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Two USPSTF leaders fired, sparking concern about panel's credibility
The ouster of two U.S. Preventive Services Task Force members is sparking concern among population health experts who worry the panel may no longer be independent.
Health and Human Services Secretary Robert F. Kennedy Jr. terminated two chairs of the U.S. Preventive Services Task Force last week, adding to industry concerns about the panel's future independence.
The move comes at a time of turmoil for the panel, which advises on which preventive services should be covered under the Affordable Care Act. The USPSTF hasn't met for over a year and has nearly half of its seats empty.
Moreover, the Trump Administration has signaled interest in restructuring the panel, issuing a request for nominations for new members in April.
This latest news raises concerns about that process, as John Wong of Tufts Medical Center, USPSTF chair, and Esa Davis of the University of Maryland School of Medicine, USPSTF vice chair, were issued termination letters last week.
The pair would have likely been involved in recruiting new USPSTF members. Some reporting indicates that Kennedy himself, along with Agency for Healthcare Research and Quality Director Roger Klein, will head the selection process.
According to a CNN report, both Wong and Davis will be applying to be reappointed to the panel. However, they cannot reapply to be chairs.
Industry pros fret over USPSTF future independence
The personnel change is widely panned as a move to reshape the task force and its priorities, creating unease among industry professionals. Kennedy's personal involvement in selecting new USPSTF members, granted in a Supreme Court case decided last spring, could lead to some partisan selection, public health experts indicate.
In a press statement, the non-partisan AcademyHealth said the opaque nature of the nomination review process could threaten public and population health.
"With a nomination deadline for new members this Saturday and no independent review of who gets seated, the free preventive services that millions of Americans rely on could be compromised, delayed, or reversed," the organization wrote.
Nearly everyone with private insurance benefits from free preventive services mandated under the ACA as a part of the USPSTF's work. Without a fair and transparent process for vetting and appointing Task Force members, AcademyHealth indicated that access to those services could be threatened.
"The Task Force's credibility rests on a transparent, evidence-based process that has operated across administrations of both parties for four decades," the organization added. "HHS should reinstate the chairs and ensure independent review of applications before Saturday's deadline. Congress should seek answers now. There is still time to get this right."
According to American Medical Association President Bobby Mukkamala, this latest move with USPSTF was foreshadowed by Kennedy's gutting of the Advisory Committee on Immunization Practices last spring. ACIP is part of the CDC and advises on which immunizations should be covered by insurance.
A judge eventually ruled that the ACIP's restructuring was done unlawfully. However, AMA and its peers still suggest there's a risk that Kennedy's remaking is ideology-driven.
"The task force serves an essential, non-partisan role in making evidence-based recommendations on clinical preventive services and screenings that physicians rely on to prevent disease," Mukkamala said in a statement.
"We strongly urge HHS to restore the USPSTF's long-standing, transparent process for selecting members, specifically clinicians with expertise in the fields of preventive medicine and primary care," Mukkamala continued. "We also implore HHS to commit to once again holding regular Task Force meetings to ensure its important work can continue without further delay. Our patients' lives depend on it."
Sara Heath is an executive editor at Xtelligent Healthcare Media, where she covers patient engagement, healthcare policy and health IT.
