Insurer UnitedHealth is keeping more profits, as your doctor

(Adobe)

Next year, UnitedHealth Group — one of the largest health care companies on the planet — expects to make a lot more money in this relatively simple way: by funneling more of the insurance premiums it collects from workers and taxpayers toward itself. The company, known for its sprawling insurance presence, has pivoted to become one of the largest providers of outpatient care, STAT’s Bob Herman reports.

It makes sense that there’s a limit to how much profit a pure health insurance company can make. But that became a major problem for insurers when the Affordable Care Act changed the standards for what care had to be covered. Companies couldn’t turn people away if they had cancer or some other health condition. So insurers made it a priority to enter other areas of health care — in particular, owning more providers that operate outside of hospitals. Read more on the strategy that gives other insurers “United envy.”

After unprecedented effort, Ebola clinical trial to start soon in Uganda

STAT's Helen Branswell brings us this report: The start of a clinical trial to test experimental Ebola Sudan vaccines in Uganda is imminent, the WHO said Friday. Two of the three vaccines have already received import permits; the third is expected to receive one soon. The trial will be led by Bruce Kirenga of Kampala’s Makerere University.

Ana Maria Henao-Restrepo, who heads WHO’s program to develop vaccines for outbreak diseases, said the effort to get these vaccines into the field has been unprecedented. “We started 70 days ago with no vaccines in vials, with no vaccines being developed. And we are sitting today discussing when the vaccines are going to be put in a plane to Uganda for a protocol that has already been approved, with a research team of Ugandans ready to do the trial,” she said. With no new cases in a couple of weeks, though, it’s unclear whether the trial will be able to come up with conclusive answers as to whether the vaccines work.

Pandemic-delayed medical malpractice suits are hitting hospitals hard

When the pandemic hit, one of the countless ripple effects was that medical malpractice lawsuits across the country were held up, as court dockets ground to a halt and jury trials were postponed. Now that courts have resumed normal operations, many health systems are shouldering higher medical malpractice expenses than they otherwise might expect.

The payouts, while a lifeline for the patients and families harmed by medical errors, have added significant strain onto what’s already a challenging time for hospitals facing ballooning labor and supply expenses. “Unfortunately for the hospitals, a number of the judgments are against the hospitals and so they have to find the cash to pay on the suits,” Mike Ramsay of the patient safety advocacy group Patient Safety Movement Foundation told STAT’s Tara Bannow. Read more.

Closer look: A new way to measure skin tone could be the fix for flawed pulse oximeters

(Vanessa Leroy for STAT)

There’s a growing consensus among physicians and government regulators that pulse oximeters measure oxygen levels less accurately in patients with darker skin and need to be fixed. Much of the work and research to understand the devices’ shortcomings and devise solutions is focused on race. But the issue with pulse oximeters is not one of race — it’s very clearly one of skin tone, STAT’s Usha Lee McFarling writes.

Working with Google, Harvard associate professor of sociology Ellis Monk (above) has developed the Monk Skin Tone Scale with a fuller range of darker skin tones than the cruder tools currently used. Such a scale, he said, is essential to ensure pulse oximeters — and many other technologies and medical devices — work equally well for all people. “To get pulse oximetry that works for everyone, we’re going to need to think very deeply about skin tone,” Monk told Usha. Read more.

Google’s AI tool for predicting kidney damage is less accurate for women, study finds

Maybe you remember when, in 2019, researchers at Google showed that an artificial intelligence system could predict acute kidney injury, a common killer of hospitalized patients, up to 48 hours in advance. The results were so promising that the Department of Veterans Affairs, which supplied de-identified patient data to help build the AI, said that it would immediately start work to bring it to the bedside.

But there was a problem: The AI system was trained on the VA’s predominantly male population, and doesn’t perform nearly as well on women, a recent Nature study found. And the solution, STAT’s Casey Ross reports, may not be as simple as exposing the AI to more women. “We still have a long way to go in terms of using these models to change how health care works and to change a patient’s health,” said Jie Cao, the lead author of the paper. Read more.

How a hospital system’s anonymous form prompted trainees to report mistreatment

We know that when medical students are mistreated, they will leave. Unprofessional behavior can make the already long, ruthless training process unbearable. To address this, the Mount Sinai Health System in New York created an online anonymous feedback form for all trainees, including medical and graduate students, medical residents, and postdoctoral and clinical fellows, to report complaints. Leaders from around the health system met regularly to address major claims and respond appropriately. Over the course of about two years, trainees submitted just under 200 reports, 173 of which were described as unprofessional interactions, according to a new paper in JAMA Network Open that analyzed the data.

Most complaints were about some of the 7,000 faculty members in the health system; just 20 individuals accounted for half of the 104 reports of unprofessional behavior by faculty. The most common incidents were public embarrassment or humiliation and offensive remarks about gender, sexual orientation, race, or other identity markers.

What we're reading

Exclusive: Thirty Madison, looking to stand out in a crowded telehealth market, quietly plans expansion into sleep care, STAT
Who will care for 'kinless' seniors? New York Times
Boston Children’s faced months of death threats and hate mail. Here’s how staff members are coping, Boston Globe
Image manipulation in science is suddenly in the news. But these cases are hardly rare, STAT
Drugs killed 8 friends, one by one, in a tragedy seen across the U.S., Washington Post