Healthcare provider stories you may have missed – June 2021

Healthcare provider stories you may have missed – June 2021

All eyes are on the Supreme Court as we await a decision on the latest challenge to the Affordable Care Act. The key issue this time is whether a 2017 decision by Congress to remove the financial penalty for not buying health insurance — the individual mandate — also eliminated the legal underpinnings that led the court to uphold the law previously. But despite the pending landmark ruling, President Biden and the new Centers for Medicare & Medicaid Services Administrator, Chiquita Brooks-LaSure, have said they want to expand Obamacare.

In one of her first interviews since confirmation, Brooks-LaSure laid out her plans to broaden the Affordable Care Act saying, “I believe that most people who are not enrolled want coverage but may not understand it’s available or how to get it.” Brooks-LaSure also suggested the administration would support efforts in Congress to ensure coverage for the millions of Americans in the so-called Medicaid gap.

On the private payer side, UnitedHealthcare announced a controversial new policy intended to crack down on emergency department visits and costs. Starting July 1, UnitedHealthcare will evaluate ER claims using several factors to determine if the visit was truly an emergency for its fully insured commercial members across many states. If the insurer finds the visit was a non-emergency, the visit will be “subject to no coverage or limited coverage.” No doubt misuse of the nation’s emergency departments for minor ailments is a costly issue for the healthcare industry. But is this policy in compliance with federal law? How much will it be enforced? And will this discourage patients from seeking care for actual emergencies? Answers to these questions will be the true measure of how well this policy performs.

Finally, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases and an adviser to President Joe Biden, urged more U.S. Covid vaccinations as the harmful ‘Delta’ variant continued to spread in U.K. At a news briefing, Fauci said the Delta variant that was first reported in India now accounts for more than 6 percent of cases being sequenced in the U.S. while in the U.K. it has overtaken the Alpha variant that originated there. Across the U.S., Covid-19 caseloads are falling but so too is the pace of vaccinations. To help keep the momentum up, President Biden has launched a “month of action.”

Healthcare provider stories you may have missed – June 2021

Healthcare Stories You May Have Missed – May 2021

 On consecutive days, President Biden met with six governors to discuss “best practices” in vaccinating citizens and the CDC’s advisory committee recommended giving Pfizer/BioNTech’s Covid-19 vaccine to kids as young as 12. While these are important milestones in the fight against the coronavirus, a new poll shows us that most of the Americans who remain unvaccinated need convincing. According to the survey by The Associated Press-NORC Center for Public Affairs Research, 11% of people who remain unvaccinated say they definitely will get the shot, while 34% say they definitely won’t. That leaves a large group of citizens in the middle who might still roll up their sleeves — including 27% who say they probably will and 27% who say they probably won’t — if someone credible addressed their concerns.

As efforts to combat vaccine hesitancy continue especially among communities of color, the American Medical Association (AMA) is vowing to “fight and dismantle white supremacy and racism in the U.S. health care system” — and within its own walls. In an 83-page report obtained by Stat, the AMA details many of the ways it has excluded Black, brown, and Native physicians, espoused racism, and harmed the people of color its members take an oath to treat.

This week also brought new protections for gay and transgender people against sex discrimination in healthcare. HHS Secretary Xavier Becerra said the Biden administration policy will bring HHS into line with a landmark Supreme Court decision last year in a workplace discrimination case, which established that federal laws against sex discrimination on the job also protect gay and transgender people. Hospitals, clinics and other medical providers can face government sanctions for violations of the law.

Finally, nurse burnout has been an issue for many years and the pandemic only exacerbated that. But new research from McKinsey shows there’s a real opportunity for hospitals and health systems to retain nurses. Read more in this Healthcare Dive report.

Healthcare stories you may have missed – April 2021

Healthcare stories you may have missed – April 2021

Covid-19 cases are rising once again, threatening to send more people to the hospital even as vaccinations accelerate nationwide. This week, CDC Director, Dr. Rochelle Walensky, warned the U.S. is facing “impending doom” as daily cases grow by at least 5% in 30 states and the District of Columbia. So what’s behind the uptick? Leading public health experts have warned since late February that infections could pick back up again amid the rise of virus variants, but they aren’t the only culprit. More Americans, tired of pandemic restrictions and reassured by lifesaving vaccines, are traveling for spring break and some state leaders are pulling back on restrictions.

Walensky’s warning comes as the White House touts “significant progress” toward President Joe Biden’s fresh goal of administering 200 million shots in his first 100 days in office. The U.S. has a weekly average of 2.7 million shots per day, but vaccine hesitancy continues in many communities. The New York Times reports on one nursing home’s mission to vaccinate its reluctant staff. In the piece, Tina Sandri, CEO of Forest Hills of DC, changed her approach. She had been holding “huddles” with different departments to explain the science of the vaccines, but now, instead of continuing to load people with facts, she focused on asking them: What information do you need? What is your concern? The result: 79% of Sandri’s staff was vaccinated by March.

