What's the Difference Between 'Man Flu' and Flu? Hint: Men May not be Exaggerating

MedXpress | By Thea van de Mortel (The Conversation)

The term "man flu" takes a humorous poke at men with minor respiratory infections, such as colds, who supposedly exaggerate their symptoms.

According to the stereotype, a man lies on the sofa with a box of tissues. Meanwhile, his female partner, also with a snotty nose, carries on working from home, doing the chores and looking after him.

But is man flu real? Is there a valid biological reason behind men's symptoms or are men just malingering? And how does man flu differ from flu?...

OK, but is man flu real?

Again, let's assume man flu is a cold. Do men really have worse colds than women? The picture is complicated.

One study, with the title "Man flu is not a thing," did in fact show there were differences in men's and women's symptoms.

This study looked at symptoms of acute rhinosinusitis. That's inflammation of the nasal passages and sinuses, which would explain a runny or stuffy nose, a sinus headache or face pain.

When researchers assessed participants at the start of the study, men and women had similar symptoms. But by days five and eight of the study, women had fewer or less-severe symptoms. In other words, women had recovered faster.

But when participants rated their own symptoms, we saw a somewhat different picture. Women rated their symptoms worse than how the researchers rated them at the start, but said they recovered more quickly.

All this suggests men were not exaggerating their symptoms and did indeed recover more slowly. It also suggests women feel their symptoms more strongly at the start.

Why is this happening?

It's not straightforward to tease out what's going on biologically.

There are differences in immune responses between men and women that provide a plausible reason for worse symptoms in men.

For instance, women generally produce antibodies more efficiently, so they respond more effectively to vaccination. Other aspects of women's immune system also appear to work more strongly.

So why do women tend to have stronger immune responses overall? That's probably partly because women have two X chromosomes while men have one. X chromosomes carry important immune function genes. This gives women the benefit of immune-related genes from two different chromosomes.

Estrogen (the female sex hormone) also seems to strengthen the immune response, and as levels vary throughout the lifespan, so does the strength of women's immune systems…

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All The Payment Factors Included In The 2025 Home Health Proposed Rule

Home Health Care News | By Joyce Famakinwa
 
Providers examining the 2025 home health proposed payment rule may be experiencing some déjà vu, according to William A. Dombi, the president of the National Association for Home Care & Hospice’s (NAHC).
 
“Much of what we see in the rule is just, on the payment side of it in particular, an update from ‘23 and ‘24,” he said during a recent webinar hosted by NAHC. 
 
On June 26, the U.S. Centers for Medicare & Medicaid Services (CMS) unveiled its home health proposed payment rule for 2025. 
 
The proposal includes a payment decrease in the aggregate by 1.7%, or by about $280 million.
 
“That needs qualification,” Dombi said. “That’s $280 million, not to what it would otherwise have been, but rather, in contrast to what it’s expected to be for 2024.”
 
Providers examining the proposed rule will also see a 2.5% net inflation rate update.
 
“The 2.5% is a creature of the annual inflation update of 3%, minus the productivity adjustment of 0.5, netting out at 2.5%,” Dombi said. “This is in the same range that we saw for proposed rules affecting inpatient hospital services, skilled nursing facility care and hospice services that were issued by and large in April of this year, and are moving towards final visitation sometime probably in the neighborhood of the end of July. This number of 2.5% will be updated in the final rule, using more recent data than they use for this calculation.” 
 
Dombi pointed out that CMS has refused to increase the inflation updates, for all sectors, 
based on what wasn’t accounted for each year. 
 
The proposed payment rule also comes with a $100 million reduction in the spending tied to a change in the outlier formula. The change will decrease the frequency of episodes 
qualifying for outlier payment, Dombi noted.
 
“The outlier fixed dollar loss ratio is the element of the outlier formula that’s going to be leading to a decrease in the number of outlier episodes,” he said. “When the FDL goes up, it means you have fewer and fewer episodes that will qualify because you’ve got to be above the normal PDGM episodic rate, in terms of cost, at a higher level, before you trigger outlier payments.” 
 
Additionally, CMS proposed a permanent prospective adjustment to the 2025 home health payment rate of -4.067%.
 
