America celebrates a grim milestone

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economic Recovery, Economy Reopening, Epidemic, Health Policy, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Intensive Care (ICU), Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://mailchi.mp/7d224399ddcb/the-weekly-gist-july-3-2020?e=d1e747d2d8

Epidemic vs. Pandemic, What Is the Difference Between an Epidemic ...

 

As the nation headed into the 4th of July weekend, the number of new COVID cases hit a string of daily highs, reaching a record high of more than 55,000 on Thursday. States across the South and Sunbelt, especially those that lifted stay-at-home orders early, saw the worst spikes.

Florida broke a new record with more than 10,000 cases on Thursday, and Georgia also experienced a new daily high. Hospitalizations continued to rise sharply in several states as well. Many hospitals reported a shift in COVID admissions toward younger, otherwise healthy adults, reports borne out by the lower death rate than that experienced in the initial surge of cases in the Northeast. (Advances in the management of severely ill COVID patients have also brought death rates down.)

In a Senate hearing on Tuesday, top White House health advisor Dr. Anthony Fauci said that the US was “not in total control” of the pandemic, and predicted that daily new case counts could top 100,000 if more stringent measures are not taken.

California, Florida, and other states took steps to roll back reopening efforts, and Texas Gov. Greg Abbott abruptly reversed direction and ordered a statewide mask mandate. Welcome news, but likely too late to prevent cities like Houston from exceeding available ICU capacity. Cases in the city have skyrocketed across the past month, with its positive test rate hitting 20 percent yesterday; its cancer and children’s hospitals began admitting COVID-positive adults to provide added capacity.

With celebrations scheduled across the nation this weekend, including another large event today at Mount Rushmore to be attended by President Trump, where masking and social distancing will be optional, it seems certain that we will continue to reap the whirlwind of careless behavior and hasty reopening for the rest of this month and beyond.

And looming in just six weeks—students return to schools and colleges.

US coronavirus update: 2.7M cases; 130K deaths; 33.5M tests conducted.
 

 

 

 

June’s cautious economic recovery is based in part-time work and vulnerable industries

Posted on by • Posted in 2020 Election Issues, Coronavirus, Economic Crisis, Economic Recovery, Economy Reopening, Employer-Based Health Insurance, Health Insurance Coverage Adequacy, Job, Job Growth, Job Market, Job Search, Job Security, Market Outlook, Pandemic, Underinsured, Unemployment, Unemployment Insurance, Uninsured • Leave a comment

https://www.washingtonpost.com/business/2020/07/02/junes-cautious-economic-recovery-is-based-part-time-work-vulnerable-industries/?fbclid=IwAR290sM5RZgwuxNMBDi1chv_i1ulzy4zY2KF4f1cDUMCsiTTpME2wkGVM6s&utm_campaign=wp_main&utm_medium=social&utm_source=facebook

 

The June unemployment rate of 11.1 percent, down from a peak of 14.7 percent in April, reflects a continuing, cautious economic recovery. What those numbers don’t show is an increase in employment driven disproportionately by part-time work and industries that are vulnerable to another shutdown.

The unemployment rate is a blunt tool. It takes into account anyone who works, even if they work for only one hour a week. And part-time employment has recovered much more quickly from April’s catastrophic losses than full-time employment. While full-time employment is still 12 percent lower than it was in February, part-time employment is back to pre-pandemic levels.

According to the Labor Department’s survey of American households, many of those workers would work full-time if they could and are working part-time only because of poor economic conditions. The number of people pushed into part-time work has more than doubled since February. Meanwhile, the number of people who work part-time by choice is still down by 23 percent.

 

 

The unemployment rate isn’t wrong: Part-time work is still work. However, those jobs have already proved to be vulnerable to a slowing economy. Anyone pushed into part-time work by the coronavirus’s initial shock to the economy may be even more vulnerable in the case of future shutdowns. And part-time workers may not have access to benefits such as health insurance that are available to full-time workers.

The industries that bounced back in May and June are also at the mercy of future shutdowns as coronavirus cases surge across the Sun Belt. For instance, unemployment in leisure and hospitality is still very high but dropped by 10 percentage points from April’s staggering 40 percent. Retail and wholesale unemployment dropped by a third. In contrast, finance, government and professional services have had a slow start to recovery. Unemployment in the information industry actually increased from May to June.

