Tag: health

Surviving the Health Care System: 5 Money-Saving Tips

This tale is component of So Money, an on the net community committed to monetary empowerment and guidance, led by CNET Editor at Massive and So Funds podcast host Farnoosh Torabi.

I basically had a pleasurable excursion to the dentist after.   

Several years back, just after a plan teeth cleansing, I was supplied a expensive estimate for a needed dental course of action. Due to the fact the expense exceeded my insurer’s maximum annual protection, I would have to spend $1,000 out of pocket. Desperation and worry made me discuss up.  

“Can we minimize the price tag in some way?” I questioned, with the dental bib however affixed to my shirt. 

That is when issues took a turn for the greater. My dentist talked about the request with his employees and proposed we do the 2nd 50 percent of the technique in the new 12 months, which was only a thirty day period away. That way, with my coverage renewed, far more of the value would be covered. Asking my dentist for fiscal guidance — some thing I did not realize I could do — saved me $300.  

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It is a smaller example of how self-advocacy can lead to improved economical benefits, like professional medical discounts. And, as wellbeing treatment expenses continue to climb, we require to exercise this now far more than ever. In the very last five several years, extra than half of US older people say they have long gone into debt from medical or dental expenses. 

The advice was echoed on my podcast when I spoke with Emily Maloney, author of Cost of Living, a book that chronicles her painful observations and activities as both of those a health-related expert and a client battling mental sickness. 

In our discussion, Maloney cited the lots of dysfunctions in our wellness treatment labyrinth that can guide to large professional medical costs and other troubles for patients. For example, at a person medical center in which she labored, the facility had $54 million in personal debt (widespread for tiny, large-use well being treatment facilities), which led to professional medical shortcuts, fewer team and dated equipment, as properly as billing glitches and misdiagnoses. “That debt generates rationing, and then that rationing, of program, trickles back down to patients,” Maloney claimed.

5 strategies to cut down well being treatment costs and pressure

Since the burdensome expenses of professional medical care largely tumble on us as people today, Maloney offered these crucial pieces of information that can support to conserve us dollars and worry.

  1. Have the ‘money talk’ with your health care provider

As my encounter at the dentist proved, health professionals have a “fiduciary obligation” as aspect of their Code of Professional medical Ethics to advertise their patients’ best interest and welfare — that includes fiscally. 

But we have to proactively mention that we want to help save money. If your doctor does not convey it up on their have, ask about reduced-expense generic drugs. Talk to them to assessment your wellbeing insurance policies to get a far better feeling of what is economically feasible. Be positive your physician incorporates the right professional medical billing codes for your check out to make certain correct health care protection, as effectively. Ahead of reserving a course of action, you can look at costs on sites like Overall health Care Blue Ebook and Truthful Health and fitness Customer and see if your doctor can match or conquer the lowest shown cost.

2. Query your clinical payments

Quite a few clinical costs consist of faults, so you may perhaps want to maintain off on spending ideal away. “Commonly, it truly is not suitable or it has not been despatched by way of all the insurance policy, so you end up with a bill that may possibly not be essentially accurate,” explained Maloney. 

You can work with a billing specialist or advocate that may arrive provided through your employer to overview the expenses and diagnostic codes. Or, get in touch with the overall health treatment supplier and inquire for a entirely itemized breakdown of all the billable factors of the visit to detect doable errors. If your monthly bill is suitable and you require extra time to fork out, talk to the professional medical office to make a payment system. 

3. Assessment financial debt legislation

If a healthcare monthly bill goes unnoticed and is turned about to a credit score agency, there are protections in spot to give Us residents up to a single calendar year to crystal clear their superb health-related costs right before they are posted on credit score reports. Also, in 2023, the 3 significant credit rating bureaus — Equifax, Experian and Transunion — will finish reporting all healthcare collections underneath $500.

If your health care credit card debt has absent into collections and it really is hard to spend even the minimums on substantial healthcare charges, critique your state’s statute of constraints on collecting that credit card debt. For healthcare credit card debt, the lawful window for collectors to sue you for unpaid balances ranges from a few to 10 many years. In Maloney’s circumstance, she figured out about this by means of a assortment agent who informed her that her financial debt experienced in essence “expired” and would be canceled. It would mark the finish of her five-figure health care financial debt saga.  

4. Seek out healthcare allies 

It may possibly sound clear to say that you want a medical professional who you truly feel comfy with, but that is not a specified, particularly if your insurance policy won’t permit for a extensive alternative of vendors, Maloney said. “It’s genuinely important to obtain suppliers you can rely on, and which is something that I assume can be a challenge.”

A lot of ladies aren’t taken very seriously, so it can be normally really hard to uncover compassionate health treatment, according to Maloney. As properly, she reported, individuals of color and LGBTQ individuals might deal with important discrimination. Seek references from friends, family, colleagues and even social media groups. You can also study patient critiques on web pages this sort of as Zocdoc before making appointments.

5. Get a welcoming advocate

No matter where you conclusion up getting treatment, for additional major or associated appointments, have a mate or cherished one accompany you for both of those technological and emotional aid. 

