Current Events

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Real-world cost of health interventions. Looks and career success. Improved PubMed search.  A-APM vs. MIPS  Political alignment and tax evasion.

Elimination of the Medicaid asset test?

No, this is not coming nation-wide, but it may be on its way in California. Kaiser Health News reports: A provision in California’s newly approved state budget will eliminate the asset test for the 2 million Californians enrolled in both Medi-Cal and Medicare, the federal health insurance program for people 65 and older and people …

Elimination of the Medicaid asset test? Read More »

Bucks in six!

Taking a break today from my normal health economics posting to celebrate my hometown Milwaukee Bucks winning the NBA Championship. What an amazing playoff run! The Sun block… And the alley oop!

Friday Links

$2.2 trillion deficit in 2021. Adverse selection and ACA plans. COVID-19 and panic drug purchasing. Amazon: $6 six-month prescriptions Pharmacist’s opinion on value-based comprehensive medication management

Biden’s Executive Order on Promoting Competition in the American Economy: What does it say about health care?

Last Friday, President Biden released an executive order titled “Promoting Competition in the American Economy” While the order talk about transportation, internet companies, and farming, there were a number of provisions related to health care. I summarize each of these below. Specifically I review OTC hearing aids. Currently, many patients need to visit a doctor …

Biden’s Executive Order on Promoting Competition in the American Economy: What does it say about health care? Read More »

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Administrative simplicity vs. single payer. 340B case heads to the Supreme Court. Marketing and mammograms NY ends state of emergency: what happens to out-of-state licensed health care professionals? Key facts on the Delta Variant.

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Evaluating the robustness of CMS Hospital VBP measurement system. ICER’s gene therapy evaluations. Who are high-frequency hospital users? EHR and malpractice. What is Evio? Has in vivo gene editing come of age?

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Why the FDA approved aducanumab.  How to report changes in clinical trial protocols due to COVID-19 (CONSERVE) Democrats eye Medicare and Medicaid expansions. ACA and biosimilars. The challenges of improving quality of care. Native Americans and health equity.

Friday Links

Supreme court upholds ACA. Nature on lab-leak hypothesis. The geography of global warming. The return of boarding houses.  Business perspective on single payer.

Friday Links

A decade of value-based payment. What caused him to resign from an expert panel. In case you missed it. Do physicians have an “ethical and legal duty” to reinterpret genetic test results? What to do when MCMC fails? Medicare drug price negotiations back on the table?

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Physician compensation during the pandemic. Caring for an aging nation. The debt snowball. Infection rate among the unvaccinated is as high as it was back in January CMS all-in on mandatory pay-for-performance reimbursement. Patients minimize cost by reducing Q, not trying to minimize P.

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Affordability vs. Innovation. “standardizing contracts generates larger savings with less variance than savings from single‐payer strategies” The placebo effect examined Income growth in knowledge industries. Alcohol sales restrictions and alcohol poisoning mortality.

Coronavirus Origins

I’m going to regret writing about this, but it’s not a topic to be ignored. Where did the current coronavirus come from? If you ask that question, you get all sorts of answers from all sorts of people. Let me downgrade some of those right up front. To start at the far end of the …

Coronavirus Origins Read More »

Crypto and COVID

Some interesting and very positive news linking the world of cryptocurrencies to the fight against COVID-19. As reported in Forbes: Ethereum’s co-founder Vitalik Buterin, who became the world’s youngest known crypto billionaire less than two weeks ago, has donated over $1 billion in crypto to the India Covid Relief Fund and a range of other charities. He …

Crypto and COVID Read More »

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LGBTQ Economics. Does health insurance improve health outcomes for cancer patients? Shattered. Mr. Jim. KHN: “Moderna…announced in October that it would not enforce its covid-related patents during the pandemic. Even so, no known independent producer has used the available patents to replicate the company’s mRNA vaccine. Experts say that’s telling.”

Waiving IP

The announcement by the Biden administration about waiving IP rights to the coronavirus vaccines obviously calls for some comment. Keep in mind that I have been doing research in the pharma industry for over 30 years now, so my viewpoint is obviously going to be affected by that, for better and for worse. With that …

Waiving IP Read More »

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Disability and distress. COVID-19 vaccine showdown: California vs. Texas. Opioid trajectories. “beliefs…are insufficiently skeptical about nondisclosed information in the absence of repeated feedback” What is ARPA-H?

