Biden invokes Cold War-era measure to boost medical supplies

By Steve Holland and Jason Lange - President Joe Biden on Monday invoked a Cold War-era measure to boost investment in U.S. manufacturing of medicines and medical supplies that he has deemed important for national defense. Read Full Article…

VBA Article Summary

1. Supply Chain Improvement and Inflation Control Efforts: President Biden used the inaugural meeting of his supply chain resilience council to highlight the administration's progress in addressing disruptions caused by the COVID pandemic. He acknowledged ongoing challenges but emphasized efforts to stabilize supply chains and manage inflation. Biden referenced the use of the Defense Production Act to increase U.S. manufacturing of medical supplies and medicines, part of a broader strategy of 30 measures aimed at strengthening industrial supply chains and countering high inflation.

2. Investment in Health and Supply Chain Monitoring: The administration, under Biden's directive, authorized the Department of Health and Human Services to leverage the Defense Production Act for investments in essential medicines and medical countermeasures. This includes resources for diseases related to chemical, biological, radiological, or nuclear attacks. Furthermore, the federal government plans to enhance supply chain monitoring through inter-agency data sharing, with the Commerce Department developing new tools to assess supply chain risks, including those related to renewable energy resources.

3. Political Context and Consumer Benefits: As Biden gears up for the 2024 re-election campaign, addressing inflation and economic concerns remains crucial. Despite a reduction in consumer prices from last year’s highs, inflation continues to pose a political challenge. Biden's National Economic Council, led by Lael Brainard, acknowledges the need for continued work on supply chain stress. Biden also pointed to the potential for U.S. consumers to experience a cost-effective holiday shopping season, citing stocked shelves and improved supply chains as evidence of his administration's success in these areas.

Gov. Kathy Hochul reviewing biomarker testing bill that doctors say is game changer in treating cancer

By Carolyn Gusoff - A bill on Gov. Kathy Hochul's desk would make insurance companies cover what doctors call life-saving cancer genetic testing. Biomarker testing helps create more targeted treatment plans. However, one-third of health plans don't currently cover it. Hal Sieger recently thanked his doctor after reversing stage 4 melanoma. "It was terrible, very bad. Everyone thought they were going to lose me," Sieger said. Read Full Article…

VBA Article Summary

1. Personal Impact and Medical Innovation: The article begins with a patient's experience, highlighting how biomarker testing at Northwell Labs led to the successful treatment of his cancer using precision drugs. This testing, which identifies genetic mutations responsive to targeted drugs, played a crucial role in reversing his cancer, emphasizing the importance and effectiveness of personalized medicine in cancer care.

2. Insurance Coverage and Legislative Action: A significant focus of the article is on the challenges of insurance coverage for biomarker testing. Despite its life-saving potential, 32% of insurance carriers, including Medicaid, do not cover all biomarker tests. The article discusses a bill passed in Albany that mandates insurance coverage for biomarker testing, similar to other cancer treatments, reflecting a legislative effort to make these crucial tests more accessible and standard in medical care.

3. Broader Applications and Health Equity: The article also touches on the wider applications of biomarker testing beyond cancer, including in diseases like arthritis and preeclampsia, and its role in saving time and reducing ineffective treatments. It highlights the ongoing efforts to reduce health disparities, as the high out-of-pocket cost of these tests limits access for many patients. The recent legislative changes are seen as a step towards equalizing access to advanced medical treatments and reducing overall healthcare costs.

Higher Incidence of COVID-19 Found Among Consistent Mask-Wearers: Study

By Naveen Athrappully - People who wore protective masks were found to be more likely to contract COVID-19 infections than those who didn't, according to a recent Norwegian study. Read Full Article…

VBA Article Summary

1. Norwegian Study on Mask Use and COVID-19 Incidence: A peer-reviewed study from Norway, published in the journal Epidemiology and Infection, analyzed mask usage among 3,209 individuals. It found that frequent mask wearers had a higher incidence of COVID-19. The study initially indicated that individuals who wore masks sometimes or often had a 33 percent higher incidence of contracting COVID-19 compared to those who seldom wore masks. This increased to 40 percent among regular mask users. However, after adjusting for various factors, the increased risk was only 4 percent.

