White House tells hospitals to bypass CDC on COVID-19 data reporting

https://thehill.com/policy/healthcare/507321-white-house-tells-hospitals-to-bypass-cdc-on-covid-data-reporting?fbclid=IwAR2Q0n6LNYQa1p6rPQeRGUPi-54i8uTAyRxcmTcZXC6Q9mbVRZx3e1GH518

White House tells hospitals to bypass CDC on COVID-19 data ...

Hospitals will begin sending coronavirus-related information directly to the Department of Health and Human Services (HHS), not the Centers for Disease Control and Prevention (CDC), under new instructions from the Trump administration.

The move will take effect on Wednesday, according to a new guidance and FAQ document for hospitals and clinical labs quietly posted on the HHS website.

Previously, hospitals reported to the CDC’s National Healthcare Safety Network, which the agency describes as the nation’s most widely used health care-associated infection tracking system.

The CDC tracked information including how many beds are available, the number of ventilators available and how many COVID-19 patients the hospitals have.

Beginning Wednesday, hospitals will report the same data but will bypass the CDC and send it to HHS directly. 

According to HHS, the goal is to streamline data collection, which will be used to inform decisions at the federal level such as allocation of supplies, treatments and other resources.

But the move comes amid concerns that the White House has been sidelining the CDC and after Trump administration officials attacked Anthony Fauci, the nation’s top infectious disease expert and a member of the White House coronavirus task force.

 

 

8 health systems with strong finances

https://www.beckershospitalreview.com/finance/8-health-systems-with-strong-finances-0713.html?utm_medium=email

Here are eight health systems with strong operational metrics and solid financial positions, according to reports from Fitch Ratings, Moody’s Investors Service and S&P Global Ratings.

1. Baylor Scott & White Health has an “AA-” rating and stable outlook with S&P. The health system has an expansive and growing market position in Texas, healthy operating performance and robust cash flow, S&P said. The health system’s financial cushion positions it well for its COVID-19 response, according to the credit rating agency.

2. South Bend, Ind.-based Beacon Health System has an “AA-” rating and stable outlook with Fitch. Beacon is the acute care leader in its northern Indiana service area and has a track record of strong operating margins, Fitch said. The credit rating agency expects Beacon to return to strong operating margins and sustain strong liquidity, despite pressure from the COVID-19 pandemic.

3. Boston Children’s Hospital has an “Aa2” rating and stable outlook with Moody’s. The hospital has a preeminent reputation as the top children’s hospital in the U.S., robust cash reserves and strong fundraising capabilities, Moody’s said. The credit rating agency expects the hospital’s exceptional market position and robust liquidity to help it return to pre-COVID-19 levels to support proposed increases in leverage and capital investments.

4. Carle Foundation, a three-hospital system based in Urbana, Ill., has an “AA-” rating and stable outlook with Fitch. The health system has a very strong financial profile, and Fitch expects it to sustain profitable operating margins after managing through the pandemic.

5. Salt Lake City-based Intermountain Healthcare has an “AA+” rating and stable outlook with Fitch and an “Aa1” rating and stable outlook with Moody’s. The health system has a leading market position, low debt levels and strong absolute and relative cash levels, Moody’s said. The credit rating agency expects Intermountain will be able to substantially return to and sustain pre-COVID-19 volume levels and margins.

6. Oakland, Calif.-based Kaiser Permanente has an “AA-” rating and stable outlook with Fitch. The rating agency said Kaiser has a leading market share in California and other key markets, and its operational profile is arguably the most emulated model of healthcare delivery in the nation.

7. New York City-based Memorial Sloan Kettering Cancer Center has an “AA-” rating and stable outlook with S&P. The hospital has robust fundraising capabilities, an advantageous payer mix and has expanded its ambulatory footprint, providing additional revenue diversity, S&P said.

8. Tacoma, Wash.-based MultiCare Health System has an “Aa3” rating and stable outlook with Moody’s and an “AA-” rating and stable outlook with Fitch.. The 10-hospital system has an extensive footprint, a track record of successfully executing on multiple projects and strategic ventures concurrently and good financial management, Moody’s said. The credit rating agency expects MultiCare to return to stronger operating results after recovering from disruptions related to the COVID-19 pandemic.

