About healthcare quality
Medicare and Medicaid Programs; Application From the Joint Commission for Continued Approval of its Hospital Accreditation Program: CMS had granted The Joint Commission (TJC) approvals for six years at a time to certify hospitals for Medicare and Medicaid participation. CMS is now shortening it to two year periods. Here is the summary statement explaining why the change is occurring:
“… we [CMS] approve TJC as a national accreditation organization for hospitals that request participation in the Medicare program. The decision announced in this final notice is effective July 15, 2020 through July 15, 2022 (2 years). In accordance with § 488.5(e)(2)(i) the term of the approval will not exceed 6 years. This shorter term of approval is based on our concerns related to the comparability of TJC's survey processes to those of CMS, as well as what CMS has observed of TJC's performance on the survey observation. Some of these concerns stem from the level of detail TJC provides in the daily briefings it provides to facilities, as well as TJC's processes surrounding its staff interview practices. Additionally, we are concerned about TJC's review of medical records and surveying off-site locations, in particular for the Physical Environment condition of participation.”
About hospitals and health systems
Appeals court rules HHS has authority to implement site-neutral payments, dealing blow to hospitals: This ruling (which will undoubtedly be appealed) could have the largest impact on hospital finances of this generation. “A federal appeals court ruled the Department of Health and Human Services has the authority to cut Medicare payments to off-campus clinics to bring them in line with independent physician practices, reversing a lower court’s decision.”
Hospitals overbilled Medicare $1B by upcoding claims, inspector general finds:”Hospitals overbilled Medicare $1 billion by incorrectly assigning severe malnutrition diagnosis codes to inpatient hospital claims, according to a report from HHS' Office of Inspector General.
The inspector general did the review after previous claims audits found that hospitals had incorrectly billed Medicare by using several malnutrition diagnosis codes when they should have used codes for other forms of malnutrition or not used a malnutrition code at all.”
Virginia Mason in acquisition talks with CommonSpirit's CHI Franciscan: “Thursday, the two health systems announced they signed an agreement to explore combining through the formation of a joint operating company.”
Not-for-Profit [NFP] Hospital Medians Improved Prior to Coronavirus: From Fitch: “Audited data show that the sector had stabilized after a period of prior operational softness, with improvements first seen in our 2019 medians (2018 audited data). The 2020 medians are expected to show operating margin expansion driven by higher revenues and targeted cost reductions along with improvement in liquidity and debt service ratios due in part to a favorable investment market in 2019 and increased cash flow….The NFP healthcare sector is unlikely to stabilize until an effective coronavirus vaccine is widely available…”
About the public’s health
July 2020 update: scientific terminology of Covid-19: From the Oxford English Dictionary [OED]. This article is an excellent source of definitions about COVID-19 related terms. For example: “While the official name for the disease caused by the coronavirus Sars-CoV-2 is Covid-19, the terms Covid, C-19, CV-19, CV, and corona are also used to refer to the virus and the disease.” COVID-19 (all caps) has also become an acceptable designation for the illness.
Reconstruction of the full transmission dynamics of COVID-19 in Wuhan: This article provides a model for when it is safe to “open up” after cases of COVID-19 start to decline. The important variable is how many undetected cases exist in the population. Re-opening 2 weeks after a decline in detection of new cases could result in another wave if the undetected numbers are not low enough. We therefore need universal testing to determine re-opening times.
U.S. infant mortality rate hits all-time low, CDC reports: Finally, some good news. Infant mortality has reached an all-time low in the United States, according to data released Thursday by the U.S. Centers for Disease Control and Prevention.
In 2018, 21,498 infant deaths were reported across the country, a decline of 4% from the 22,341 deaths reported in 2017, the agency's analysis said.”
U.S. prepares push to reduce 'unnecessary' COVID-19 testing: official:”Details of the guidance are still being hammered out but it would be aimed partly at discouraging COVID-19 patients who have completed home quarantine from getting retested before returning to work or school, said Brett Giroir, assistant secretary for health at the U.S. Department of Health and Human Services.
Speaking on a call with reporters, he said such unnecessary tests were ‘clogging up the system.’”
Covid-19 Infections on the Rise in Kids and Teens With School Approaching:”In response to questions from Bloomberg, the CDC cited a chart, updated today, with data from the states showing children make up 6.4% of those infected, though information isn’t included on almost 1 million cases. The numbers are rising, epidemiologists say, as testing has become more available to those with mild or no symptoms, encompassing many of the pediatric cases, and as those under 18 are increasingly involved in social activities.”
Working memory [WM] capacity predicts individual differences in social-distancing compliance during the COVID-19 pandemic in the United States:”We found that participants’ social-distancing compliance at this initial stage could be predicted by individual differences in WM capacity, partly due to increased awareness of benefits over costs of social distancing among higher WM capacity individuals. Critically, the unique contribution of WM capacity to the individual differences in social-distancing compliance could not be explained by other psychological and socioeconomic factors (e.g., moods, personality, education, and income levels).Furthermore, the critical role of WM capacity in social-distancing compliance can be generalized to the compliance with another set of rules for social interactions, namely the fairness norm, in Western cultures. Collectively, our data reveal contributions of a core cognitive process underlying social-distancing compliance during the early stage of the COVID-19 pandemic, highlighting a potential cognitive venue for developing strategies to mitigate a public health crisis.”
CVS, Walmart lead retailers adding requirements for face masks in all stores: “Walmart, including its Sam's Club stores, and CVS Pharmacy announced this week that they would both institute the mask policies. The two companies are likely set a trend in the retail and pharmacy industries, and several other chains followed in Walmart's footsteps, including grocery chain Kroger and retail giant Kohl's.”
Cigarette Use Before and After the 2009 Flavored Cigarette Ban:”Findings support the effectiveness of flavored cigarette bans at reducing cigarette use among young people and suggest a substitution effect between flavored tobacco products.”
Deep immune profiling of COVID-19 patients reveals distinct immunotypes with therapeutic implications: Not everyone’s immune systems reacts the same to COVID-19. “These analyses identified three ‘immunotypes’ associated with poor clinical trajectories versus improving health. These immunotypes may have implications for the design of therapeutics and vaccines for COVID-19.”
About pharma
Hydroxychloroquine in Nonhospitalized Adults With Early COVID-19: Recent studies focus on hospitalized patients. This study concluded: “Hydroxychloroquine did not substantially reduce symptom severity in outpatients with early, mild COVID-19.”
About health insurance
Use of Health Savings Accounts Among US Adults Enrolled in High-Deductible Health Plans: “These findings suggest that many US adults enrolled in an HDHP lack an HSA, and few with an HSA saved for health care in the last year. Targeted interventions should be explored by employers, health plans, and health systems to encourage HSA uptake and contributions among individuals who could benefit from their use.”
About healthcare IT
Early Impact Of CMS Expansion Of Medicare Telehealth During COVID-19: CMS has relaxed and expanded terms for telemedicine use and reimbursement during the COVID-19 pandemic. CMS administrator Varma discusses these changes and what will likely become permanent. Particular attention needs be paid to providing such services when an in-person visit is possible and the terms of payment.
Federal COVID-19 data-reporting change leaves states scrambling to adjust: “The Missouri Hospital Association is among several state-based organizations working to develop new COVID-19 data-reporting methods and dashboards after the federal government changed its requirements….
While the CDC director and HHS CIO said in a joint media briefing that state public health officials will still have access to the data reported to HHS, they did not say whether the information would still be publicly posted.”
Dave Dillon, a spokesperson for the Missouri Hospital Association said the group “does not have access to the new HHS system, and the system is different from the CDC's.” Maine and Idaho are in the same situation.