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We hope everyone had a merry Christmas this year, despite the challenging circumstances.

2020 has been such a strange year, with time feeling like it has passed both slowly in some regards and quickly in others.

In November, Kaiser Health News reported that 83% of the 3,080 hospitals evaluated by CMS had readmissions that exceeded certain thresholds. CMS enacted a policy of penalizing hospitals that saw too many readmissions in an effort to increase quality (reduce unnecessary patient procedures) at the same time as lowering costs (avoiding paying for unnecessary patient procedures). Understandably, the hospital industry has objected to the readmission measure as imprecise and biased against certain hospitals. The patient readmission metric is undoubtedly imperfect; however, waiting for a perfect measure to be agreed upon by the medical community would likely mean no progress at all.

83% seems like a high number for the percentage of eligible hospitals that failed to demonstrate sufficient progress or had adequate performance. However, it is unclear whether the goals were too lofty, or the penalty was too small, or perhaps most likely, a combination of the two.

A spokesperson for the American Hospital Association pointed out that the timing of this penalty is terrible, given the financial strain that many hospitals experienced this year.

Kaiser Health News published an article about many smaller doctors' offices shutting down because of the lack of patients during the pandemic. The closure of these doctors' offices is sadly ironic that in the pandemic's current surge, many hospitals lack personnel and many patients have difficulty getting access to medical care.

Doctors' offices can have high fixed overhead (e.g. trained medical staff), and when their primary source of revenue vanishes, then understandably, many offices might not survive. There is likely a lesson from this scenario, in case a widespread lockdown is ever needed again: it might well be worth paying doctors' offices to stay open, similar to how the US government subsidizes certain industries that it considers strategic (and therefore important to be domestic).

In November, Amazon announced their launch of a new service: Amazon Pharmacy, where patients can have prescriptions fulfilled online. As Americans have grown accustomed to the convenience and transparency in pricing of Amazon's offerings, this could be another welcomed offering and might have some implications on medication pricing over time.

The impact of this announcement feels reminiscent of when Target announced $4 generic prescription medicine: a consumer-friendly move by an industry giant. As others followed Target's pricing strategy, perhaps we will see other major retailers follow suit.

It's been a difficult year for many, but we are still thankful for much. Hope everyone had a Happy Thanksgiving!

May this holiday season bring much needed cheer.