Russian Vaccine Behavior

In the last post, I mentioned the Twitter response to the Brazilian rejection of the Gamaleya vaccine. I believe that the official blue-check-marked “Sputnik V” Twitter account is run by the Russian Direct Investment Fund, the sovereign-wealth part of the Russian state that is in charge of rolling out the vaccine to different countries. In …

Russian Vaccine Behavior Read More »

Weekend Links

ACA ‘family glitch’ Hospital price transparency.  NBA players and COVID-19. Good work if you can get it. SPACs and digital health. Dark chocolate is not a superfood.

Friday Links

Urgent care vs. ED. FDA review of old drugs. R&D incentives and innovation spillovers. Pharmaceuticals and the Developing World. Care managers vs cost centers.

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Misperceptions of people with disabilities. A bundled payment success story.   Do people with COVID-19 tell their employers? The history of vaccine backlash. Oral COVID-19 vaccine? Things are getting better. Vaccines in Gibraltar.

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Public health spending lags medical spending. On the importance of pre-analysis protocols. Medicare spends over $10 billion on COVID-19 in 2020.  Home health = infrastructure? Will enrollment in cancer clinical trials continue to be difficult post-COVID? Yes vs No.

Blood Clots and the AZ Vaccine, Revisited

Once again, what’s going on with vascular events and the AZ/Oxford vaccine? I last wrote about this situation a couple of weeks ago, and it’s taken some real turns since then. At that point several EU countries had suspended dosing, but over the next week several began administering the vaccine again after the European Medicines …

Blood Clots and the AZ Vaccine, Revisited Read More »

Mid-week Links

Health insurance coverage for sexual minorities. PhD = doctor? Ghost rides. Mini-COBRA. Pasaporte corona en Dinamarca.

Friday Links

COVID-19 vaccine monitor. Impact of immunotherapies on Medicare cancer cost. Amazon Care telehealth. What’s wrong with my model? Is Brazil’s health system collapsing?

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ISPOR’s new Science Strategy. MedPAC: “CMMI has put 54…[alternative payment] models into practice during the past decade. But only four of them have met the criteria for expansion.” Lifestyle and mental health disruptions since COVID-19. Impact of COVID-19 on small business CDC guidance for the fully vaccinated

Democrats vs. Republicans: Health Policy Battle Royale

Conventional wisdom holds that the U.S. has become more and more partisan and the views of both Democrats and Republicans have become less moderate over time. Is that the case with respect to views on health policy? A paper in JAMA last week by Blendon et al. (2021) conducted probability-based national surveys on four topics …

Democrats vs. Republicans: Health Policy Battle Royale Read More »

Friday Links

Food insecurity and health care spending. Access in a new world. Credibility Revolutionistas.  Do individuals with limited English proficiency use telehealth? Desk clearing and drug safety. UCI: Re-open California schools

Healthcare Economist joins FTI Consulting’s Center for Healthcare Economics and Policy

I am very excited to announce that I have joined the FTI Consulting team. An excerpt from the press release is below. WASHINGTON, March 01, 2021 (GLOBE NEWSWIRE) — FTI Consulting, Inc. (NYSE: FCN) today announced the appointment of Jason Shafrin, Ph.D. as a Senior Managing Director in the Center for Healthcare Economics and Policy within the firm’s Economic Consulting segment. Dr. Shafrin, who will …

Healthcare Economist joins FTI Consulting’s Center for Healthcare Economics and Policy Read More »

Is the UK destined to be the next life science hub?

That is a question considered in the latest edition of The Economist. In the article “How British science came to the rescue“, the magazine notes that COVID-19 had highlighted some of the advantages the UK has. Alongside vast clinical trials, the country has been home to most of the world’s genetic sequencing, the development of …

Is the UK destined to be the next life science hub? Read More »

Friday Links

Impact of reducing air pollution on health expenditures. Does psychotherapy work? Does losing health insurance increase claims for SSI? Why governments decide to de-fund medical services. Can nonrandomized RWE replicate RCTs?

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Medicare Advantage star ratings and quality. ACA and cancer detection. We can open schools safely. SF eliminates gas stoves? Overshooting the output gap?

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Cost of care for residential opioid use disorder treatment 2021 Deficit: $2.3 trillion GAO recommendations on the COVID-19 supply chain “recreational marijuana policies were positively associated with opioid‐related hospitalizations” COVID and mental health. A tale of two thresholds. Hedonic vs. capability views on health. Patients at the center of value assessment.

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What is The birthday rule? EHR kickbacks? Who will be the digital head coach? Why did Haven fail? (one perspective) Is workers’ comp still in the quality-measurement dark ages?

