MRCS Weekly Recap 10 (4.3.2022 - 4.9.2022)

1. COVID

A new study found that Covid vaccination early in pregnancy is not linked to congenital problems. JAMA Pediatrics analyzed over 2,600 patients' records for vaccination results in the first weeks of pregnancy. Meanwhile, 60% of Americans have already decided that they will get a second booster shot if it is recommended. Only 18% of those surveyed say they will not get a second booster no matter what. A substantial portion (22%) say they will get the second booster if covid cases increase or another variant arises. This research comes when the Biden administration has ramped up long-term research on Covid. The NIH will lead this effort to help determine the long-term burden of the pandemic on the health care system and the economy.

The National Nurses United union is fighting in court for a more permanent COVID-19 protection rule. They argue that the existing "temporary" emergency standard is not enough to protect healthcare workers from the threats of COVID-19. The union wants OSHA to issue a permanent bar for health services workers. The JAMA Health Forum says that there will continue to be a covid toll following the lifting of restrictions. Once restrictions are lifted, we should expect a rebound in cases. However, there is no magic moment in doing this. Once restrictions are lifted, there will be a rebound, but uncertain to what lengths.

2. Practice Management Updates

A new study from Elsevier Health showed that 1 in 3 nurses plan to leave their current roles in 2-3 years. Companies are starting to connect compliance and HR to make credentialing nurses a more straightforward process to combat this. This is one of the burdens for nurses in the workforce, thus alleviating some of the pains with the job.

Patients and providers are in demand of an innovative and more involved pharmacy. Outdated processes are holding pharmacists back. MedCity News believes that there need to be improvements for medication safety, optimizing the supply chain, and alleviating staffing pressures. Organizations can create the most efficient patient care by taking measures that lead to an independent pharmacy. Healthcare is changing as we know it. Pharmacies are not the only avenues that will be changing. Walmart announced that they are opening five health "superstores" in Florida. As part of the partnership with IT software giant, Epic, Walmart centers will deliver primary and urgent care, labs, X-rays, diagnostics, dental, optical, hearing, behavioral health, and counseling! This move marks one of many companies entering the health industry; see Amazon, Google, and Apple.

3. Policy Updates

President Biden has proposed to fix the ACA's "Family Glitch" to help 1 million people benefit from less expensive plans. This would allow families to qualify for more subsidized coverage through the health insurance marketplace. The Administration calls this plan the most significant action to improve the ACA since its enactment 12 years ago. The CMS shared that Medicare Advantage plans will see a revenue increase of around 8.5% in 2023. CMS is not making changes to the risk adjustment calculation, despite calls for an overhaul while they are being called out for abusing the system.

The surprise billing act has been a success story for American consumers. Nevertheless, several health experts warn that compliance with the act is "very daunting" for health providers. Putting the bill's requirements into practice has proven difficult for providers and could warrant some changes in the future. On another note, the NIH Cancer Chief, Ned Sharpless, is stepping down by the end of May. Sharpless has held the position for the past five years. His departure comes after significant changes from the federal government and relaunching "Cancer Moonshot."

The FDA is set to advance critical regulatory reviews between April and June. Be on the lookout for five crucial decisions from the FDA:

o Bluebird bio's beti-cel in beta-thalassemia and eli-cel in CALD

o Bristol Myers Squibb's mavacamten in hypertrophic cardiomyopathy

o Amylyx Pharmaceuticals' AMX0035 in amyotrophic lateral sclerosis

o Bristol Myers' Breyanzi in early lymphoma

o TG Therapeutics' ublituximab and Ukoniq in two types of lymphoma

4. IT Updates

A recent report showed that more than half of the healthcare data comes from the US and China. The author of the paper, Leo Celi, explained that "we need to be much more diverse in terms of the datasets we use to create and validate these (AI) algorithms." The past several years have produced various apps, tools, and platforms to leverage big data and analytics to better support employee mental well-being. One of the goals is to use this combination of data analytics and technology to help determine who would engage and benefit from lifestyle and medication guidance. After deciding who would benefit most, the idea is to design personalized solutions to find the best possible mental health care for employees.

5. Telehealth Updates

Telehealth use increased for the third straight month. Telehealth claims increased by more than 10% from December to January. Sixty percent of these claims were for mental health conditions, while COVID-19 and acute respiratory diseases were tied for second-most telehealth diagnoses. Soon, Congress will have to debate whether pandemic era telehealth reimbursement and relaxation of rules should be made permanent. Kevin Dedner, the founder of Hurdle, shared that "What we've seen over the last two years is the largest increase in treatment-seeking behavior among African-Americans and Asian-Americans that we've ever seen." Dedner explains how people from these backgrounds are now seeking treatment when they never did before.

6. Key Trends

In the 2022 ECRI report, the top two factors affecting patient safety are staffing shortages and worsening providers' mental health. According to the CMS, the US National Health Spending grew by 4.2% in 2021. This is a deceleration from the 9.7% growth rate in 2020. Nonetheless, total spending will reach almost $4.3 trillion in 2021.

Clinical facilities and academic leadership at American medical schools are not as diverse as in other countries. Female faculty levels and deans have risen over the past 40 years, but racial minority groups have not kept at the same pace. The report's authors noted that "This increasingly diverse, complex population will benefit from a profession with expanded perspectives that can inform solutions to pervasive and persistent health inequities."

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