“The practical experience of remaining in the physician’s business office can be actually stressful,” claimed Maloney, who sought out support when she was attempting to uncover suitable care. “Will not be scared to carry a person with you. They can get notes. They can be your advocate. They can dangle out with you in the waiting around room.”

Viewing the larger societal photo

To improve the overall health care process, Maloney insists that we need to have improved health literacy throughout the country so that, for example, sufferers know when to pay a visit to the crisis area vs . urgent care or a physician’s office. Our country also requires extra medical professionals and health-related practitioners, as well as a standardized, electronic health-related document system to guarantee patients get constant and proper treatment wherever they transform, she pointed out.

As for a much more elementary change, Maloney proposes one-payer or universal wellbeing care the place the federal government foots the complete bill. “There really should be a process for everybody to get care.” In her watch, it is really a fantasy that this form of program will be more high priced. “It is really just a query of who ends up paying for that care,” she stated.

Digital Health Tools Need a New Benchmark

Through the Covid-19 pandemic, electronic overall health technologies remodeled the way that quite a few of us received well being care, supercharging the uptake of digital equipment such as telehealth platforms, mobile symptom trackers, and distant monitoring. On the other hand, the total-scale adoption and effect of digital overall health know-how in countrywide health and fitness systems all-around the planet has still not but entirely materialized. A essential motive is that they generally lack the necessary scientific evidence to back again the variety of benefits—from improved wellbeing outcomes for sufferers to superior price tag-gain outcomes  for payers these types of as insurance plan providers and overall health care providers—that its producers claim they can deliver. 

A current research by healthtech seed fund Rock Wellbeing and Johns Hopkins College demonstrated the extent of the trouble. The scientists reviewed the connected clinical trials, regulatory statements filings, and shown results by 224 health care firms. Incredibly, only 20 per cent attained the threshold regarded appropriate for rigorously tested remedies. This predicament, of program, represents a barrier in the uptake of new innovations in overall health care.

In 2023, we will see heightened scrutiny for the proof needed of electronic health and fitness technologies and how that proof is generated. This will be led by regulators and payors who will involve rising clarity on evidence for reimbursement. This is by now occurring in the United kingdom, US, and Germany. Other nations will comply with go well with as a consensus is designed among foremost bodies and professionals.

Typically, new medication and medical equipment are analyzed and validated by arduous randomized command trials. This methodology, having said that, is not always ideal for electronic health units which have more quickly cycles of iteration and frequent advancement. In 2023, we will instead see increasing acceptance of diverse techniques of generating the essential evidence, from clinical simulation trials applying mock client knowledge to the use of true-earth proof generated in hospitals and health care facilities. 

For occasion, in 2021, pharmaceutical company Roche applied a simulation to examination a new device that automatic the research for appropriate clinical trials for cancer people, a approach that historically will involve clinicians painstakingly seeking many databases. This simulation involved building so-termed synthetic affected person data—mock info that is based mostly on genuine-individual knowledge, but with altered names, dates, scientific heritage, medication, and affected individual results. It was executed remotely and at various situations, although the clinical trial research device alone continued to be iterated.

This kind of medical simulations give a amount of advantages: They can rapidly replicate genuine-world health and fitness care scenarios and be done remotely on various spots at very low value, in addition they allow for for the inclusion of large-possibility affected individual conditions, which are typically excluded on conventional trials, even though reducing details privateness issues. These attributes are why, in 2023, we will see clinical simulations and synthetic data progressively getting to be the new gold common in trialing new electronic wellness applications.

Regulators will also go towards accepting these novel methodologies as validation and favor a far more pragmatic technique to proof technology. Just lately, the National Institute for Wellness and Care Excellence (Good) has established up the Early Price Evaluation Plan for Digital Equipment, a plan that will aid choose promising systems and conduct a fast evaluation of their clinical usefulness and effects in advance of embarking on more robust trials. In 2023, pilots will be executed for digital applications for stress and melancholy in children, and it is hoped this will be rolled out as effectively for early most cancers diagnostics, grownup psychological wellness, and cardiovascular condition. In the around long run, applications these types of as these indicate that clinicians will be able to thoroughly evaluate any bold statements designed by digital health and fitness organizations with regards to their products. At the time we have cracked this, we will see a far better selection of digital overall health technologies that can truly reward affected individual treatment.

Holistic health trends for 2023: Sleep, rest and live with the sun

Simply call it self-awareness, enlightenment or the solitary confinement enforced by the pandemic but 2023 is heading to be the calendar year of producing aware options. It is likely to be a year of holistic health, where by the intellect-entire body-soul communion is going to be paramount and, in simple fact, can even develop into additional than just an outlook. It may well develop into the only way we stay. In the gush of materials gratification of the previous two decades, we forgot our purely natural state of getting, our harmonised residing with character and most importantly our bio-rhythms as they have been intended to be. So, all that we rebelled in opposition to as staying gradual and sluggish is now getting seen as a panacea for all the diseases that we have obtained courtesy our contemporary life-style.

