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What We’re Reading: Respiratory Illnesses Strain Hospitals; Pfizer Booster Addresses Omicron Subtypes; Audits Reveal MA Overcharges


Covid, flu, and respiratory syncytial virus are overwhelming hospitals across the nation; Pfizer claims its new booster may give protection against new subvariants of the COVID-19 Omicron variant; federal audits reveal overcharges and other payment errors in Medicare Advantage (MA) plans.

Respiratory Illnesses Overwhelm Hospitals

Respiratory illnesses, such as respiratory syncytial virus, COVID-19, and the flu, are a major factor in hospitals across the country feeling overwhelmed and filling at a faster rate, according to The Washington Post. Staffing shortages and nursing home closures have also contributed to the overburdened health care system, with experts believing that the problem could further worsen in the coming months. More than half a million people who worked in the health care and social services areas left their job in September, leaving many hospitals swarmed as hospital beds continue to fill. Experts believe the number of occupied beds will increase as COVID-19 season collides with the earlier flu season.

New COVID-19 Booster May Be Effective Against New Variants

Pfizer claims that its updated booster for COVID-19 may be able to protect boosted individuals from new Omicron mutations, according to AP News. Although the new doses target the BA.5 Omicron strain, it has not been revealed how the new boosters will hold up against variants of BA.5. Pfizer said that their booster would be able to create virus-fighting antibodies to target 4 of the Omicron subtypes, including BQ.1.1, although the immune response wasn’t as strong against the new mutations. Adults 55 years and older had a 9-fold jump in antibodies against BQ.1.1 in the month after receiving the updated booster compared with a 2-fold rise in people who got another dose of the original vaccine, according to a study from the University of Texas.

Federal Audits Reveal Medicare Advantage Overcharges

Newly released federal audits revealed that payments for Medicare Advantage health plans included overcharges and other errors, according to NPR. Some of these plans overbilled the government more than $1000 per patient per year on average. The 90 audits that examined billings from 2011 to 2013 revealed $12 million in net overpayments for the care of 18,900 patients in Medicare Advantage, which is primarily run through major insurance companies. Officials at CMS said that they would extrapolate the payment error rates across the total membership of each plan to recoup an estimated $650 million from insurers but have yet to do so, with the final extrapolation rule now expected in February 2023.

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