Breaking News

A baffling Medicare rule on testing transplanted organs, suicide hotline info shared with Facebook, & the brain's response to nutrients in obesity

June 13, 2023
Reporter, Morning Rounds Writer
Good morning. We're still looking for your ideas on great books to read or podcasts to tune into this summer for our annual roundup. New or classic, as long as it relates to health and science, we'd welcome a few sentences saying why you think we should be fans, too. Please chime in.

chronic disease

New Medicare rule on monitoring transplanted organs baffles doctors and patients 

Portrait of Margaret Gamble in her homeNora Williams for STAT

New guidance from Medicare is having a chilling effect on patients who need tests to monitor the health of their transplanted kidneys and hearts. Because the organs are vulnerable to infection or rejection, patients are regularly evaluated with a molecular test that costs $3,000 but is less invasive than the biopsies recipients used to undergo. For some patients, including Margaret Gamble (above), biopsies are not an option because she takes blood thinners. But her molecular test has been stalled by Medicare. "I'm just baffled that we're being denied access to science that is available to help us," she said.

Medicare issued the new guidance on MolDx, a cell-free DNA test, in March, but its ambiguous language has left patients and doctors in limbo. "This has thrown a part of the transplant endeavor that most people don't focus on into disarray," transplant surgeon Steven Potter told STAT's Elaine Chen. Read more on the impact.


obesity

With obesity, the brain's response to nutrients remains impaired after weight loss, study suggests

A small, tightly controlled study adds to mounting evidence that obesity is far more complex than just how much one eats. The new paper, published in Nature Metabolism, used brain imaging to determine that even after 30 people with obesity lost 10% of their body weight, their responses to nutrients in the gut were still impaired. That's in contrast to 28 people without obesity, whose brains appeared to signal they'd received food and no longer needed more. 

To ensure that the brain responses they were monitoring weren't reactions to food's smell, taste, or appearance, participants got tap water, glucose, and lipids were infused directly into their stomachs. "People think that if you're overweight, it's really simple, just stop eating and you lose weight," said Paul Kenny of the Icahn School of Medicine at Mount Sinai (not involved in the study). "Papers like this get to the fact that it's not so easy." STAT's Elaine Chen has more.


Health tech

'We don't want to scare patients': What providers are telling patients about AI

We've been hearing a lot about how health systems might fit AI tools into strategies for communicating with patients, from billing to after-hours queries about symptoms or medications. There's another piece to the communication story: actually talking to patients about it. STAT's Mohana Ravindranath asked six health system leaders how they are going about what can be a delicate task. None of the health systems are using generative AI to respond to patients directly; here are two responses in the meantime: 

  • "We're not having the conversation with patients yet because of the expectation that it will be more confusing than anything else," said Vanderbilt's Brad Malin.
  • "We don't want to scare patients [into thinking] that there was some autonomous AI that is communicating with them, but we want to ensure that they're clear that their physician is fully in control of the communication," said Brent Lamm of UNC Health. 

Read more.



Closer Look

Suicide hotlines are sending data to Facebook

Illustration of various facial features displayed in boxes with the a 988 text conversation featured in the center
Eva Redamonti/The Markup

They promise anonymity to its visitors, but websites for mental health crisis resources have been quietly sending sensitive visitor data to Facebook, The Markup reports in a story co-published with STAT. Testing by the nonprofit newsroom found that dozens of sites tied to the new 988 crisis hotline transmitted the data through Meta Pixel, a short snippet of code included on a webpage that enables advertising on Facebook. Facebook often got signals when visitors attempted to dial the emergency number by tapping on dedicated call buttons on the websites. Sometimes it got hashed — but easily unscrambled — contact info.

After The Markup contacted the 33 crisis centers it studied about their practices, some said they were unaware that the code was on their sites and they'd take steps to remove it. In an emailed statement, Meta spokesperson Emil Vazquez told The Markup, "Advertisers should not send sensitive information about people through our Business Tools." Read more.


the cost of health care

Patients with diabetes — and insurance — turn to GoFundMe to pay their costs

Living with diabetes can be expensive, even with health insurance. It can cost a person on insulin $4,800 a year for medications, doctors' visits, supplies, hospitalizations, and lost wages. As many as 40% of U.S. patients struggle to afford this, and 56% of them skip care. Some turn to GoFundMe campaigns. A new study in the Annals of Internal Medicine looked at which expenses added up to financial pain inspiring 313 campaigns. 

Beyond insulin, help was sought for hospital stays, food, and for 35% of people with type 1 diabetes, diabetic alert dogs, which cost $15,000. The study authors recommend continuous glucose monitors instead. One GoFundMe page asked: "Please help us raise $3,000 so that we can buy her a continuous glucose monitor along with the monthly supplies that keep it running." Two other pleas:

  • "Eating healthy is not cheap."
  • "The bills are accumulating faster than his recovery."

medicaid

States are urged to slow down cutting people from Medicaid

The Biden administration's top health official urged states yesterday to put the brakes on removing people from Medicaid coverage, saying the purge that began when the pandemic health emergency ended is harming lower-income people disenrolled for "procedural reasons." In some states, about half of those whose Medicaid renewal cases were decided in April or May have lost coverage, according to data submitted to the Centers for Medicare and Medicaid Services and obtained by the Associated Press. Nearly 18 million people might lose coverage, a KFF survey projected last month.

In many cases, people lost health care coverage due to administrative reasons, such as the failure to return forms, possibly because they changed addresses, didn't receive a form, or didn't have enough information about the renewal process, HHS Secretary Xavier Becerra has said. "I am deeply concerned with the number of people unnecessarily losing coverage, especially those who appear to have lost coverage for avoidable reasons that state Medicaid offices have the power to prevent or mitigate," he wrote in yesterday's letter to governors.


More around STAT
Check out more exclusive coverage with a STAT+ subscription
Read premium in-depth biotech, pharma, policy, and life science coverage and analysis with all of our STAT+ articles.

What we're reading

  • Obamacare mandate for preventive care is restored, for now, New York Times
  • She survived a White House lightning strike. Could she survive what came next? Washington Post
  • What the scientists who pioneered weight-loss drugs want you to know, Wired
  • Ro pauses advertising of weight loss drug Wegovy amid shortages, STAT
  • A family affair: how scientist parents' career paths can influence children's choices, Nature
  • Novartis to buy Chinook Therapeutics, developer of kidney disease therapies, in $3.2 billion dealSTAT


Thanks for reading! More tomorrow,


Enjoying Morning Rounds? Tell us about your experience
Continue reading the latest health & science news with the STAT app
Download on the App Store or get it on Google Play
STAT
STAT, 1 Exchange Place, Boston, MA
©2023, All Rights Reserved.

No comments