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As the consumer demand for COVID-19 rapid tests increased due to the spread of the omicron variant, the nation's largest non-profit patient safety organization 

 and found serious gaps in their usability. According to experts at ECRI and their release, none of the tests were rated as excellent and some had noteworthy usability concerns.

ECRI analyzed seven popular COVID-19 rapid tests based on the well-established 

, which rates products on a scale of 0 to 100 with 100 being the easiest to use. More than 30 points separated the top and bottom tests analyzed.

"Our evaluation shows that some rapid tests are much easier to use than others," says Marcus Schabacker, MD, PhD, president and CEO of ECRI, in the release. "If given options, consumers should choose tests that are the easiest to use because when a test is difficult for a consumer to use, it may lead to an inaccurate result."

The tests evaluated and their ratings on the SUS scale are:

ECRI analysts said some tests require particularly fine motor control or have instructions with extremely small font size that may make it difficult for older adults and others with complex health conditions to use the tests correctly. Often, these groups are more susceptible to contracting COVID-19 and face more severe complications.

Given demand and supply issues, Schabacker said consumers may not be able to choose their rapid test and may have to rely on whatever is available to them. In that case, they should be aware of the specific usability concerns for that test so that they can try to mitigate any factors that may lead to an inaccurate result.

Articles

As the need for rapid tests increase, the nation's largest non-profit patient safety organization evaluated seven COVID-19 rapid tests and found serious gaps in their usability. Results shared that none of the tests were rated as excellent and some had noteworthy usability concerns.

Concerns in the Ease of Use for At-Home COVID Tests

CMS announced today that more than 13.6 million people had enrolled in ACA health plans that will provide health insurance coverage next year. The press release described the enrollment has a “historic high.”

According to CMS, more than 9.7 million people have enrolled in plans in the 33 states that use the federal government’s insurance exchange, HealthCare.gov, and another 3.9 million have enrolled through state-run exchanges in 17 states. (The District of Columbia also runs its own exchange).

Open enrollment in the Healthcare.gov states started on November 1 and ends January 15. States that with their own ACA exchanges can, and often do. have a longer enrollment period.

The CMS press release says the previous record for enrollment through Healthcare.gov was 8.8 million during the 2018 open enrollment period.

Enrollment has increased for a number of reasons. Premiums have dipped. In the HealthCare.gov states, the average benchmark plan premium is about 

Kaiser Family Foundation “issue brief”

 published in October. In addition, the subsides that offset the cost of those premiums have increased as a result of the American Rescue Plan legislation that President Joe Biden signed into law in March.

The increased subsidies mean that the premiums for a benchmark silver plan are now fully covered for people with incomes up to 150% of the federal poverty level. The legislation also extended eligibility for ACA subsidies to people with higher incomes (up to 400% of the federal poverty level).

CMS said in a press release that 13.6 million people had enrolled in ACA plans through Healthcare.gov and state-run exchanges.

CMS: ACA Enrollment At Record Level

Countries worldwide still lack critical needs for COVID-19 assistance despite signs of hope in the unprecedented levels of investments in COVID-19 response, according to a recent report released by the 

x and conducted by the Nuclear Threat Initiative (NTI), the Johns Hopkins Center for Health Security and Economist Impact. The study finds this will hinder their ability to respond effectively to future health emergencies.

Findings highlight while some countries have built new capacities during the COVID-19 pandemic, many are temporary. Countries must commit durable funding for long-term preparedness. The report reveals despite the emergence of the COVID-19 pandemic within weeks of the release of the first Global Health Security Index, only two more countries, for a total of 69 of nearly 200, have overarching response plans in place to deal with diseases with epidemic and pandemic potential.

Built around a revised framework, the 2021 GHS Index assesses each country’s capacity to prevent, detect and respond to health emergencies, as well as the effectiveness of their health systems, their commitment to global norms, and the political, socioeconomic and environmental risk factors that can hinder effective response.

COVID-19 has prompted countries to develop some capacities identified as lacking by the 2019 GHS Index. However, no country is placed in the top tier of the 2021 GHS Index—preparedness remains fundamentally weak in all countries.

Whether countries will strengthen their preparedness for future epidemic and pandemic threats by making durable investments is currently unclear.

“Gaps in preparedness leave the world incredibly vulnerable to future health emergencies which could have an even more devastating impact than COVID-19,” said Claire Casey, Global Head of Policy & Insights at Economist Impact. “The second iteration of the Index should be a wake up call: leaders need to act now and put permanent capacities in place to prepare for future health crises.”

