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| Presented By UnitedHealth Group |
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| Axios Vitals |
| By Tina Reed ·Oct 08, 2021 |
| 😙 Happy Friday, Vitals readers. (And to those of you who have Monday off, I hope you enjoy your long weekend. I'm not at all jealous.) Today's newsletter is 1,004 words, or a 4-minute read. |
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| 1 big thing: Pandemic fuels activity in health care billing |
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| Illustration: Annelise Capossela/Axios |
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| Money is flowing heavily into the business of medical billing as hospitals and doctors — whose revenues were disrupted by the coronavirus — focus on maximizing every dollar they can collect, Axios' Bob Herman writes. The big picture: The rise and even existence of the billing industry is the result of a fragmented system designed around multiple types of insurance plans and a system that has increasingly forced patients to shoulder more of the costs. The state of play: Companies involved with billing and collections, called "revenue cycle management" in industry jargon, increasingly advertise themselves to health care providers as one-stop shops for all things involving payments. The pandemic drastically shrank revenue among hospitals and other providers and spurred even more revenue cycle activity. - Ensemble Health Partners filed to go public last week. The company pitched investors by saying, "Coding standards are constantly evolving ... it is often difficult for providers to adapt to these changes on a timely basis."
- UnitedHealth Group is attempting to buy Change Healthcare for $8 billion, although the Federal Trade Commission has asked for more information.
Hospitals aren't just clients of revenue cycle firms. They also are investors in some cases. - R1 is part-owned by hospital systems Ascension and Intermountain, and Ensemble is part-owned by Catholic hospital system Bon Secours Mercy Health.
- Tenet Healthcare recently sold five of its hospitals, and stipulated those hospitals had to continue using Tenet's revenue cycle firm, Conifer Health Solutions. HCA Healthcare also owns one of the country's largest billing firms, Parallon.
The bottom line: The revenue cycle frenzy is a result of "providers trying to win as much revenue as possible," said Ge Bai, a health policy and accounting professor at Johns Hopkins. But that's also meant "patients are more and more being treated as a revenue-generating product." |
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| 2. Public feels "meh" about flu shots |
 A "potentially severe" flu season could be on the way, the CDC warned this week, as public health officials once again urge the public to get its flu shot, Axios' Marisa Fernandez writes. Why it matters: Americans may now have reduced immunity against the flu after cases reached an all-time low last year. Driving the news: Nearly 25% who are at higher risk for flu-related complications said they are not planning to get vaccinated this season, according to a new survey out Thursday from the National Foundation for Infectious Diseases - 71% of adults age 65 years and older plan to get a flu vaccine compared with only 42% of adults 18–64 years old.
What to watch: 54% of U.S. adults plan to wear a mask in certain situations during flu season and 45% say the pandemic will make them more likely to stay home from work or school if they are sick. |
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| 3. New clues to our brains' movement centers |
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| Reconstructions of several different types of neurons showing their position in the mouse brain. Credit: Allen Institute |
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| In the journey to understanding how the brain works, scientists have mapped the cells in the brain region that helps to control our movements, Axios' Alison Snyder writes. Why it matters: Determining the circuits that connect neurons could help researchers understand processes in the brain and what happens when they go awry from disease. Driving the news: Hundreds of researchers collaborated to define and catalog the cells in the primary motor cortex region of the brains of mice, marmosets and humans, they reported this week in 17 papers in the journal Nature. - The goal of the research is to generate a "parts list for the brain" as they seek to eventually map the entire brain, says Hongkui Zeng, director of the Allen Institute for Brain Science and co-author of some of the papers.
- Ultimately, the hope is these brain maps will provide new targets for drugs to treat diseases like Alzheimer's and Parkinson's, says John Ngai, director of the NIH's Brain Research through Advancing Innovative Neurotechnologies Initiative, which coordinated the effort.
- Ngai and others envision treatments that act on specific cell circuits that give rise to disease rather than every cell. Such targeted treatments could help reduce the side effects seen with some drugs.
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| A message from UnitedHealth Group |
| Helping to advance health equity by improving health literacy |
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| Up to 59% of people in certain U.S. counties have limited health literacy, with older Americans demonstrating the lowest levels of any age group. See how UnitedHealth Group is working to improve health literacy to achieve better outcomes. |
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| 4. MedPAC: It's the prices, stupid |
| Higher prices are the main reason why Medicare spending on drugs has exploded over the past decade, and the government should finally do something about it, Bob writes about member comments at the Medicare Payment Advisory Commission meeting Thursday. Why it matters: MedPAC has argued for Medicare drug pricing reforms for several years, and federal agencies often take their recommendations seriously. But industry opposition has been the primary roadblock to several MedPAC proposals. Driving the news: MedPAC staffers and commission members highlighted the issues within Medicare Part B, which covers infused and injectable drugs and pays for the drug's average sales price plus a 6% markup. - Aduhelm, the controversial Alzheimer's drug, made an appearance on a presentation slide because experts believe the drug's high launch price combined with current payment policy could decimate Medicare.
- "If you continue pay [average sales price plus 6%], we can continue to guess what providers are going to do," said David Grabowski, a MedPAC commission member and Harvard health policy professor.
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| 5. The number of steps to access an abortion |
 Data: Guttmacher Institute; Map: Aïda Amer/Axios In more than a third of the U.S, there are at least six steps a person needs to take to obtain an abortion. - Eight states — Utah, South Dakota, Missouri, Arkansas, Oklahoma, Alabama, Tennessee and North Carolina — require a waiting period of more than 24 hours, and 16 states have a 24-hour waiting period.
- Twenty-eight states require parental consent for minors to obtain an abortion. A dozen states require at least two trips to the facility, and 14 states require an ultrasound.
📫 Watch for our Axios AM Deep Dive on women's health access in your inboxes tomorrow. |
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| 6. Dog of the week |
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| Gray. Photo: Casey Green |
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| Meet Gray, a three-year-old husky rescued in Bakersfield, California, in August 2020. - Gray was discovered on the streets before she was taken in for fostering. After tech policy consultant Casey Green of Studio City found her on Petfinder, the foster parent agreed to stop by his home with the dog.
- "I had about 10 minutes to make a 12-year decision," he said. But it was "love at first sight!"
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| A message from UnitedHealth Group |
| Improving health literacy can achieve better health outcomes |
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| UnitedHealth Group's research shows older Americans in counties with the highest health literacy levels have fewer hospitalizations and experience 13% lower costs. See how we're working to provide clear, simple, actionable health information to help people achieve better outcomes. |
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