(1) Resting and snooze: This is predicted to be the prime trend as nearly each individual study finds out the benefit of a very good 7 to 8 hrs of rest and rest. Scarce or patchy rest has been connected to the load of life-style illnesses that have impacted our heart health, brought on diabetes and absolutely imbalanced our intestine well being, ensuing in each individual of us developing comorbidities. The emphasis on having a excellent night’s rest has also yielded benefits in phrases of people today providing far better, decreasing their anxieties and devising a swap-off mechanism for their body and head to mend. In truth, we will shortly be returning to the roots, waking up and sleeping with the soaring and setting sun. Researchers and health and fitness industry experts have now coined the phrase circadian well being, indicating it will be a critical pillar of lifestyle administration. Even tech firms are gearing themselves up to offer sleep-inducing aids and props.

(2) The return of yoga: Specified the trajectory of health and fitness center fatalities because of significant intensity workouts that do not match everybody’s entire body potential, the desire will shift back to yoga, thinking of that each asana is targetted at the well-staying of each organ of the physique and can be completed very easily as opposed to other exercise routines. The Suryanamaskar, or the “Indian press-up” as it is becoming known as globally, is becoming witnessed as a composite physique exercise session that allows prevent virtually each life style sickness from occurring. A rather basic routine of breathing, stretching, contracting, meditation and Shavasana has been located to be successful in general well being.

(3) Having the very last food ahead of sunset: This once again is part of our conformity with the circadian rhythm. As the sunshine rises, our digestive technique works very best and with sunset, the secretion of digestive juices lessens. That is why article-sunset meals are tricky to digest leading to a toxin and calorie pile-up. Also, in accordance to the circadian rhythm, our body rate of metabolism slows down with sunset. All this disturbs our gut well being, which is the origin of all our persistent illnesses. This is considerably more mature than the fad known as intermittent fasting these days.

(4) Getting variety to the environment and not abusing it: We are not just likely to worry about lessening our carbon footprint but be useful resource-acutely aware and waste fewer. This will affect the way we take in, ensuring we do not tax character and eliminate species by way of human usage but shift to sustainable dwelling at an individual level.

(5) Wholesome ageing: With a fast ageing inhabitants which is going to have to get care of them selves, there is currently an growing concentrate on age-ideal work out regimes and meal plans. Dwelling previous and healthy will be the new mantra as geroscience is currently being analyzed under the microscope.

Even technology is becoming increasingly harnessed for self-like and self-treatment. If I were being to summarise in just one line, then our way of lifestyle would be shuddhikaran, which usually means purify, control and fortify for healing and wholeness.

(Dr Mehta has qualified Bollywood superstars Akshay Kumar, Preity Zinta, billionaires, politicians, Miss out on Environment/Skip Universe candidates and the Maharashtra Police. A greatest-providing creator, he has been appointed In shape India Movement Winner by the Sporting activities Authority of India).

Borrego Health assets to be sold at auction amid bankruptcy

Borrego Neighborhood Overall health Basis, the federally funded nonprofit health care provider that declared personal bankruptcy before this yr amid an ongoing felony fraud investigation, has been permitted to offer off its property to the highest bidders.

The auction of tens of millions of dollars truly worth of serious estate, healthcare equipment and other assets is scheduled for late subsequent thirty day period under a ruling from a federal personal bankruptcy courtroom choose.

Officers at the nonprofit known as Borrego Health stated the sale is the very best way to shield the countless numbers of low-revenue and rural people across San Diego and Riverside counties who depend on it for health-related care.

“The exploration of a sale is good for absolutely everyone who cares about the availability and excellent of healthcare in rural Southern California,” spokesperson Daniel Kramer mentioned.

The group acknowledges that less than prior management it abused the Medi-Cal reimbursement plan, and it has sued a slew of former board customers, executives and sellers to check out and get well hundreds of thousands of bucks in what it states had been misspent cash.

“The only way to ensure the continuity of treatment to Borrego Health’s people is to transfer the clinics to a extra financially steady operator,” Kramer claimed.

But the sale is becoming opposed by regulators, who advised the court docket they are anxious that assets compensated for by U.S. taxpayers will be involved in the residence established to be bought to the maximum bidder.

The U.S. Office of Health and fitness and Human Companies “contends that the federal government, not the individual bankruptcy estate, owns the (Wellbeing Methods and Services Administration) funds, personal house ordered with HRSA funds, and (federal aid) resources,” the govt wrote in a current personal bankruptcy court docket filing.

“To the extent (the) debtor is requesting authority to offer these assets, the courtroom need to initial ascertain irrespective of whether these types of belongings are property of the estate,” the filing added.

Regulators stated Borrego Wellness gathered $17.6 million in federal COVID-19 aid funds authorised in the early months of the pandemic. The agency has not nonetheless reported on how it spent just over $6 million of that help.

According to Hugh Vance, a wellness insurance plan professional at the Centers for Medicare and Medicaid Products and services, Borrego Health and fitness has not appropriately accounted for other federal funds.

