Axios Vitals

A briefcase with a red cross on the front.

March 23, 2022

Good morning, Vitals readers. Today's newsletter is 892 words or a 3-minute read.

🏥 Situational awareness: It's the 12th anniversary of the ACA.

1 big thing: Private equity's pandemic-era health care push

Data: Pitchbook, American Investment Council; Table: Thomas Oide/Axios

Private equity firms invested nearly $70 billion in the life sciences and medical device industries last year — a sign that the pandemic's disruptions didn't cool interest in the sectors, Axios' Caitlin Owens writes about a new report by the American Investment Council.

Why it matters: The influx of capital could help bring more lifesaving drugs and medical technologies to market.

  • But private equity's growing presence in health care isn't always viewed positively, particularly when it's associated with price increases or reduced access to care.
Data: PitchBook, American Investment Council; Table: Thomas Oide/Axios

By the numbers: Private equity deals in the life sciences sector were worth nearly $26 billion in 2021, the highest amount in a decade.

  • Medical devices and supplies deals were worth nearly $44 billion last year, which was also the highest value over the last decade — by far.
  • Private equity has invested more than $280 billion into the sectors over the last decade, according to the report.

What they're saying: "What COVID brought was probably a bigger focus on health care gaps and needs in the country, and I think you saw more money going into this sector as a result," Drew Maloney, CEO of the private equity lobby American Investment Council, said in an interview.

The big picture: Private equity already has invested heavily in hospitals, nursing homes and staffing companies — which not everyone thinks is a good thing.

  • Its role was particularly prominent during Washington's surprise billing debate, which focused partially on the behavior of private equity-backed physician staffing firms. Private equity-owned nursing homes have also been criticized as offering lower-quality care.

Yes, but: Investing in drug and device development isn't the same as investing in these other areas, said Craig Garthwaite, a professor at Northwestern University's Kellogg School of Management.

  • "In a product market, we think of this being the domain of for-profit companies," he said.

2. COVID testing, treatment for uninsured ends

Illustration of an at-home COVID swab casting a shadow in the shape of a question mark.

Illustration: Maura Losch/Axios

The congressional standoff over additional COVID-19 funding is idling the federal program that pays for testing and treatment for the uninsured, Axios' Adriel Bettelheim writes.

Why it matters: Some 28 million Americans lack health coverage and may have fewer incentives to get care while COVID-19 continues to circulate.

Driving the news: The Health Resources & Services Administration's Uninsured Program stopped accepting claims for testing and treatment at midnight due to insufficient funds. Without additional money, it will only pay on vaccination-related claims through April 5.

  • The program reimburses health providers that care for the uninsured: Harris Health System in Texas has received the most payments for uninsured COVID patients of any hospital in the country — $198 million, per Larry Levitt, executive vice president for health policy at the Kaiser Family Foundation.

Background: The Biden administration is trying to convince Congress that $22.5 billion in additional COVID-19 spending is worth it amid the threat of new waves of virus. Earlier this month, lawmakers passed a $1.5 trillion spending package after stripping out a pared-down $15.6 billion request for COVID funds.

Don't forget: The government also is at risk of falling behind on booster shots if it doesn't get more COVID relief money soon. The Biden administration needs between $4 billion and 9 billion to purchase another round of vaccine, officials say.

3. The kidney have-nots

Illustration: Eniola Odetunde/Axios

A new study found young Latino and Black adults are much less likely to receive necessary treatment for kidney disease than their white counterparts, though some programs are starting to fill the gaps, writes Marina E. Franco of Noticias Telemundo for Axios.

Why it matters: Chronic kidney disease has been rising among Latinos since 2004, even as it remained steady among other groups.

  • Disparities are largely linked to insurance status and access to primary care before kidney failure, researchers say.

What they're saying: "If Medicare were to expand eligibility to individuals with a kidney disease that hasn’t yet progressed to failure, that could build some bridges to improving treatment for those populations and make possible an earlier management of kidney disease," lead researcher Adam Wilk, from Emory's School of Public Health, told Axios Latino.

4. Alcohol-related deaths up

Data: JAMA Network; Chart: Thomas Oide/Axios

Alcohol-related deaths in the U.S. rose 25% from 2019 to 2020, Axios' Erin Doherty reports.

  • The largest spike was among 35- to 44-year-olds.

Between the lines: Alcohol-related deaths, including liver disease and accidents, exceeded COVID-19 deaths in 2020 among adults younger than 65, the New York Times notes.

The big picture: Deaths linked to alcohol were increasing before the pandemic, but at an average annual rate of 2.2% from 1999 to 2017, according to researchers.

  • "As with many pandemic-related outcomes, this is an exacerbation of issues that were beginning before the pandemic for many people," Katherine Keyes, a professor of epidemiology at Columbia University, told the Times.
  • Total alcohol sales in the U.S. by volume increased by 2.9% in 2020 from 2019, the greatest annual increase in sales in more than 50 years, White said.

What's we're watching: "We are concerned that the numbers from 2021 could be even worse," Aaron White, the report's first author and a senior scientific adviser at the National Institute on Alcohol Abuse and Alcoholism, told Axios.

5. Catch up quick

  • New gene therapy carries the promise of a potential cure for sickle cell disease. (New Yorker)
  • Texas hospitals are pulling back on gender-affirming care for kids in response to GOP efforts to investigate the care as child abuse. (Texas Tribune)
  • Tennessee was just added to a growing list of states legalizing at-home tests to detect fentanyl in drugs. (WPLN)