 

 

If the greatest gains in employment are in industries that suffered most in the early stages of the pandemic, those gains are vulnerable to future waves of shutdowns. Meanwhile, less-volatile industries may continue to be slow to bounce back. A Congressional Budget Office report predicted that the unemployment rate is expected to stay above its pre-pandemic levels through the end of 2030.

 

 

Ability to Reduce Your Chances of Getting Covid by 5x

Posted on by • Posted in 2020 Election Issues, Coronavirus, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

Image may contain: text that says 'INEQUALITY MEDIA IMAGINE IF THERE WAS A MEDICATION THAT REDUCED YOUR CHANCES OF GETTING COVID BY 5X. EVERYONE WOULD WANT THAT MEDICATION. WELL, THAT'S WEARING A MASK. @JasmynBeKnowing'

12 hospitals laying off workers in response to COVID-19

Posted on by • Posted in Cash, Cash Reserves, Coronavirus, Cost Management, Cost Reduction, Crisis, Crisis Management, Economic Crisis, Economic Stimulus, Elective Procedures, Elective Surgery, Employee Benefits, Employee Furlough, Employee Hiring Freeze, Employee Layoffs, Employee Pay Cuts, Employer-Based Health Insurance, Health Policy, Health System, Hospital, Hospital Industry, Job, Job Growth, Job Loss, Job Search, Job Security, Liquidity, Net Income, Nonoperating Income, Operating Expenses, Operating Income, Operating Margin, Operating Performance, Operating Revenue, Pandemic • Leave a comment

https://www.beckershospitalreview.com/finance/12-hospitals-laying-off-workers-in-response-to-covid-19.html?utm_medium=email

Facing a financial squeeze, hospitals nationwide are cutting jobs

To address the financial fallout from the COVID-19 pandemic, hospitals across the nation are looking to cut costs by implementing furloughs, layoffs or pay cuts. 

U.S. hospitals are expected to lose $323.1 billion this year due to the pandemic, according to a recent report from the American Hospital Association. The total includes $120.5 billion in financial losses that hospitals are projected to see from July through December, as well as $202.6 billion in losses that were projected between March and June. The losses were largely due to a lower patient volume after canceling elective procedures. 

Although Congress allocated $175 billion to help hospitals offset some of the revenue losses and expense increases to prepare for the pandemic, hospitals have said it is not enough.

Nearly 270 hospitals and health systems have furloughed workers in response to the pandemic and several others have implemented layoffs. 

Below are 12 hospitals and health systems that have announced layoffs since June 1:

1. Trinity Health furloughs, lays off another 1,000 workers
Trinity Health, a 92-hospital system based in Livonia, Mich., will lay off and reduce work schedules of 1,000 employees.

2. Ohio children’s hospital cuts jobs
Dayton (Ohio) Children’s Hospital said it has cut jobs to help offset financial losses due to the COVID-19 pandemic.

3. Munson Healthcare to cut 25 leadership positions
Traverse City, Mich.-based Munson Healthcare cut 25 leadership positions to help offset financial losses amid the COVID-19 pandemic.

4. Erlanger lays off 93 nonclinical employees
Chattanooga, Tenn.-based Erlanger Health System has cut 93 nonclinical positions to help offset financial damage from the COVID-19 pandemic. The layoffs come after the health system cut 11 leadership positions June 12, including the CEO of Erlanger Western Carolina Hospital in Murphy, N.C., and made staff and pay cuts in March.

5. Michigan Medicine to lay off 738 employees by end of June
Ann Arbor-based Michigan Medicine planned to eliminate 738 positions by the end of June amid financial challenges from the COVID-19 pandemic.

6. Pennsylvania health system cuts 10% of workforce amid pandemic losses
As part of a restructuring effort to cut pandemic-related losses, State College, Pa.-based Mount Nittany Health System plans to lay off 10 percent of its workforce, or about 250 employees.

7. TriHealth eliminates 440 positions to cut costs
Cincinnati-based TriHealth cut 440 positions as part of a plan to trim at least $140 million in expenditures this year.

8. Layoffs hit U of Kansas Health System
The University of Kansas Health System St. Francis Campus in Topeka laid off employees after previously implementing furloughs.

9. Tower Health to cut 1,000 jobs
Citing a $212 million loss in revenue through May due to the COVID-19 pandemic, West Reading, Pa.-based Tower Health plans to cut 1,000 jobs.

