly transferred funds to its own accounts, paid only a fraction to healthcare providers, and retained the difference, unjustly benefiting itself at Grainger's expense.

2. Deception and Concealment: Aetna is accused of actively deceiving Grainger by concealing breaches of its duties. Through tactics such as limiting audit rights, providing false claims reports, and obstructing access to transaction data, Aetna allegedly prevented Grainger from discovering its improper conduct, thereby exacerbating Grainger's losses.

3. Breach of Fiduciary Duties: Despite being entrusted with discretionary authority over plan management and asset disposition, Aetna purportedly breached its fiduciary duties. By approving and paying false, fraudulent, and improper claims, and commingling funds between different accounts, Aetna is accused of causing significant financial harm to Grainger. The suit seeks remedies including reimbursement for losses, disgorgement of profits, preliminary injunction for claims data disclosure, and other appropriate relief, emphasizing the importance of fulfilling fiduciary obligations in both health and retirement plans under ERISA.

Is Mental Illness 'Transmissible'?

By Alicia Ault - Teens with classmates who have a mental illness have a significantly greater risk for a psychiatric diagnosis later in life, even after controlling for parents' mental health history and other factors, a new study suggested. Read Full Article…

HVBA Article Summary

1. Peer Influence on Mental Health: The research highlights that adolescents within specific peer networks may transmit mental disorders like depression and anxiety to each other. Having a classmate with a mental illness was associated with a 3% higher risk for subsequent psychiatric diagnosis, with the risk peaking at 13% in the first year of follow-up, particularly for mood, anxiety, and eating disorders.

2. Large-Scale Study on Adolescent Mental Health: This study, involving over 700,000 ninth graders in Finland, is the largest to date on the topic. It followed participants for up to 18 years, providing significant insights into the potential peer influences on mental disorders among youth.

3. Causality and Treatment Implications: While the study suggests a potential transmission of mental disorders within adolescent peer networks, the authors caution that the observed associations do not prove causation. The findings offer new directions for treatment, such as incorporating peer support, particularly for adolescents, although further research is needed to understand the mechanisms underlying peer influence on mental health.

Semaglutide Significantly Improves Chronic Kidney Disease

By Nancy A. Melville - Semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has shown significant benefits in preventing major kidney disease, cardiovascular events, as well as mortality in patients with chronic kidney disease (CKD) and type 2 diabetes in the landmark FLOW trial. Read Full Article…

HVBA Article Summary

1. Semaglutide's Kidney Protection: The FLOW trial, led by Vlado Perkovic and Katherine R. Tuttle, marks a milestone in diabetes care by demonstrating the kidney-protective effects of GLP-1 receptor agonists, specifically semaglutide. The trial, conducted internationally with 3533 patients, revealed a significant 24% reduction in the risk of major kidney events among those treated with semaglutide compared to placebo, fundamentally altering treatment paradigms for diabetic kidney disease.

2. Incorporation into Treatment Guidelines: The study's findings are expected to prompt regulatory agencies and medical guidelines to integrate semaglutide as a recommended therapy for diabetic kidney disease alongside established treatments like RAAS blockers and SGLT2 inhibitors. The addition of semaglutide as a fourth pillar underscores its efficacy in mitigating kidney complications, aligning with the evolving landscape of precision medicine in managing comorbidities of diabetes and CKD.

3. Addressing Therapeutic Combinations: Despite the trial's success, questions linger about the optimal use of semaglutide in conjunction with other standard treatments, notably SGLT2 inhibitors. Ongoing research aims to discern whether combining these therapies yields additive benefits, challenging the notion of an either-or approach. This highlights the need for nuanced treatment strategies tailored to individual patient profiles, emphasizing the importance of comprehensive care in combating the dual pandemic of diabetes and kidney disease.

Reversing progress, stroke rates are rising, especially in working-age adults

By Elizabeth Cooney - Stroke prevalence has been climbing over the past decade, reversing a steady decline among all Americans while rising the most among adults under 65, a new CDC analysis reports. Read Full Article…

HVBA Article Summary

1. Shift in Stroke Prevalence: While strokes traditionally affected older adults, there's been a notable increase in younger age groups, particularly those under 45. Despite advancements in medical treatments and technologies, stroke rates in the United States had fallen but then surged again by 7.8% overall and by 15% for adults under 65 from 2010 to 2022.

2. Rising Risk Factors and Behaviors: The rise in stroke prevalence among younger adults is associated with shifts in risk factors and health-related behaviors. Factors such as obesity, high blood pressure, and opioid use have increased among younger age groups, contributing to the uptick in strokes. The opioid epidemic, along with infective endocarditis, has been identified as a significant factor in stroke-related hospitalizations for individuals under 45.

3. Persistent Disparities and Awareness Needs: Ethnic and racial disparities persist in stroke prevalence, with certain groups experiencing higher rates than others. Additionally, individuals with lower education levels have a higher prevalence of strokes, often linked to limited access to healthcare. There's a crucial need to expand awareness not only of stroke symptoms but also of underlying health conditions that increase stroke risk. Prevention and early intervention strategies targeting conditions like hypertension and diabetes are crucial for reducing the impact of strokes, emphasizing the importance of public health initiatives and improved access to healthcare.

Big Pharma’s most improved drugs: a new generation of blockbusters

By Michael Gibney - Every blockbuster drug needs to start somewhere. Behind the bestselling treatments atop a major pharma’s earnings statement are products that might not be raking in the big sales numbers yet but have grown significantly in the beginning of their life cycles. Read Full Article…

HVBA Article Summary

1. Eli Lilly's Mounjaro: Despite facing supply issues due to overwhelming demand, the GLP-1 diabetes and weight loss drug Mounjaro saw a remarkable revenue surge of 218% from Q1 2023 to Q1 2024, signaling a new era of growth for Lilly as it ramps up its supply chain to meet market needs.

2. Novo Nordisk's Wegovy: Novo Nordisk's GLP-1 medication, Wegovy, experienced explosive growth, doubling its sales over the course of a year and demonstrating the company's significant impact on the diabetes and weight loss landscape, with soaring demand indicating promising future prospects.

3. Johnson & Johnson's Tecvayli: J&J's bispecific T cell engager, Tecvayli, emerged as a stronghold for the company, doubling its sales from 2023 to 2024 and highlighting the demand for innovative treatments, particularly in challenging areas like multiple myeloma, indicating a shift towards newer therapies amidst changing market dynamics.