New findings from the 2021 Global Health Security Index reveal that:

Most countries, including many high-income countries, have not made dedicated investments in strengthening epidemic or pandemic preparedness

155 out of 195 countries have not allocated funds within the past three years to improve their capacity to address epidemic threats; among those who have, only two low-income countries have evidence of allocating funds. Ninety countries have not fulfilled their full financial contribution to the WHO; 14 of those countries are high-income.

Most countries saw little or no improvement in maintaining a robust, capable, and accessible health system for outbreak detection and response

70% of countries have insufficient health capacity in clinics, hospitals, and community health centers, including human resources and facilities capacity. Only 49 countries (25%) have published an updated health workforce strategy over the past five years to address staffing shortages.

Political and security risks have increased in nearly all countries, and those with the fewest resources have the highest risk and greatest preparedness gaps

Trust in government, which has been a key factor associated with success in countries’ responses to COVID-19, is low and decreasing. 161 countries have low to moderate levels of public confidence in their government. Only 16 countries score in the top tier for government effectiveness.

Countries are continuing to neglect the preparedness needs of vulnerable populations, exacerbating the impact of health security emergencies

Only 33 countries have an overarching emergency preparedness and response plan in place that includes considerations for vulnerable populations. 149 of 195 countries do not identify how risk communication messages will reach populations and sectors with different communication needs related to language, location, and media reach.

Countries are not prepared to prevent globally catastrophic biological events that could cause damage on a larger scale than COVID-19

Nearly two-thirds of countries have not published and implemented an overarching national public health emergency response plan for diseases with epidemic or pandemic potential. Seventy-three percent of countries do not have the ability to provide expedited approval for medical countermeasures, such as vaccines and antiviral drugs, during a public health emergency. One-hundred-seventy-eight countries score less than 50 out of 100 points for whole-of-government biosecurity systems, training, personnel vetting, transport of infectious substances, and cross-border transfer and screening.

“COVID-19 offers a devastating illustration of how poor pandemic preparedness and response can impact health and security at every level—local, national and global,” said NTI Co-Chair and CEO Ernest J. Moniz. “The stakes are high, and world leaders need to act. Biological risks are growing in frequency, and all countries need more investment in durable capabilities to address these risks.”

Dr. Jennifer Nuzzo, senior scholar at the Johns Hopkins Center for Health Security said leaders now have a choice.

"They can make dedicated, sustainable investments in the new capacities created during the COVID-19 response to prepare their countries for the long term, or they can fall back into the decades-long cycle of panic-and-neglect that will leave the world at grave risk for inevitable future public health threats," Nuzzo said.

New study shows opportunity exists to make healthcare more durable to further long-term gains in preparedness for emergencies like COVID-19.

The World Remains Dangerously Unprepared to Meet Future Health Emergencies

COVID-19's latest variant, omicron, could increase the chance that folks will need a fourth vaccine dose earlier than expected, according to executives at Pfizer.

In a report by The Washington Post, Pfizer claimed early lab experiments suggest the standard two-dose regimen remains provides some protection against severe illness from the variant, and boosters are likely to control it.

Executives of Pfizer have said a fourth and necessary dose could be needed at least a year after a third, however more recently it's been said it could be sooner. 

It's been stated by the CDC and the WHO, more than 40 people in the U.S. have tested positive for the omicron variant and that the variant has been Most showed mild reported in 57 countries so far. 

Pfizer and BioNTech have been working on an Omicron-specific vaccine they hope to have available by March 2022 if the variant becomes widespread. Researchers started working on the new vaccine on Thanksgiving Day, Nov. 25, 

COVID-19's latest variant, omicron, could increase the chance that folks will need a fourth vaccine dose earlier than expected, according to executives at Pfizer.









A Fourth Booster May be Needed to Fight the Latest COVID Variant

The COVID-19 pandemic has disrupted healthcare and many parts of the U.S. economy, but employer-based health insurance? Largely unruffled, according to results of the Kaiser Family Foundation’s annual survey of employer health benefits. 

The average annual premium for single and family coverage increased by 4% from 2020 to 2021, the same percentage increase as the year before, according to the survey. Covered workers shouldered 17% of the premium for single coverage and 28% for family coverage, similar to the worker share in 2020. The steadiness of the increase does not negate how fast premiums have risen: According to Kaiser, the average premium for family coverage has gone up 22% since 2016, twice the rate of inflation during that period.

