‘Why On Earth Would Any Senator Vote for a Bill That Causes 22 Million People to Lose Their Health Insurance?’ Connecticut Senator Murphy asks.

As Senate Majority Leader Mitch McConnell counts the dwindling number of GOP votes for the Republican healthcare bill, the  Congressional Budget Office tallied the potential losses — of insurance coverage for millions of people. Oh, the entire population of 13 states, Sen. Chris Murphy (D-Conn.)  says, calling the measure a “humanitarian disaster.”

Sure, it gets rid of Obamacare and its problems, but the proposed GOP Senate healthcare bill makes everything else worse, Murphy said on the Senate floor last night.

At least 22 more Americans would lose coverage under the Republicans’ Senate bill, with an estimated 49 million uninsured by 2026, the CBO report released yesterday says. That compares to  28 million lacking insurance that year under the current Obamacare.

The House bill said one million more in the U.S. would lose coverage.

Premiums would go through the roof, especially for the poor and elderly. Medicaid takes a huge hit under the Senate bill, the report says. Remember President Trump’s vow to keep it intact  He wanted less meanness, more heart?

“The largest savings would come from reductions in outlays for Medicaid – spending on the program would decline in 2026 by 26 percent in comparison with what CBO projects under current law,” the report says.

Are the Republicans courting disaster for themselves and the populace?  More GOP Senators say they are against or hedging against the bill. The measure is teetering at best. McConnell is the ringleader of the bill. (Interestingly, the  Daily Beast reports that a free government clinic helped save McConnell’s life years ago…..oh that government!)

“This CBO score should be the last straw for Republicans,” Murphy said in a statement. “Why are on earth would any senator vote for a bill that causes 22 million to lose their health care, drives up healthcare premiums, and reduces the quality of care people receive?”

“This bill is a humanitarian disaster and now CBO has confirmed this fact. Republicans should scrap this monstrosity of a bill and sit down with Democrats to craft a better path forward for our country’s health care system,” Murphy said.

Next year alone, 15 more people would be uninsured under the proposed Senate bill than under Obamacare, mostly because the penalty for not having insurance would be eliminated, the CBO says. The number of uninsured would increase to 19 million in 2020, and 22 million in 2026. It would then increase in subsequent years.

The Senate plan would reduce the deficit by $320 billion through 2017, at least $220 billion more than the estimated savings of the House bill, the report says.

 

 — Joe Cantlupe

A Day in the Life of Healthcare, A Sickening Feeling

At the Florida rehabilitation facility, the musician pounds his piano and sings some really old oldies – and the patients shuffle their feet, clap to the songs, and try to move their wheelchairs to get a better view. The patients are mostly in their 80s.

The music is a bit of a joyful reprieve from the day’s often mind-numbing ritual at the facility.  A few patients walk slowly in the halls. A  few babble incoherently or break the silences by screaming.  Someone is sitting near the nurse’s station, seemingly fighting off a dizzy spell from medications.  A woman demands a visitor roll her wheelchair to her room, only to find it is someone else’s.

There is singing in one room, where a patient is reportedly celebrating a birthday a few years beyond 100.  In contrast, some patients don’t seem to have any visitors. The other day there was a scary moment: someone fell inside her room, startling everyone, as the staff scrambled to help her.

This is a stop from a hospital stay for a patient, often from a chronic condition or a nagging ailment, part of aging. Some have been in and out of the hospital and the rehabilitation center several times over the last few months.  Others may be on their way home, a dream.

I am visiting a family member, who is recovering from an infection and can’t wait to leave after repeat visits to the rehab center.  Blaring from the rooms are the TVs, where healthcare seems to be all the news all the time: the Senate’s once secret, but now almost ready for a vote, healthcare bill.   Today on CNN, chief political correspondent Dana Bash interviews HHS Secretary Tom Price, who dismisses Obamacare and vows the administration is working to ensure people don’t fall through the cracks. Price keeps talking up the GOP plan, and Bash, a solid professional, peppers him with questions, focusing on the gaping inconsistencies of the promise vs. the plan. As Price answers, she has an incredulous look on her face, listening politely to Price’s answers. Like, really?

To me, it’s a blur what he’s saying. I’m astonished by the obfuscation. The untruth.

For some reason, I feel even worse on this day, surrounded by the truth of healthcare, in this rehabilitation center. The Senate GOP’s plan, as the New York Times reports, shifts “money from the poor to the rich,” with substantial cuts in Medicaid, and the potential for more people to lose insurance coverage. Here at this rehabilitation center aren’t the poor, exactly, but I can only imagine the struggle ahead for many of them and their families if this bill is passed. As AARP notes, cuts in Medicaid would eliminate funding for “millions of low-income and vulnerable Americans,” including 17 million senior citizens, and children and adults with disabilities. A so-called “age tax” would allow insurers to “charge older Americans five times more for coverage than everyone else while reducing tax credits that help make insurance more affordable,” AARP said.