10. Colorado hospital cuts 22 positions
Parkview Medical Center in Pueblo, Colo., eliminated 22 positions in response to the COVID-19 pandemic.

11. Arkansas Children’s cuts 42 positions
Little Rock-based Arkansas Children’s Hospital said it is eliminating 42 jobs as part of cost-savings measures in response to the COVID-19 pandemic.

12. North Carolina health system cuts 10% of workforce, closes clinics
Citing a financial hit from the COVID-19 pandemic, Lumberton, N.C.-based Southeastern Health will permanently close several clinics, cut 10 percent of its workforce and reduce executive pay.

 

 

6 latest hospital credit rating downgrades

Posted on by • Posted in Credit Quality, Credit Ratings, Health System, Hospital, Hospital Industry • Leave a comment

https://www.beckershospitalreview.com/finance/6-latest-hospital-credit-rating-downgrades-0702.html?utm_medium=email

credit ratings | Özde Kurter

The following six hospital and health system credit rating downgrades occurred since June 1. They are listed below in alphabetical order.

1. Care New England (Providence, R.I.) — from “BB” to “BB-” (Fitch Ratings); from “BB-” to “B+” (S&P Global Ratings)

2. Holy Redeemer Health System (Meadowbrook, Pa.) — from “Ba1″ to Ba2” (Moody’s Investors Service); from “BBB-” to “BB+” (Fitch Ratings)

3. Indiana (Pa.) Regional Medical Center — from “Baa2” to “Baa3” (Moody’s Investors Service)

4. Mon Health (Morgantown, W.Va.) — from “BBB+” to “BBB” (S&P Global Ratings)

5. Nuvance Health (Lagrangeville, N.Y.)  — from “A3” to “Baa2” (Moody’s Investors Service)

6. Virginia Mason Medical Center (Seattle)  — from “BBB” to “BBB-” (S&P Global Ratings)

 

 

FTC, Justice Department have new guidelines for vertical mergers

Posted on by • Posted in Antitrust, Competition, Dept of Justice (DOJ), Federal Trade Commission (FTC), Horizontal Merger, Market Consolidation, Market Power, Mergers & Acquisitions, Monopoly, Monopoly Behavior, Vertical Merger • Leave a comment

https://www.beckershospitalreview.com/hospital-transactions-and-valuation/ftc-justice-department-have-new-guidelines-for-vertical-mergers.html?utm_medium=email

Trump Administration Updates Vertical Merger Guidelines - Multichannel

Guidance on vertical mergers got its first major overhaul from the Federal Trade Commission and the U.S. Department of Justice in more than 35 years under new joint guidelines published June 30.

Vertical mergers are those that combine firms or assets at different stages of the same supply chain, such as healthcare company CVS Health’s acquisition of insurer Aetna. Previously proposed mergers like that of insurers Humana and Aetna would be considered horizontal.

FTC Chairman Joe Simon said in a news release that the new guidances “are an important step forward in maintaining vigorous antitrust enforcement, and reaffirm our commitment to challenge vertical mergers that are anticompetitive and would harm American consumers.”

Leaders said that the guidelines explain FTC and Justice Department investigative practices and will give the business community clarity about antitrust concerns, such as the type of evidence the FTC and Justice Department review and how they define markets.

To read the full guidelines, click here. 

 

 

 

 

 

Flu vs. Covid-19 Death Rate, by age

Posted on by • Posted in Centers for Disease Control & Prevention (CDC), Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economy Reopening, Health Policy, Infection Control, Infection Control Plan, Infectious Virus, Mortality, Pandemic, Personal Protective Equipment (PPE), Preexisting Conditions, Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

No photo description available.

 

Despite COVID-19, less dramatic decline in Q2 M&A than expected, Kaufman Hall reports

Posted on by • Posted in Health System, Hospital, Hospital Industry, Market Consolidation, Mergers & Acquisitions, Pandemic, Strategy • Leave a comment

https://www.fiercehealthcare.com/hospitals/despite-covid-less-dramatic-decline-q2-m-a-than-expected-kaufman-hall-reports?mkt_tok=eyJpIjoiT1RJMlpqWTNPREJtTmpGaSIsInQiOiJ0enNDdXU5R0ZEdUJmSE1GcXl5UHd4VjdcL1FQcWE3ckN2YmhLVUhnazNFNlhUOEdLQndTcnRnXC9TbWNzWDhZMW5KWEhtMUxJRDRFdG1uXC84NGVhTHZ5QklGK0Fyc2dadXVcL0phNWFaVGY1SGlVVzN6NFRxVlRLOE9mRmdHR2VmdDgifQ%3D%3D&mrkid=959610

Mergers and acquisitions deals consolidation

While the COVID-19 pandemic has done a financial number on organizations across the healthcare industry, it did not stymie mergers and acquisition deals as much as anticipated, according to a new report.

