Author Archives: henrykotula

U.S. declares public health emergency over monkeypox

Posted on by • Posted in Food and Drug Administration (FDA), Infection Control, Infectious Virus, Monkeypox, Public Health, Public Health Crisis, Public Health Strategy, Public Opinion, Public Perception, Vaccination, Vaccine, World Health Organization (WHO) • Leave a comment
https://www.axios.com/2022/08/04/monkeypox-public-health-emergency-us?stream=top&utm_source=alert&utm_medium=email&utm_campaign=alerts_all

The Biden administration has declared the monkeypox outbreak a public health emergency — a move that gives officials more flexibility to tackle the virus’ spread.

Why it matters: New York, California and Illinois all declared public health emergencies related to monkeypox in the last two weeks. The World Health Organization has already declared monkeypox a global emergency.

Details: Department of Health and Human Services secretary Xavier Becerra made the announcement Thursday in a briefing on monkeypox.

  • Federal health officials can now expedite preventative measures to treat monkeypox without going through a full federal review, the Washington Post reports.

What they’re saying: “We’re prepared to take our response to the next level in addressing this virus,” Becerra said Thursday. “We urge every American to take monkeypox seriously and to take responsibility to help us tackle this virus.”

  • Dr. Rochelle Walensky, the director of the Centers for Disease Control and Prevention, said the declaration will help “exploit the outbreak” and potentially increase access to care for those at risk.
  • Dr. Demetre Daskalakis, the White House national monkeypox response deputy coordinator, said “today’s actions will allow us to meet the needs of communities impacted by the virus … and aggressively work to stop this outbreak.”

State of play: Dr. Robert Califf, the commissioner of the Food and Drug Administration, said the U.S. is “at a critical inflection point” in the monkeypox outbreak, requiring “additional solutions to address the rise in infection rates.”

  • There are 6,600 cases of monkeypox in the U.S. as of Thursday, Becerra said.
  • There were less than 5,000 cases of monkeypox last week, he added.

The big picture: Biden’s decision to declare monkeypox a public emergency allows him to raise awareness of the virus and unlock more flexibility for spending on ways to treat and tackle the virus.

  • About 20% of Americans are worried they’ll contract monkeypox, Axios previously reported. But there are still some gaps in Americans’ knowledge of the virus and how it impacts our population.

What’s next: U.S. health officials said that 800,000 monkeypox vaccine doses will be made available for distribution. But in hotspot states for the monkeypox outbreak, there’s a drastic disconnect between the number of doses that local health officials say they need versus what they have been allotted.

  • The U.S. will receive another 150,000 monkeypox vaccine doses in the strategic national stockpile in September, Dawn O’Connell, administrator at HHS’ Administration for Strategic Preparedness & Response, told reporters Thursday. These were previously scheduled to arrive in October.

1 in 5 Americans fear they’ll get monkeypox

Posted on by • Posted in Infection Control, Infectious Virus, Misinformation, Mistrust, Monkeypox, Public Health, Public Opinion, Public Perception • Leave a comment

https://www.axios.com/2022/07/29/monkeypox-cases-virus-vaccine-us

About 20% of Americans are afraid they’ll soon contract monkeypox, but there are still some significant holes in the public’s understanding of the virus, according to a new survey from the Annenberg Public Policy Center.

The big picture: These early stages of monkeypox outbreaks aren’t nearly as dangerous as early COVID outbreaks were, but some of the challenges for public health officials — like educating people about a virus they’re not familiar with, and mobilizing vaccination efforts — are similar.

By the numbers: One in five Americans are worried about getting monkeypox in the next three months, the Annenberg survey found.

  • Nearly half are unsure whether monkeypox is less contagious than COVID, although 69% correctly identified the way it usually spreads (through close contact with an infected person).
  • Two-thirds said they either don’t think there’s a vaccine for monkeypox, or aren’t sure. (There is a vaccine. The Biden administration said Thursday that it’s allocating another 786,000 doses, on top of the more than 340,000 it distributed this month.)
  • Women were more worried about contracting monkeypox than men, even though the overwhelming majority of cases in the U.S. have been among men.

Between the lines: Memories of false assurances and mixed messaging about the coronavirus in the early days of the pandemic are factoring into public sentiment on monkeypox, said Kathleen Hall Jamieson, director of the Annenberg center.

  • “There is some suspicion scientists don’t know what they know, so that translates to higher worry,” Jamieson told Axios.

Misinformation and conspiracy theories are also a problem.