“This new Senate bill was crafted in secrecy behind closed doors without a single hearing or open debate – and it shows,” said AARP Executive Vice President Nancy LeMond. “The Senate bill would hit millions of Americans with higher costs and result in less coverage for them.”

AARP isn’t the only one railing against this piece of legislation that sends America into the dark ages of healthcare protections.  It seems most of healthcare is against it.

I walked the corridors of the rehabilitation facility after I stopped listening to the music. I wonder how many of these patients even know who Mitch McConnell is.  The Senate majority leader is said to be working the chamber back doors in hopes of rounding up the necessary votes to pass the bill, a potential close call as seemingly more Senators indicate they just aren’t ready to stomach the plan.

Thinking of those people in the rehab center,  it’s hard not to have a sickening feeling, and wonder why these politicians don’t feel bad about potentially costing so many lives if this bill is passed.  Maybe they should visit the sick and the aged to help them understand the importance of healthcare, compared to political rhetoric.

— Joe Cantlupe

A Bundle of Caution

While many support bundled payments in healthcare – how hospitals and physicians are reimbursed through so-called “episodes of care” — for their impacts on quality and cost of care, there are still many challenges ahead.I explore the status of bundled payments with my colleagues in a piece for athenahealth insight.

As the story notes: “Under the Obama administration, many healthcare organizations looked at bundled payments as the first step toward major payment reform — and assumed that more and more providers would need to gain competency with them.”

 

“But under the Trump administration, the future of bundled payments is uncertain. Secretary of Health and Human Services Tom Price, M.D., has spoken out against the programs. His department has delayed a proposed expansion of some mandatory bundling initiatives, as well as the implementation of new cardiac and orthopedic bundled-payment models.”

“And even some major advocates of alternative payment models have asked HHS for revisions and delays.”

— Joe Cantlupe

 

Blink Health Announces Giving Away $10 Million Worth of Prescription Meds To Its Diabetes Patients

In a real and symbolic move to address the high prices of drugs, Blink Health, the low-cost online drug and prescription service, says it is giving away a free year’s supply of the top three generic prescribed medications for type-2 diabetes patients who create a company account.

The New York City-based company announced today it has committed to $10 million in free medications in its #TreatType2 program, which it says represents savings to consumers of up to $80 million.

“Diabetes is a growing epidemic that affects 1 in 11 Americans, and Blink Health is committed to doing all it can to help patients manage this chronic illness,” said Geoffrey Chaiken, co-founder and CEO of Blink Health in a statement. “We have seen far too many people who are struggling to afford prescription medication, and we’ve launched this program to help address the problem one patient at a time.”

At least 29 million Americans have diabetes, with 90 percent having type 2; their healthcare costs are more than twice those who are not managing the chronic illness, according to Blink Health. The top three generic medications for type 2 diabetes that will be given away are metformin, glipizide, and pioglitazone, the company says.

Patients having a prescription for any or all of these three medications are eligible to receive the drugs for free, the company said. As a free prescription service, the medication can be picked up at over 57,000 pharmacies nationwide, including Walmart, CVS, Rite-Aid, Target, and most independent pharmacies and grocers, according to the company. The program also will cover these three medications for existing Blink Health patients who use them.

“Everyone enrolled in the program must have a prescription for the three covered medications,” said spokeswoman Renee Soto. “If they have a Blink account and a prescription, they can receive a free, one-year supply of one or more of the medications. We hope there is no confusion and we have customer service representatives standing by to answer questions.” Blink estimates that the giveaway will be able to “cover hundreds of thousands of patients,” Soto says. “We hope that as many as possible will sign up.”

Blink officials could not say precisely how much each patient could save on the prescriptions, with Soto noting that it will “depend on how much they are currently paying for the drugs out-of-pocket, what their dosage is.”

The company publishes the average price of all medications on its website, and if someone enters the names of the drugs, they can see how much the medication costs, compared to Blink charges. As an example, the average price for 30 tablets of pioglitazone 30 mg is $294.74. Blink offers that medication for $13.83. Under the program, the cost would be “zero,” Soto says.

Another diabetic medication, metformin, the average retail price is $20.74. Blink Health currently offers it for $5.28, a 74 percent discount. Again, that price would be zero, she says.

Blink Health, which was profiled in February’s Health Data Buzz, has been attracting new customers who have been buying medications about 50 percent lower than they usually spend, for drugs $10 or less, while drug costs overall have continued to climb.

