CMS Announces Multi-State Initiative to Strengthen Primary Care

New Model Aims to Enhance Access and Quality of Primary Care, Improve Health System

Today, the Centers for Medicare & Medicaid Services (CMS) announced a new primary care model – the Making Care Primary (MCP) Model – that will be tested under the Center for Medicare and Medicaid Innovation in eight states. Access to high-quality primary care is associated with better health outcomes and equity for people and communities. MCP is an important step in strengthening the primary care infrastructure in the country, especially for safety net and smaller or independent primary care organizations. The model seeks to improve care for patients by expanding and enhancing care management and care coordination, equipping primary care clinicians with tools to form partnerships with health care specialists, and leveraging community-based connections to address patients’ health needs as well as their health-related social needs.

More> https://www.cms.gov/newsroom/press-releases/cms-announces-multi-state-initiative-strengthen-primary-care

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Although social media use by children carries benefits such as increasing connectedness and providing a forum for self-expression, a new advisory from US Surgeon General Vivek Murthy, MD, MBA, warns of potential downsides. [JAMA Network]

Factors such as excessive or compulsive social media use and exposure to violent or sexual content are linked with outcomes including poor sleep quality, anxiety and depression, and body dissatisfaction. “We are in the middle of a national youth mental health crisis, and I am concerned that social media is an important driver of that crisis,” Murthy, who published an advisory calling attention to children’s mental health in December 2021, said in a statement.

The advisory suggests actions that institutions and individuals can take to create healthful social media environments. Policy makers, for example, can enforce age minimums for platforms and back digital and media literacy lessons in schools. Technology companies can develop and evaluate platforms and algorithms with a focus on minimizing risks for children, and families can set aside time to create a family media plan.

Download 27-page report here. 

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There is no way around this: More patients need organ transplants than there are organs available to transplant. It is cold, hard arithmetic. No amount of negotiating with an insurance company or engaging in prior authorization can change that. [Medscape]

As a kidney doctor, this issue is close to my heart. There are around 100,000 people on the kidney transplant waiting list in the US, with 3000 new patients being added per month. There are only 25,000 kidney transplants per year. And each year, around 5000 people die while waiting for a transplant.

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Today, the U.S. Food and Drug Administration granted marketing authorization for the Cue COVID-19 Molecular Test. The product is a molecular nucleic acid amplification test (NAAT) that is intended to detect genetic material from SARS-CoV-2 virus present in nasal swabs from adults with signs and symptoms of upper respiratory infection. This test is the first at-home over-the-counter (OTC) test for COVID-19 to be granted marketing authorization using a traditional premarket review pathway and the first ever at-home test authorized using a traditional premarket review pathway for any respiratory illness.  [Food and Drug Administration]

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“Despite various investments and political action, maternal death rates have climbed in recent years, especially for Black women. California passed a law in 2021 to confront racial disparities in maternal and infant health, but advocates say there needs to be mechanisms for transparency and accountability and deeper investment. [Public Health Institute] 

Dana Sherrod is co-founder and director of the California Coalition for Black Birth Justice and an expert in advancing health and racial equity at hospitals and government agencies. 

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The field of transplant medicine is rapidly developing technologies to address the severe organ shortage. With the transplant system and organ procurement organizations under increasing congressional scrutiny to improve efficient use of organs, there are growing efforts to optimize use of transplantable organs coming from donors who have been declared dead by circulatory criteria. Unlike organs obtained from living or brain-dead donors, those procured from donations after circulatory death are often compromised by hypoxic-ischemic injury because they cannot be removed until the donor has been declared dead, which in the US is typically after the donor has been pulseless for 5 minutes. [JAMA Network]

Although multiple techniques have been developed to minimize or partially reverse the ischemic injury associated with donation after circulatory death, none has been as promising as normothermic regional perfusion. Although enthusiastically endorsed by many as an approach to procuring more and higher-quality organs, normothermic regional perfusion has also drawn criticism, including concerns that it may violate the “dead donor rule,” a fundamental ethical principle of organ procurement that prohibits procedures that may result in patients dying either by or for the procurement of their organs.

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About 10% of people infected with Omicron reported having long COVID, a lower percentage than estimated for people infected with earlier strains of the coronavirus, says a study published in The Journal of the American Medical Association. [Medscape]

The research team looked at data from 8,646 adults infected with COVID-19 at different times of the pandemic and 1,118 who did not have COVID. 

"Based on a subset of 2,231 patients in this analysis who had a first COVID-19 infection on or after Dec. 1, 2021, when the Omicron variant was circulating, about 10% experienced long-term symptoms or long COVID after six months," the National Institutes of Health said in a news release. 

People who were unvaccinated or got COVID before Omicron were more likely to have long COVID and had more severe cases, the NIH said.

Previous studies have come up with higher figures than 10% for people who have long COVID. 

For instance, in June 2022 the CDC said 1 in 5 Americans who had COVID reported having long COVID. And a University of Oxford study published in September 2021 found more than a third of patients had long COVID symptoms.

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A global collaboration, known as the International Pathogen Surveillance Network, will harness pathogen genomics to improve disease surveillance and identify and respond to disease-causing agents before they become pandemics or epidemics, the World Health Organization (WHO) announced. The Network will connect members of different countries to improve sample collection and analysis and facilitate public health decision-making, among other goals.

Pathogen genomics—which involves analyzing the genomes of viruses, bacteria, and other contagions to understand their infectivity, deadliness, and transmission—has played a key role in the world’s ability to respond to diseases, from COVID-19 to HIV, according to the WHO. [JAMA] 

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