FIRST IN PULSE: CMMI UNDER THE MICROSCOPE — Leading Republican Party lawmakers are calling for an investigation into the agency created to test ways to finance health care costs after it increased spending by more than $1 billion, Ben reports.
Chairman of the Committee on Budgets Jodey Arrington (R-Texas) and Rep. Michael Burgess (R-Texas), chairman of the panel’s health care task force, today called on the Government Accountability Office to take a closer look at the Center for Medicare and Medicaid Innovation.
“CMMI has failed to deliver on its mandate,” Arrington and Burgess said in a statement, first reported by POLITICO.
They asked GAO to review the agency’s funding and performance and determine which of the agency’s tested payment models had saved money or increased spending.
The bigger picture: The move comes as lawmakers try to rein in health care spending and could shed more light on CMMI’s practices. The US spends significantly more on health care than other wealthy countries, but still has worse health outcomes than other countries.
The Congressional Budget Office found last year that the agency, created to test strategies for financing health care costs, will increase federal spending by $1.3 billion between 2021 and 2030, POLITICO reported. It has increased spending by $5.4 billion over the past decade, CBO found.
Republicans on the House Ways and Means Health Subcommittee have been pushing for more guardrails for CMMI and introduced legislation on the issue late last year, aiming to limit the model’s scope in early testing phases.
CMMI’s history: The center was founded under the Affordable Care Act to enable alternative payment models to address growing concerns about healthcare costs and quality. So far, most experiments have been unsuccessful and CMMI has acknowledged shortcomings.
The agency has said that only six of the more than 50 models it has tried over the past decade have resulted in statistically significant savings. Only four of these met the criteria for wider use.
Announcing a “strategic refresh” in 2021, CMMI said complex policies and overlap in models can create “conflicting or opposing incentives” for providers, so it aimed to reduce the number of models it uses to reduce overlap.
The agency also said that some benchmarks and methodologies allowed for “potential gaming and upcoding among participants,” minimizing savings. It said it would test methodologies that encourage “appropriate coding” and improve testing before launching models.
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A HEAVY PRINT COST — The net cost of weight loss drugs would have to drop by 90 percent to “stay in the ballpark” of not widening the national budget deficit, the head of the Congressional Budget Office said Thursday.
CBO Director Phill Swagel provided insight into his office’s view on how many obesity drugs the federal government could cost. government if they are covered by Medicare.
In 2003, Congress banned Medicare from covering obesity medications, and some lawmakers hope to change that. Earlier this year, CBO told Congress it was evaluating how the drugs, if covered by Medicare, could change baseline projections for health program costs.
Over the next thirty years, growth in Medicare spending is expected to account for more than two-thirds of the increase in spending on major health care programs.
Swagel said policymakers could explore lowering the cost of the drugs to lower Medicare costs in the long run, but the price drop would be steep. On the other hand, he said, more people using the drugs could mean savings for other programs, such as services for the disabled.
Swagel also said the CBO is analyzing how the cost of treating hepatitis C could impact health care spending in the long term. The number of hepatitis C cases has increased in recent years.
“If we can spend money upfront, improve people’s health… Basically, we can reduce health care spending,” Swagel said.
GOT MILK (RAW)? DO NOT – A fifth of U.S. milk production contains fragments of bird flu — indicating the virus may have spread beyond symptomatic dairy herds, POLITICO’s Emily Cadei, David Lim and Marcia Brown report.
The news from the FDA comes Thursday evening as the Biden administration and the dairy industry rush to convince the public not to worry.
Public health experts say the government needs to be more transparent about its efforts to expand testing and research into bird flu amid an outbreak among cows in multiple states.
The pathogen has been found in at least 33 dairy herds in eight states since it was first discovered among Texas cattle in late March, and virologists say the disease could be much more widespread than data suggests.
Federal officials and industry executives say the discovery of inactive fragments of the virus strain, known as H5N1, in milk sold to consumers is not in itself a concern — instead, it is evidence that the pasteurization process is working to destroy the virus. neutralize. However, raw milk should be avoided.
Other safety warnings: The Biden administration has cautiously said that pasteurization will “likely” inactivate the avian flu virus in milk, but acknowledges that detection of the virus in dairy cows “is a new and evolving situation” and “there has been no research on the effects of pasteurization on dairy cows”. HPAI viruses (such as H5N1) in bovine milk are more likely to mature.”
Jennifer Nuzzo, director of the Pandemic Center at Brown University School of Public Health, questioned why the FDA did not immediately say it would test milk products and quickly culture any virus fragments found.
“Just from a government credibility perspective, it’s important to be transparent about what you’re doing,” Nuzzo said.
LONG COVID DATES RELEASED — The NIH on Thursday released data from more than 14,000 adults involved in federal long Covid research, making it available to researchers.
The NIH, which has been researching long Covid through its RECOVER initiative since 2021, said it had uploaded anonymized data to a cloud-based database to “help researchers identify and investigate long COVID links that could benefit future studies or can inform them.”
Long Covid is a series of symptoms – ranging from annoying to disabling – experienced after a Covid infection. Treatment advocates have criticized federal officials for moving too slowly in researching the condition, with few treatment options during the three years of the RECOVER initiative. Federal officials have defended their pace where necessary.
“Sometimes it takes as long as it takes to get results,” Admiral Rachel Levine, HHS deputy secretary of health, told Pulse earlier this year. “It’s taking longer than people want, but we want to make sure we get robust results that will actually help patients.”
Researchers can request data from studies conducted between October 29, 2021 and September 15, 2023. The NIH will regularly add new research.
TRANQ USE LINKED TO INFECTIONS – An increase in bloodstream infections among people who inject drugs, observed at a Vermont medical center, coincided with the rise of the illegal use of xylazine, an equine tranquilizer.
A CDC study released Thursday found that the University of Vermont Medical Center saw a significant increase in the number of people with community-acquired group A streptococcal bloodstream infections during 2022-2023, especially among people who inject drugs.
This increase came as xylazine became more prominent in the illicit drug supply, with dealers adding it to synthetic fentanyl. Last April, the White House called the deadly tranquilizer, which can rot a user’s flesh, an “emerging threat.” The president signed a bill late last year to coordinate research into the drug at the NIH.
According to the study, 64 cases of bloodstream infections were reported at the Vermont Medical Center during 2022-2023, with 45 of those occurring in the first ten months of 2023. Seventy percent were among patients known to self-inject medications. Nearly all of those patients who self-injected drugs had wounds consistent with xylazine use — which researchers say could contribute to the entry of bacteria that cause bloodstream infections.
What’s next? Researchers said the study suggests that introducing wound care as part of harm reduction from substance use can prevent infections.
POLITICO’s Paul Demko reports of Democrats pushing the DOJ to loosen weed restrictions.
The Washington Post reports of people contracting HIV during treatments at unlicensed medical spas.
Reuters reports on a lawsuit by GSK against Pfizer and BioNTech, alleging that the latter companies have infringed patents relating to mRNA in their Covid vaccines.