“Debtor has failed to post overdue price tag stories that HHS estimates collectively mirror upwards of $1,500,000,” he wrote in a latest declaration. “When a supplier fails to file cost reports, all reimbursement is suspended until eventually the price tag experiences are filed.”

Borrego Wellbeing is a federally certified healthcare provider, or FQHC. The designation means it gets greater-than-regular payments for offering clinical, dental and psychological health providers to needy patients.

At its peak in 2020, Borrego Overall health was 1 of the maximum-funded FQHCs in the nation, obtaining much more than $340 million in complete profits.

But the healthcare company was the subject matter of many prison research warrants in Oct of that calendar year, when dozens of FBI and point out Office of Justice brokers turned up at clinics and administrative places of work.

They seized pcs, boxes of files and other material as part of a legal investigation into the provider’s expending and business enterprise practices.

Neither state nor federal agency would go over the circumstance past confirming the queries.

Late in 2020, the condition Division of Well being Treatment Solutions, which administers federal Medi-Cal plans in California, suspended all reimbursements to Borrego Overall health. State regulators explained the company could not appropriately account for payments.

Inside numerous months, however, California regulators agreed to reinstate most of the payments — excluding only reimbursements manufactured for the dental providers that witnesses and court docket filings say is at the heart of the felony investigation.

Borrego Health and fitness subsequently changed lots of of its board customers and govt officers.

Before this calendar year, it submitted a sweeping lawsuit in opposition to previous administrators, workers and contractors, accusing them of engaging in a long-functioning fraud that incorporated tens of millions of bucks in alleged kickbacks, abnormal salaries and popular nepotism.

The go well with accused defendants of Racketeer Influenced and Corrupt Companies Act violations — expenses that, if proved, could outcome in improved monetary damages.

By late summertime, California regulators were being not convinced that Borrego Overall health was conference all of its obligations under the 2021 settlement that had led to the reinstatement of Medi-Cal reimbursements.

They imposed a new suspension — a decision that Borrego Wellness claimed would jeopardize its potential to remain open and in a position to serve more than 90,000 clients.

The group submitted for Chapter 11 individual bankruptcy protection and persuaded the judge to keep the Medi-Cal suspension, properly forcing the state to resume reimbursements.

In excess of the a few months since, Borrego Well being, its creditors and regulators have been litigating conditions of the individual bankruptcy and asset sale.

Kramer said Borrego Wellbeing is now scheduled to enter mediation over the state’s opposition to the asset sale.

The healthcare provider also been given authorization from the bankruptcy judge to provide personnel bonuses and incentives to continue to keep individuals from leaving.

“Borrego Wellbeing however has to sustain individual care and simply cannot find the money for to get rid of any extra staff members who provide that care,” Kramer explained by e-mail.

In its most not long ago financial submitting, covering the thirty day period that ended on Oct. 31, 2022, Borrego Well being documented overall assets of $84.7 million and complete liabilities of $92.8 million.

Dementia, stem cell, and mental health research

2022 has been an eventful year when it comes to medical research, but what are some of the most intriguing findings and trends? Our editors, Maria Cohut, Yasemin Nicola Sakay, and James McIntosh reflect on this year’s highlights in our December “In Conversation” episode.

While 2020 and 2021 may have stuck in the collective memory as two intense pandemic years, 2022 has also been an eventful one.

Google’s Year in Search report pinpoints some of people’s most pressing concerns at a global scale throughout 2022. One of these is the monkeypox epidemic, which the World Health Organization (WHO) declared a “public health emergency of international concern” in August.

The death of Queen Elizabeth II of Great Britain in September, after a record 70-year reign, garnered global interest, as did the impact of the ongoing conflict in Ukraine.

And the overturning of Roe v. Wade in the United States sparked concern among medical communities worldwide.

But 2022 has also seen a wealth of advances in medical research, from a new way of assessing potential dementia symptoms that may help to diagnose it up to 9 years sooner than the current standard to the discovery of an insulin-mimicking molecule that may, in the future, help treat diabetes.

This December, three of our editors — myself, the Feature Editor, Yasemin Nicola Sakay, the Global News Editor, and Managing Editor James McIntosh — joined the “In Conversation” podcast to talk about some of 2022’s research highlights.

These include the twists and turns dementia research has taken this year, why scientists are increasingly interested in the potential of psychedelics in mental health treatments, and how stem cell research is advancing at a steady pace.

Listen to this month’s installment of our podcast below, or on your preferred streaming platform.

This year has been a very charged one for dementia research. As many as 55 million people around the world live with a form of dementia, the most common form of which is Alzheimer’s disease.

While there are some treatments that target symptoms of dementia, such as memory loss and anxiety, there is currently no cure for Alzheimer’s disease and related neurodegenerative conditions.

One thing that would help researchers find better treatments to prevent or slow down the progression of dementia symptoms would be finding out its true cause and the mechanisms that drive it.

The ‘amyloid hypothesis’ controversy

In 2006, a study that appeared in the journal Nature lent credibility to what is now known as the “amyloid hypothesis,” which holds that an overaccumulation of beta-amyloid protein in the brain — forming sticky amyloid plaques — disrupts the communication between neurons, thus being largely responsible for the main symptoms of dementia, such as memory and thinking problems.

