Infant Mortality Increases

Infant and Maternal Health

Infant mortality rose for the second consecutive year in 2022, with a 3% increase. The five leading causes of infant mortality remained the same as in 2021, including infant deaths due to maternal complications, which increased by 9%. This rise is linked to insufficient care in many states. Infant and maternal mortality rates in the US far exceed those of other high-income countries.

• Federal Efforts: Healthy Start Programs aim to improve health outcomes in communities where the infant mortality rate is at least 1.5 times greater than the national average. Additionally, the Centers for Medicare & Medicaid Services (CMS) proposed new policies to improve access to maternity care and promote health equity, including baseline health and safety standards for obstetric services.

• Postpartum Care: Despite the expansion of Medicaid for a year postpartum in most states, many new mothers still face barriers to postpartum care. A new study in JAMA highlights how an intervention using text message reminders could support the postpartum transition to primary care.

Resources & Initiatives

• The CDC’s Division of Reproductive Health offers a range of resources on maternal and infant health.

• A report by the Blue Cross Blue Shield Association reveals significant racial and ethnic disparities in postpartum maternal health outcomes.

• Learn about the objectives of the Healthy People 2030 Maternal, Infant, and Child Health Workgroup, which includes leading federal agencies.

• Adding doulas to maternity care teams is associated with improved maternal health outcomes. Blue Cross and Blue Shield of North Carolina is funding a program to increase the number of certified doulas in the state.

Health Care Industry News

• Physician Fee Schedule: CMS released the proposed 2025 Physician Fee Schedule (PFS), detailing changes to digital health and virtual care programs in a move towards value-based care. Health care leaders and CMS met to discuss a new proposal in the PFS that aims to strengthen primary care services for Medicare patients with complex health conditions through new billing codes.

• Technology: Technological outages continue to negatively impact health care services and productivity. An unintentional global IT outage, which affected at least 12 major hospitals or health systems, resulted in delayed access to care. The impact of outages caused by malicious ransomware attacks at rural hospitals are the focal point of a new NIHCM Research Insights.

• Federal Tech Advancements: In response to the growth of technology in health care, the Office of National Coordinator for Health Information Technology underwent a reorganization and name change, adding the newly-created Office of the Assistant Secretary for Technology Policy. The expanded office recently issued a proposed rule to advance interoperability and data sharing.

Pharmaceutical Drugs

Researchers have found new evidence that GLP-1s may aid in cognitive health and AI is showing promise in improving drug development. In addition, the pharmaceutical industry continues to face issues with patents and shortages. High drug costs remain an important issue, as the White House is expected to release the results of Medicare drug price negotiations soon.

• Patents: A new study published in Nature found that errors in the US Patent and Trademark Office's automated program erroneously resulted in patent extensions. While these mistakes are uncommon, they can result in hundreds of millions in excess spending.

• Shortages: Drug shortages hit an all-time high in the first quarter of this year, affecting a wide variety of medications. Since generic drugs account for almost 90% of prescriptions, their scarcity can severely impact patient health. Continued shortages of critical cancer medications remain of concern.

• GLP-1s: The demand for weight-loss drugs is greater than the supply and the industry is attracting more competitors. A recent analysis found that the rising costs of GLP-1s are likely to impact overall health care costs. The high cost of GLP-1s also limits access to the drug, further exacerbating health disparities, and raising concerns about shortages affecting diabetes treatment.

• AI: Drug development companies are using artificial intelligence in an effort to improve the efficacy of drugs and create them at a faster rate. Researchers at MIT are using AI to identify molecules that may have properties that can be used to develop new medicines.

Resources & Initiatives

• The Food and Drug Administration (FDA) has a public portal for current drug shortages.

• A recent article by a NIHCM grantee examines questions about the potential cardiovascular benefit of GLP-1 drugs.

• Blue Cross and Blue Shield of Louisiana is working to improve patient medication adherence by working with patients, providers, and health coaches.

• Blue Cross and Blue Shield of North Carolina is reimbursing independent pharmacists to help patients manage their care and collaborate with primary care teams.

Chronic Diseases

Chronic diseases remain the leading cause of illness, disability, and death in the US. Researchers at public and private health organizations are making strides in identifying and addressing specific chronic conditions, such as cancer and dementia.

• Cancer Trends: A new study from the National Cancer Institute (NCI) projects a higher rise in cancer rates in Gen Xers compared to the Baby Boomer generation. As screening for lung cancer remains low, CDC researchers find rates of lung cancer vary by geographic region and sex from 2010 to 2020.

• Dementia: CMS launched the GUIDE Model to support people with dementia and their unpaid caregivers. In addition, new developments in Alzheimer's drugs include the FDA-approved Kisunla, which can moderately slow the disease’s progression. A new blood test may aid in diagnosing Alzheimer’s. However, doctors are reluctant to place an order for the tests due to a lack of guidelines.

• Emerging Research: A new study from the University of Arizona found adults with chronic pain have a higher likelihood of experiencing anxiety and depression than adults without chronic pain. There is increased recognition of the limited research on chronic diseases and women’s health. A report by the National Academies of Sciences, Engineering, and Medicine calls on the NIH and other relevant federal research agencies to prioritize research on chronic diseases.

• AI: A new tool made by NCI & Memorial Sloan Kettering Cancer Center uses predictive analytics and AI to advance patient cancer care. Researchers at Louisiana State University are advancing an AI platform to improve health outcomes through chronic disease management. There is high potential for generative AI to improve clinical processes and patient outcomes.

Resources & Initiatives

• To meet the health care needs of older patients, including those experiencing Alzheimer’s disease and related dementias, the Biden-Harris Administration is investing over $200 million to help health care providers improve care.

• AHIP and a coalition of health organizations launched a campaign to spread awareness about the availability of covered preventive services (no out-of-pocket costs) under the Affordable Care Act.

• Blue Cross Blue Shield of Massachusetts releases their Health Equity Report highlighting racial inequities in many areas of chronic disease care. Blue Cross Blue Shield of Tennessee’s Health Equity Report highlights disparities in cancer screening.

• Elevance Health created a Whole Health Index that incorporates information on clinical quality, such as chronic disease care.