|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
Turning the tide in the battle against the virus
The national COVID indicators all continued to move in the right direction this week, with new cases down 16 percent, hospitalizations down 26 percent, and deaths (while still alarmingly high at more than 3,000 per day) down 6 percent from the week prior. More good news: both nationally and globally, the number of people vaccinated against COVID now exceeds the total number of people infected with the virus, at least according to official statistics—the actual number of coronavirus infections is likely several times higher. On the vaccine front, Johnson & Johnson filed with the Food and Drug Administration (FDA) for an Emergency Use Authorization for its single-dose COVID vaccine, which could become the third vaccine approved for use in the US following government review later this month. The J&J vaccine is reportedly 85 percent effective at preventing severe COVID disease, although it is less effective at preventing infection than the Pfizer and Moderna shots. Elsewhere, The Lancet reported interim Phase III results for Russia’s Sputnik V vaccine trials, showing it to be 91 percent effective at preventing infection, and a new study found the Oxford-AstraZeneca vaccine to be 75 percent effective against the more-contagious UK virus variant.
Amid the positive vaccine news, the Biden administration moved to accelerate the vaccination campaign, invoking the Defense Production Act to boost production and initiating shipments directly to retail pharmacies. With the House and Senate starting the budget reconciliation process that could eventually lead to as much as $1.9T in stimulus funding, including billions more for vaccines and testing, it feels as though the tide may be finally turning in the battle against coronavirus. While the key indicators are still worrisome—we’re only back to Thanksgiving-week levels of new cases—and emerging variants are cause for concern, it’s worth celebrating a week that brought more good news than bad. Best to follow Dr. Fauci’s advice for this Super Bowl weekend, however: “Just lay low and cool it.”
Humana partners with DispatchHealth for hospital at home
Humana, the nation’s second-largest Medicare Advantage (MA) insurer, is pushing further into home-based care, partnering with Denver-based startup DispatchHealth to offer its members—especially those with conditions like heart failure, chronic obstructive pulmonary disease, and chronic cellulitis—access to hospital-level care at home. The service will initially be available in the Denver and Tacoma, WA markets, with plans to expand to Arizona, Nevada, and Texas across 2021. Humana members who meet hospital admission criteria will receive daily home visits from an on-call, dedicated DispatchHealth medical team, as well as 24/7 physician coverage enabled by remote monitoring and an emergency call button. DispatchHealth will also coordinate other patient care and wraparound services in the home as needed, including pharmacy, imaging, physical therapy, durable medical equipment, and meal delivery. Dispatch’s earlier offerings centered around home-based, on-demand urgent and emergency care services, now available in at least 29 cities nationwide. Humana’s partnership with DispatchHealth could deliver a full care continuum of home-based services to its Medicare Advantage enrollees and has the potential to displace hospitals from at least a portion of acute care services. Post-COVID, it’s becoming increasingly clear that the nexus of care delivery has shifted even more rapidly to consumers’ homes—and traditional providers will need to rethink service strategies accordingly.
McKinsey agrees to a half billion-dollar opioid settlement
On Thursday, blue-chip consultancy McKinsey & Company entered into settlement agreements with 49 states and the District of Columbia related to advice it provided to opioid manufacturers. It agreed to pay nearly $600M to settle allegations that it helped Purdue Pharma and other drug makers drive sales of painkillers, contributing to a national epidemic of opioid addiction, even after the production and sale of high-dose opioids came under intense scrutiny by the Food and Drug Administration (FDA). States will use the money from the McKinsey settlement, along with money from an earlier $8.3B settlement with Perdue Pharma, to fund opioid recovery and treatment programs. As part of the settlement agreements, McKinsey agreed to future restrictions on its work related to narcotics, and to disclose publicly the extent and nature of its work with opioid manufacturers.
Although the consultancy admitted no legal wrongdoing, a statement from McKinsey’s global managing partner said that the firm “deeply regret[s] that we did not adequately acknowledge the tragic consequences of the epidemic unfolding in our communities.” Not that the consultants were unaware of those consequences: in one document delivered to its pharma client, for example, McKinsey estimated that nearly 2,500 CVS customers would likely overdose or develop an addiction to OxyContin in a single year alone, and in another suggested trying to “lobby Walgreen’s leaders to loosen up” on the opioid issue, despite ongoing FDA scrutiny. Companies often hire marquee firms like McKinsey to provide external validation of their business strategies, creating a moral hazard for consultancies that lack adequate internal controls and guidelines on the advice they give. This week’s half billion-dollar settlement is a stark reminder that the privilege of giving strategic advice comes with responsibility—a useful reminder for those serving clients in healthcare, where patients’ lives are often at stake.