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JAMA March 04, 2020

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Good morning. Here are today's top stories.
March 4, 2020

Leading the News

Administration says any American can now be tested for coronavirus if a physician deems it necessary

The  (3/3, Kim, Sacchetti, Dennis) reports that the “administration vowed late Tuesday that any American can now be tested for” coronavirus “if a doctor deems it necessary.” Vice President Pence said, “We’re issuing clear guidance that subject to doctors’ orders, any American can be tested.”

Meanwhile, the  (3/3, Thomas, Sheikh) reports public health laboratories are questioning the FDA’s ability to deliver one million coronavirus tests this week as Commissioner Stephen Hahn promised on Monday. The article says, “The figure includes orders for commercial tests that companies said were still weeks away from approval, and public health laboratories said their capacity doesn’t come close to that.” The article adds that the White House has “been trying to address the lag in testing caused by botched test kits that were rolled out by the” CDC last month.

AMA-brokered deal secures coverage for Hahnemann residents, fellows
Court-approved settlement will pay for legally required long-tail medical liability insurance for the 1,400-plus residents and fellows affected. The AMA has underwritten the legal work in the case. .

Ending the obesity shame game
Obesity medicine specialist Fatima Cody Stanford, M.D., M.P.H., M.P.A. is campaigning to change the way obesity is viewed in a culture where too often body appearance comes first, and people come last. .

Kaplan USMLE Step 1 prep: Man is dizzy when waking up
Prep with help from Kaplan Medical. The case: A healthy 62-year-old man complains of dizziness, especially after arising in the morning. What’s going on? .

5 changes to fix prior authorization that are well overdue
Unconstrained expansion of prior authorization requirements has created an exhausting burden for patients and doctors. Learn more about the way forward. .

CDC COCA Call: What Clinicians Need to Know to Prepare for COVID-19 in the U.S.
Join the call March 5th from 2 – 3 PM EST to learn what you can do to prepare for COVID-19 including identifying persons under investigation, applying infection prevention and control measures, assessing risks for exposures, optimizing the use of personal protective equipment supplies, and managing and caring for patients. .

        

 GOVERNMENT AND MEDICINE

Administration considering reimbursing health care providers for care of uninsured people with coronavirus

The  (3/3, Armour, Subscription Publication) reports the Administration is considering reimbursing health care providers if they care for uninsured people with coronavirus.

 HEALTH COVERAGE AND ACCESS

In 2016, Americans and their insurance companies spent an estimated $134.5 billion on lower back and neck pain, researchers say

 (3/3, Rogers) reports, “In 2016, Americans and their insurance companies spent an estimated $134.5 billion on lower back and neck pain – more than all forms of cancer combined,” researchers concluded after estimating “U.S. public, private and out-of-pocket spending on health care for 154 health conditions from 1996 to 2016.” Back and neck pain were followed by “musculoskeletal conditions including joint and limb pain, then spending for diabetes, heart disease, falls and urinary diseases.”

 (3/3, Gerogiou) reports, “The United States now spends more on health care than at any point in its history, and significantly more than nearly any other nation on Earth, according to the” study. The  were published in JAMA.

Nearly one-third of patients worry about health care costs, poll finds

 (3/3, Heath) reports, “Nearly one-third of patients are worried about health care costs, including the ability to pay for health insurance and out-of-pocket prescription drug costs, according to a new poll from NBC News and the Commonwealth Fund.” The  “investigated the concerns top of mind for the American patient, with health care affordability leading the way. Overall, 31% of respondents said they are worried about being able to pay for their health insurance, while 29% are concerned about the out-of-pocket costs associated with many prescription drugs.”

 QUALITY AND SAFETY

Report looks at how hospitals adhere to key patient safety protocol when delivering common but high-risk surgeries

 (3/3, Heath) reports, “Adherence to key patient safety protocol during high-risk surgery may be getting better, but steps lay ahead for organizations delivering a slate of certain medical procedures, according to a new report from the Leapfrog Group.” The  (PDF) “looked at how hospitals adhere to certain patient safety protocol when delivering one of eight common but high-risk surgeries.”

 PUBLIC HEALTH

WHO says COVID-19 may have fatality rate around 3.4%

 (3/3, Nebehay, Kelland) reports the WHO said that around 3.4% of confirmed cases of COVID-19 have resulted in death, suggesting the disease’s fatality rate is far higher than that of influenza. However, the WHO also said that coronavirus can be contained and “urged countries to prepare for patients with the virus turning up in their hospitals and ensure that health workers are protected.”

Researchers say mercury exposure may be tied to increased skin cancer risk

 (3/3, Rapaport) reports, “Americans who eat a lot of mercury-containing seafood might be at increased risk for skin cancer, suggests a study based on national surveys.” The data based on “29,000 adults showed those with the highest mercury levels in their blood were 79% more likely to report having had a non-melanoma skin cancer than those with the lowest levels.” For the , published in the British Journal of Dermatology, investigators “analyzed data from annual health surveys of nationally-representative samples of adults between 2003 and 2016 that included blood tests.”

 PHARMA & DEVICE UPDATE

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FDA grants breakthrough therapy status to pirfenidone for interstitial lung disease

 (3/3, Miller) reports the FDA granted breakthrough therapy status to Roche’s Esbriet (pirfenidone) for interstitial lung disease (uILD), “a catch-all term for 200-plus lung-damaging disorders.” Back in 2014, the drug was approved for the treatment of “adults with lung-scarring idiopathic pulmonary fibrosis.”

Coronavirus may cause drug shortages due to Chinese factories being closed and India’s government restricting exports

The  (3/3, Goel) reports that coronavirus “is now starting to hurt the supply of essential drugs” with pharmaceutical companies “struggling to get vital raw ingredients for common antibiotics and vitamins from Chinese factories, which were closed for weeks as China battled to contain the coronavirus.” The article adds that “even as some of the country’s factories have restarted, shortages of some drugs may develop.” On Tuesday, India ordered pharmaceutical companies “to stop exporting 26 drugs and drug ingredients, most of them antibiotics, without explicit government permission,” which could have a large impact around the world, because many of the world’s generic drugs are exported from India.

 ALSO IN THE NEWS

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Popular APMs including ACO, bundled payment models have high drop-out rates, review finds

 (3/3, LaPointe) reports, “Alternative payment models (APM) primarily run by Medicare have generally produced modest savings and quality improvements,” although “popular APMs including accountable care organization (ACO) and bundled payment models have high drop-out rates, which may indicate a problem with downside risk, according to a new review article in Health Affairs.” The  looked at “40 APMs operated by the CMS Innovation Center, including the Medicare Shared Savings Program (MSSP), Bundled Payments for Care Improvement (BPCI), Comprehensive Care for Joint Replacement (CJR) model, and the Comprehensive Primary Care Plus (CPC+) initiative,” and “found that population- and episode-based payment models – which largely cover ACO and bundled payment programs – generated some savings on average, with ACO models making the biggest impact overall. Bundled payment savings largely depended on the model.”

 TUESDAY'S LEAD STORIES

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