Since its publication, the Nature paper has been cited in over 2,200 other studies, and the amyloid hypothesis has informed the vast majority of the dementia research conducted until now.

Yet in July 2022, an assistant professor of neurology at Vanderbilt University called into question claimed that some of the images in the seminal study had been manipulated, which may affect the credibility of the amyloid theory.

While the 2006 Nature paper has not, at the time of writing, been retracted, the recent claims of scientific misconduct have caused an uproar among dementia experts, and given rise to many questions.

One question is: If the paper truly does build on inaccuracies, will this invalidate some of the findings in dementia research reported until now? Not so, some experts say.

Speaking to Medical News Today, Dr. Sara Imarisio, head of research at Alzheimer’s Research UK, explained that “the findings from the [Nature] paper were very specific and, contrary to some reports, have not significantly affected the progress or direction of research into Alzheimer’s.”

“Even for research groups who work in this particular area, findings that can’t be reproduced will be identified as controversial and lose credibility, while genuine findings will come to predominate and guide the direction of future studies.”

– Dr. Sara Imarisio

Indeed, some findings about amyloid plaques seem to hold true, as a recently developed drug, lecanemab, which attacks the accumulation of beta-amyloid in the brain, has shown clear promise in recent clinical trials, and its developers hope that the drug will be approved for use in people aged 65 years and older in the U.S. as soon as next year.

New research avenues

But scientists were already aware that beta-amyloid plaques are not the be-all and end-all of dementia research. How so? In our June 2022 podcast, we spoke with Dr. Kamar Ameen-Ali, a lecturer in biomedical science at Teesside University in the United Kingdom.

Dr. Ameen-Ali explained that the crux of the matter is this: Beta-amyloid accumulates in the brains of healthy people just as it does in those of people with dementia symptoms. What makes this protein disruptive in some cases but not others remains unclear.

This is one of the reasons why dementia research does not, and has never stopped at the amyloid hypothesis, influential as it may be.

The controversy has also meant that more and more researchers are looking into alternative or additional pathologies in Alzheimer’s disease and other forms of dementia, including the role of tau, another protein implicated in dementia, which, some experts say, may be a better indicator of Alzheimer’s disease progression.

In September, an animal study whose results appeared in PLOS Biology suggested that brain inflammation caused by a dysfunction in the blood-brain barrier may be a likely cause of Alzheimer’s disease.

“These findings may have a significant global impact on the millions of people living with Alzheimer’s disease,” Prof. Warren Harding, chair of Alzheimer’s WA, told MNT about the study.

And in November 2022, a study published in Nature argued that disruptive swelling along axons, which form the link between neurons, may be the true cause of Alzheimer’s symptoms.

One emerging treatment for dementia is stem cell therapy, thanks to the potential of stem cells — which are a kind of “blank slate” cells — to differentiate and “specialize” into cells with different functions, thus providing healthy cells to replace those that have experienced some degree of “damage.”

Stem cell research has made great strides this year, with scientists looking at the potential of stem cell treatment in many incurable or difficult-to-treat diseases.

In April 2022, for instance, a study whose findings appeared in npj Regenerative Medicine showed how implanting induced pluripotent stem cells in rats with Parkinson’s disease-like motor symptoms helped reverse those symptoms by replacing damaged neurons.

Speaking to MNT about the study results, Dr. Jeffrey Kordower, director of the ASU-Banner Neurodegenerative Disease Research Center at Arizona State University, said that they gave him “great confidence” about the treatment’s applicability in human patients in the future.

Another stem cell therapy highlight made the press in summer 2022, when the fourth, and oldest patient yet with HIV and leukemia achieved remission after receiving a stem cell transplant.

The patient, a 66-year-old man, achieved long-term remission of HIV 3 years after receiving a stem cell transplant for leukemia, which is a blood and bone marrow cancer.

“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence. I never thought I would live to see the day that I no longer have HIV,” the patient declares in a statement for the press.

Creating embryo and brain models from stem cells

Stem cell research has also reached other intriguing and much-debated heights this year. In August 2022, two different research teams reported having successfully created embryo models in the laboratory, using not sperm and egg cells, but stem cells to do so.

The embryo models managed to develop rudimentary structures, including a beating heart, blood stem cell circulation, a head region with folds, and the beginnings of a gut tube.

They are also viable enough to allow researchers to delve deeper into the study of embryonic development. Models like these can also help researchers steer free of experiments with potential ethical implications.

Other researchers managed to create brain organoids — models of brain tissue — from stem cells in the lab. Such models can help scientists learn more about rare neurological conditions, such as microcephaly, where the size of the brain is reduced compared to that of a healthy brain.

More widely, researchers could use models of brain tissue to better understand the way in which viruses, such as SARS-CoV-2, might attack and affect the brain, and to further dementia research.

The importance of stem cell donation

Our own Managing Editor, James McIntosh, donated stem cells earlier this year to help further research on better treatments for people with blood cancers and blood disorders. James talks about his experience at length in a “Through My Eyes” personal perspective article.

