Influenza Trends In The United States

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  • Every state and age group fall well below the CDC’s target vaccination rate of 70%.

  • Influenza and pneumonia (a common complication from the flu) are one of the top 10 causes of death in the United States.

  • 2017 was the most severe flu season of the last decade with increased severity across all age groups.

  • For the 2016-2017 flu season, CDC estimates indicate that the flu vaccine prevented 5.3 million illnesses, 2.6 million medical visits, and 85,000 hospitalizations.

  • On average, employees miss 3-5 days of work as a result of the flu, resulting in the loss of over 600,000 life-years and lost earnings of approximately $16 billion each year[1].

Impact of Proposed 2019 E&M Changes

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CMS has proposed significant changes to how E&M office visits will be reimbursed starting FY2019. Based on analysis by the AMA, we noted the following highlights:

  • A wide range of projected impacts from -20% (Hospice) to 18% (Maxillofacial Surgery).

  • Family Practice and Internal Medicine show positive, albeit small, reimbursement impacts.

  • Urology Shows the largest overall increase in reimbursement dollars ($84.8 M).

The proposed changes have not been finalized and it will be very interesting to see what, if any, modifications to the proposed rule are included in the final rule. For more details on the proposed rule, click here.

Care Variability Across Regions

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Based on 2016 MEDPAR Inpatient Data we calculated a variability score using total charges as proxy.  Amongst hospitals in the 5 major DRGs shown:

  • The Pacific region consistently shows the highest variability.
  • The East and West South Central regions consistently have the least variability.
  • LOS is a key driver of claim level variability within a DRG.

We reviewed correlation to other variables and found region variances were not related to total volumes, average charges, or length of stay.

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The Heart Of Our Country Has A Heart Problem

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According to the CDC:

  • Every 40 seconds, someone has a heart attack.
  • 1 in every 4 deaths is related to heart disease.
  • Heart disease is the leading cause of death for both men and women.
  • Heart disease cost the US around $200 billion each year. 
  • Several risk factors include:
  • High blood pressure
  • High LDL cholesterol
  • Smoking
  • Diabetes
  • Obesity
  • Poor diet
  • Physical inactivity
  • Excessive alcohol use

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