Missed the midterms?

If you somehow didn’t know that US midterm elections were last week… can you recommend the rock you’ve been sleeping under? I could use some rest. Here are some election stories InsightCity readers will find interesting: Healthcare was on voters’ minds more than any other issue, as shown by exit polls and money spent on advertising. Antivax PACs funded candidates to retaliate against politicians who push vaccination requirements in their districts. Former Celgene head Bob Hugin lost to incumbent Bob Menedez in the battle of the Bobs New Jersey’s senate race. Idaho, Nebraska, and Utah voters decided to expand Medicaid in their states, while Montana voters said ‘no, thanks.’ Michigan and Missouri waved a green flag for recreational and medical marijuana, respectively. Need more? You can find a more detailed healthcare-related election round-up here (just without InsightCity’s signature snark.)

Show me the drug money

While any DTC drug commercial will likely include shots of people happily hiking and a list of side effects longer than the symptoms of the disease it’s curing, one thing you won’t see advertised is the price of the prescription. New federal policy could change that for drugs covered under Medicare and Medicaid, forcing companies to disclose list prices in TV advertisements. While most patients don’t typically pay the full price for their prescriptions, Health and Human Services Secretary Alex Azar says, “They deserve to know if the drug company has pushed their prices to abusive levels.” PhRMA says their members would be willing to include a link to a website that has pricing information in advertisements, to which Azar pretty much replied, that’s not what I meant.

Doctor Who?

Sorry, not the Doctor Who you were likely thinking of. One of the hypothesized “issues” with Obamacare was that with more people in the insurance system, the US would soon have a physician shortage. “Not so” says a recent study published in JAMA and reported on by the New York Times. Citing several sources, it seems that availability wait times have gone up (the proportion of privately insured patients having to wait at least 30 days for an appointment grew to 10.5% from 7.1%) but the ability to see a physician has not been impacted for the privately insured and it has improved for Medicaid patients. Mostly winner, winner, chicken dinner, right? With the seemingly endless parade of negative healthcare news, this is a little piece of good news. Enjoy.

Medicare over(under)sight

Hospitals must report the number of hospital-originated patient infections to Centers for Medicare and Medicaid Services (CMS). This is mandated because, according to a 2016 report (paywall warning), medical errors are the 3rd leading cause of death in the U.S. No way?!? Way. Medicare is then supposed to review and investigate suspicious reports—ones that hint of under-reporting. But why would a healthcare facility under-report these figures, you ask? Because results are made public and hospitals receive financial bonuses or penalties based on their numbers. A recent investigation by the Office of the Inspector General reported that the vast majority of hospitals they sampled passed inspection, but CMS needs to rely more heavily on data analytics to identify likely offenders. If you ever think InsightCity is behaving unethically, let us know. We’ll investigate ourselves and get back to you. Trust us.

5. BOOM (and a bust)

The Justice Department announced Wednesday that about 300 people have been charged with $900 million in false billing — a new record for the Medicare Fraud Strike Force. The arrested include 60 licensed medical professionals, including approximately 30 doctors. In one case, five people were arrested in Brooklyn for running an $86 million scam, in which they paid patients to receive unnecessary physical and occupational therapy, then billed Medicare and Medicaid for the treatment. We wish someone would pay us to go to the doctor.

1. Crossing the telemedicine chasm in the US?

Please keep in mind the source, but having that said, according to the America Telemedicine Association, telemedicine might finally be gaining traction in the US. 29 states have passed laws legislating that insurance cover telemedicine, 35% of employer onsite health centers now offer telemedicine services, and 86% of states (via Medicaid) cover services without any distance limitations. Telemedicine is one more piece of the health technology ecosystem (home health monitors, EMRs, Apps, fitness trackers, sensors on a patch, smart pills) and technology adoption always comes down to one thing: Who pays? Telemedicine has had a bumpy road in the US and time will tell if/when it really takes off, but for now it looks like momentum is on its side. Stay tuned.