Healthcare Articles from My In Box

Trip Notes

Slept > 8-hours last night. Took off from Las Vegas, New Mexico yesterday morning and headed to Holbrook, Arizona.. If you are ever near Los Vegas NV, you might want to stay in The Plaza hotel, a blast from the past, still done up with a nineteen century interior. Bourbon was good as well as the food. Rooms comfy and styled in a similar motif as the rest of the hotel.

Allan Affeldt started the restoration (more to come) of The Plaza, Previously he and his team restored the La Posada Hotel in Winslow AZ as . Allan also bought the Castaneda Hotel across town Los Vegas, NM. Besides staying on the corner in Winslow, the La Posada is a pretty impressive hotel and worth the see and a meal.. 

Still making waves heading west. I40 was crazy having multiple backups due to road reconstruction. Backups were 1 mile or so long. Average time waiting inline was 10-15 minutes. Speed limit on these roads is 75 mph and yet there are some fools who wish to go faster in their overpriced foreign vehicles or pick-me-up trucks with oversized tires. We moved along at a few miles over speed limit.

Monday Healthcare

The Justice Department article is interesting. Unless they start to dismantle ACOs , consolidation is still going to happen. Healthcare will resist any attempts to break them up.

Public Health Policy and General Professional Issues

This ruling confirmed what many of us in the sexual and reproductive health space feared: the Supreme Court will no longer protect Americans from state and local governments trying to restrict bodily autonomy and eliminate the right to choose.

This ruling affects everyone — not only in Texas, but also across the country as more states look to adopt draconian laws that restrict access to sexual and reproductive healthcare. But the biggest impact will undeniably be on lower-income and other marginalized individuals who are seeking an abortion.

Idaho Hospitals Begin Rationing Healthcare Amid COVID Surge (

Idaho public health leaders announced Tuesday that they activated “crisis standards of care” allowing health care rationing for the state’s northern hospitals because there are more coronavirus patients than the institutions can handle.

The Idaho Department of Health and Welfare quietly enacted the move Monday and publicly announced it in a statement Tuesday morning — warning residents that they may not get the care they would normally expect if they need to be hospitalized.

Medicare Physician Payment Reform — Enhancing Incentives for Value-Based Care | NEJM

Models that hold organizations responsible for managing patients’ total cost of care are an important tool for payment reform. Bringing more clinicians into such models is essential, and strengthening current participation incentives could generate long-term benefits.

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Supporting Value-Based Health Care — Aligning Financial and Legal Accountability | NEJM

Under value-based payment models, there is a misalignment between organizations’ incentives to spend wisely and individual physicians’ incentives to reduce malpractice liability risk. One idea that has been proposed to correct this mismatch is enterprise liability.

Value based compensation is BS

Quantifying The Economic Burden Of Drug Utilization Management On Payers, Manufacturers, Physicians, And Patients | Health Affairs

The continuing launch of innovative but high-price drugs has intensified efforts by payers to manage use and spending and by pharmaceutical manufacturers to support patient access and sales. Payers are restricting drug formularies, requiring more stringent prior authorizations, and raising patient cost-sharing requirements. Manufacturers are investing in programs that help patients and physician practices navigate administrative controls and help patients meet cost-sharing obligations.

More nonsense

We Can All Benefit From Helping Patients Understand Breakthrough COVID | MedPage Today

The recent change in masking guidance from the CDC and reinstated public health measures from local and state governments have been met with frustration and defiance, with people understandably questioning why they got vaccinated if they have to go back to masking and distancing anyway. The answer is in the degree of exposure to SARS-CoV-2, and the explanation lies in the way vaccines work. We can help our patients understand this with three talking points:

Coronavirus update: Mu variant in 49 states, cases rise 300% (

The Mu variant of the coronavirus, first identified in Columbia in January, has spread across the U.S. and is reportedly present in 49 states and the District of Columbia. California has seen the most cases of the new variant.

“The identification of variants like Mu, and the spreading of variants across the globe, highlights the need for L.A. County residents to continue to take measures to protect themselves and others,” said Dr. Barbara Ferrer, director of LA County Public Health.

New Covid Virus

Even Those Who Just Test Positive at More Risk for Long COVID: CDC (

Long-term symptoms, like those linked with COVID-19, were common in people who  had even just a single positive test, new Centers for Disease Control and Prevention (CDC) data show.

The data show that symptoms in this group — including fatigue, cough, and headache — tended to last for more than a month. 

Frequency of symptoms in people with a positive test was 1.5 times higher compared with people whose tests had always been negative, according to the research published Thursday in the CDC’s latest Morbidity and Mortality Weekly Report.

Issues coming out of Covid infection.

TSA Doubles Penalties for Face Mask Policy Violations (

The Transportation Security Administration is doubling fines for travelers who violate face mask rules on airplanes, trains, buses, and other forms of transportation governed by TSA regulations.

The new penalties, which took effect Friday, will be $500-$1,000 for first offenders and $1,000-$3,000 for second offenders, the TSA said in a news release. The rules say passengers must wear masks while traveling except when eating or drinking.

“We appreciate the majority of travelers each day who voluntarily follow the requirement but find this action necessary to maximize the protections for those who use and work within the transportation system, and to contain COVID-19,” TSA Administrator David Pekoske said in the news release.

Is a variant worse than Delta on the way? Viral evolution offers clues. (

Somewhere in India last October, a person—likely immunocompromised, perhaps taking drugs for rheumatoid arthritis or with an advanced case of HIV/AIDS—developed COVID-19.

Their case might have been mild, but because of their body’s inability to clear the coronavirus it lingered and multiplied. As the virus replicated and moved from one cell to another, parts of the genetic material copied itself incorrectly. Maybe the person lived in a crowded home or went out to buy food in a busy market, but wherever it happened, the altered virus was spread to others. Experts believe this singular situation in one individual is likely how the Delta variant now wreaking havoc in the U.S. and around the world was born.

Justice Department targets health system consolidation ‘detrimental to our economy’ (

President Joseph Biden attacked anticompetitive acquisitions earlier this year with an executive order to crack down on them, and the U.S. Justice Department plans to follow suit.

Associate Attorney General Vanita Gupta spoke at the 15th annual Global Antitrust Enforcement Symposium at Georgetown Law School Sept. 14, emphasizing the department’s focus on preventing monopolies and maintaining a competitive economy.

“This work is urgently needed,” she said. “In many industries, consolidation is greater now than it was even just 20 years ago. For example, today, dominant health systems can approach 50 percent control of a relevant local or regional market. This kind of consolidation can be detrimental to our economy.”