  • 12% of respondents in the Annenberg survey said they believe the monkeypox virus was probably or definitely created in a lab; 21% said they were not sure whether it was caused by exposure to a 5G signal.
  • The fact that the virus has so far spread primarily among men who have sex with men has also fueled widespread perceptions that it’s a sexually transmitted infection, which it is not.

What we’re watching: Perceptions of risk remain fluid and could shift if monkeypox finds new modes of transmission, or if it continues to affect children.

  • “If kids get it and there’s been no contact with individuals at risk, then you have a completely different situation than you have now,” Jamieson said.

Sutter Health’s rising expenses and rough investments yield a $457M net loss for Q2 2022

Posted on by • Posted in Credit, Credit Quality, Credit Ratings, Financial Performance, Financial Pressure, Financial Reporting, Health System, Hospital, Hospital Industry, Net Income, Nonoperating Income, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Model, Operating Performance, Operating Revenue • Leave a comment
https://www.fiercehealthcare.com/providers/sutter-healths-rising-expenses-and-rough-investments-yield-457m-net-loss-q2-2022?utm_source=email&utm_medium=email&utm_campaign=HC-NL-FierceHealthcare&oly_enc_id=8564C4000334E5C

Updated on Aug. 5 with comments from Sutter Health.

A $457 million net loss for the quarter ended June 30 has brought Sutter Health even deeper into the red for 2022, according to new financial filings.

The Sacramento-based nonprofit health system brought in $3.49 billion in total operating revenues from the quarter, down slightly from the prior year’s $3.51 billion.

At the same time, the system’s operating expenses grew from $3.41 billion in the second quarter of 2021 to $3.55 billion in the most recent quarter, driven by $30 million and $151 million year-over-year increases in salaries and purchased services, respectively. The latter includes the increased professional fees being felt by labor-strapped systems across the country.

These led the system to report a $51 million operating loss for the quarter as opposed to the $106 million operating gain from last year’s equivalent quarter.

“Poorly” performing financial markets also took a toll on Sutter’s numbers. The system’s quarterly investment income dipped from $251 million to $56 million from 2021 to 2022. A $495 million downward change in net unrealized gains and losses on its investments was also a stark reversal from the prior year’s $270 million increase.

The new numbers cement what was already looking to be a tricky year for Sutter Health, which had previously reported a $184 million net loss for its opening quarter.

Despite a 1.5% year-over-year operating revenue increase to $7.05 billion for the opening six months, a 1.7% year-over-year operating revenue bump places the system’s year-to-date income at $44 million (0.6% operating margin), slightly below last year’s $57 million (0.8% operating margin).

However, market struggles through both quarters and a $208 million loss tied to the disaffiliation of Samuel Merritt University now has Sutter sitting at a $641 million net loss for the opening half of 2022. The system was up $825 million at the same time last year.

“Sutter’s finances have stabilized, but our year-to-date numbers show we still have more affordability work ahead as we strive to best position Sutter Health to serve our patients and communities into the future,” the system wrote in an email statement. “We are grateful for our employees and clinicians who have worked diligently over the last several years to help bring our costs down—at the same time managing through the pandemic and continuing to provide high-quality, nationally recognized care.”

Sutter noted in the filing that it is or will be in labor negotiations with much of its unionized workforce, as 43% of its contract agreements have either expired or will be running their course within the year.

The filing also included notice of a handful of legal matters that have yet to be resolved. These include an antitrust verdict in favor of Sutter that is being appealed by the plaintiff, a lawsuit regarding an alleged privacy breach of two anonymous plaintiffs and two separate class-action complaints regarding employee retirement plan funding, among others.

“The organization continues to face financial headwinds like inflation and increased staffing costs, as evidenced by our near breakeven operating margin,” Sutter said in a statement. “Even still, we are encouraged that independent ratings agencies have recently acknowledged our efforts to date. In the second quarter, Moody’s, S&P and Fitch all affirmed the system’s existing ‘A’ category bond ratings.”

Much of Sutter’s pains are being felt across the industry. A recent Kaufman Hall industrywide report showed only marginal relief from expenses and middling non-COVID volume recovery through June, while a Fitch Ratings update on nonprofit hospitals warned that these challenges and broader inflation pressures will likely weigh down the sector through 2022.

U.S. adds whopping 528,000 jobs in July as labor market booms

Posted on by • Posted in Dept of Labor, Economic Indicators, Economic Outlook, Economy, Inflation, Job, Job Market, Job Search, Job Security, Labor Market, Labor Spend Management, Recruiting, Talent Management • Leave a comment
https://www.axios.com/2022/08/05/july-us-jobs-report?stream=top&utm_source=alert&utm_medium=email&utm_campaign=alerts_all

Employers added a stunning 528,000 jobs in July, while the unemployment rate ticked down to 3.5%, the lowest level in nearly 50 years, the Labor Department said on Friday.