When a person donates blood, they can also choose to donate stem cells, which are separated through a process called “apheresis.” It may seem like an unsettling experience, but, James wrote, it was nowhere near as scary as a first-time stem cell donor might think.

In his article, he explains how apheresis works:

“All the heavy lifting was going to be done by a cell-separating machine. The nurse inserted a needle into a vein in my left arm from which my blood was drawn into the machine. The machine then separated the blood into its separate components: red blood cells, white blood cells, plasma, and platelets. Once the blood was separated, the parts containing my precious stem cells were taken away, leaving the rest of the blood to return to me. The nurse inserted another needle into a vein in my right arm, and the blood was able to rejoin my bloodstream here from the machine.”

James encourages everyone who can to donate stem cells for treatment and research: “Stem cells are a vital part of treatment for several serious conditions while also showing a lot of potential in the development of new therapies for currently untreatable diseases. As a result, it is very important for there to be people willing to donate their stem cells. Many will be able to save lives by joining a donation register.”

Our January 2022 podcast on blood donations and transfusions further explains how blood donation works, how to prepare, what the different types of blood donation are, and why this is such a vital part of medical treatment and research.

Another research avenue that has been gaining ground in 2022 is the use of psychedelics in the treatment of anxiety and depression.

Around the world, hundreds of millions of people live with anxiety or depression, which can severely affect their quality of life.

The standard treatments for these mental health conditions include psychotherapy and cognitive behavioral therapy (CBT), as well as medications such as serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) — also known as “antidepressants” — which are meant to help rebalance the levels of key chemicals in the brain.

However, according to some estimates, up to 30{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of adults living with major depressive disorder have treatment-resistant depression, which does not respond to standard lines of treatment.

And around 50{bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} of adults with generalized anxiety disorder do not respond to first-line treatments, such as antidepressants.

In a bid to find more effective ways of addressing the symptoms of hard-to-treat depression and anxiety, researchers have turned to a sometimes-controversial line of inquiry, namely psychedelics, particularly ketamine, LSD, and psilocybin, the psychoactive compound in magic mushrooms.

What do psychedelics do?

These drugs are, for the most part, illegal in the U.S. and elsewhere, at least for personal use, but researchers can study their effects in humans under closely supervised, clinical trial conditions, and the results of some of these studies have been intriguing.

In our May 2022 podcast, we spoke to Dr. Adrian Jacques Ambrose, medical director of the Columbia Psychiatry Practice Office.

“For anxiety disorder, as well as panic disorder, there’s hyperactivation of what we call the fear network. [By this] I mean specific parts of the brain that includes the thalamus, the amygdala, the hippocampus, and the striatum,” Dr. Ambrose explained.

And since the human brain has a negativity bias — meaning it tends to hold onto negative memories and emotions — this may exacerbate the negative thinking that occurs in anxiety and depression.

Dr. Ambrose believes that standard treatments such as antidepressants may not always work “because of their lack of specificity.” In contrast, psychopharmacological treatments may be able to “rewire” the parts of the brain involved in this vicious cycle of negative thoughts.

Indeed, a study whose results appeared in JAMA Psychiatry in October 2022 concluded that ketamine can ease depression symptoms in as little as 4 hours by “updating” negative beliefs that people with severe depression hold about themselves and the future.

“We observed each patient before and after ketamine and found an early cognitive effect on beliefs about the future. Notably, patients started to show an optimism bias in belief updating 4 hours after [the] first, single infusion. At one week of treatment, the optimist bias in belief updating correlated to the clinical antidepressant effect,” says study author Dr. Liane Schmidt.

And in November, a study from NEJM found that a single, 25-milligram dose of a synthesized formulation of psilocybin also relieved the symptoms of treatment-resistant depression, although the exact way in which psilocybin acts on the brain remains unclear.

The catch

While studies such as the ones mentioned above seem to indicate that psychedelics may indeed be the way to go when it comes to severe anxiety and depression, they all come with a series of caveats.

In the JAMA Psychiatry study, the participants received ketamine infusions, which is a very specific method of administration. They also received their regular antidepressant treatment throughout the study period.

Speaking to MNT, Dr. Guochuan Emil Tsai, neuropsychiatry expert and CEO of the company SyneuRx, not involved in the study, pointed out that:

“Ketamine infusion is available but not commonly used. It’s usually reserved only for treatment-resistant depression and can only be done in facilities that offer IV infusion and can monitor patients. It would be similar to a dialysis center. Ketamine is also a Schedule III controlled substance with inherent risks.”

The NEJM study came with an even greater caveat: Although psylocibin did help reduce depression symptoms in most of the participants, about a week after the treatment, the most commonly reported side effects were suicidal ideation and intentional self-injury.

“It’s not a recreational process — it”s not like do-it-yourself self-help,” Dr. David A. Merrill, psychiatrist, and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, CA, not involved in the study, told MNT in an interview.