 

 

Pandemic spurs national union activity among hospital workers

https://www.healthcaredive.com/news/coronavirus-spurs-healthcare-union-activity/581397/

Pandemic spurs national union activity among hospital workers ...

When COVID-19 cases swelled in New York and other northern states this spring, Erik Andrews, a rapid response nurse at Riverside Community Hospital in southern California, thought his hospital should have enough time to prepare for the worst.

Instead, he said his hospital faced staffing cuts and a lack of adequate personal protective equipment that led around 600 of its nurses to strike for 10 days starting in late June, just before negotiating a new contract with the hospital and its owner, Nashville-based HCA Healthcare.

“To feel like you were just put out there on the front lines with as minimal support necessary was incredibly disheartening,” Andrews said. Two employees at RCH have died from COVID-19, according to SEIU Local 121RN, the union representing them.

A spokesperson for HCA told Healthcare Dive the “strike has very little to do with the best interest of their members and everything to do with contract negotiations.”

Across the country, the pandemic is exacerbating labor tensions with nurses and other healthcare workers, leading to a string of disputes around what health systems are doing to keep front-line staff safe. The workers’ main concerns are adequate staffing and PPE. Ongoing or upcoming contract negotiations could boost their leverage.

But many of the systems that employ these workers are themselves stressed in a number of ways, above all financially, after months of delayed elective procedures and depleted volumes. Many have instituted furloughs and layoffs or other workforce reduction measures.

Striking a balance between doing union action at hospitals and continuing care for patients could be an ongoing challenge, Patricia Campos-Medina, co-director of New York State AFL-CIO/Cornell Union Leadership Institute.

“The nurses association has been very active since the beginning of the crisis, demanding PPE and doing internal activities in their hospitals demanding proper procedures,” Campos-Medina said. “They are front-line workers, so they have to be thoughtful in how they continue to provide care but also protect themselves and their patients.”

At Prime Healthcare’s Encino Hospital Medical Center, just outside Los Angeles, medical staff voted to unionize July 5, a week after the hospital laid off about half of its staff, including its entire clinical lab team, according to SEIU Local 121RN, which now represents those workers.

One of the first things the newly formed union will fight is “the unjust layoffs of their colleagues,” it said in a statement.

A Prime Healthcare spokesperson told Healthcare Dive 25 positions were cut. “These Encino positions were not part of front-line care and involved departments such as HR, food services, and lab services,” the system said.

Hospital service workers elsewhere who already have bargaining rights are also bringing attention to what they deem as staffing and safety issues.

In Chicago, workers at Loretto Hospital voted to authorize a strike Thursday. Those workers include patient care technicians, emergency room technicians, mental health staff and dietary and housekeeping staff, according to SEIU Healthcare Illinois, the union that represents them. They’ve been bargaining with hospital management for a new contract since December and plan to go on strike July 20.

Loretto Hospital is a safety-net facility, catering primarily to “Black and Brown West Side communities plagued with disproportionate numbers of COVID illnesses and deaths in recent months,” the union said.

The “Strike For Black Lives” is in response to “management’s failure to bargain in good faith on critical issues impacting the safety and well-being of both workers and patients — including poverty level wages and short staffing,” according to the union.

A Loretto spokesperson told Healthcare Dive the system is hopeful that continuing negotiations will bring an agreement, though it’s “planning as if a strike is eminent and considering the best options to continue to provide healthcare services to our community.”

Meanwhile in Joliet, Illinois, more than 700 nurses at Amita St. Joseph Medical Center went on strike July 4.

The Illinois Nurses Association which represents Amita nurses, cited ongoing concerns about staff and patient safety during the pandemic, namely adequate PPE, nurse-to-patient ratios and sick pay, they want addressed in the next contract. They are currently bargaining for a new one, and said negotiations stalled. The duration of the strike is still unclear.

However, a hospital spokesperson told Healthcare Dive, “Negotiations have been ongoing with proposals and counter proposals exchanged.”

The hospital’s most recent proposal “was not accepted, but negotiations will continue,” the system said.

INA is also upset with Amita’s recruitment of out-of-state nurses to replace striking ones during the COVID-19 pandemic.

