Private equity’s Welsh Carson and its pursuit of profits in health care

(THUMY PHAN FOR STAT)

Private equity firms are earning a bad reputation in health care for generating returns in corners of the system that may look like unlikely targets while putting patient care behind profits. Welsh, Carson, Anderson & Stowe has carefully crafted its image as being different from the rest, unfairly painted with the same brush. STAT’s Tara Bannow and Bob Herman take a deeper dive into four of the 14 companies in its portfolio, revealing the lengths the firm is willing to go to provide a return to investors.

At one of them, InnovAge, the nonprofit’s mission was to help the sickest and poorest seniors live comfortably in their communities under a little-known taxpayer-funded program. After it was acquired, allegations of neglect, lawsuits, and government investigations ensued. Welsh Carson and its portfolio companies declined to make their executives available for interviews for this article. Read more about this and other examples: a physician staffing firm, a Medicaid managed care provider, and a micro-hospital chain.

Study: Genetically engineered pig heart developed abnormal electrical conduction in a human body

The University of Maryland team that transplanted the first genetically engineered pig heart into a human has found that the procedure altered the organ’s electrical properties in unexpected ways, STAT's Megan Molteni tells us. Research from the groundbreaking experiment, presented today at a meeting of the American Heart Association, shows electricity traveled through the transplanted organ much more slowly than a pig heart in a pig body, and even slower than what would be considered normal in a human.

That raises questions for the field of xenotransplantation — grafting tissues or organs from one species to another — which has garnered renewed interest recently as a potential solution to the shortage of donated human organs. Slowed conduction can cause irregular heartbeats and may require a pacemaker to correct them. Timm Dickfeld, who led the research, said the abnormal activity never led to any clinically significant heart rhythm changes, even in the days leading up to the patient’s death in March. Still, it points to a need to closely monitor future experiments and “to expect the unexpected,” he said.

Flu season is off to an early start. Now what?

How bad will flu season be? Scientists who study and track respiratory illnesses just don’t know yet, an honest and familiar response from not just flu but more than two years of coronavirus twists and turns. One thing is clear: The season has started early in the U.S., mirroring the Southern Hemisphere’s experience. Other points:

The numbers: There were 880,000 influenza illnesses, 6,900 flu hospitalizations, and 360 flu deaths this month, CDC says in its unusually early FluView report.
On that report from Chile of 49% flu shot efficacy against the circulating virus that we mentioned Friday: A pleasantly surprised Ed Belongia of Wisconsin’s Marshfield Clinic Research Institute said “49% is about as good as you can expect to see for H3N2. So I thought that was encouraging.”
On getting that shot: “You need to get vaccinated now,” CDC’s Lynnette Brammer said.

Closer look: In another mystery, polio-like syndrome in kids didn't flare

(Adobe)

As infectious disease mysteries go, this is a good one to have. Doctors who care for children who develop a strange polio-like syndrome known as acute flaccid myelitis had been bracing this fall for more cases, which appear to be triggered by infection with an enterovirus known as EV-D68 that peaks at two-year intervals. The 2020 jump never happened, when kids were in masks and out of school, but the telltale signs of EV-D68 infections in August and September didn’t come this year, leaving experts “grateful but flummoxed,” Janell Routh, team lead for AFM and domestic polio at the CDC, told STAT’s Helen Branswell.

So what’s going on? Scientists are pondering theories including viral interference — all the other bugs kids are fighting — something called antibody dependent enhancement better known in dengue, differences in the strains, genetic variation, or some combination. Read more, including a note of caution.

'I'm more optimistic now': Francis Collins on the long road to treating genetic disease

STAT’s Usha Lee McFarling first interviewed Francis Collins when he was racing against Craig Venter to sequence the first human genome. Twenty years later, at this year’s annual meeting of the American Society of Human Genetics in Los Angeles, he told her "science is just rocketing forward."

Your lab co-discovered the cystic fibrosis gene in 1989 amid hopes a cure would come soon. What lessons can we take from that?
I think the expectation was that CF would be a good candidate for gene therapy. That thinking was naive and massively underestimated the immune system’s ability to discover what you are doing and upend your plans.

What about other, rarer genetic diseases?
I’m more optimistic now that we might get to them by the ability to do in-vivo gene editing because that’s scalable.

Read the full interview here.

Opinion: Hospitals need to open their physical and digital doors to all

It would be unfathomable — and illegal — for hospital entrances to be inaccessible to people with disabilities. But the homepages of 106 top U.S. hospitals — their digital front doors — are not accessible, Amanda Krupa and Jill Roark of the AHIMA Foundation and Kirsten Barrett of Mathematica write in a STAT First Opinion. The issue isn’t just the homepage: Millions of American also face difficulty accessing their personal health information through patient portals.

“Even a semi-compliant webpage is likely to cause people with disabilities trouble navigating it, likely rendering it inaccessible to them,” the authors write. Read their recommendations on how health care facilities can keep both their physical and digital doors open to everyone.

What we're reading

‘Dying inside’: chaos and cruelty in Louisiana juvenile detention, New York Times
More children are being screened for mental-health issues. But then what? Wall Street Journal
Florida medical board votes to ban gender-affirming care for transgender minors, NBC News
This brain molecule decides which memories are happy — or terrible, Wired
Opinion: How motivational interviewing can improve health workforce well-being, STAT