Monthly Archives: June 2022

CHS’ turnaround efforts stall

Posted on by • Posted in Health System, Hospital, Hospital Industry, Net Income, Nonoperating Income, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Performance, Operating Revenue, Turnaround, Turnaround Plan • Leave a comment
https://www.beckershospitalreview.com/finance/chs-turnaround-efforts-stall.html?utm_medium=email&utm_content=newsletter

Pandemic pressures and a high debt load are among the factors stalling Franklin, Tenn.-based Community Health Systems’ financial turnaround, Bloomberg Law report June 8. 

CHS, an 83-hospital system, is facing many of the same challenges as other health systems across the U.S., including a surge in labor expenses in the first quarter of this year. The higher expenses and a COVID-19 surge that negatively impacted operating revenues dragged down the company’s earnings in the first quarter of this year. CHS ended the first three months of 2022 with a net loss of $1 million.

CHS leaders expect some of the pressures to continue through the second quarter. 

“Moving through the second quarter and the remainder of the year, we anticipate contract labor rates to remain elevated, however, we expect our operational momentum to continue, as we anticipate capturing deferred healthcare demand, benefitting from recent strategic investments, and continuing the execution of the company’s margin improvement program,” Tim Hingtgen, CEO of CHS, said in an April 27 earnings release. 

The company cut its earnings forecast in April when it released results for the first quarter, and it has seen its bonds and stock slide since March, according to Bloomberg Law. 

Shares of CHS closed June 8 at $5.16, down from $5.25 the day before.

As COVID-19 restrictions loosen, diseases rebound in atypical ways

Posted on by • Posted in Immunity, Infection Rates, Infectious Virus, Pandemic, Public Health • Leave a comment
https://www.beckershospitalreview.com/public-health/as-covid-19-restrictions-loosen-diseases-rebound-in-atypical-ways.html?utm_medium=email&utm_content=newsletter

Numerous viruses that were seemingly dormant during the pandemic are returning in new and atypical ways, CNBC reported June 10.

Flu, respiratory syncytial virus, adenovirus, tuberculosis and monkeypox are among the viruses that have recently surged or exhibited unusual behaviors. 

The U.S. saw extremely mild flu seasons in 2020-21 and 2021-22, likely due to high rates of mask-wearing, social distancing and other COVID-19 prevention measures. However, flu cases started to rise this February and continued to climb through the spring as more public health measures receded. 

“We’ve never seen a flu season in the U.S. extend into June,” Scott Roberts, MD, associate medical director for infection prevention at Yale New Haven (Conn.) Hospital, told CNBC. “COVID has clearly had a very big impact on that. Now that people have unmasked [and] places are opening up, we’re seeing viruses behave in very odd ways that they weren’t before.”

Washington state is also reporting its most severe tuberculosis outbreak in 20 years, while the world is grappling with a monkeypox outbreak that’s affected more than 1,000 people. 

These viruses, suppressed during the pandemic, now have more opportunities to spread as people resume daily life, become more social and travel more. Society, as a whole, also has less immunity against the viruses after two years of reduced exposure to them, according to the report.

The pandemic has also boosted surveillance efforts and public interest in other outbreaks, experts say. 

“COVID has raised the profile of public health matters so that we are perhaps paying more attention to these events when they occur,” Jennifer Horney, PhD, professor of epidemiology at the University of Delaware in Newark, told CNBC.

View the full article here.

Travel nursing presents hospital employers with legal risks

Posted on by • Posted in Health System, Hospital, Hospital Industry, Independent Contractor, Joint Employer, Labor Laws, Liability, Nurse Agency Staffing, Nurse Travelers, Nurses, Nurses Shortage • Leave a comment
https://www.beckershospitalreview.com/legal-regulatory-issues/travel-nursing-presents-hospital-employers-with-legal-risks.html?utm_medium=email&utm_content=newsletter

The popularity of travel nursing is leaving healthcare facilities and the companies serving them susceptible to misclassification accusations and joint-employer disputes, Bloomberg Law reported June 14.

Providers should read contracts to understand who is liable if a travel nurse sues a healthcare facility and staffing company, according to the report. Even if agreements state that a hospital is not a temporary employee’s employer, courts may decide it’s a joint employer. If they are a joint employer, they may have to pay legal fees if a staffing agency is sued.

If classified as an employer, healthcare facilities may be bound by labor laws that didn’t apply to independent contractors. In California, for example, employers are required to pay part of a worker’s cell phone bill if a phone is needed for the job.

“Given the already serious issues with many of these healthcare workers feeling overwhelmed and underpaid, they’re going to turn these questions not just to the individual hospitals, but potentially also to the companies that are hosting these platforms,” Sonya Rosenberg, a labor and employment partner at Neal Gerber Eisenberg, told Bloomberg Law.

Read more here.

Digging Into the Growth in 340B Contract Pharmacies

Posted on by • Posted in Access, Access & Quality of Healthcare, Accessible Care, Contract Pharmacies, Health Policy, Low-Income Patients, Medicare 340B Drug Discount Program, Retail Pharmacy, Safety Net Hospitals, Safety-Net Providers • Leave a comment
Digging Into the Growth in 340B Contract Pharmacies

This week’s contributor is Paula Chatterjee, a physician and assistant professor at the Perelman School of Medicine at the University of Pennsylvania. Her research focuses on improving the health of low-income patients and evaluating policies related to safety-net health care delivery and financing.