“It really needs to be done with professionally trained, licensed, or certified practitioners who understand the power of these drugs to create a mind-altered state. Dissociation, even at times hallucinations, [are] part of the journey of psychedelics to open the mind to new possibilities, but that journey needs to be supported with professional help,” stressed Dr. Merrill.

So in the course of studying psychopharmacological treatments, a few questions remain: What are the safest doses and delivery methods? Do the benefits outweigh the risks? And who would most benefit from these interventions?

Our editorial team hopes that, in 2023, we may be one step closer to finding the answers to these and other questions that could transform healthcare practices for the better, and that our audience will continue to join us in our exploration of medical innovations.

2022’s most interesting health care research papers, according to the experts

Though the pandemic and all its attendant health care crises remained the major health care story of 2022, churning all the while in the background has been the critical work of academic scholars, operating on longer timelines, who are still trying to make sense of US health care and of medicine itself, to get a better idea of what’s wrong and how to make it better.

To wrap up this year, I asked a couple dozen health policy experts what research released this year (though, as one of them reminded me, these papers are often years in the making) had surprised them, changed their thinking, or struck them as especially notable.

Here are five particularly interesting papers, at least in my view. Because many more than that warrant mention, I have tried to cram in as many references to other work as I could. One of my lessons from this exercise was that there are noteworthy new studies being produced all the time. The US health system certainly merits such extensive investigation, given the number and diversity of its flaws.

These studies cover a broad range of subjects, from the intricacies of Medicaid provider networks to prescription uptake by Medicare beneficiaries to how bystanders react when a person experiences a cardiac episode in public. But first, on the topic of the pandemic…

1) Vaccination education campaigns in nursing homes didn’t make much difference

Several experts pointed me to data sets related to Covid-19 vaccination in nursing homes, the scenes of so much illness and death in that frightening first year of the pandemic. Larry Levitt, executive vice president of the Kaiser Family Foundation, flagged one recent KFF survey that found less than half of nursing-home residents are up to date on their vaccines.

That put into sharp relief the findings of a study that Harvard Medical School’s David Grabowski cited as one of his favorites of the year. The paper, published in JAMA Internal Medicine in January 2022, evaluated an effort to use educational campaigns and other incentives to improve vaccination rates among residents and staff in nursing homes.

They did not find a meaningful effect, despite three months of programming. There was plenty of room to grow, particularly among the staff, roughly half of whom were unvaccinated during the study period. (Vaccination rates among residents were already high at the time, though the experiment still did not find a significant effect of the multi-faceted campaign.)

“The conventional wisdom was that a big part of lagging vaccination rates was a lack of information and knowledge about the benefits of vaccination,” Grabowski said. But this study found instead that “these educational efforts were unsuccessful at encouraging greater vaccination. Although information campaigns sound like great policy, they really aren’t.”

He lamented that the study had been ignored by policymakers, noting federal efforts to increase vaccination rates among this population remain focused on education. Grabowski said the policies with the strongest evidence are vaccine clinics and vaccine mandates for staff.

2) Medicaid’s “phantom” networks may overstate patients’ access to health care

I love good jargon, and “ghost physicians” is one of my favorite new phrases of the year, which was recently brought to my attention by Harvard University professor (and former Vox contributor) Adrianna McIntyre.

It comes from this May 2022 Health Affairs paper, authored by Yale University’s Avital Ludomirsky and colleagues, which evaluated the provider networks of Medicaid managed-care plans. Those are privately administrated plans for low-income people that must follow state and federal Medicaid rules; they have grown in enrollment in recent years, with more states deciding to outsource their role in providing health coverage for the most vulnerable.

One of those rules is that enough doctors and hospitals accept those Medicaid plans, otherwise known as network adequacy. The Health Affairs study examined managed-care plans in four states over several years to get a better sense of providers’ participation in the program.

Their most striking finding is that while nominal participation was fairly high, about one-third of providers who technically accepted Medicaid actually saw less than 10 Medicaid beneficiaries in a given year. The responsibility for providing care to these patients was concentrated among a small number of practices, with 25 percent of primary care doctors providing 86 percent of the care and 25 percent of specialists providing 75 percent of those services.

In other words, while plenty of doctors might say they accept the plans, people who are enrolled in them may in practice find they have relatively few doctors to choose from. “Our findings suggest that current network adequacy standards might not reflect actual access,” the authors wrote in their conclusion. “New methods are needed that account for beneficiaries’ preferences and physicians’ willingness to serve Medicaid patients.”

The move toward more Medicaid-managed care has spurred a lot of debate and study. Matthew Fiedler, senior fellow at the Brooking Institution, sent me a Harvard study with its own surprising finding: In Texas, transitioning Medicaid enrollees to managed care had actually led to an increase in the use of prescription drugs and outpatient services, while the number of avoidable hospitalizations fell.

What seems to have happened, Fiedler said, is the state had been “penny-wise, pound-foolish” when running the program itself by imposing an unusually strict cap on the number of prescriptions patients could fill in a year. With that cap relaxed under the managed-care plans, patients filled more prescriptions and that corresponded to fewer episodes in which they ended up in the hospital when they didn’t have to.