It sent a letter to the Illinois Department of Financial and Professional Regulation, asserting the hospital used “emergency permits that are intended only for responding to the pandemic for purposes of aiding the hospital in a labor dispute.”

 

 

 

 

Consumer confidence declines as COVID surges

https://mailchi.mp/86e2f0f0290d/the-weekly-gist-july-10-2020?e=d1e747d2d8

 

Just as consumer confidence was approaching pre-COVID levels in early June, cases began surging in many parts of the country. The graphic below shares highlights from a recent Morning Consult poll, which found reduced consumer confidence in participating in a range of activities, like dining out or going to a mall.

The poll also showed a significant consumer divide based on political affiliation, with Republicans’ confidence levels for many activities being twice that of Democrats. It remains to be seen whether the current surge will result in consumers pulling back on healthcare utilization the way they are beginning to for other activities.

A coalition of healthcare organizations is urging consumers to continue social distancing but “stop medical distancing”—in hopes that the new surge will not lead patients to avoid needed medical care. While cell tower data at thousands of hospital facilities suggest volumes may be stalling again, we anxiously await the latest national data on outpatient visit and elective procedure volumes.

We’d predict the surge will exacerbate consumer discomfort with “waiting” in healthcare settings—urgent care clinics, emergency departments and the like—though we’d expect the reduction in utilization to be less severe and more regionally varied this time around. 

Let us know what you’re seeing!

 

 

 

 

Facing another round of elective surgery shutdowns

https://mailchi.mp/86e2f0f0290d/the-weekly-gist-july-10-2020?e=d1e747d2d8

COVID-19: Hospitals brace for elective surgery shut-downs | New ...

With elective surgery shutdowns hitting health systems in Florida and Texas, providers across the country are thinking through the odds of a second round coming to their markets. While shutting down nonemergent cases in areas truly overwhelmed by the virus may be a necessity, we have been struck by how much better prepared systems are to deal with a second surge.

According to one of our member COOs, the enormous amount that hospitals and doctors have learned about COVID across the past six months, and the operational changes they’ve made to ensure safety (which now feel routine) make systems much better equipped to manage elective cases even if COVID admissions begin to rise.

“We created designated non-COVID facilities, supported by rigorous safety procedures. And we now have a few months of evidence that these changes allow us to manage electives without putting patients or staff at risk,” he said. “Just like none of us are wiping down our groceries with bleach anymore, we’ve learned what is and isn’t essential to create a safe environment in a surgery center.”

But he cautioned that, in their market, supply shortages will likely threaten electives before a local surge of COVID cases. The system recently postponed some procedures when the turnaround time for COVID test results suddenly jumped, and they are once again worried about shortages of PPE.

As we look toward fall, when more surges are likely as kids return to school and the flu season sets in, hospitals must have the resources to manage COVID spikes without shutting down the rest of the system. Many patients with ongoing health needs put their care on hold for much of the spring. If much of healthcare is forced into a second months-long shutdown, the toll from untreated conditions could be enormous.

 

 

 

 

Sutter loses bid to delay $575M antitrust settlement approval

https://www.healthcaredive.com/news/sutter-loses-bid-to-delay-575m-antitrust-settlement-approval/581393/

Dive Brief:

  • A San Francisco Superior Court judge on Thursday denied Sutter Health’s request to delay preliminary approval of a $575 million antitrust settlement with California amid the uncertainty and financial upheaval of the COVID-19 pandemic.
  • The approval process and settlement agreement are flexible enough to continue as scheduled and the needs of the plaintiffs — a union that operates a trust for employee healthcare benefits and California Attorney General Xavier Becerra — to see the health system’s behavior change are pressing, Judge Anne-Christine Massullo wrote in her order.
  • In a statement Thursday, Becerra applauded the court’s decision. “Sutter’s practices harmed California’s healthcare market by charging higher prices unrelated to quality or cost of care,” he said. “They did that long before the COVID-19 pandemic. There is no period of time that medical providers, like Sutter, should be able to carry out such destructive market practices.”

Dive Insight:

Sutter, like health systems throughout the country, has taken a significant hit to its bottom line as the pandemic forced lucrative elective procedures to be put off for weeks earlier this year. The company posted a net loss of more than $1 billion in the first quarter of this year.