Blink Health’s customers purchase their medications through Blink’s website or app, both free, and then take their prescriptions to any pharmacy in the country to be filled. At the pharmacies, the customers then show their “Blink Card,” which is proof of purchase and receive their medications. No payment is made to the pharmacy.

The company also announced it is offering a 40 percent discount on Eli Lilly insulin through what they describe as a first of its kind access program.

“There is no catch, no hidden fees,” the company says. “This is something we are doing to help people manage this illness and to raise awareness of the huge impact diabetes has on our healthcare system and the lives of so many millions of Americans.”

“If you know anyone living with diabetes, we hope you’ll help us spread the word about this new program.”

In April, Blink Health raised $90 million to drive innovations that accelerate its mission of making prescription medications affordable and transparently priced for everyone in the U.S.

— Joe Cantlupe

 

Gathering Intelligence: Antimicrobials

First of an occasional series  

The fight against antimicrobial resistance is ongoing, on many fronts, and in some ways, scientists are working like spies, gathering intelligence, figuring out the landscape of each person’s ability to thwart infection, what new threats are out there, and how to confront them.

You name it: anti-infective medications, antibiotics, antibacterial, anti-fungal, antivirals, antiprotozoals.

These drugs, used against infectious diseases over the decades, are increasingly finding resistance. At least 23,000 people die each year as a result of infections with bacteria resistant to antibiotics, and many more perish from related complications, says the Centers for Disease Control and Prevention.

VigiLanz of Minneapolis, is one of those digital intelligence companies on the forefront of this fight, with an antimicrobial stewardship platform that is not only trying to combat these infections as they appear – but also working to thwart those that are still evolving but haven’t even been named yet.

“Organisms out there are becoming more resistant in response to pharmaceuticals, and the response to that has to come in real time,” says Stacy Pur, the company’s VP of Clinical Intelligence. “You need a module that can be flexible enough to not only identify those cases that are known and published in the literature, but even those not yet published, having a novel type of resistance.”

VigiLanz says it is helping hospitals and health systems save patient lives and improve the efficiency of care. It is doing so by leveraging data collected from a hospital’s electronic medical record, physician order entries, and laboratory and pathology systems to monitor patients for drug interactions and ineffective or inappropriate antibiotics – right now, the company says.

Predictive Analytics

The key is what VigiLanz calls a “flexible electronic platform,” pharmacy stewardship programs,  infection prevention tools and applying the predictive analytics measures. That goes to the heart of patient safety, quality improvement, and cost containment issues, Pur says.

Pur says the company’s data programs have delved into numerous drug scenarios and resistance patterns associated with those medications, with “ongoing surveillance.”

Finding those new patterns are extremely important, “because once resistance is established, it is difficult to eradicate,” Pur says. “When you are able to identify the first case when it shows up, it’s much easier to prevent that from becoming embedded in the patient population.”

The antimicrobial threat is real and growing. “While antibiotics and similar drugs, called antimicrobial agents, have been responsible for reducing deaths and illnesses from infectious diseases, they have been used so much over the past 40 years, the infectious organisms the antibiotics are designed to kill have adapted to them, making them less effective,” the CDC notes.

At least 2 million people each year become infected with bacteria that are resistant to antibiotics, causing severe illnesses such as sepsis, the CDC says. The organism known as methicillin-resistant Staphylococcus aureus (MRSA) is responsible for more deaths annually than “emphysema, HIV/AIDS, Parkinson’s disease, and homicide, combined,” according to the Infectious Diseases Society of America.

Vigilance and a Relentless Fight

National health officials are working feverishly to combat the antimicrobial threat, using data as a key component, with companies such as VigiLanz helping to lead the way. Healthcare systems and physicians are coordinated electronically with VigiLanz in a system that identifies antimicrobial threats. VigiLanz has been working for more than a decade with its “platform that specifically addresses antimicrobial use with the goal to prevent resistance,” Pur says.

“VigiLanz has a proprietary system that is highly complex and allows us to build rules that generate very targeted alerts, aligning the clinician more closely with what they need,” Pur says. “It is both a predictive model that helps the healthcare worker intervene sooner, and supports the clinician in outpatient settings as well.”

When potential issues are identified, alerts are triggered to enable clinical pharmacists and other members of the care team to take appropriate action. “They are sending us real time data coming out of the electronic medical record,” Pur says.

The alert system “has a broad spectrum of data” and is geared toward the organization using it and “really varies of what the acute needs are,” she adds.

There are plenty of alerts out there, but too often they are not targeted or focused and “that’s where healthcare needs to go,” she says. The VigiLanz system provides standardization, “smart alerting what people need to know.” For instance, the VigiLanz system may identify patients who not only need more treatment but those that have had too much. At least 160 hospitals and health systems are using the VigiLanz system.

