Chart of the Week
Congress
Reconciliation/Infrastructure. The battle between House Progressives and Moderates over linking reconciliation and infrastructure continues at a simmer. Pelosi has offered a procedural move meant to assuage their concerns and Budget Chairman Pete DeFazio has pled for unity. They will probably get it worked out in some way, but the battle gives voice to the very tenuous grip of the Speaker whose majority is very slim.
Federation of American Hospitals Weighs In. Their leader, Chip Kahn, sent a letter in support of a number of policies being considered for inclusion in the reconciliation package.
The FAH likes:
- Permanent expansion of the ACA subsidies above the 400% of FPT
- Market based approaches to reducing cost of prescription drug prices
- Expanding federal support of the health care workforce through new visa policies for foreign workers and domestic education and training programs
There were also a few things it didn’t like:
- Reduction in the eligibility age for Medicare
- An expansion of Medicaid or a public option to fill the “Medicaid Gap.”
Medicare Advantage Plans are worried about expansion of FFS benefits. They would be required to include in their benefit package if Congress approves. It will take a few years to develop a history of FFS payments so it is not clear when the additional benefit cost will be factored into the PMPM payment. The plans sponsors want some assurance that the increase will begin immediately. Given cuts to MA plans are on the table as an offset to the cost of reconciliation changing the base payments seem unlikely. The Kaiser Family Foundation has piled on with some analysis released on Tuesday.
The White House
Vaccine Boosters. On Monday, PFE announced they had submitted P1 data on a third booster shot of their COVID-19 vaccine. On Tuesday the CDC announced a meeting of their vaccine advisory committee meeting for Aug. 24. On Wednesday, the White House announced a third booster would be widely available on Sept. 20. Today, the CDC announced it was postponing is August 24th meeting to Aug. 30.
Got all that?
The urgency that was absent in the fall of 2020 is now in force. As was the case then, there is no shortage of criticism. The scientific community is a bit aghast the president would front run the scientific evidence. The world health groups are shocked the U.S. would provide boosters domestically before distributing internationally.
Unfortunately for the scientific and health communities, politics demands they be ignored. COVID-19 is leaving Florida and following the same path of summer/fall of 2020 up the east coast and in September, it should arrive at the center of America’s political nerve center, the BOS-DCA corridor. The president can ill-afford the criticism that comes with that so, BOOSTERS!
Vaccine Mandate. The White House announced on this week it would be considering emergency rules that require all nursing home employees to be vaccination. The industry responded with opposition. Lest you think it was a cold-hearted move, the concern is a legitimate one as we have highlighted with employment data. Many health care workers, especially those of child-bearing age, have resisted getting vaccination. Given the low pay scale at nursing home and all the other available options, the industry fears many workers will walk away rather than get vaccinated.
Medicare Rule-A-Rama. No rules pending
Proposed Rule on OTC Hearing Aids. The FDA is considering rules, as required by statute, governing the sale of hearing aids Over The Counter. (i.e. no required visit to physician/audiologist)
Other Stuff
The 340B Cold War Continues. MRK is now requiring hospitals to share data to support their claims for 340B discounts. Their reason is a desire to prevent providers from claiming multiple discounts consistent with the law. MRK’s approach is elegant in that it is hard to argue with obeying the law.
Google Health Closes Shop. The company reports that various initiatives will be split among the company’s existing divisions (read: fighting for resources against other priorities). It is not a surprise. Health care is a difficult industry and Google isn’t the first and it will not be the last to discover disruption is difficult.
Cost-sharing returns for COVID cases. The KFF-Peterson Health Tracking program reported that 3/4 of health plans are no longer waiving cost-sharing for COVID patients. These data re the most recent evidence that insurers are moving to control costs in light of both an available vaccine and the steadily increasing acuity of non-COVID patients.
ILMN and the FTC. ILMN went ahead and closed on their acquisition of Grail in spite of an open FTC action. The EU promptly launched an investigation.
SPAC and S-1 Corner
IPOs.
Procept Corporation, Guggenheim “Commercial-stage surgical robotics company focused on advancing patient care by developing transformative solutions in urology.”
SPACs.
One new SPAC filing titled “Future Health ESG” has got to be the high water mark for sketchy ideas funded by way too much free money and not nearly enough oversight.
You can access the updated SPAC spreadsheet here.
If you are investing in SPACs but not super familiar with health care, hit and we can help.
Recent Events
Replay Brad Smith, former Director of the Innovation Center at CMS and I will be talking about the history and potential of direct contracting.
Upcoming Events
Sept. 7-10th What is Next for Health Care? Virtual Event with Matthew Holt of The Health Care Blog and Jess DaMassa, Host and Executive Producer of WTF Health. At this point, it looks like I will be sharing a panel with Matthew and Bill Taranto of MRK’s Global Health Innovation Fund, among others. The line-up is great if you are interested in innovation.
August 26-Sept 1st: I will be taking time off with family. Expect the next “Dose” on Sept. 3rd.
Have a great weekend
Emily Evans
Managing Director – Health Policy
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