Kaufman Hall officials said in their latest M&A report that deals in the second quarter declined in comparison to the same quarter a year earlier.

However, they said, two “transformational” deals announced in June pushed the quarter to a far less dramatic decline in deal activity relative to the underlying performance measures in the sector—and could even indicate deals will ramp up in the near future.

“I don’t think there could’ve been any sort of realistic expectations of what might’ve happened as a result of the pandemic,” the report’s author Anu Singh, managing director and leader of the mergers, acquisitions and partnerships practice, told Fierce Healthcare.

“I think there was a feeling that because of what this would do to financial performance and maybe the trajectory of the industry participants themselves, there was a thought this would perhaps significantly slow down transaction activity as well,” Singh said. “And, as the quarter played out, there was not a significant … drop in the level of activity.”

Deals in the second quarter included Steward Health Care’s acquisition by a group of affiliated physicians and Advocate Aurora Health proposed a merger with Beaumont Health. Lifespan and Care New England Health System in Rhode Island also resumed partnership talks.

“What we were, perhaps, a little surprised to see is there still was large scale transformational system partnership. There still was large portfolios of for-profit or hospital management companies looking to retool their portfolio,” Singh said. “There still was a need for community hospitals to look upwards to find the benefits of larger health systems.”

Overall, the report says, there were 14 deals in the second quarter, down from 19 deals in the same quarter a year earlier and down from 29 deals in the first quarter of 2020.

The report also found:

  • At more than $800 million, the second quarter had one of the highest figures for average size of seller by revenue ever recorded by Kaufman Hall. The historic high previous recorded in 2018 was $409 million.
  • Total transacted revenue for the quarter was just over $12 billion.
  • Nine of the 14 transactions were by for-profit hospital and health systems. None of the transactions in the last quarter were completed by academic medical centers or religiously affiliated health systems.

Impact of COVID-19

So what does the second quarter say about the potential future impact of the COVID-19 pandemic on deals? Singh wrote that while health systems paused their activities for a while, the pandemic may also have “strengthened their rationale” for partnering up in the first place.

Like leaders in many other sectors, healthcare leaders are reevaluating their business and may be examining their healthcare delivery models, Singh said.

The pandemic may have been a catalyst for more organizations to work together to serve patients, which could support reevaluation of the potential for future deals. As an example, Singh pointed in the report to Lifespan and Care New England, which had suspended talks for a potential deal in 2019 but restarted talks after the two systems began “working together in unprecedented ways,” in response to the crisis.

Finally, for-profit health systems have continued to reshape their portfolios over the quarter, with six of the 14 transactions representing divestitures by major for-profit health systems including Community Health Systems, Quorum and HCA.

“For many organizations, it’s going to serve as a reminder or a catalyst that there is safety in scale,” Singh said. “There is safety in being part of a large system that has more deployable resources and maybe more capabilities to deal with situations like that.”

 

Hospitals in new COVID-19 hot spots face delicate balancing act with elective surgeries

Posted on by • Posted in Access, Access & Quality of Healthcare, Coronavirus, Crisis, Crisis Management, Elective Procedures, Elective Surgery, Emergency Care, Health System, Hospital, Hospital Industry, Intensive Care (ICU), Pandemic, Personal Protective Equipment (PPE), Supply Chain • Leave a comment

https://www.fiercehealthcare.com/hospitals/hospitals-new-covid-19-hotspots-face-delicate-balancing-act-elective-surgeries?mkt_tok=eyJpIjoiT1RJMlpqWTNPREJtTmpGaSIsInQiOiJ0enNDdXU5R0ZEdUJmSE1GcXl5UHd4VjdcL1FQcWE3ckN2YmhLVUhnazNFNlhUOEdLQndTcnRnXC9TbWNzWDhZMW5KWEhtMUxJRDRFdG1uXC84NGVhTHZ5QklGK0Fyc2dadXVcL0phNWFaVGY1SGlVVzN6NFRxVlRLOE9mRmdHR2VmdDgifQ%3D%3D&mrkid=959610

Hospitals in new COVID-19 hot spots face delicate balancing act ...

