Primary Care Physician Turnover Tied to Increased Healthcare Spending

March 08, 2022 - The continued strain on the healthcare system is driving physicians out of practice and new findings suggest that primary care physician turnover has a large financial effect on healthcare spending.

Primary Care Physician Turnover Leads to $979M in Excess Healthcare Spending

Primary care physician turnover, triggered in part by clinician burnout, led to around $979 million in excess healthcare spending, according to a study published in Mayo Clinic Proceedings.

According to the study, Medicare patients generated an excess of $189 of healthcare spending in the first year after losing a primary care physician to turnover. Non-Medicare patients generated an average excess of $61. After combining the excess expenditures from Medicare and non-Medicare patients, the researchers estimated that primary care physician turnover generated $86,336 per physician in extra spending in the first year following the turnover.

Using previous physician data, researchers estimated that 25 percent of physicians who expressed an intent to leave their practice would follow through. Subsequently, they determined that 11,339 primary care physicians would leave their current practice each year.

The study results suggest that reducing physician burnout could help decrease physician turnover and cut down on unnecessary healthcare expenditures. READ MORE

Blues Association Looks to Generic Insulin to Increase Medication Access

The Blue Cross Blue Shield Association (BCBSA) has partnered with a nonprofit generic drug company to help increase access to low-cost insulin for members living with diabetes. Along with several other Blue Cross Blue Shield (BCBS) companies, the payer is collaborating with Civica to manufacture and distribute insulin biosimilars.

More than 8 million Americans need insulin to survive. However, one in four users reported skipping doses or taking less than their prescribed amount because of the medicine’s high cost. This can result in patients developing health conditions that they could have avoided if no financial barrier limited insulin access.

Through the partnership, BCBSA and BCBS companies will support Civica as it manufactures and distributes glargine, lispro, and aspart — three biosimilar insulins of brand-name drugs Lantus, Humalog, and Novolog.

The company plans to sell vials of the drugs at no more than $30 each and boxes of five pre-filled pens for no more than $55 each. According to Civica, the prices reflect the development, production, and distribution costs and are well below what uninsured individuals currently pay for insulin. READ MORE

UC Berkeley Loses Patent Appeal for CRISPR Gene Editing Technology

The US Patent and Trademark Office (PTAB) recently ruled that CRISPR gene-editing technology belongs to the Broad Institute of Harvard and MIT, according to multiple news sources.

After an eight-year-long legal battle over the commercial application of CRISPR, the recent decision rocked the University of California, Berkeley and biotech companies that originally licensed the technology to develop treatments.

Now, the university faces a potential loss of $100 million to $10 billion in licensing revenues and these companies are forced to negotiate with Harvard and MIT for the right to use CRISPR for human therapies.

Notably, top CRISPR-based companies, including Caribou Biosciences, Intellia Therapeutics, and CRISPR Therapeutics, are the farthest in clinical trials and hold licenses from UC Berkeley, not MIT. READ MORE

Value of Medical-Legal Partners to Addressing Social Determinants of Health

Medical-legal partnerships effectively mitigate some social determinants of health impacting pediatric populations, reducing hospitalizations by over a third, according to the latest data in Health Affairs emailed to journalists.

Particularly, medical-legal partnerships can help children and their families ameliorate issues like potential eviction, denial of public benefits like food stamps or Medicaid/CHIP, and unhealthy housing situations. These social determinants of health can have downstream impacts, but the researchers showed that legal aid can help stem these factors and reduce high-acuity healthcare utilization.

Medical-legal partnerships have come to rise as the healthcare industry continues its focus on social determinants of health. Some social determinants of health, like food insecurity or transportation, are amenable to hospital or clinic intervention, but others, like housing eviction, require external help. Legal teams that work with medical staff can help patients navigate these legal challenges that impact patient health.

And in an analysis of about 2,200 families receiving a medical-legal partnership referral and over 34,000 who did not, these interventions can effectively improve health. Those receiving legal assistance through the partnership were about 37 percent less likely to have a hospitalization within 12 months after the initial referral than patients who did not receive a referral of legal aid. READ MORE

Organizations Call for Continued Virtual Access to Controlled Substances

Seventy-two organizations, including the American Telemedicine Association and American Psychiatric Association, have sent a letter to government agencies urging them to solidify continued access to controlled substances via telehealth by not requiring initial in-person visits.

Before the COVID-19 pandemic, the standard set by the Drug Enforcement Administration (DEA) and the Department of Health and Human Services (HHS) was that a patient could only be prescribed controlled substances via telemedicine if an in-person visit had taken place beforehand.

As telemedicine increased and in-person visits dropped during the pandemic, the DEA temporarily waived this standard, allowing patients to access controlled medications through telemedicine.

In anticipation of pandemic policies expiring, the organizations are asking the federal government to ensure continued access to controlled substances via telehealth. READ MORE

Michigan Medicine Predictive Analytics Model to Tackle Opioid Use

In response to the addiction and medical risks associated with excessive opioid use, Michigan Medicine researchers developed a risk prediction model that can help define appropriate opioid dosages for patients, according to a study published by the University of Michigan.

Over 90 percent of surgical patients in the US have been prescribed opioids after surgery, and of these patients, between 9 and 13 percent have no prior experience using them, the study stated. Despite the benefits that opioids can provide following an operation, there are also various risks associated with their use.

Researchers used a sample of derivation and validation cohorts from the Michigan Genomics Initiative. The model consisted of three different versions: a full model of 216 predictors, a restricted model of ten predictors, and a minimal model of five predictors. All three performed better at predicting continued opioid use than existing models, the study shows.

Researchers also found that the three versions were more successful at predicting opioid use among preoperative opioid users than inexperienced users. However, researchers noted that the minimal version of the model provided the worst evaluation among inexperienced opioid users. READ MORE