Meaningful Use Certification

Recently, VigiLanz announced it is one of the first to achieve Meaningful Use Stage 3 certification for use by facilities enrolled in the CDC’s National Healthcare Safety Network (NHSN), dubbed the nation’s most widely used healthcare-associated infection tracking system, for Antimicrobial Use and Antimicrobial Resistance (AUR) reporting.

The data allows clinicians to better benchmark their antibiotic usage and organism resistance nationally to target areas of improvement, according to the CDC. The registry has been used to help the CDC get a better handle on the impacts of antimicrobial resistance in hospitals and healthcare facilities.

Although the VigiLanz model has been around since 2001, VigiLanz leans on its name and what it stands for – vigilance – and the company constantly updates its programs to deal with new and evolving issues. “We make it compatible with the new issues that are emerging each day,” Pur says.

Interestingly, as hospitals and health systems juggle more data, sometimes it’s actually more difficult for them to get the information they really need.

“Even with significant investments in the electronic medical record (EHR) systems, today’s clinicians are still in need of easier access to the insights that can help them improve care delivery,” said VigiLanz CEO Dr. David Goldsteen at a recent conference.

“Data and analytics – when leveraged in real-time – can help bridge this gap, enabling improved decision-making and predictions that link directly to clinical, operational and financial outcomes,” he said.

— Joe Cantlupe

Trump Trashes Paris Agreement; Mocks Green Climate Fund – ‘Nice Name’

 

Health Data Buzz Editorial

There are not many worldwide efforts, generally, where most nations overwhelmingly agree. The Paris climate agreement is one of those. And it’s a doozy:  the future of human health at stake.

The goal is to reduce air pollution, have cleaner technologies, improved air quality, or as a Harvard news article put it a few years ago, the prospect of  “fewer droughts, low-carbon, (a) climate resilient future, less disruption to agriculture and food supplies and a dietary shift to less meat and more plants.”

“This is a strong agreement for public health, probably one of the biggest we’ll sign this century,”  María Neira, director of the World Health Organization’s Department of Public Health and Environment, was quoted at a Harvard T.H. Chan School of Public Health meeting.

The world was so happy when China and the United States formally joined the Paris agreement,  with those two countries, Russia, India, Japan, and Germany accounting for over 55 percent of total global greenhouse gas emissions.  The U.S. ranks second to China as the nation’s top greenhouse gas emitters.

“The Paris Agreement is an ambitious, dynamic and universal agreement.  It covers all countries and all emissions and is designed to last.  This is a monumental agreement. It solidifies international cooperation for climate change. It provides a way forward,” United Nations officials said in a Q and A,

“The agreement provides a pathway forward to limit temperature rise to well below 2 degrees, maybe even 1.5.  The agreement provides a mechanism to increase the level of ambition.”

Part of that effort is the Green Climate Fund described as a “unique global initiative to respond to climate change by investing into low-emission and climate resilient development.” It adds:  “Given the urgency and seriousness of the challenge, the Fund is mandated to make an ambitious contribution to the united global response to climate change.”

“Climate change is the defining challenge of our time. The human impact on our planet is unprecedented. Long-term changes in the earth’s climate system are significant,” the fund states.

Many pro-earth organizations have been unabashed in their support of the Paris agreement.

“Dozens of American mayors—spread throughout the U.S.—sent an open letter calling on the President to continue being an active participant in the Paris agreement. These local elected officials know that their constituents want more action on climate and that global action is needed,” National Resources Defense Council wrote earlier this year. “States and provinces around the world also benefit from the mechanisms of cooperation that the Paris Agreement has built. State, provincial and local governments in the Under2 Coalition, led by California, have secured commitments to reduce emissions 80 percent by 2050 across 165 different jurisdictions. These areas represent close to $26 trillion, or one-third of global GDP.”

No Thanks
To all this and much more, President Trump’s response: “We’re getting out.”

The go-with-the-gut President announced his decision for the U.S. to withdraw from the Paris climate agreement, and as  The Washington Post reported today, “relied on dubious facts and unbalanced claims” to make his case.

“I was elected to represent the citizens of Pittsburgh, not Paris,” he said, making his announcement. “I  promised I would exit or renegotiate any deal which fails to serve America’s interests. Many trade deals will soon be under renegotiation,” Trump said. “Very rarely do we have a deal that works for this country, but they’ll soon be under renegotiation.  The process has begun from day one.  But now we’re down to business.”

Trump said the Paris accord was “yet another scheme to redistribute wealth out of the United States through the so-called Green Climate Fund — nice name — which calls for developed countries to send $100 billion to developing countries all on top of America’s existing and massive foreign aid payments.”

“So we’re going to be paying billions and billions and billions of dollars, and we’re already way ahead of anybody else.  Many of the other countries haven’t spent anything, and many of them will never pay one dime,” Trump said.