RISE summarizes recent health care-related research and news.
HHS backs new push to develop vaccines to prevent cancer recurrence, WSJ reports
The Department of Health and Human Services (HHS) is launching a public‑private initiative to accelerate development of vaccines designed to prevent cancer from returning in high‑risk patients, according to an exclusive report published by The Wall Street Journal on Tuesday.
Unlike traditional vaccines that prevent infectious diseases, these cancer vaccines train the immune system to recognize and attack residual tumor cells after a patient has undergone treatment. The new effort, coordinated through the National Cancer Institute (NCI), aims to fund large clinical trials of experimental vaccines that have shown encouraging early results in smaller studies.
NCI Director Dr. Anthony Letai told The Wall Street Journal that the signals so far suggest these therapies could help patients with aggressive cancers for whom few effective options remain.
The partnership is expected to mobilize roughly $200 million in combined government and private‑sector support to expand research and accelerate commercialization. Supported vaccine modalities will include mRNA‑based platforms—technology that HHS wound down last year in infectious‑disease programs due to performance concerns, but which may play a new role in oncology.
Cancer‑prevention vaccines differ fundamentally from childhood or infectious‑disease shots, which must demonstrate exceptional safety before being given broadly to healthy populations. In advanced cancer patients, however, the risk‑benefit calculation is different, Letai noted.
MA pilot study explores new behavioral health care approach for older adults
A new pilot program developed by VNS Health in collaboration with Vitalic demonstrates the potential for proactively identifying and treating behavioral health needs among Medicare Advantage (MA) members—particularly older adults with multiple chronic conditions.
Using claims data and health assessments, the program identifies members likely to have unmet behavioral health needs and rapidly engages them through telehealth delivered by a geriatric‑specialized multidisciplinary team.
During the first six months of the program:
- Depression scores (PHQ‑9) declined by nearly four points.
- Anxiety scores (GAD‑7) declined by almost three points.
- Emergency department use dropped from 17.1 percent to 12.9 percent, and hospital admissions decreased from 4.3 percent to 2.9 percent.
- Among members whose depression improved from moderate or severe to mild levels, combined rates of inpatient hospitalizations or ED visits declined from 41 percent pre‑enrollment to 18 percent post‑enrollment.
For Medicare Advantage plans, the program produced an additional benefit: more accurate risk adjustment. Behavioral health evaluations uncovered previously undocumented depression and bipolar disorder, enabling more members to qualify for relevant HCCs and improving the accuracy of risk adjustment factor scores.
Continuous glucose monitoring on the rise among MA members with type 2 diabetes
A new study published in the current issue of the Journal of Managed Care & Specialty Pharmacy (JMCP) finds a notable increase in the use of continuous glucose monitors (CGMs) among Medicare Advantage members with type 2 diabetes from 2021 to 2023.
The research, conducted by a Humana Health Care Research team and Joseph S. Ross, M.D., of the Yale School of Medicine compared the demographic and clinical characteristics of members with type 2 diabetes who used CGMs with those who did not in 2023.
CGMs represent a major advancement over traditional fingerstick glucose monitoring methods, providing real-time, continuous blood glucose data that supports more effective management of dangerous highs and lows and reduces the burden of daily monitoring. Yet, clinicians still have incomplete information about which patients use these devices and what barriers may exist for those not currently using them.
The study found:
- The proportion of Medicare Advantage members with type 2 diabetes who use insulin and continuous glucose monitors increased from fewer than 2 in 100 in January 2021 to about 1 in 6 by December 2023.
- The growth in adoption of CGMs was concurrent with the expansion of Medicare coverage for the devices in 2023.
“This research is significant because, until now, there has been limited information about the use of continuous glucose monitors among Medicare Advantage members—a population in which diabetes and the management of multiple health conditions are common,” said Mark Mugavin, M.D., medical director, Humana, in the study announcement. “These insights help us identify which patients may benefit most from CGMs, including those who do not visit the doctor frequently, and guide our strategies for reaching and supporting those who need them most. Ultimately, this work enables us to improve health outcomes by ensuring that more members receive timely and effective diabetes management tools.”
Medical debt associated with deferring dental, medical, and mental health care
Medical debt is associated with deferred dental care, medical care, and mental health care, even among people with health insurance, according to a new study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health and published this month in the Journal of General Internal Medicine.
Researchers based their findings on data involving 30,000 adults from the 2023 National Health Interview Survey. They found that 42.3 percent of people with medical debt delayed dental care compared with 17.7 percent of those without—almost 2.4 times as many; 23 percent of people with medical debt delayed medical care compared with just 5.3% percent of those without—about 4.3 times as many; and 14 percent of people with medical debt delayed mental health care compared with 5 percent of those without—nearly three times as many.
Uninsured adults were more likely to defer medical care when experiencing medical debt compared to those covered by commercial insurance. More than 19 percent of uninsured adults, 13 percent of adults with Medicaid, 9 percent of adults with commercial insurance, and 8 percent of adults with Medicare reported medical debt. The share of deferred care for both mental health and dental needs was comparable among those who are insured and uninsured.
This study adds to a growing body of research that shows that people facing financial barriers to care experience poorer physical and mental health, higher mortality rates, and increased utilization of high-cost resources that could have been averted with preventive and routine care. However, previous research has not compared which types of care are most often deferred by people experiencing medical debt.
“Avoiding routine or preventative care can worsen patient health conditions, ultimately making them more costly to address—for patients, insurers, and taxpayers who subsidize much of the medical care in the U.S.,” said senior author Catherine Ettman, Ph.D., an assistant professor in the Bloomberg School’s Department of Health Policy and Management, in the study announcement.