Fiedler thought the study could also have implications for Medicare Advantage as well, another version of a government health insurance program that is being administered by private companies.

“To be clear, in many of these cases, it might well be better to fix this problem by just fixing the public program directly,” he told me. “But given that we often seem unwilling to do that, this does point to one very real advantage of involvement from private plans.”

3) Many Medicare beneficiaries don’t fill important prescriptions

Rachel Sachs, who studies prescription drug policy at Washington University in St. Louis, highlighted a study on a similar subject that was published in Health Affairs in April 2022, led by Vanderbilt University’s Stacie Dusetzina. The researchers studied the difference in prescription uptake by Medicare beneficiaries who receive a government subsidy to offset their drug costs versus those who do not.

The latter group, who can sometimes be on the hook for hundreds of dollars for every prescription they fill, was substantially less likely to actually use their medication as it had been prescribed, even for serious diagnoses like cancer. People receiving subsidies were twice as likely to fill their prescriptions. The study found that 30 percent of prescriptions for anti-cancer drugs and 22 of prescriptions for hepatitis-C treatment were never started.

The problem of drug affordability for Medicare patients has been an ongoing concern. Because of how the program is currently structured, beneficiaries who are enrolled in the traditional Medicare program but do not qualify for subsidies have no upper limit on how much they can be asked to spend on pharmaceuticals in a given year.

As part of the Inflation Reduction Act, Congress is instituting such a cap for the first time, using savings from the new drug pricing controls also included in the law, capping out-of-pocket costs at $2,000 starting in 2025. That is the kind of intervention the Health Affairs authors were calling for when they published the paper. Now we’ll see if that policy change has an effect on seniors actually taking their medicine.

4) Black and Hispanic Americans are less likely to receive CPR in public spaces

One of the experts I asked for input is Harvard Medical School’s Michael Barnett, who publishes his own overview of the year’s best research every year on Twitter. He sent me a few studies, most of which I’ll let him share in his own overview, but one study in particular stuck out, looking at which people are more (or less) likely to get assistance when they have a health emergency in a public setting with other people around.

The paper, published in the New England Journal of Medicine in October by a collection of scholars across the country, examined more than 100,000 incidents of cardiac arrest that occurred outside of the hospital from 2013 to 2019. They focused in particular on whether the person experiencing cardiac arrest in public received CPR from a bystander.

The results were profound: Black and Hispanic people were significantly less likely to be given CPR than a white person, 45 percent versus 60 percent. And this pattern held across neighborhoods of different racial and socioeconomic make-ups. Whether the neighborhood was predominantly white, Black, or Hispanic, up and down the income ladder, in integrated neighborhoods, white people were more likely to receive CPR than someone who is Black and Hispanic.

“Racial and ethnic differences in bystander CPR in public locations raise additional concerns about implicit and explicit biases in layperson response to out-of-hospital cardiac arrests,” the authors wrote.

Racism within the medical system is well established. Black and Hispanic Americans tend to have less access to health care. They tend to have worse experiences with doctors. Clinical trials and other research does not prioritize them. Medical treatments tend to be developed and designed with white people in mind.

But this study would suggest that even the more casual forms of racism and internalized bias can have a real health effect for marginalized Americans.

5) Prices go up after private equity acquires a physician’s practice

Private equity’s deeper investment into US health care is one of the most important ongoing stories in the field right now. The stakes can be life or death, as one paper that I covered last year about mortality rates in nursing homes purchased by private equity firms found. (Of note this year, according to Harvard’s Amitabh Chandra, was another paper that documented the wide disparities in outcomes among nursing homes, even those who are located in the same area.)

A report published by scholars from Johns Hopkins, Harvard, and Oregon Science & Health University in September 2022 in JAMA Health Forum, which Emma Sandoe of North Carolina Medicaid and Duke University shared with me, examined what happened to costs and care utilization when private equity firms had purchased outpatient practices specializing in ophthalmology, dermatology, and gastroenterology, some of their favorite targets.

The study detected several effects: The cost of individual services went up and those practices were seeing more new patients and also charging more time for their existing patients. The amount billed by the private equity-acquired offices per service increased by 20 percent compared to the study’s control group. They saw 38 percent more new patients and there was a 9 percent increase in the number of existing patient visits that were billed as lasting longer than 30 minutes.

On the surface, that could look like partially good news, in spite of the price hikes, with more patients being seen and spending more time with their doctor. But some of the other findings call into question the value of those increases in service volume. In dermatology, the increase in outpatient visits did not correspond to an increase in biopsies ordered. In the gastroenterology practices, there were more visits and scopes but no notable increase in polyp removals. And likewise, at the eye clinics, there was more diagnostic imaging but not any effect on actual cataract removals.

The authors ended their paper with this warning. “Private equity ownership of physician practices has added a distinctly private and market-driven influence to the broader trends in corporate consolidation of physicians by health systems and insurers,” they wrote. “This study contributes evidence for potential overutilization and higher spending on care that will be important for policy makers to monitor.”

Yes, I’ll give $120/year

Yes, I’ll give $120/year