|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
- Over-the-counter hearing aids begin hitting store shelves. As of this week, US consumers can purchase hearing aids for mild to moderate hearing loss without a prescription, thanks to a Food and Drug Administration (FDA) rule issued in August. For the 15 percent of adults reporting at least some difficulty hearing, this change could lower their cost of obtaining a pair of hearing aids by up to $3,000, after factoring in clinician visits, hearing tests, and fittings. The change does not apply to more specialized devices needed by those experiencing severe hearing loss, which remain available only by prescription.
The Gist: As retailers rush to offer the best hearing aid deals to capture this new market, millions of individuals availing themselves of this new opportunity will be navigating the purchase on their own, despite calls from hearing specialists to seek professional testing and assistance. That’s because this new rule is a regulatory reform workaround, as Congress continues to refuse to expand Medicare coverage to include hearing benefits. But, importantly, it’s also part of a broader movement to make healthcare more accessible and affordable by reducing unnecessary prescription barriers—and with a new approval request filed with the FDA, over-the-counter birth control pills may be next.
- Babylon Health announces planned sale of California physician group. In a press release, London-based telemedicine provider Babylon Health said it intends to divest Meritage Medical Network, its 1,800-physician independent practice association located in Northern and Central California. Babylon claims the sale will allow it to better focus on its core business model of digital-first, value-based care contracts. After going public last year at $4.2B, Babylon’s valuation has fallen over 95 percent.
The Gist: Yet another highly touted healthcare startup with digital-first “solutions” has announced a massive pullback in its care footprint. As we wrote about Bright Health last week, these companies have failed to meet investor demands, and must now shutter services or sell assets to buy time to prove their core business model can actually turn a profit. In Babylon’s case, integrating established physician practices into a digital-first, value-based care model was always going to be costly, challenging and time-consuming—too slow to deliver the returns demanded by an increasingly difficult investor market.
- Report finds majority of health systems now following price transparency rules. After a Centers for Medicare and Medicaid Services (CMS) rule requiring hospitals to publish clear, accessible pricing information went into effect in January 2021, most hospitals were slow to comply, in part due to weak CMS enforcement. However, a recent scorecard developed by Turquoise Health, a startup that works with providers and payers to provide clear pricing information for healthcare consumers, estimates 65 percent of US hospitals have now published their prices in compliance with the regulation. The report also found that 80 payers have published negotiated rates, following a tandem rule that went into effect earlier this year requiring price transparency from insurers.
The Gist: It’s encouraging to see this progress from health systems, after many initially dragged their feet. So far, only two hospitals have received fines for noncompliance. In January, CMS raised the maximum penalty to $2M per hospital per year, which could add up to a sizeable penalty for a large system, but it remains questionable whether the elevated penalties are yet stiff enough to drive compliance and investment in needed resources and technology. Despite this, most payers and providers are now following the letter of the regulation. The challenge now is to embrace the spirit of the rule, which is to make hospital services more “shoppable” for consumers. Just because some pricing information is available, doesn’t mean consumers will know where to find it, how to interpret it, how to act on it. This is only the first step in a long journey.
Plus—what we’ve been reading.
- The alarming way doctors approach caring for the disabled. In a concerning New York Times article, reporter Gina Kolata relates the findings of a recent Health Affairs study that convened focus groups of physicians to anonymously discuss the ways they provide—or too often, don’t provide—care to disabled patients. Many admitted to avoiding seeing patients in wheelchairs and complained about having to provide accommodations to speech-impaired patients, citing the high costs of adapting their clinic operations while dealing with disruptions to workflow. People with disabilities interviewed for the article, including Harvard professor of medicine Dr. Lisa Iezzoni, who ran the study, found its results confirmed impressions of widespread bias against the disabled, which is pervasive across healthcare.
The Gist: Reducing disparities in access and quality of care for disabled people often receives less attention than reducing economic, racial, and gender disparities. What’s revealing about this piece is how these disparities among disabled patients manifest, ranging from personal biases (physicians not wanting or knowing how to care for certain groups of disabled people) to structural challenges (constraints of time, money, and facilities needed for proper care). However, for disabled patients, these factors result in an often substandard and unacceptable healthcare experience, which must be addressed head-on by physician and health system leaders.