It said the financial losses from the COVID-19 crisis could force it to close or divest hospitals. In its June argument to delay the settlement approval, Sutter said the agreement’s cap or chargemaster prices could be too low “to cover the unprecedented and unforeseeable increases in expenditures to respond to COVID-19 particularly given declining revenue.”

But the judge did not agree, saying the court is “not persuaded that the proposed injunction will interfere with Sutter’s ability, or the broader healthcare system’s ability, to provide patient care during the COVID-19 pandemic.”

Massullo continued: “To the extent that a provision of the proposed injunction poses a threat to patient care or the public interest during the COVID-19 pandemic, or as a result of some other presently unforeseen circumstance, any party may seek a modification of the offending provision if and when such a modification becomes appropriate.”

The preliminary approval hearing is now set for Aug. 12 and Aug. 13, according to multiple news reports.

Sutter avoided a jury trial late last year by agreeing to the settlement, which in addition to the $575 million payout includes stipulations like ceasing contracts that require all of its facilities be in an insurer’s network or none of them. The system, however, did not admit guilt as part of the agreement.

 

 

 

Intermountain, Stanford Children’s CEOs say hospitals need to get comfortable being a ‘frenemy’

https://www.fiercehealthcare.com/hospitals/intermountain-stanford-children-s-ceos-say-hospitals-need-to-get-comfortable-being-a?mkt_tok=eyJpIjoiTlRZNFpUa3hZbU0zWlRGaSIsInQiOiJjR0Y5WWdaZ1lxc2w3aHY0dlpFQ0w2czhrY0h3NVwvTkVnaVwvdStPYld1NzlIWFI1aFlRQUVLRjNmb25ETGNxR3Rza3czYjV2VzlpYVwvRmRqSnQ5a29Wc2tjeDhxcnl2VHZOSzg4OWx3WUp4eGR4ano2dURRYlhzamJHU3ZHTEdcL2YifQ%3D%3D&mrkid=959610

Intermountain, Stanford Children's CEOs say hospitals need to get ...

Health systems have had to adjust to a lot of change in a short amount of time since the COVID-19 pandemic began.

Among the biggest changes they need to get comfortable with?

Collaborations with their rivals, said Intermountain President and CEO Marc Harrison, M.D., at Fortune’s Brainstorm Health virtual event Wednesday.

“I think that the opportunity is to get comfortable with the whole ‘frenemy’ relationship,” Harrison said. “Other industries recognize that an organization is both going to compete and collaborate with another organization, often simultaneously.”

Intermountain and the other system have co-branded drive-thru testing sites to eliminate redundancies, they share personal protective equipment numbers and they load level patients between systems. They have also “harmonized” clinical trials to ensure consistent criteria for all patients admitted to them, he said.

“I think that’s fantastic,” Harrison said, speaking during a virtual panel called Reinventing the Hospital. “We will compete in the future in certain areas but I’d love to continue to see this.”

The increasing level of collaborations amid the pandemic is also among the biggest changes Paul King, CEO of Stanford Children’s Health, has noticed since COVID-19 began its spread across the U.S.

“That is one of the silver linings of what we’ve seen with this crisis, particularly in the children’s hospital space. We’ve seen a level of collaboration, heretofore unseen, with the amount of sharing of best practices real-time,” King said. “The other outcome of this crisis is the idea of speed. We’ve been able to really stand up some capabilities that we would’ve said weren’t possible just 12 weeks ago. That level of collaboration is part of the genie we don’t want to go back in the bottle.”

 

 

 

 

Texas and Arizona ER doctors say they are losing hope as hospitals reach capacity

https://www.cnn.com/2020/07/08/us/emergency-room-doctors-coronavirus-capacity/index.html?utm_source=Sailthru&utm_medium=email&utm_campaign=Issue:%202020-07-08%20Healthcare%20Dive%20%5Bissue:28354%5D&utm_term=Healthcare%20Dive

Texas and Arizona ER doctors say they are losing hope as hospitals ...

As concerns over the capacity of hospitals resurface amid surging Covid-19 cases, two emergency room doctors say they worry about where the pandemic could take them next.