Last month, healthcare providers also saw the damaging results of a Wall Street Journal examination on the newly implemented Hospital Transparency Rule. According to the law, hospitals must publish their previously confidential prices in an attempt to make the industry more consumer friendly. But reporters for the Journal found that hundreds of hospitals embedded code in their websites that prevented Google and other search engines from displaying pages with the price lists. Foley Hoag attorney and Greenough client, Thomas Barker, told the Journal, “They’re taking an active step to make something harder to find. I would say it violates the spirit of the rule.”

Finally, in an essay published in Stat, R. Sean Morrison M.D., geriatric and palliative medicine physician and professor and chair of the Department of Geriatrics and Palliative Medicine at the Mount Sinai Health System in New York, details the reasons why palliative care teams are underutilized despite studies showing improved outcomes for patients and families. He also outlines how to overcome financial barriers for hospitals as well as how to eliminate confusion between hospice and palliative care.

Healthcare provider stories you may have missed – June 2021

Healthcare provider news articles you may have missed – February 2021

All eyes are on the vaccine rollout, but despite a bumpy start, COVID-19 case numbers are dropping and the fall is not just a result of mass vaccinations. In a column published on the New England Journal of Medicine’s Journal Watch website, Brigham and Women’s Hospital infectious disease specialist, Dr. Paul Sax, says there are five factors that could be behind the weakening of the coronavirus pandemic across the nation, but it’s not clear which factor, or combination of them, is responsible.

Additionally, with equitable distribution at the forefront of the vaccine conversation, community health centers (CHCs) are gearing up for an expanded role in Massachusetts’s vaccination effort. CHCs often serve the most vulnerable populations and provide direct access to the neighborhoods hardest hit by COVID-19. During a recent interview with the Boston Globe, Michael Curry, CEO of the Massachusetts League of Community Health Centers, said “Our health centers want to make sure that the patients that are closest to the disease are closest to the vaccine.” Manny Lopes, CEO of the East Boston Neighborhood Health Center and Greenough client, added, “When you open up the doors, you’ll see that first flood of people, the strong yesses. But you’ve got to stay focused on those that are on the ‘maybe’ list, and those that are saying the hard ‘no.’ ”

On the health policy side, Xavier Becerra’s pathway to becoming the next health and human services secretary appears smoother after this week’s confirmation hearing. During his first day of questioning, the California attorney general threw his support behind efforts to improve access to care, aligning himself with President Joe Biden’s healthcare agenda. He also embraced price transparency, which received widespread, bipartisan support from the Senate committee. Becerra said that HHS would aggressively enforce price transparency under his leadership, suggesting that Congress should give the agency more power to create and enforce transparency rules.

President Biden’s pick for CMS administrator, Chiquita Brooks-LaSure, will also face senate confirmation. A health policy veteran, Brooks-LaSure worked at the agency in the Obama administration. According to Avalere CEO Dan Mendelson, “Chiquita has very broad experience at CMS and also has experience in the major governmental organizations where CMS collaborates. She is also an outstanding listener which combined with her experience will help her succeed.” It will be interesting to see how these two appointments impact the Affordable Care Act and the transition to value-based care as the year progresses.

Healthcare provider stories you may have missed – June 2021

Recent healthcare articles you may have missed – Jan. 2021

 

The U.S. has surpassed 400,000 COVID-19 deaths, nearly one year after the nation’s first confirmed case. This grim milestone comes as a highly transmissible variant of the novel coronavirus threatens to cause a new surge in infections. Simultaneously, new presidential administration looks to speed up vaccinations and restore trust in public health agencies. In an interview with The Wall Street Journal, Dr. Rochelle Walensky, incoming director of the U.S. Centers for Disease Control and Prevention, said that one of her top priorities is strengthening the nation’s public-health departments: “We need to build a sustainable public-health infrastructure across the country, because one of the reasons that we’re in this mess is because we didn’t have it.”

Even amid a new surge in COVID infections, healthcare executives are moving “with haste” to forge new strategic and financial partnerships. According to a new report by BDO and Kaufman Hall published in Healthcare Dive, 44% of hospital CFOs expect the pandemic to drive an increase in partnerships across the healthcare ecosystem and 42% predict further consolidation. Additionally, 77% of healthcare organizations are looking to invest in primary care, 63% in specialty services, 61% in post-acute residential care, 59% in home care, 56% in elder care, 54% in virtual care and 50% in behavioral health, BDO said.

Physician-owned ASCs face similar pressures to merge with larger organizations to survive, especially amid the pandemic, which has accelerated the shift from in-hospital surgery to the outpatient setting. In this Becker’s ASC Review piece,  Jim Freund of ASCs Inc. says that in addition to hospitals and healthcare systems expanding their freestanding surgical facilities footprint, “we have seen an influx of new investment coming from the private equity and investor markets, through their own firms or partnering with ASC industry organizations and individuals.”

Finally, as more seniors look to age in place, home health aide jobs will skyrocket, growing the most out of nearly 800 job titles, with an expected addition of 1.16 million positions. The Wall Street Journal details how other healthcare jobs are expected to fare over the next decade.

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