Friday Links

Appropriateness of step therapy. Fiscal impact of anti-obesity medications. Can individual hospitals survive? A health economist takes on Kenya’s pandemic. The invisible graveyard.

Friday Links

Faster drug access in the Netherlands (Drug Access Protocol) “Hospitals might annually exploit extra reimbursements of about 8%–10% from primary diagnosis manipulations” Comparison of costs and benefits of European country COVID-19 responses Health Affairs’ priorities for Biden. Fauci on Trump.

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Pharmacy desserts. Why Israel leads in COVID vaccinations (speculative).  Does temperature screening really work? A mRNA vaccine for multiple sclerosis? Mark Cuban Cost Plus Drugs.

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Palau: A leader in health? The Great Bucatini Shortage of 2020. Bayesian fatigue. Illinois to cover undocumented seniors. Excess returns in Rx supply chain?

A Haven No More

Haven was a high-profile effort whereby three industry titans–Amazon, Berkshire Hathaway and JP Morgan–created a joint venture with the hope of lower costs and improving quality. Today, Haven announced it is shutting down in February. What happened? I don’t know the answer, but below are a few possibilities. Scale. Although these are three large companies, …

A Haven No More Read More »

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No more snow days in medicine. Hospitals overwhelmed. Drug lag. Racial bias and treatment algorithms. Number of COVID-19+ individuals that will show up at your event.

The 3Cs

The Economist has an interesting article on how Japan has been able to largely contain COVID-19. Part of the success has been a strong public health initiatives around avoiding the san-mitsu, or the “3Cs”. The 3Cs to avoid are: Closed spaces, Crowded places, and Close-contact settings. The phrase was blasted across traditional and social media. …

The 3Cs Read More »

COVID-19 now a top 3 leading cause of death in US

That is the conclusion from Woolf et al. (2020) in JAMA this past week. The authors examine rates of COVID-19 mortality in the US between March and October 2020 and compare them with other leading causes of death from March to October 2018. We see that COVID-19 is currently the 3rd leading cause of death …

COVID-19 now a top 3 leading cause of death in US Read More »

Friday Links

Am I disabled? EHR burden on physicians: US vs. rest of world. COVID-19 vs. religion. Toilet politics. Giannis on COVID-19. Bonus: Largest US metro areas across decades (for some reason I find this fascinating)

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Smile when you get your vaccine. Financial toxicity and QoL among cancer patients. How does ICER use RWE. Challenges to buying more vaccines. Trump administration to void existing health regulations?

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Impact of unemployment insurance on health. Digital Health trends in 2021. Making coal history. How a libertarian would allocate vaccines. LA County sets new infection record.

Drug importation from Canada won’t work

I’ve mentioned this in a number of previous posts, but large scale importation from Canada won’t work to bring down US drugs prices. The US market is too large and Canada does not have the supply to meet US demand. Further, policies proposing drug importation from Canada assume that Canadians will be passive actors in …

Drug importation from Canada won’t work Read More »

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Who gets the vaccine first? Amazon Pharmacy. What’s different now? Interoperability and the pandemic. Becoming homebound.

Friday Links

US debt rises about 100% of GDP. Racism and sickle cell disease. Health insurance among the self-employed. The interaction of minimum drinking age laws and genetics on binge drinking. Sanctuary policies and crime. Does social care prevent healthcare utilization? HDHPs impact the extensive but not intensive margins. DITF .Impact of SES on knee pain.

Friday Links

Performance of private equity-owned nursing homes during COVID-19  GrimAge #WhiteCoatsForBlackLives Jews and Catholics come together in Wisconsin. The disappearance of the primary care physical examination. Remdesivir final report. (Self-reported) mask use tops 90%.

Friday Links

Clinical trials going digital.  JAMA return-to-play guidance. Would a COVID-19 vaccine produce larger health or economic benefits?  Pros and cons of telemedicine. Are we there yet? A review of 4 value-based care programs.

Friday Links

AZ/J&J resume COVID-19 trials. Nature and Predictors of Response Changes in Modified-Delphi Panels. Thanksgiving and COVID-19 risks. Misleading maps? Average annual premium for a family of four is $21,342.

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Trump vs. Biden: Impact on the deficit How does mental illness impact COVID-19 mortality rates? 11pt font. Physicians on proposed changes to Medicare Physician Fee Schedule. Shakespeare’s greatest villain Half of black adults won’t get a COVID-19 vaccine. Remdesivir final trial findings.

