02
03
04
05
06
07
08
Editor in Chief
: Jitendra Kumar Shukla
09
Featured article
Francis Collins: Precision medicine has made great strides but has yet to reach full potential
Francis Collins (National Institute of Health) For decades, medicine existed in “one-size-fits-all land,” but with new technology that’s changing, according to Francis Collins, M.D. Collins, director of the National Institutes of Health, said that the advent of precision medicine is the result of physicians and researchers realizing that approaching healthcare that way doesn’t always work. “It is such a promising opportunity to transform the way we approach medical challenges,” Collins said. “Wouldn’t you rather, if you need a medical intervention, have it take account of your health behaviors, your lifestyle, your genetics so that you end up with a recommendation that has the best chance of working for you?” Collins spoke at The Atlantic Festival this week, highlighting both the progress made in precision medicine and the challenges that remain. Collins said that the most obvious place that precision medicine has taken off is in oncology, but genomics holds promise in emergency areas, as well. Neurological disorders, for example, maybe be the next frontier for precision medicine. More research is needed into diseases like Alzheimer’s and Parkinson’s in general, Collins said, but genomics experts can identify potential genetic risk factors for these conditions. However, that work is often done too
late, when a patient is already showing signs of deterioration. Even in cancer, where it’s well established, precision medicine identifies useful treatments only about 20% of the time, Collins said. Collins also said precision medicine has yet to reach its potential as a tool for preventive care. More and more patients are getting their genomes mapped by the companies—such as 23andMe—that are moving into this space. But that information is not necessarily being translated into an actionable format. Collins said that he had his own DNA analyzed by three such companies and received the same map interpreted in three very different ways. In addition, providers themselves may never see these reports. “For the most part, we’re not using that information as it’s not integrated into medical practice,” Collins said. If it were used more effectively, he said, it could serve as a tool that’s more useful than current biomarkers like cholesterol and blood pressure. Ensuring that providers know they have access to this data and educating them about how it can be used in
Microbioz India October 2018
10
11
Featured article their own practice may be one of the key benefits of NIH’s All of Us program, which seeks to gather health data on 1 million Americans over the next 15 years. To date, about 115,000 people have begun the enrollment process since it started in May, and many of them work for healthcare organizations, Collins said, which is energizing them around precision medicine. Another key tenet of All of Us is ensuring that people of color and people with low incomes are included. Collins said that about 46% of sign-ups so far have been in those groups. “It will be unlike any platform for information we’ve ever tried to construct,” Collins said. Note: The credit and source of story is fiercehealth.com authored by: Paige Minemyer
Verma: CMS is exploring ways to expand site-neutral payments
recommendations to CMS, has long supported siteneutral payments for several post-acute care conditions. The agency has already received some industry pushback for a proposed rule issued in July that would create site-neutral payments for clinic visits, the most common services billed through the outpatient prospective payment program. CMS said that proposal would save the Medicare an estimated $760 million in 2019 alone. But hospital groups, including the American Hospital Association, have long opposed such a shift in payments that would lower hospital reimbursements. In a recent letter to CMS, AHA said the change could lead to patient access issues, and hinted that it could take legal action if the rule goes through. At the same time, policy experts have been largely supportive of the shift that would create more equitable reimbursement between providers. An August analysis by experts with the USC-Brookings Schaeffer Initiative for Health Policy commended CMS for its initial step, but urged the agency and lawmakers “move expeditiously to implement siteneutral payment as broadly as possible in the Medicare program.” Ultimately, however, CMS may need help from Congress to enact widespread implementation. “I think we will likely need help from Congress to get where we want to go, but again, what we’re trying to do at CMS is look at every lever that we possibly have within the program,” Verma said. “So, it could be a combination of things.”
Following a proposal that would change the way Medicare pays for clinic visits; the Trump administration is looking at ways to expand site-neutral payments to other areas of care. Note: The credit and source of story is fiercehealth.com Post-acute care could be one of those areas, Centers for authored by: Paige Minemyer Medicare & Medicaid Services (CMS) Administrator Seema Verma told audience members at an event hosted by The Economist Group on Wednesday morning. “We are taking a look at [siteneutral payments] across the board and looking at our authority and where we can weigh in on it,” she said. “But I think the post-acute space is something where there are a lot of differentials in payments and something we’re very interested in exploring.” Verma was responding to an audience member that asked specifically whether CMS was considering site-neutral CMS Administrator, Seema Verma ( Credit : YouTube) payments for post-acute care. MedPAC, which makes policy
Microbioz India October 2018
12
13
14
15
16
17
18
19
02
21
22
23
24
26
27
28
29
30
31
RNI NUMBER: UPENG/2017/73675