Low-income patients face many barriers to care, one of which is the high cost of prescription medications. The 340B program lets certain hospitals and clinics (like federally qualified health centers) receive discounts on outpatient medications. They can then use those savings to provide medication and additional care for little to no charge to low-income patients. However, policymakers and other stakeholders have raised concerns that the 340B program might not be reaching the patients it was designed to support.

A recent paper in the American Journal of Managed Care by Sayeh Nikpay*, Gabriela Garcia, Hannah Geressu and Rena Conti sheds light on one of the latest examples of 340B mistargeting: so-called contract pharmacies. These are retail pharmacies that fill 340B prescriptions and split the savings with the hospital or clinic. These relationships have been on the rise, with hospitals and clinics arguing they make it more convenient for patients to get their prescriptions. Given their growth, the authors looked at whether contract pharmacies were more likely to open up in areas where low-income and uninsured people live.

They found the pattern was different for pharmacies contracting with 340B clinics vs. 340B hospitals:

  • The number of counties with a pharmacy contracted with a 340B clinic grew from 20.8% to 64.8% over the past decade. Counties with higher poverty rates were more likely to gain a clinic-contracted pharmacy.
  • The number of counties with hospital-contracted pharmacies grew much more (from 3.2% to 76.3%), but those counties had fewer uninsured residents and were less likely to be medically underserved.

The researchers acknowledge that counties may be an imperfect geographical area to represent a pharmacy’s market and that they were unable to collect information on how many (if any) 340B prescriptions a pharmacy actually filled.

Nonetheless, their results reveal a mismatch between where the 340B program is growing and where low-income patients live, especially for pharmacies contracting with 340B hospitals. The authors argue that any 340B policy changes should take these differences between hospitals and clinics into account.

Despite decades of policies designed to bolster the safety-net, it remains perennially reliant on a patchwork of subsidies that are often mistargeted.

This study adds to a growing body of work highlighting the opportunity to improve the 340B program so that it achieves its intended goal of improving access for low-income patients.

Hospitals scooping up physician practices increases health care prices

Posted on by • Posted in Antitrust, Competition, Health Policy, High Prices, Market Consolidation, Market Power, Mergers & Acquisitions, Physician, Physician Acquisition, Physician Aggregator, Physician Alignment, Vertical Integration • Leave a comment

https://mailchi.mp/tradeoffs/research-corner-5222129?e=ad91541e82

This week’s contributor is Aditi Sen, the Director of Research and Policy at the Health Care Cost Institute. Her work uses HCCI’s unique data resources to conduct analyses that inform policy to promote a sustainable, accessible and high-value health care system.

High health care prices in the U.S. make it hard for people to access care, difficult for employers to provide insurance, and challenging for policymakers to balance health care spending with other budgetary priorities. That’s why it’s important to understand what drives prices higher and identify policies to keep prices from getting so high.

In a new paper in Health Affairs, Vilsa Curto, Anna Sinaiko and Meredith Rosenthal examined whether hospital and health systems’ acquisition of and contracting with physician practices – two forms of what is often called vertical integration – has led to higher prices for physician services. The researchers combined four sets of data from Massachusetts from 2013-2017 for their analysis.

They found that: 

  • The percent of physicians who joined health systems grew meaningfully: The percent of primary care physicians who remained independent dropped from 42% in 2013 to 31.5% in 2017, and the percent of independent specialists fell from 26% to 17%.
  • Over this same period, prices for physician services rose. Price increases were especially large – 12% for primary care physicians and 6% for specialists – when physicians joined health systems that had a high share of admissions in their area. 

This study stands out for several reasons. First, it shows vertical integration drives up health care prices. Second, the authors highlight actions states can and are considering taking to monitor and curb vertical integration, including antitrust enforcement and enacting laws to promote competition.

Finally, the Massachusetts data allow the public to better appreciate what’s happening across the state. Many earlier studies on health care consolidation have been limited to a subset of insurers, physicians or patients. Massachusetts is a leader when it comes to creating and sharing its data thanks to its all-payer claims database, which pulls together all the health care bills from private insurers and public programs like Medicare and Medicaid in the state. This critical information helps to illuminate patterns of care and prices and connect them to issues like consolidation and competition. Neither the federal government nor most states track how vertical integration mergers influence health care prices.

As these findings demonstrate, acquisitions and other forms of vertical integration impact what people pay for health care services. Given that prices in this sector continue to climb, this paper underscores the need for more state and national data to understand the downstream effects on all of us who use and participate in the U.S. health care system.

The FTC says it’s getting tougher on hospital consolidation. Antitrust experts aren’t buying it

Posted on by • Posted in Antitrust, Federal Trade Commission (FTC), Health System, Horizontal Mergers, Hospital, Hospital Industry, Market Consolidation, Market Power, Market Share, Mergers & Acquisitions, Vertical Mergers • Leave a comment
The FTC says it’s getting tougher on hospital consolidation. Antitrust experts aren’t buying it
FTC Chairwoman Lina Khan

Two lawsuits against hospital mergers announced the same day may look like the FTC under Chair Lina Khan (pictured) is flexing its muscle to restrain deals that raise prices. But those complaints are “more smoke than fire,” Ken Field, a former FTC lawyer and current co-chair of Jones Day’s global health care practice, told STAT’s Tara Bannow.

The real target shouldn’t be the mergers in Utah and New Jersey between hospitals, antitrust experts said, but something called vertical mergers, in which hospitals buy up physician groups. After such deals, doctors spent $73 million more on 10 common imaging and lab tests over four years, a 2021 Health Affairs study found.

An FTC spokesperson didn’t comment on the agency’s strategy with respect to hospital consolidation.