Dr. Mina Tran, an emergency room doctor in Texas, said 70 to 80% of her patients have been admitted with upper respiratory or coronavirus complaints.
In Arizona, which saw its lowest-ever number of available ICU beds Tuesday, Dr. Murtaza Akhter told Lemon so many patients are coming in that he is already having to make tough decisions over resources.
“I’m trying not to be an alarmist. I’m an emergency physician — we’re prepped for this. Dr. Tran and I both trained very hard for this. But we can’t just build beds overnight. We can’t just hire staff overnight. And like I said, our numbers are only increasing,” he said. “It’s only going to get worse and that’s the scary part.”
With a rise in hospitalization rates across the US, doctors like Akhter are reporting waiting lists for ICU beds and having to decide who will be admitted for treatment and who will not.
Surges in hospitalization and infection rates have followed larger crowds gathering in newly reopened public spaces. Every state has started their plan to reopen, and 35 are currently seeing more new cases reported compared to last week.
Tran applauded Texas Gov. Greg Abbott closing down bars once again but said she does think the state was too quick to open back up.
While many states have paused or rolled back reopening in light of a resurgence of cases, Akhter said seeing individuals continue disregard safe practices as his emergency room treats coronavirus patients makes him feel like he is “losing hope.”
“I’m going through shifts making some very tough decisions and then I’m driving home and seeing people who are clearly not distancing, having their Fourth of July celebrations, being in big congregate settings, and it feels like what I’m doing is futile,” Akhter said. “I don’t know what more people need to hear.”
And California and Florida are feeling the strain as well.
In Florida, where cases have surged, ICUs at 56 hospitals have reached capacity. And California’s hospitalizations were at an all-time high on Tuesday with nearly 6,000 coronavirus patients.

 

 

 

Providence, Humana back ad campaign urging patients to stop ‘medical distancing’

https://www.healthcaredive.com/news/providence-humana-back-ad-campaign-urging-patients-to-stop-medical-distan/581172/

Dive Brief:

  • A coalition of providers, payers and other healthcare organizations on Tuesday launched an ad campaign to encourage patients not to put off important care during the COVID-19 pandemic.
  • The announcement encourages people to continue social distancing but not “medical distancing” by putting off routine care or avoiding checking on concerning symptoms. That could be either through telemedicine or an in-person visit.
  • The campaign will be on TV, in print and across social media. The 11 organizations behind it include Providence, Humana, Baylor Scott & White, LabCorp and Walgreens.

Dive Insight:

While some hospitals in hotspots in Texas, Florida, California and Arizona have had to once again put off non-emergency procedures, providers in other areas of the country are trying to ramp up regular patient volumes as the number of positive cases eases.

Surveys show, however, that people are wary of returning to the doctor’s office, either because they worry about exposure to the novel coronavirus or have lost coverage to help pay for care.

The new ad campaign seeks to ease these concerns. No dollar figure was attached to the plan, which advertising agency MullenLowe U.S. took on pro bono. It follows an ad the American Hospital Association launched in May to ensure the public facilities are still available for non-COVID-19 care.

Since the pandemic’s onset in the United States, health officials have been concerned about the short- and long-term consequences of routine and preventive care being delayed or put off entirely. Chronic diseases that are caught early can be managed more easily and less expensively.

Also, research shows even some crucial services aren’t being sought even for issues such as strokes and heart attacks. In April, emergency room visits nationwide dropped more than 40%, according to the Centers for Disease Control and Prevention.

Public health experts are also beginning to fear vaccinations may be avoided, which could cause trouble with the upcoming flu season.

For providers the reduction in patient volumes has meant a major revenue loss. Some patient volume has been recaptured, but that rolled back again in recent weeks with hospitals in large states like Texas and Florida again reaching capacity with a COVID-19 surge.

At the end of June, hospital traffic in Arizona, New York and Texas was down week over week, according to an analysis from Jefferies.

Primary care has particularly suffered. Visits to medical offices were down nearly 60% in March and April, meaning losses to those practices could top $15 billion this year, according to a recent Health Affairs study.

The ad campaign stresses that providers have guidelines in place to keep patients safe, such as isolation of those suspected of having COVID-19 and increased virtual options.

“While we understand the fears that many people have around contracting the virus, our country’s medical facilities have adopted CDC guidelines and best practices and even telemedicine options to make your visit as safe as possible to prevent the spread of the virus,” Humana CMO William Shrank said in a statement. “The intent of the campaign is to let people know that protecting yourself against getting this virus does not need to come at the expense of your overall health.”