The budget neutrality adjustment is a combination of what was left over when CMS took the almost 5.8% projected, permanent adjustment and cut it in half to 2.89%. 
 
“Kicking the can down the road doesn’t kick the can into a trash can, it just postpones the application of that, so now we see CMS taking that 2.89% leftover from last year and adding to an additional 1.125%,” Dombi said. “They don’t add up together to 4.067 because of the compounding effects of these kinds of things.” 

Submit a Formal Comment on the Proposed Rule https://www.federalregister.gov/documents/2024/07/03/2024-14254/medicare-program-calendar-year-cy-2025-home-health-prospective-payment-system-hh-pps-rate-update-hh
 
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The Supreme Court Just Limited Federal Power. Healthcare is Feeling the Shock Waves

Fierce Healthcare | By Stephanie Armour
 
A landmark Supreme Court decision that reins in federal agencies’ authority is expected to hold dramatic consequences for the nation’s healthcare system, calling into question government rules on anything from consumer protections for patients to drug safety to nursing home care.
 
The June 28 decision overturns a 1984 precedent that said courts should give deference to federal agencies in legal challenges over their regulatory or scientific decisions. Instead of giving priority to agencies, courts will now exercise their own independent judgment about what Congress intended when drafting a particular law.
 
The ruling will likely have seismic ramifications for health policy. A flood of litigation—with plaintiffs like small businesses, drugmakers and hospitals challenging regulations they say aren’t specified in the law—could leave the country with a patchwork of disparate health regulations varying by location.
 
Agencies such as the FDA are likely to be far more cautious in drafting regulations, Congress is expected to take more time fleshing out legislation to avoid legal challenges and judges will be more apt to overrule current and future regulations.
 
Health policy leaders say patients, providers and health systems should brace for more uncertainty and less stability in the healthcare system. Even routine government functions such as deciding the rate to pay doctors for treating Medicare beneficiaries could become embroiled in long legal battles that disrupt patient care or strain providers to adapt.
 
Groups that oppose a regulation could search for and secure partisan judges to roll back agency decision-making, said Andrew Twinamatsiko, director of the Health Policy and the Law Initiative at Georgetown University’s O’Neill Institute. One example could be challenges to the FDA’s approval of a medication used in abortions, which survived a Supreme Court challenge this term on a technicality.
 
“Judges will be more emboldened to second-guess agencies,” he said. “It’s going to open agencies up to attacks.”…
 
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CMS Proposes 2.9% Cut to Physician Pay for 2025

HealthcareDive | By Rebecca Pifer

Dive Brief:

• Doctors would see their Medicare reimbursement fall by 2.9% on average next year if a new CMS payment rule is finalized.
• Regulators blamed statute requiring Medicare’s physician benefit to remain budget neutral for the cuts, which were immediately slammed by physician groups.
• However, it’s unlikely the cuts go into effect as proposed, as Congress historically steps in to mitigate dramatic decreases to doctor pay.

Dive Insight:

The CMS is proposing lowering the conversion factor used to translate the cost of providing medical services into physician payments by 2.8% for next year.

It’s the fifth straight year that regulators proposed slashing the conversion factor, according to the American Medical Association. Last year, the CMS finalized a 3.4% cut to the conversion factor, which was expected to lower physician payments by 1.25% on average.

However, Congress has prevented the worst of the reductions from going into effect. Spending legislation passed earlier this year enacted a temporary bump for services from March through December that reduced the cuts by about half.

In recent years, Washington has relieved on average 60% of the CMS’ proposed cuts, according to Brian Tanquilut, an equity analyst at Jefferies. If that trend holds true, physicians could see their reimbursement for 2025 fall by about 1.1% instead of 2.9%.

Still, associations representing U.S. doctors decried the proposed rule, arguing they’ve been forced to absorb higher costs without commensurate payment updates from the government.

They’re not the only groups raising the alarm. Recently, a key congressional advisory committee and top health officials in the Biden administration have also flagged that ongoing Medicare cuts are straining providers.

“The consecutive years of Medicare cuts demand a comprehensive legislative solution,” AMA President Bruce Scott said in a statement Wednesday. “A Band-Aid goes only so far when the patient is in dire need.”

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