2. Contradictory Findings and Study Limitations: The study's results contrast with previous research, which generally indicated that mask-wearing reduces the risk of COVID-19 infection. The researchers acknowledged limitations in their study, such as the possibility of mask wearers using masks due to their own infection risk, reliance on self-reporting, and behavioral biases. They also suggested that mask wearers might have neglected other preventive measures like social distancing, thereby increasing their infection risk.

3. Context of Masking Policies and Further Research Need: Amid fluctuating mask mandates in North America, the study arrives at a critical juncture. It emphasizes the need for caution in interpreting observational studies on mask-wearing and infection risk. The researchers advocate for more comprehensive trials to better understand the effectiveness of masks against respiratory pathogens. Meanwhile, regions like the Bay Area and certain hospitals in Canada have reinstated mask mandates, whereas states like Texas and Florida have opposed such mandates.

How much is the economic loss of untreated mental illness? One state did the math

By Elizabeth Gabriel - Doctors diagnosed Willie Frazier with depression when he was about 13 years old and borderline personality disorder roughly six years later. “As I got older, all the colors in the world would just become so dull. Like, the things you love you will no longer really care for. And it's just like, why? Like, why what's going on?” Read Full Article…

VBA Article Summary

1. Prevalence and Financial Impact of Untreated Mental Illness: In Indiana, approximately 400,000 individuals suffer from untreated mental illness, contributing to a range of adverse effects, including heightened risk of chronic conditions and unstable lives. A 2008 study highlights the national economic burden, with untreated mental illness costing the U.S. nearly $193 billion in lost earnings annually. In Indiana alone, the cost reached $4.2 billion in 2019, surpassing the revenue generated by the state's leading commodity, corn. This financial loss is partly due to lost wages, reduced productivity, and strained criminal justice and homelessness services.

2. Barriers to Mental Health Care Access: Multiple barriers hinder access to mental health treatment in Indiana. Stigma, particularly in communities of color, plays a significant role in deterring individuals from seeking help. In a 2018-2019 California survey, only a small percentage of minority groups reported feeling comfortable discussing mental health issues. Additionally, systemic issues like unreliable transportation, inadequate internet for telehealth, and insurance coverage challenges exacerbate the problem. Indiana has a severe shortage of mental health providers, with 560 individuals per provider, ranking eighth worst in the country.

3. Efforts and Potential Solutions for Mental Health Care: Indiana lawmakers have taken steps to address mental health care challenges, such as passing Senate Bill 1, which focuses on expanding community mental health services and establishing a crisis hotline. However, experts argue that these measures, while positive, are insufficient to significantly address the complex issue of mental illness. Mental health professionals emphasize the importance of social support and open discussions about mental health to reduce stigma and encourage individuals to seek treatment. Personal stories, like that of Willie Frazier, illustrate the ongoing struggle to overcome mental health challenges and the need for better access to care and support systems.

If you or someone you know is in crisis, please call, text or chat with the Suicide and Crisis Lifeline at 988, or contact the Crisis Text Line by texting TALK to 741741.

Cigna said to be going after Humana to buy its way into Medicare Advantage

By Wendell Potter - Cigna and Humana, the two big insurers where I worked for nearly two decades, reportedly are in secret talks to join forces. The union–which would create a company much closer in size to UnitedHealthcare and CVS/Aetna, the fifth and sixth largest companies by revenue in America–likely would take shape as an acquisition of Humana by Cigna. Read Full Article…

VBA Article Summary

1. Strategic Business Realignments: Humana and Cigna, two major players in the health insurance industry, are undergoing significant changes in their business models. Humana, a leader in Medicare Advantage plans, is exiting the commercial health insurance business, while Cigna is reportedly considering selling its Medicare Advantage business. These moves are seen as strategic steps to facilitate a potential merger that could pass regulatory scrutiny, given their respective focuses on different market segments.