 

 

 

 

U.S. Tops Three Million Known Infections as Coronavirus Surges

https://www.usnews.com/news/top-news/articles/2020-07-07/us-coronavirus-cases-hit-3-million-stoking-fears-of-overwhelmed-hospitals

U.S. tops three million known infections as coronavirus surges ...

 The U.S. coronavirus outbreak crossed a grim new milestone of over 3 million confirmed cases on Tuesday as more states reported record numbers of new infections, and Florida faced an impending shortage of intensive care unit hospital beds.

Authorities have reported alarming upswings of daily caseloads in roughly two dozen states over the past two weeks, a sign that efforts to control transmission of the novel coronavirus have failed in large swaths of the country.

California, Hawaii, Missouri, Montana, Oklahoma and Texas on Tuesday shattered their previous daily record highs for new cases. About 24 states have also reported disturbingly high infection rates as a percentage of diagnostic tests conducted over the past week.

In Texas alone, the number of hospitalized patients more than doubled in just two weeks.

The trend has driven many more Americans to seek out COVID-19 screenings. The U.S. Department of Health and Human Services said on Tuesday it was adding short-term “surge” testing sites in three metropolitan areas in Florida, Louisiana and Texas.

In Houston, a line of more than 200 cars snaked around the United Memorial Medical Center as people waited for hours in sweltering heat to get tested. Some had arrived the night before to secure a place in line at the drive-through site.

“I got tested because my younger brother got positive,” said Fred Robles, 32, who spent the night in his car. “There’s so many people that need to get tested, there’s nothing you can do about it.”

Dean Davis, 32, who lost his job due to the pandemic, said he arrived at the testing site at 3 a.m. on Tuesday after he waited for hours on Monday but failed to make the cutoff.

“I was like, let me get here at three, maybe nobody will be here,” Davis said. “I got here, there was a line already.”

In Florida, more than four dozen hospitals across 25 of 67 counties reported their intensive care units had reached full capacity, according to the state’s Agency for Health Care Administration. Only 17% of the total 6,010 adult ICU beds statewide were available on Tuesday, down from 20% three days earlier.

Additional hospitalizations could strain healthcare systems in many areas, leading to an uptick in deaths from the respiratory illness that has killed more than 131,000 Americans to date.

A widely cited mortality model from the University of Washington’s Institute for Health Metrics and Evaluation (IHME) projected on Tuesday that U.S. deaths would reach 208,000 by Nov. 1, with the outbreak expected to gain new momentum heading into the fall.

A hoped-for summertime decline in transmission of the virus never materialized as previously predicted, the IHME said.

“The U.S. didn’t experience a true end of the first wave of the pandemic,” IHME Director Dr. Christopher Murray said in a statement. “This will not spare us from a second surge in the fall, which will hit particularly hard in states currently seeing high levels of infections.”

‘PRESSURE ON GOVERNORS’

U.S. President Donald Trump, who has pushed for restarting the U.S. economy and urged Americans to return to their normal routines, said on Tuesday he would lean on state governors to open schools in the fall.

Speaking at the White House, Trump said some people wanted to keep schools closed for political reasons. “No way, so we’re very much going to put pressure on governors and everybody else to open the schools.”

New COVID-19 infections are rising in 42 states, based on a Reuters analysis of the past two weeks. By Tuesday afternoon, the number of confirmed U.S. cases had surpassed 3 million, affecting nearly one of every 100 Americans and a population roughly equal to Nevada’s.

In Arizona, another hot spot, the rate of coronavirus tests coming back positive rose to 26% for the week ended July 5, leading two dozen states with positivity rates exceeding 5%. The World Heath Organization considers a rate over 5% to be troubling.

The surge has forced authorities to backpedal on moves to reopen businesses, such as restaurants and bars, after mandatory lockdowns in March and April reduced economic activity to a virtual standstill and put millions of Americans out of work.

The Texas state fair, which had been scheduled to open on Sept. 25, has been canceled for the first time since World War Two, organizers announced on Tuesday.

In Ohio, Governor Mike DeWine said the state was ordering people in seven counties to wear face coverings in public starting on Wednesday evening.