The proportion of employers who offered coverage (59%) and the proportion of employees who enrolled in plans offered by their employers (62%) also saw little change between 2020 and 2021.

The broad outlines of the survey may suggest the gelling of a status quo for employer-based health benefits, but that does not mean there haven’t been notable shifts and adjustments. For example, the Kaiser survey found that the proportion of large firms offering biometric screening — checks of cholesterol levels, blood pressure and body mass index — is decreasing, from 50% in 2020 to 38% in 2021. 

Wellness programs have, not surprisingly, gone digital and remote. The survey respondents indicated that 21% of the programs added a digital offering in 2021 and 34% reported tweaking their programs to accommodate people working at home.

And, of course, telemedicine is ascendant. Nearly all (95%) of the employers with 50 or more employees offered telemedicine in 2021, which the Kaiser survey defined as telecommunications with a provider in a different location (email and web-based videos did not count). That’s up from 85% in 2020.

The survey also revealed an interesting swing to “level-funded” plans among small employers that are self-insured. As explained by the Kaiser researchers who conducted the survey, level-funded plans bundled self-funding with extensive stop-loss insurance. The companies that sell the coverage charge a monthly fee (as the Kaiser researchers point out, it resembles a premium) that includes a percentage of the expected cost of the provision of the healthcare benefits, a premium for stop-loss coverage and an administrative fee. 

The plan administrator, often an insurer, can consider the health status of the workforce, so level-funding can be a good deal for companies with employees who are young and, on average, healthy. But level-funding, because it is a form of self-insurance, escapes state premium taxes and state-mandated benefits. The Kaiser researchers reported that the survey showed a steep increase in the share of small firms with level-funded plans, from 13% in 2020 to 42% in 2021.

The Kaiser survey was conducted from mid-January 2021 through July. Representatives of 1,686 firms filled out the survey. Kaiser researchers reported the findings in 

The COVID-19 pandemic has disrupted healthcare and many parts of the U.S. economy, but employer-based health insurance?

It’s Steady as She Goes in Employer-Based Health Insurance 

The Oncology Care Model (OCM) was CMS’ main attempt to usher value-based care into oncology. What will come after OCM is unclear as the future of successor, Oncology Care First, is now very much in doubt. Regardless, results of a study of OCM’s first three years may give some value-based care proponents pause.

The 201 practices that volunteered to participate in the model spent $297 less per six-month episode of care than 534 practices in a comparison group, reported Nancy Keating, M.D., M.P.H., a professor of health care policy at Harvard Medical School and the lead author of the study published in

 in November. But that savings was offset by an average of $704 in extra payment to the participating practices to cover the cost of enhanced services, such as creation of care plans and around-the-clock access to clinicians. As a result, OCM wound up costing the Medicare program $315.6 million over a two-and-a-half-year period, according to calculations by Keating and her colleagues.

Others have previously reported on OCM’s less-than-stellar results; the study by Keating paints a more complete picture.

An accompanying editorial noted that new and expensive immunotherapy and targeted therapies were introduced during the period when practices were participating in OCM. Those new therapies constrained the ability of oncologists to make cost-saving substitutions and perhaps realize some of the potential of value-based care, wrote Raymond Osarogiagbon, M.B.B.S., of Baptist Memorial Health Care in Memphis, Tennessee, and Samyukta Mullangi, M.D., and Deborah Schrag, M.D., M.P.H., both of Memorial Sloan Kettering Cancer Center in New York City. They noted that drug costs account for an increasingly large share of the cost of cancer and including them in value-based care arrangements
is “problematic.”

OCM might be viewed as the 1.0 of value-based care for oncology, with the not-great results chalked up to the learning curve. Oncology Care First was going to be the chance to iron out some of the problems by, among other things, moving toward prospective capitated payment and gearing benchmarks to specific cancers. Officials at the Center for Medicare & Medicaid Innovation have said they now expect there to be a gap between when OCM ends in June 2022 and when a successor starts. The Biden administration CMS is putting an emphasis on equity issues, so equity is likely to be an important part of whatever comes after OCM. 

The Oncology Care Model (OCM) was CMS’ main attempt to usher value-based care into oncology. What will come after OCM is unclear as the future of successor, Oncology Care First, is now very much in doubt.