2. Financial and Market Positioning: Cigna's growth and market capitalization have been significantly enhanced by its acquisition of Express Scripts in 2018, shifting its revenue focus more towards pharmacy benefits management. Despite this, it remains a smaller player in the Medicare space compared to Humana. Cigna's current market capitalization is around $85 billion with substantial revenues, while Humana's market cap is above $63 billion. A merger would create a combined entity with a considerable market presence, but still smaller than the industry leader, UnitedHealthcare.

3. Potential for Merging and Industry Dynamics: The speculated merger between Cigna and Humana is not new; similar discussions were in the air in 2017. The current healthcare market, especially the lucrative Medicare Advantage sector, makes a merger increasingly attractive. Humana's recent appointment of Jim Rechtin as COO and future CEO, with his background in healthcare mergers, adds to the speculation. This merger would significantly consolidate their market positions, although UnitedHealth would remain the largest player in terms of enrollment.

Ardent Health Services hit with ransomware attack, forcing hospitals in multiple states to divert ambulances

By Heather Landi - Hospitals in multiple states have been forced to divert ambulances and reschedule some elective patient procedures after U.S. hospital owner Ardent Health Services was hit with a ransomware attack. Read Full Article…

VBA Article Summary

1. Cybersecurity Incident at Ardent Health Services: On Thanksgiving, Nashville-based Ardent Health Services experienced a ransomware attack. This led to the company taking its entire network offline, affecting numerous IT applications, including corporate servers, Epic software, the internet, and various clinical programs. Ardent Health Services operates 30 hospitals and over 1,300 aligned providers across six states.

2. Impact and Response Measures: The attack has caused significant disruptions. Some Ardent facilities are rescheduling non-urgent procedures and redirecting certain emergency room patients to other hospitals. The company has continued delivering patient care despite these disruptions. In response, Ardent has engaged law enforcement, forensic experts, and cybersecurity specialists to restore its IT operations. However, the extent of compromised patient health or financial data remains unconfirmed.

3. Wider Implications and Industry Perspective: The Ardent Health Services incident underscores the growing threat of cyberattacks in the healthcare sector. Experts highlight the increasing sophistication of cybercriminals and the need for proactive cybersecurity measures. This incident is part of a larger trend of cyberattacks on healthcare organizations, as seen with previous attacks on networks in Florida, Idaho, and Prospect Medical Holdings, affecting hundreds of thousands of patients.

States Making Progress Toward Setting Payment Limits for Some Drugs

By Joyce Frieden - ​As drug prices continue to rise, some states are fighting back through the use of prescription drug affordability boards (PDABs), which usually set limits on how much some patients will have to pay for medications. Read Full Article…

VBA Article Summary

1. Origins and Implementation of PDABs: Prescription Drug Affordability Boards (PDABs) were initiated by Jennifer Reck and the National Academy of State Health Policy (NASHP) in 2016 to address states' struggles with soaring drug prices. PDABs use rate-setting as a tool to establish Upper Payment Limits (UPLs) for in-state drug transactions, adhering to federal law and the U.S. Constitution's Commerce Clause. As of now, eight states have implemented PDABs, each with varying scopes of authority. For instance, Maryland's PDAB applies UPLs to state-run health plans, whereas Colorado's extends to nearly all state-governed plans.

2. Colorado's Leadership in PDAB Progress: Colorado is recognized as the most advanced in implementing PDABs, having established its board in 2021. The board has been active in setting up the program, including forming a 15-member advisory council. It has initiated affordability reviews for five drugs, considering various criteria like health equity impact and patient cost-sharing information. Colorado's progress is attributed to the specific legislative requirements and the pace set by the PDAB board.

