| | | | |  | | By Chelsea Cirruzzo and Ben Leonard | Presented by Humana | With Daniel Payne and Carmen Paun
| | |  Some patients with Covid-19 who are candidates for Paxlovid don't take the antiviral treatment for fear of a Covid rebound. | Joe Raedle/Getty Images | WHY PATIENTS DON’T TAKE PAXLOVID — Studies have consistently shown that very few eligible patients take Paxlovid, the Covid-19 antiviral — and some health experts are pointing the finger at the government for the lack of uptake. Cost, confusion and a lack of access to care are a big part of the problem. But another factor likely has affected uptake — which reveals how contradictory messages from the government might play a role in dissuading patients with Covid from seeking out the treatment — our Erin Schumaker reports: fear of Paxlovid rebound, in which a patient recovers from Covid only to have symptoms return. It’s an irrational fear, judging by a Centers for Disease Control and Prevention analysis, not only because rebound is a minor side effect. “There has been no consistent association between Paxlovid and Covid-19 rebound,” Cria Perrine, a lieutenant commander in the U.S. Public Health Service and an epidemiologist at the CDC, said. Fear of rebounds: Public perceptions that Paxlovid can cause rebound took root soon after the drug’s release when a string of well-known people, including President Joe Biden, reported rebound after taking the medication, and then-CDC Director Rochelle Walensky drew the connection in a TV interview. The agency has always said people at high risk for Covid should consult their doctors about taking Paxlovid because it could save their lives. Unsettled science: Some health experts think Paxlovid increases the risk for rebound, but they say it’s no reason for people at high risk for Covid not to take the pill and believe the CDC’s position is fueling skepticism of public health. “The public [is] smart. They’re going to figure it out, and then they’re going to ask us why we haven’t been forthcoming. And that will undermine their faith in our work and in our job,” said Dr. Mark Siedner, an infectious disease clinician at Massachusetts General Hospital in Boston who led a study that found a connection between Paxlovid and rebound. WELCOME TO VALENTINE’S DAY PULSE. Roses are red, violets are blue, 42 percent of adults got a shot for the flu. By comparison, only 21 percent got a shot for Covid. Send your health policy valentines, tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.
| | | | A message from Humana: As detailed in Humana's value-based care report, developing relationships between healthcare providers and patients allows providers to focus on disease prevention and chronic disease management. Humana facilitates whole-person healthcare through care coordination. At CenterWell—a Humana Inc. Company—doctors, nurses, specialists, and other health professionals collaborate on primary care teams. These facilities also function as wellness centers where patients can socialize, exercise, and participate in activities that support their health. Read more. | | | | | | | 
Rep. Larry Bucshon expects a fix for doctors' pay cuts will be included in the next government funding package. | House Television/AP | DOC PAY ON THE WAY? Rep. Larry Bucshon (R-Ind.) believes a doctor pay fix is just around the corner, likely to be included in a March government funding package, he told members of the American Medical Association on Tuesday, Daniel reports. “I think we’ll get most of those cuts mitigated here at the end of this month or in March,” he said. Bucshon is a cardiothoracic surgeon and a member of the GOP Doctors Caucus. Doctors have faced a nearly 3.4 percent cut in Medicare pay since the start of the year, leading to a furious lobbying effort from doctor’s groups. Those lobbying efforts have so far come up empty, but Bucshon, as well as a number of other lawmakers on the Hill, say they hope a fix will be included in the next funding package. But he said the timeline for other provider priorities might not be as promising. The Safety from Violence for Healthcare Employees (SAVE) Act, which would create federal penalties for assault or intimidation of a hospital employee, faces a number of hurdles to becoming a law, Bucshon said. “In this Congress?” he said. “Probably not.” Bucshon, who introduced the bill with Rep. Madeleine Dean (D-Pa.), said some members don’t believe the federal government should step into an issue already under the jurisdiction of state and local authorities. FENTANYL SANCTIONS PASS SENATE — A supplemental defense package, with provisions related to fentanyl, passed in the Senate yesterday but faces uncertainty in the House. The supplemental appropriations package includes fentanyl sanctions legislation, called the FEND Off Fentanyl Act, which includes $1.2 billion requested by the Biden administration to fight the deadly drug — with much of that money earmarked for the Department of Homeland Security. It would allow sanctions on fentanyl cartels and demand the administration complete a series of reports on its efforts to curb fentanyl trafficking. What’s next: The White House has launched a pressure campaign urging lawmakers to pass the legislation in the House, while former President Donald Trump — with sway among some Republican members in Congress — continues to rail against it.