Some hospital systems located in states that are seeing huge spikes of COVID-19 are continuing to perform elective procedures and developing strategies to avoid a total shutdown.

The experiences of hospitals in states such as Florida and Arizona could inform how systems will handle new surges of COVID-19 cases, especially if a second surge of the virus arrives in the fall. Hospitals have been reticent to shut down surgical procedures, which are pivotal to their bottom line and also impact patient care.

“We are not turning it all the way off,” said Marjorie Bessel, M.D., chief clinical officer for Banner Health, referring to elective procedures. “Our surgeries are needed and medically necessary and people need to have those surgeries done.”

The 28-hospital system has a large footprint in Arizona, which is experiencing a major spike in cases. Bessel said 45% of Arizona COVID-19 patients are in a Banner Health facility.

Like many states, Arizona’s governor required hospitals to shutter elective procedures to ensure there is enough capacity and personal protective equipment (PPE) for COVID-19 patients. The governor lifted the shutdown May 1, and Banner has slowly ramped up delayed or canceled elective procedures.

“We attempted to reduce the backlog of people who had been waiting or wait-listed,” Bessel told Fierce Healthcare. “We didn’t quite get back to full normal operations, but we got close.”

That progress has been hindered now as COVID-19 cases soar in the state.

But instead of doing a full shutdown, Banner is implementing a tiered and step-wise approach to surgeries.

“One of the things that we are going to try is to do surgeries for patients that don’t need an inpatient stay,” Bessel said. “We are gonna try that and see how that works for us.”

The system is also tightly monitoring the patients that need an intensive care unit stay after their surgery. Banner can transfer patients to other facilities to ensure it has enough capacity.

“We look at our [patient] census almost hourly throughout the day and the night and make these adjustments to best meet the needs of those in the community,” she said.

Tampa General Hospital in Florida resumed elective procedures back in early May and is still performing surgeries as COVID-19 cases rise. The hospital told Fierce Healthcare that it treats COVID-19 patients in a “negative-pressure unit that is separate from other areas of the hospital.”

The hospital has 81 of these rooms and 100 hospitals and has a surge plan to adjust capacity when necessary.

Another important factor for hospitals is to communicate with patients about what is going on. Tampa General, for instance, issued a release on when it is appropriate to go to the emergency room and outlined the procedures for screening patients of COVID-19 to assuage fears.

Hospitals’ own internal processes have also gotten better amid the COVID-19 pandemic.

“In the operating area, COVID-19 has made us more efficient,” said Michael Zinner, M.D., CEO of the Miami Cancer Institute, which is part of 11-hospital system Baptist Health South Florida. “It has taught us how to move things out of the general operating room into ambulatory and more efficient in the turnovers. It has taught us how to adapt.”

Some states could decide to shut down elective procedures again, which is a move Texas has decided to make in four counties in the state.

Getting and keeping enough PPE

One of the key reasons that states ordered hospitals to shut down surgeries was to preserve enough PPE for COVID-19 care.

But hospital systems say they are in a better place now in terms of PPE than they were at the onset of the pandemic, when a buying spree caused hospitals to fight among each other to get supplies.

“We are a heck of a lot better than we were two months ago,” Zinner said.

He added that Baptist Health even bought a stake in a domestic PPE manufacturer, a move Banner Health made as well.

“Besides the current spike, we were preparing for what we think will be a surge in the fall,” Zinner added.

Another important development for hospitals now is there are guidelines for how to reprocess PPE.

“We have found ways to reprocess some PPE safely so you can reuse it without losing efficacy and take it through a decontamination procedure,” said Michael Calderwood, M.D., an epidemiologist at Dartmouth-Hitchcock Medical Center in New Hampshire.

He pointed to using ultraviolet light and hydrogen peroxide as among methods facilities can use to reprocess their supplies.

The type of PPE that is used in surgeries is also sometimes different than the equipment used to treat COVID-19 patients, Bessel said.

“They use a procedural mask for most of the cases, while the masks in shortage has been the N-95 respirators,” she said.