Why it matters: It’s the fastest pace of jobs growth since February as the labor market continues to defy fears that the economy is heading into a recession.

  • Economists expected the economy to add roughly 260,000 jobs in July.
  • Job gains in May and June were a combined 28,000 higher than initially estimated.

The backdrop: The data comes at a delicate time for the U.S. economy. Growth has slowed as the Federal Reserve raises interest rates swiftly in an attempt to contain soaring inflation.

  • Many economists and Fed officials alike are pointing to the ongoing strength of the labor market as a sign the economy has not entered a recession.
  • Policymakers want to see some heat come off the labor market. They are hoping to see more moderate job growth as the economy cools, in order to ease inflation pressures.

Inpatient payment increase not enough, AHA says

Posted on by • Posted in American Hospital Association (AHA), Center for Medicare and Medicaid Services (CMS), Financial Performance, Financial Pressure, Financial Viability, Financially Distressed, Health Policy, Health System, Hospital, Hospital Industry, Medicare Reimbursement, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Model, Operating Performance, Operating Revenue, Transformation, Transformational Change • Leave a comment

https://www.healthcarefinancenews.com/news/inpatient-payment-increase-not-enough-aha-says?mkt_tok=NDIwLVlOQS0yOTIAAAGGA2hNPoWk8cdzEHcBC5xk1t_79ltx5DUnzCdiUWpAvrtC-_vON29agi9pNZf0kUGl9cKeinq1FXBXdCEr_RCHDNPIsIG9WjhKw1KLwH8

Hospitals are forced to absorb inflationary expenses, particularly related to supporting their workforce, AHA says.

The Centers for Medicare and Medicaid Services’ increase in the inpatient payment rate for 2023 is welcome but not enough to offset expenses, according to the American Hospital Association.

CMS set a 4.1% market basket update for 2023 in its final rule released Monday, calling it the highest in the last 25 years. The increase was due to the higher cost in compensation for hospital workers.

The final rule gave inpatient hospitals a 4.3% increase for 2023, as opposed to the 3.2% increase in April’s proposed rule.

WHY THIS MATTERS

CMS used more recent data to calculate the market basket and disproportionate share hospital payments, a move that better reflects inflation and labor and supply cost pressures on hospitals, the AHA said.

“That said, this update still falls short of what hospitals and health systems need to continue to overcome the many challenges that threaten their ability to care for patients and provide essential services for their communities,” said AHA Executive Vice President Stacey Hughes. “This includes the extraordinary inflationary expenses in the cost of caring hospitals are being forced to absorb, particularly related to supporting their workforce while experiencing severe staff shortages.”

The AHA would continue to urge Congress to take action to support the hospital field, including by extending the low-volume adjustment and Medicare-dependent hospital programs, Hughes said.

In late July, Senate and House members urged CMS to increase the inpatient hospital payment.

Premier, which works with hospitals, also said the 4.3% payment update falls short of reflecting the rising labor costs that hospitals have experienced since the onset of the pandemic. 

“Coupled with record high inflation, this inadequate payment bump will only exacerbate the intense financial pressure on American hospitals,” said Soumi Saha, senior vice president of Government Affairs for Premier.

THE LARGER TREND

Recent studies show hospitals remain financially challenged since the COVID-19 pandemic’s effect on revenue and supply chain and labor expenses. Piled onto that has been inflation that has added to soaring expenses.

Hospital margins were up slightly from May to June, but are still significantly lower than pre-pandemic levels, according to a Flash Report from Kaufman Hall.

The effects of the pandemic on the healthcare industry have been profound, resulting in the creation of new business models, according to a report from McKinsey.

Transformational change is necessary as hospitals have been hit hard by eroding margins due to cost inflation and expenses, Fitch found.

HOSPITALS SEE NEGATIVE MARGINS FOR SIXTH CONSECUTIVE MONTH

Posted on by • Posted in Financial Distress, Financial Performance, Health System, Hospital, Hospital Industry, Labor Spend Management, Net Income, Nonoperating Income, Operating Expense Reduction, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Model, Operating Performance, Operating Revenue, Physician Practice Management, Productivity • Leave a comment

https://www.healthleadersmedia.com/finance/hospitals-see-negative-margins-sixth-consecutive-month

Expenses are still weighing heavily on hospitals, health systems, and physician’s practices as the cost of care continues to rise.