| | | | CONGRESS OVERDRIVE: Since day one, POLITICO has been laser-focused on Capitol Hill, serving up the juiciest Congress coverage. Now, we’re upping our game to ensure you’re up to speed and in the know on every tasty morsel and newsy nugget from inside the Capitol Dome, around the clock. Wake up, read Playbook AM, get up to speed at midday with our Playbook PM halftime report, and fuel your nightly conversations with Inside Congress in the evening. Plus, never miss a beat with buzzy, real-time updates throughout the day via our Inside Congress Live feature. Learn more and subscribe here. | | | | | | | | | INVESTING IN MA — Private equity firms’ investment in Medicare Advantage reached a high in 2021 but has since come down amid Biden administration restrictions on marketing, according to a report by the Private Equity Stakeholder Project, a group focused on accountability for private equity. Why it matters: Medicare Advantage enrollment grew by 8 percent last year, and more than half of eligible Medicare enrollees are covered by an MA plan, according to KFF, a private health foundation. According to the report, private equity growth in MA presents a number of risks that policymakers should monitor, including consolidation where firms sell smaller plans to larger insurers or buy marketing companies to target potential enrollees. Since 2016, most private equity investments in MA have gone toward insurance marketing — which the Biden administration cracked down on last year. Between 2016 and 2023, there were 80 private equity-backed investments, buy-outs and acquisitions in the Medicare Advantage sector, according to the report. Most of those deals were made between 2016 and 2021, the year private equity deals related to MA peaked before petering out a bit, likely due to rising interest rates and regulation. What’s next: A CMS rule proposed last year puts further scrutiny on how much insurers can pay third-party brokers and marketers per enrollee they bring in, but the report authors note this rule might be rolled back under a new presidential administration that’s more friendly to MA.
| | | | A message from Humana:   | | | | | USING AI TO STUDY DEADLY DISEASES — The leader of the House coronavirus pandemic subcommittee says artificial intelligence could be used to conduct research that involves enhancing pathogens to make them more deadly or more easily transmittable as a way to develop vaccines or drugs to fight them. AI could make the case for so-called gain-of-function research obsolete, Rep. Brad Wenstrup (R-Ohio) told Carmen. He leans toward the theory that a leak at a Chinese lab conducting gain-of-function research caused the Covid-19 pandemic. “Most of the evidence would point toward that, just considering the actions of the Chinese,” he said in an interview, arguing that AI could do the job without the risk. Others believe Covid more likely resulted from an animal infecting a person. Hope in AI: Wenstrup, a podiatric surgeon before he became a lawmaker, isn’t a scientist, but he talks the talk. “It all comes down to amino acids, receptor-binding domains, furin cleavage site, and then you can probably gauge some predictability,” he said.
| | | | DON’T MISS POLITICO’S GOVERNORS SUMMIT: Join POLITICO on Feb. 22 to dive into how Governors are wielding immense power. While Washington remains gridlocked, governors are at the center of landmark decisions in AI and tech, economic development, infrastructure, housing, reproductive health and energy. How are they setting the stage for the future of American politics, policies and priorities? How are they confronting major challenges? Explore these questions and more at the 2024 Governors Summit. REGISTER HERE. | | | | | | | | | The National Association of Accountable Care Organizations has elected Jenny Reed, of Baylor Scott & White; Dr. Nina Taggart, of Lehigh Valley Health Network; and Tom Gronniger, of Signify, to its board of directors. Chris Adamec is now executive director of the Alliance for Connected Care, replacing founder Krista Drobac, who is staying on to offer thought leadership. Adamec previously served as the Alliance’s vice president. Roshal Marshall is now chief counsel, privacy, security and data strategy, at Verily. She was managing chief counsel, enterprise data privacy, security and technology law, at McKesson.
| | POLITICO’s Alfred Ng reports on a company that allegedly tracked people’s visits to hundreds of Planned Parenthood locations and gave the data to anti-abortion campaigns. The Washington Post reports on how a rare case of bubonic plague cropped up in the U.S. — and where the plague stands today. STAT reports on the slow start for Biogen’s Alzheimer’s drug.
| | | | A message from Humana: Many patients, especially those with chronic conditions, need cross-disciplinary care.1
Humana connects beneficiaries with access to primary care physicians, specialists, and pharmacists, assisting their health journey when and where they need it. Some patients can also access care within their homes, which may improve outcomes.2
1. The Journal for Nurse Practitioners, "Improving Care Coordination of Patients With Chronic Diseases," 2022.
2. AJMC, "Value-Based Care Through Postacute Home Health Under CMS PACT Regulations," 2022.
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