3. Maryland's Approach and Broader Implications: Maryland's PDAB, established in 2019, is making significant progress with its independent agency structure and a diverse 26-member stakeholder council. The state is preparing for its first round of drug cost reviews in 2024. Maryland’s PDAB, like others, can add nuance to the conversation about drug pricing by considering a broader range of factors than the federal Medicare drug price negotiation program. The PDABs' impact extends to physicians, with potential changes in how they dispense and bill for medications.

Back pain? Bum knee? Be prepared to wait for a physical therapist

By Mark Kreidler - ​At no point along his three-year path to earning a degree in physical therapy has Matthew Lee worried about getting a job. Being able to make a living off that degree? That's a different question — and the answer is affecting the supply of physical therapists across the nation: The cost of getting trained is out of proportion to the pay. Read Full Article…

VBA Article Summary

1. Shortage of Physical Therapists (PTs) and High Student Debt: The United States faces a significant shortage of physical therapists, with a notable job vacancy rate of 17% in outpatient settings as reported by the American Physical Therapy Association. Students like Lee from California State University-Sacramento, who are pursuing PT degrees, are concerned about starting salaries around $80,000 while grappling with potential student debts up to $200,000. This economic challenge is exacerbated in high-cost living areas and rural regions, where the shortage is particularly acute.

2. Industry Challenges and Economic Shifts: The physical therapy industry has not fully recovered from the mass exodus of PTs during the pandemic, with over 22,000 leaving their jobs in 2021. The field is further stressed by aging baby boomers requiring more physical therapy and the backlog of delayed procedures like knee and hip replacements. Economic shifts, including consecutive cuts in Medicare reimbursement rates and the growing influence of private equity firms in the PT market, are impacting the staffing and operational practices of PT clinics, making them less appealing workplaces.

3. Efforts to Address the PT Shortage and Rising Education Costs: To combat the shortage and high turnover rates, universities are expanding their PT programs, incorporating innovative methods like virtual classes. However, the growth of these programs is limited by rigorous accreditation processes and the increasing cost of obtaining a physical therapy doctorate. The American Physical Therapy Association is lobbying against further Medicare reimbursement cuts and pushing for more transparency in PT program costs. Despite these efforts, the challenges of high student debt and inadequate salaries remain significant hurdles for new PT graduates entering the workforce.

UChicago study finds fatty acid found in some red meat can help fight cancer

By Jenna Greene - In a discovery that might seem to run contrary to health guidelines – but that researchers say really doesn't – new research shows a nutrient found in red meat such as beef and lamb could actually help fight cancer. Read Full Article…

VBA Article Summary

1. Trans-Vaccenic Acid (TVA) and Immune Enhancement: Researchers at the University of Chicago Biological Sciences Division discovered that trans-vaccenic acid, a fatty acid found in meat and dairy products from grazing animals, enhances the ability of CD8+ T cells to infiltrate tumors and destroy cancer cells. This research, published in Nature, also revealed that individuals with higher TVA levels in their blood showed better responses to immunotherapy.

2. Nutritional Impact on Health: The study, led by Jing Chen, PhD, at UChicago, emphasizes the significance of understanding the influence of specific nutrients and metabolites derived from food on human health. By concentrating on nutrients that activate T cell responses, the researchers identified TVA as a crucial element in boosting anti-tumor immunity.

3. Caution Against Overconsumption of Red Meat: Despite these findings, the scientists caution against interpreting this as advice to increase red meat consumption. They point out the established health risks associated with excessive intake of red meat and dairy. Instead, they suggest that nutrient supplements like TVA could be used to enhance T cell activity, noting that other plant-based fatty acids also signal through similar receptors to TVA. This is in light of other studies, like one from Harvard University, highlighting the increased risk of type 2 diabetes with regular red meat consumption.