Hospitals, health systems, and physician’s practices are still struggling under the weight of significant financial pressure, that the rise in patient volume and revenue can’t seem to outweigh.

The increase in patient volume and revenue has not been able to offset the historically high operating margins these organizations are facing, according to data from Kaufman Hall’s National Hospital Flash Report and Physician Flash Report. Hospitals, health systems, and physician’s practices dealt with negative margins in June for the sixth consecutive month this year.

“To say that 2022 has challenged healthcare providers is an understatement,” Erik Swanson, a senior vice president of data and analytics with Kaufman Hall, said in an email report. “It’s unlikely that hospitals and health systems can undo the damage caused by the COVID-19 waves of earlier this year, especially with material and labor costs at record highs this summer.”

The median Kaufman Hall year-to-date operating margin index for hospitals was -0.09% through June, for the sixth month of cumulative negative actual operating margins. However, the median change in operating margin in June was up 30.8% compared to May, but down 49.3% from June 2021.

Hospital revenues for June continued to trend upward, even as volumes evened out, according to the Kauffman Hall data. Organizations saw a 2.1% drop in patient length of stay. Both patient days and emergency department visits each dropped by 2.6% in June when compared to May. Hospital’s gross operating revenue was up 1.2% in June from May.

Expenses have been dragging down hospital margins for months, however, June saw a slight month-over-month improvement as total hospital expenses dropped 1.3%, despite this, year-over-year expenses are still up 7.5% from June 2021. Physician practices saw a drop in provider compensation, according to the Kaufman Hall data, however, this wasn’t enough to offset expenses. The competitive labor market for healthcare support staff resulted in a new high for total direct expense per provider FTE in Q2 2022 of $619,682—up 7% from the second quarter of 2021 and 12% from the second quarter of 2020.

“Given the trends in the data, physician practices need to focus on efficiency in the second half of 2022,” Matthew Bates, managing director and Physician Enterprise service line lead with Kaufman Hall, said in the email report. “Amid historically high expenses, shifting some services away from physicians to advanced practice providers like nurse practitioners or physician assistants could help rein in the costs of treating an increased patient load while taking some of the weight off the shoulders of physicians.”

National uninsured rate hit record low this year

Posted on by • Posted in ACA, Health Insurance Coverage Adequacy, Health Policy, Out of Pocket Expenses, Underinsured, Uninsured • Leave a comment
https://www.beckerspayer.com/payer/national-uninsured-rate-hit-record-low-this-year.html?origin=PayerE&utm_source=PayerE&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G

The national uninsured rate reached an all-time low of 8 percent in the first quarter of 2022, according to an HHS report released Aug. 2. 

The report analyzed data from the National Health Interview Survey and the American Community Survey, according to an Aug. 2 HHS news release. 

Three things to know:

1. The previous record low uninsured rate was 9 percent, set in 2016. 

2. The uninsured rate among adults ages 18-64 was 11.8 percent in the first quarter of 2022. The uninsured rate for children ages 0-17 was 3.7 percent. 

3. About 5.2 million people have gained health coverage since 2020. Gains in coverage are concurrent with the implementation of the American Rescue Plan’s enhanced ACA Marketplace subsidies, the continuous enrollment provision in Medicaid, several state Medicaid expansions and enrollment outreach efforts.  

Fitch: Outlook is negative for CHS

Posted on by • Posted in Credit Downgrade, Credit Quality, Credit Ratings, For-Profit, Health System, Investment Banking, Investor Owned, Net Income, Nonoperating Income, Operating Expenses, Operating Income, Operating Margin, Operating Metrics, Operating Model, Operating Performance, Operating Revenue • Leave a comment
https://www.beckershospitalreview.com/finance/fitch-outlook-is-negative-for-chs.html?utm_medium=email&utm_content=newsletter

Fitch Ratings has affirmed the “B-” long-term issuer default ratings of Franklin, Tenn.-based Community Health Systems, and revised the company’s rating outlook to negative from stable. 

The credit rating agency said the negative outlook reflects operating performance deterioration in the first half of this year, with significant increases in labor costs. Higher costs, weakness in volumes and acuity mix drove a downturn in the for-profit company’s revenue, resulting in a reduction in its financial guidance for this year, Fitch said. 

CHS ended the first six months of this year with a net loss of $327 million on revenues of $6.04 billion. In the first half of 2021, the company posted a net loss of $58 million on revenues of $6.02 billion.

Fitch noted that CHS still benefits from its strengthened liquidity and balance sheet after several debt refinancing and exchange transactions. CHS also benefits from investments in outpatient care and higher-acuity inpatient services, the credit rating agency said.