News & Commentary

Briefly Noted August 2016

Rules for wellness programs under the ACA differ in some ways from what’s allowed by the Equal Employment Opportunity Commission, so companies need to be careful, reports Bloomberg BNA. One expert says that while they “echo” each other, they aren’t identical, which means employers need to pay attention to the particulars of each law to make sure they are in compliance.

Progress continues to be made against one of the most deadly diseases, according to a study in Cancer. “Among men and women of all major racial and ethnic groups, death rates continued to decline for all cancers combined and for most cancer sites; the overall cancer death rate (for both sexes combined) decreased by 1.5% per year from 2003 to 2012,” the study stated.

Educational interventions and prompts from electronic health records caused primary care physicians to significantly reduce the number of prescriptions they wrote for antibiotics to treat acute respiratory tract infections, according to a study in JAMA. “Among primary care practices, the use of accountable justification [prompting clinicians to enter justification for antibiotic prescriptions into the EHR] and peer comparison as behavioral interventions resulted in lower rates of inappropriate antibiotic prescribing for acute respiratory tract infections,” the study stated.

Hospital mergers among systems in the same state increase health care prices by 6% to 10%, according to researchers at Northwestern University’s Kellogg School of Management. But this is interesting: Mergers across state lines did not lead to any statistically meaningful increases. “The results suggest that cross-market, within-state hospital mergers appear to increase hospital systems’ leverage when bargaining with insurers,” according to the researchers.

Employees and volunteers at long-term care facilities are posting degrading pictures of residents on social media platforms. Regulators and law enforcement officials are playing catch-up because many of the abuse laws that might apply have been on the books for years and didn’t anticipate social media.

Most of the nearly 100,000 prison inmates in halfway houses will be eligible for Medicaid thanks to a new federal policy, USA Today reports. If successful, the move will fill a huge gap in care. “Most people involved in the justice system have been uninsured and they are far more likely to have chronic health conditions, such as diabetes and high blood pressure, and infectious disease,” federal officials said.

When should someone older than 60 be prescribed medication for high blood pressure? Systolic blood pressure (SBP) of 140 mm Hg might be a starting point, argues a study in Hypertension, which looked at 1,750 patients 60 or older in the Northern Manhattan Study. The researchers found that after adjustments for diastolic blood pressure and other factors, the stroke risk was considerably higher for those with SBP 140 to 149 mm Hg (hazard ratio, 1.7) compared with those with SBP less than 140 mm Hg. Two years ago, the Eighth Joint National Committee set the treatment threshold higher than that, recommending action at 150 mm Hg and above for people older than 60 without diabetes or kidney problems.

Employers will have to publicly post employee injury and illness data, thanks to a new federal regulation that businesses are none too happy about, according to the Wall Street Journal. “The rule is the culmination of a long-running debate between workplace safety regulators and businesses who have been at odds over what and how much safety information should be available to the government and the public,” the newspaper reported.

A recent ruling by the Supreme Court on patents is being hailed in some quarters as a game-changer that might lower drug costs for health insurers and PBMs. The court upheld a new process for challenging patents—known as the inter partes review—which Congress created in 2011. It allows a panel within the U.S. Patent and Trademark Office to hear patent challenges. Previously, those challenges were litigated, with the courts narrowly focusing on patent language and usually siding with the pharmaceutical companies. An inter partes review interprets more broadly, making the overturning of patent protection more likely. The case divided major stakeholders. Without the old-style patent protections, says PhRMA, companies that manufacture branded drugs will find it hard to recoup the millions of dollars needed to bring a new product to market, hurting research and development. Not surprisingly, the Generic Pharmaceutical Association and America’s Health Insurance Plans applauded. They argued that inter partes review will push more generics into the market and help keep drug costs down.

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