| By Maya Goldman |
 Data: Rollins-Gallup Public Health Priorities Survey; Chart: AxiosMedical costs and access still top Americans’ health concerns by a wide margin, ahead of food and water safety or reducing chronic diseases, according to a new poll from Gallup and Emory University.Why it matters: The results show a disconnect with some of the current hot-button health debates around childhood vaccines, access to reproductive health and even maternal mortality.The sensitivity over costs and coverage could help explain the mounting public anger over health insurance and some state efforts to crank up oversight of carriers.Zoom in: More than half (52%) of Americans ranked better health care access and affordability as one of their top three priorities when presented with a list of 15 options.37% of those surveyed included ensuring safe food and water in their top three, while 32% picked reducing chronic disease.In contrast, 13% included ensuring access to comprehensive reproductive care, 11% listed ensuring childhood vaccination against preventable diseases.”People are still struggling to pay health health bills,” said Stephen Patrick, chair of health policy and management at Emory University.”Even though we’ve made progress over the last 10 years in reducing the rates of uninsurance, we still have challenges in many communities in just getting in to see somebody.”More hereMusk’s team accesses CMS recordsBy Maya Goldman  Illustration: Sarah Grillo/Axios Elon Musk’s Department of Government Efficiency has gained access to the inner workings of HHS, including data systems of the agency that manages a nearly $2 trillion budget, handles Medicare and Medicaid benefits and runs NIH, the world’s biggest biomedical research institution.Why it matters: As they march through the federal bureaucracy, Musk and his team now have a seemingly unfiltered view of the sensitive inner workings of much of U.S. health care.DOGE is looking for examples of waste, fraud and abuse as it pursues “opportunities for more effective and efficient use of resources” at CMS, an agency spokesperson said.But it’s not clear how wide a net it’s casting or how it’s defining those words.State of play: Two senior agency staff, one focused on policy and one focused on operations, are leading collaborative efforts with DOGE and “ensuring appropriate access to CMS systems and technology,” a CMS spokesperson said Wednesday.DOGE team members have also visited the Atlanta offices of the CDC and asked for sensitive information from the agencies, per the Washington Post.Musk’s staff have been given read-only access to a database including information on contracts the agency maintains, according the Wall Street Journal, which first reported on DOGE entering CMS.DOGE is also looking at the technology used by CMS and its organizational structure, per WSJ.CMS did not respond to questions on specific systems DOGE staff have access to, or how long the review is expected to last.What they’re saying: “Yeah, this is where the big money fraud is happening,” Musk wrote on X Wednesday, referring to DOGE going into Medicare systems.The definition of abuse or waste “is really in the eye of the beholder,” Chris Meekins, managing director at Raymond James, wrote in a client note.For example, there are disagreements over whether the government is overpaying privately administrated Medicare Advantage plans that now cover more than half of the country’s seniors.More herefrom 1440 Daily Digest:Degenerated Muscles RestoredA trio of patients suffering from spinal muscular atrophy saw significant improvements in their muscle function while receiving electrical stimulation in their lower spines, according to research released yesterday. The process is the first neurotechnology to reverse the decay of nerve circuitry and revive cell function in patients with a neurodegenerative disease. Spinal muscular atrophy is a rare, inherited disease that gradually kills off spinal nerve cells responsible for muscle movement (how it works). As the so-called motor neurons die, the muscles they control wither, causing significant mobility issues. There is currently no cure, though treatments exist to slow the disease’s progression. In the trial, two spinal cord stimulation electrodes implanted in three individuals with the disease’s milder form (Types 3 or 4) were stimulated for four hours at a time over 29 days. During the test period, each patient saw gains in leg strength, walking distance, and more, though upon removal, the implant’s benefits faded. Larger clinical trials are expected, as well as applications to other neurodegenerative diseases. from STAT: biotechThe CRISPR companies are not OKPhoto illustration: Christine Kao/STAT; Photos: AdobeThe gene editing tool CRIPSR was supposed to change medicine — just five years ago, a Nobel Prize committee announced that it “may make the dream of curing inherited diseases come true.” Billions of dollars were spent chasing that dream, but key scientific hurdles remained unsolved. Now, even when companies achieve encouraging results, that can’t seem to stop their stocks from tanking. Put simply, STAT’s Jason Mast writes, “there are surprisingly few places today where you can both cure a disease with gene editing and make money.” For his latest story, Jason interviewed more than 75 investors, academics, executives, analysts, and employees to figure out where, exactly, the vision went off course. Read more. (Come for the analysis and stay for the similes. In one section about the hype around CRISPR, Jason describes it “like dropping a 3D printer into a medieval workshop.” Later, he says the tool has become “as indispensable to lab scientists as whisks are to pastry chefs.”)TelehealthAmazon Pharmacy study touts refill rate  In a new paper published in JAMA Network Open, Amazon employees present data suggesting people who sign up for the company’s RxPass subscription are more likely to refill prescriptions for common drugs like statins and antidepressants than those not enrolled in the program. Launched in 2023, the subscription gives members access to 60 generic medications for a $5 monthly fee. Drugs do not just show up because someone is enrolled in RxPass; users must choose to refill them. Many RxPass drugs are meant to be taken for a long-period of time, so the data helps make the case that Amazon’s service supports medication adherence and better health care outcomes.The study design is pretty clever, but not bulletproof. The study compares 5,000 people who enrolled in the program to 5,000 people who clicked enroll but lived in states where the program wasn’t available. To reduce the impact of people going to other pharmacies, the study was limited to those who had used Amazon to fill two prescription for drugs available through RxPass. According to the data, six months after enrolling or (or clicking enroll), people in the program had on average 10 more days medication on hand and a slight uptick in refills. The paper makes a number of arguments about what may be driving this positive change, including the impact of price sensitivity and “cognitive and behavioral factors.” But I think it’s pretty clear that if you make it cheap and easy to do the right thing, people will do it.Are there confounders? Of course. Is it neat to see Amazon show some data about Amazon Pharmacy? Absolutely. Since launching RxPass, the company has only moved more aggressively into Pharmacy which remains its most successful foray into health care so far. It will be interesting to watch if the company continues to build evidence that the business is improving the health of users.DealsNew Teladoc, same acquisition strategyOn Wednesday I reported that virtual care giant Teladoc Health plans to buy Catapult Health for $65 million. Catapult makes a kit that allows people to take their blood pressure and a blood sample for lab testing at home. After mailing in their sample, people meet with a nurse practitioner to discuss the results. The purchase is aimed at growing Teladoc’s chronic disease business and is very much in line with Teladoc strategies going back years.First of all, Teladoc has always been a rollup. Before the pandemic helped Teladoc Health grow from earning $500 million a year to $2.6 billion a year, the company steadily built the foundation for this growth by strategically acquiring companies here and there. These days, people like me are constantly reminding you about the company’s record-breaking $18.5 billion deal to buy digital diabetes management company Livongo, which ultimately led to Teladoc writing off billions in losses. But it’s been a mostly good strategy: The company bought BetterHelp in 2015 for a song and has since grown it to a $1 billion business on its own. (BetterHelp is having some issues these days, but we’ll set that aside for now.)Amid growth that has slowed to a crawl, Teladoc last year replaced its CEO. New leader Chuck Divita has made some internal changes and pushed new priorities, like international expansion, but the new purchase shows how much of Teladoc’s strategy is more of the same. With 93 million people eligible for Teladoc services, the company’s main lever for growth in the United States, its biggest market, remains getting eligible people to use its more services. The hope, dating back to the Livongo purchase, is that more people using Teladoc for virtual urgent care would eventually use its chronic disease offerings. Now it’s got a home testing company to support that goal.Read more about the deal here. |
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