Dr. Christian Hinrichs, an investigator at the National Cancer Institute. Photo: Saul Loeb/AFP/Getty Images

It's hard to set the price for a new kind of procedure until you’ve done it a couple of times, but it's hard to do it very often if you can't get paid for it. And that dynamic is causing headaches for hospitals as they wade into the complexities of CAR-T cancer treatments.

Why it matters: This isn't necessarily the standard kind of payment dispute we're used to seeing between hospitals and insurers.

"It's dealing with the uncertainty … of all the contracting, exactly how much am I going to get paid, and am I going to have to provide a discount [to the insurance company] for some parts and not others, and how much is it going to be?" Boston University professor Rena Conti told STAT.

  • CAR-T is expensive, but Medicare is going to cover it, and independent analyses suggest it's worth its high price tag.
  • As they wait to follow Medicare's lead on pricing, both insurers and hospitals are more comfortable for now working out individualized, one-off payment agreements.

The bottom line: A new and complex and payment system on top of a new and complex treatment makes it hard to figure out a price, and payment can take a long time to come through, even when everyone's cooperating.

  • "It doesn't mean there's a problem, necessarily. These are very complex claims. But we have not been paid," Virginia Commonwealth University's Penny Trentham told STAT.
  • But without those payments, it's hard to keep doing CAR-T treatments — and to learn the right price.

Go deeper: Cancer hospitals lobby for pricier Medicare CAR-T payments

Go deeper

As boycott grows, Facebook juggles rights groups and advertisers

Illustration: Aïda Amer/Axios

As an advertiser boycott of Facebook over its tolerance of hate speech continues to snowball, the company has begun making small, incremental changes to mollify activists while it tries to buy time to evolve its content policies.

Driving the news: Sources tell Axios that the product and policy changes sought by the #StopHateForProfit campaign were long under discussion both inside Facebook and with some external groups. Meanwhile, CEO Mark Zuckerberg has reportedly told employees that the boycotting advertisers will be back before long.

Replacing the nursing home

Illustration: Sarah Grillo/Axios

Nursing homes have been the epicenter of the coronavirus outbreak, prompting more urgent discussions about alternative housing situations for elderly Americans.

Why it matters: Deaths in nursing homes and residential care facilities account for 45% of COVID-19 related deaths, per the Foundation for Research on Equal Opportunity — but there are few other viable housing options for seniors.

40 mins ago - Health

How Joe Biden would tackle the coronavirus

Illustration: Aïda Amer/Axios

If Joe Biden wins in November, his coronavirus response would feature a no-expenses-spared federal approach to mitigating the virus and a beefed-up safety net for those suffering its economic consequences.

Why it matters: It’s nearly inevitable that the U.S. will still be dealing with the pandemic come January 2021, meaning voters in America will choose between two very different options for dealing with it.