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Trump vs. Biden: Impact on the deficit How does mental illness impact COVID-19 mortality rates? 11pt font. Physicians on proposed changes to Medicare Physician Fee Schedule. Shakespeare’s greatest villain Half of black adults won’t get a COVID-19 vaccine. Remdesivir final trial findings.

Friday Links

ADHD, financial distress and suicide. Will approval of ‘so-so’ COVID-19 vaccine preclude development of a better one? International price index: Lessons from Europe COVID and homelessness.  Explaining variation in wait times by socioeconomic status

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Specialist compensation and ACO performance Racism in health services research. FDA updates Sentinel System website. Drone sanitation. What if the Supreme Court kills Obamacare?

Friday Links

ACA: In peril with Ginsburg’s seat in play RCT: App to help you quit smoking DCE: Framing bias? pCODR: Do they care about patient advocate input? CRFB: On the fiscal impact of the Biden health plan

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Mathematical vs. conceptual simplicity. “Hell has frozen over” Former FDA Commissioners on EUA for COVID vaccine Drug imports from Canada coming? ED wait times during COVID. COVID money tracker.

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Can hydroxychloroquine prevent COVID-19? Clinical trials during COVID-19. Specialist compensation in ACOs. Moral hazard in the Netherland health insurance system? Where do children play?

Masks work

That is based on an event study approach from a recent Health Affairs article by Lyu and Wehby (2020). Specifically, Mandating face mask use in public is associated with a decline in the daily COVID-19 growth rate by 0.9, 1.1, 1.4, 1.7, and 2.0 percentage points in 1–5, 6–10, 11–15, 16–20, and 21 or more …

Masks work Read More »

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Wear a mask. Election forecast uncertainty. Baby born after uterus transplant. Organ sales. Will pandemic lower health insurance premiums?

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JAMA perspective on back to school. Americans with HDHP aren’t using HSAs. Where are they now: digital health unicorns. EITC and mental health. Dems: $25 billion for vaccines.

A Brief Note on Immigration and American Science

There’s an article out today from John Maraganore (CEO of Alnylam, immediate past chair of the BIO industry group) and his successor at BIO, Jeremy Levin (CEO of Ovid Therapeutics). They’re making the point that the current administration’s restrictions on legal immigration (real, attempted, and threatened) are a direct threat to the biopharma industry. And …

A Brief Note on Immigration and American Science Read More »

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How are mosquitos benefiting from COVID-19. Sweden. Explaining Gödel’s proof. L.A. Teachers Union response to COVID-19: end charter schools? defund the police? COVID-19 vaccine = hope-driven hype?

LA: Distance learning only

The New York Times reports: California’s two largest public school districts said on Monday that instruction would be online-only in the fall, in the latest sign that school administrators are increasingly unwilling to risk crowding students back into classrooms until the coronavirus is fully under control.The school districts in Los Angeles and San Diego, which …

LA: Distance learning only Read More »

Some good news

As COVID-19 cases continue to rise in the US, there was some good news last week from this year’s AIDS conference. Due to COVID-19, the conference had to be held remotely. One policy goal is known as the 90:90:90, which means to identify 90% of HIV cases, treat 90% of those identified and supress viral …

Some good news Read More »

Friday Links

Long waits for COVID-19 tests. Quantifying the benefits of the Clean Air Act. Pooled testing. Double dipping? Excess deaths trends.

What explains the decline in COVID deaths despite the rising number of cases?

Take a look at these two graphs. The first gives the number of new COVID-19 cases from John Hopkins University. It is a scary graph. https://coronavirus.jhu.edu/data/new-cases The second graph is the number of COVID deaths from IHME. Not nearly as bad. https://covid19.healthdata.org/united-states-of-america CDC reported death numbers are similar. In fact, the number of deaths in …

What explains the decline in COVID deaths despite the rising number of cases? Read More »

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Why payers support prior authorizations. Russia health care fact of the day. Doug Glanville, comma. “Schizophrenia is not a casserole illness.” Mortality vs. new cases.

$1 billion antibiotic venture fund launched

Antibiotic resistance is a problem. One study from Europe found that in 2015 there were 33,110 deaths attributable to antibiotic resistance; accounting for morbidity as well, antibiotic resistance lead to a a decrease of 874,541 disability-adjusted life years. CDC data show that antibiotic resistant bacteria and fungi caused 35,900 deaths in 2019, 12,800 deaths due …

$1 billion antibiotic venture fund launched Read More »

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Modelling COVID-19 dynamics. The cost of medication non-adherence. Hydroxychloroquine is out; dexamethasone is in. CMS and value-based pricing. PhRMA: After 6 months of the COVID-19 pandemic, where are we now?