Healthcare provider stories you may have missed – September 20201

Healthcare provider stories you may have missed – September 20201

The FDA formally authorized booster shots of the Pfizer-BioNTech vaccine for adults over 65, those who are at high risk of severe Covid-19, or those who are at risk of serious complications because of exposure to the virus in their jobs. There’s a lot of ambiguity in those requirements. Now the question turns to who exactly needs a booster shot and when? The New York Times writes: “Roughly 22 million Americans are at least six months past their second Pfizer dose, according to the C.D.C. About half are 65 or older. But who exactly risks becoming severely ill? What does it mean to be exposed on the job? Do teachers count as exposed, or just frontline health care workers? And what about Americans who got the Moderna and Johnson & Johnson shots?”

One day after the FDA announcement, scientists on the C.D.C.’s Advisory Committee on Immunization Practices began tackling these complicated issues. Director Rochelle Walensky signed off on a series of recommendations, saying boosters should be offered to people 65 and over as well as those 50 to 64 years with underlying medical conditions. People with underlying medical conditions ages 18-49 may also get shots. The extra dose would be given at least six months after the last shot. But one of Dr. Walensky’s endorsements broke from the panel’s recommendation, saying people may be offered boosters if they are ages 18 to 64 years and are healthcare workers or have another job that puts them at increased risk of being exposed to the virus.

And just as the booster shot campaign begins, hospitals across the country are grappling with workforce burnout and staffing shortages. Lisa Tomasso, spokeswoman for the Hospital Association of Rhode Island, told the Boston Globe, “The healthcare workforce shortage existed prior to COVID-19. The pandemic and its protracted nature have only exacerbated that problem.” In New York, hospitals and nursing homes are bracing for the possibility that a statewide COVID-19 vaccine mandate for health care workers could lead to staff shortages when it takes effect Monday. To ensure there’s enough staff to care for all the patients, hospitals and nursing homes were preparing contingency plans that included cutting back on elective surgeries and, at one hospital, halting maternity services.

Finally, taking a novel and innovative approach to tackling health inequities, Blue Cross Blue Shield of Massachusetts will begin paying doctors more money if they close longstanding, harmful gaps in care for people of color. In an interview with WBUR, Dr. Mark Friedberg, Blue Cross Blue Shield of Massachusetts Senior Vice President of Performance Measurement and Improvement, said, “We are taking these steps to really, in an intentional way, try to improve the equity of care, because this has been a longstanding interest of the company.” Details of the financial incentives are still being worked out, but they would apply to doctors who care for Blue Cross Blue Shield members in Massachusetts and could be implemented by 2023.

Healthcare provider stories you may have missed – September 20201

Provider stories you may have missed – July 2021

The Delta variant is now responsible for 83 percent of new coronavirus cases in America. This is a drastic increase from earlier this month when the variant accounted for about 50 percent of genetically sequenced coronavirus cases. Testifying at a Senate hearing this week, CDC Director Dr. Rochelle Walensky said, “Each death is tragic and even more heartbreaking when we know that the majority of these deaths could be prevented with a simple, safe, available vaccine.”

But as case counts rise, vaccine efforts across the country have stalled and many healthcare workers are still not immunized, particularly in rural areas.  According to the New York Times, one recent estimate indicated that one in four hospital workers were not vaccinated by the end of May, with some facilities reporting that fewer than half of their employees had gotten shots. To keep their workforces healthy, some hospitals, ranging from academic medical centers like New York-Presbyterian and Yale New Haven to large chains like Trinity Health, are now mandating shots.  

Covid’s lingering effects, even in those who had mild disease, are also still impacting elective surgeries. In addition to concerns about respiratory complications from anesthesia, covid may affect multiple organs and systems, and physicians are still learning the implications for surgery. Kaiser Health News reported on a recent study that compared the mortality rate in the 30 days following surgery in patients who had a covid infection and in those who did not. It found that waiting to undergo surgery for at least seven weeks after a covid infection reduced the risk of death to that of people who hadn’t been infected in the first place. Patients with long-haul symptoms should wait even longer, the study suggested.

During the pandemic outpatient facilities rose in popularity and now they’re receiving higher patient satisfaction scores than hospitals. A new survey by The Leapfrog Group of patients at hospitals and ambulatory surgical centers suggests that while patients are satisfied on several levels, safety issues remain a significant concern, especially when children are being treated. CEO, Leah Binder, told Healthcare Dive, “We are worried about signs of patient safety problems, particularly in pediatric units, where parents appear hesitant to raise concerns about mistakes. We also see issues with communication that can lead to patient harm.” 

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Healthcare provider stories you may have missed – September 20201

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 – September 20201

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.