Volume 6
After a much-needed vacation, I’m back with the Top 10 things you need to know in healthcare. Below you will find information about COVID, monkeypox, extension of the Public Health Emergency, clinician gender-based wage gaps, and many other Big Deals in healthcare. Take a look!
1. New COVID Variant Evades Antibodies
The BA.5 COVID variant is now the dominant strain in the United States (82% of cases). Case numbers and hospitalizations are ticking up and one reason is that BA.5 not only seems to evade protection from vaccines, but even from prior infection from other omicron variants. While antibodies from vaccination and prior sickness still seem to protect against severe illness, having COVID even recently might not keep you from coming up with a positive test.
So what’s the big deal? COVID continues to evolve rapidly and with each new variant, the virus proves to be more virulent (or transmissible) and evades prior immunity. While vaccines continue to prevent severe illness and death in many as a percentage of all cases, because the virus is so transmissible the absolute number of hospitalizations and deaths are rising.
So what’s next? Public health officials, businesses and hospitals will need to reinstate mitigation efforts like masking and boosters as cases and hospitalizations rise.
2. When It Comes To COVID, Try To See Into The Crystal Ball
As COVID-19 continues to mutate virologists are working overtime to predict what could happen next. While these scientists admit their crystal ball will not be perfect, the data available grows by the day.
So what’s the big deal? Same as above. The virus is getting more aggressive, not less. Clinicians and public health officials must try to turn the tide against complacency.
So what now?: While many have moved on from the pandemic (at least psychologically), the pandemic is very much a part of our lives. As variants evolve, we will need to follow the virology closely to pivot if necessary to more aggressive mitigation plans.
3. Inflation Hits Hospitals
Supply chain challenges, skyrocketing inflation, and labor shortages are hurting everyone, even American hospitals. Total hospital expenses increased 10.7 percent from May 2021 to May 2022, largely due to inflation and labor costs. Operating revenue was up just 7.6 percent year-over-year.
So what’s the big deal? Skyrocketing costs of labor, Medicare payment cuts, inflation, and supply chain woes further threaten hospital revenues, especially those in challenging, rural markets. Higher costs could further erode access to care and burden patients with higher bills.
So what now? We need to watch this space closely. Many hospitals (especially rural ones) are shuttering, leaving communities affected and patients without access to care. The pace of rural hospital closures slowed a bit because of federal COVID aid. As Congress fights about COVID funding, lawmakers would do well to remember that fact. BipartisanPolicy
4. In New York City, Monkeypox Response Echoes Early COVID Experience
Two-and-a-half years ago, New York City was the epicenter of COVID-19 cases. The city now leads the nation in diagnosed cases of monkeypox. As The New York Times reports, like it was in March 2020, hospitals and clinicians are struggling to keep up and patients are suffering as a result.
So what’s the big deal? Two things here. One, monkeypox continues to rise and doesn’t appear to be slowing. Two, monkeypox (like COVID) is demonstrating our public health system is woefully unprepared to deal with infectious public health threats despite millions of lives lost or alerted by COVID. A lack of vaccines, treatments, information and testing appear to be the rule instead of the exception.
So what’s next? Get vaccinated against Monkeypox when available.
5. Budget Reconciliation Could Improve Health Care Affordability
Sen. Joe Manchin (D-W.Va.) said no to most of the White House’s Build Back Better plan. Democrats’ reconciliation package will not address climate change or housing but it will have big implications for health care. At a time when Americans need relief, it could help more people get the care they need.
So what’s the big deal? The Senate appears likely to pass a reconciliation package that will extend ACA subsidies and allow Medicare to negotiate prescription drug prices. If passed, these subsidies would extend healthcare insurance coverage for nearly 14 million people. Without the subsidies, most of the patients would not be able to afford insurance. The prescription drug plan is an important signal but relatively small with only 10 drugs being a part of the initial negotiations. Irrespective, that could save numerous patients money.
So what now? Wait and see. The bill will need to be reviewed by the Senate parliamentarian to determine if the bill can be passed with a simple majority. With a 50/50 Senate, the ruling from the parliamentarian will be key. The bigger news may be, however, that this bill is all the Democrats will get for their healthcare agenda.
6. The Gender Pay Gap In Medicine Is Real
A new study in the Annals of American Medicine examined how primary care physician (PCP) compensation by gender differs when applying existing productivity-based and alternative compensation models. Under a productivity-based payment formula, female PCPs earned a median of $58,829, or an incredible 21% less than male PCPs.
So what’s the big deal? Women have continued to face significant disparities with wage gaps in medicine under fee for service and/or productivity based models. As new payment models are considered, gender wage disparities will likely continue and potentially worsen.
So what next? Practice management groups, administrators, and public officials must consider the wage gap and make appropriate adjustments to ensure parity in pay.
7. Doctors Who Perform Abortions Are Criminals?
The U.S. Supreme Court overturned Roe v. Wade in June and the ruling is now final. As National Public Radio explained, the decision did not say much about clinicians, but since the moment the ruling came down, American health care providers have been affected. In fact, Mary Ziegler, a law professor at the University of California, Davis, said that since the Dobbs decision treats abortion as a crime, it will lead to "the criminalization of doctors."
So what’s the big deal? The patchwork of state abortion laws continue to place physicians in a precarious position for possible criminal prosecution if the state deems a medical advisement or act supporting the state’s definition of abortion. Some of the new laws have criminalized (or threatened) physicians who provide treatment for ectopic pregnancies, miscarriage treatment, or even IUDs and Plan B. healthcare dive
So what’s next? Medical groups and physicians who treat pregnant patients or possibly pregnant patients should work closely with hospital administration and attorneys to develop treatment protocols now.
8. Consumers Can Now Figure Out The Cost Of Health Care
As part of new federal regulation, as of July 1, insurers must list their negotiated rates with in-network health care providers and out-of-network allowed amounts and billed charges for certain items and services. Insurers who don't release this information will face a penalty of $100 per person per day per violation.
So what’s the big deal? Consumers now have access to the cost of negotiated rates with hospitals and insurance companies for healthcare services. The implications could be huge. Will this create competition between insurance companies for pricing strategies? Will employers use this information to negotiate and/or choose different plans?
So next steps? In reality, we are a long way off from fully seeing how transparency will affect consumer behavior. With significant data and technology requirements, realizing full price transparency to drive consumer behavior may be challenging.
9. COVID-19 Public Health Emergency Extended
On July 15, U.S. Department of Health and Human Services Secretary Xavier Becerra renewed the federal government’s public health emergency (PHE) declaration for COVID-19 until October 13, 2022. The PHE has been in place since January 2020. The declaration provides capabilities and flexibilities to hospitals to better care for patients.
So what’s the big deal? The PHE extension continues multiple provisions like telehealth waivers, HIPAA waivers, ACA subsidy protections among other important benefits to care for patients during the continued public health crisis.
So what now? HHS has said they will notify stakeholders of a cancellation of the PHE with 60 days notice. It’s likely the PHE will continue through the end of the year; however, stakeholders should prepare now for a pre-pandemic healthcare environment. This preparation should include reimbursement changes, workflow changes (i.e. with telehealth), and millions could lose health insurance. KFF report
10. Federal Government Establishes New 3-Digit Hotline For Mental Health Emergencies
In 2020, Congress approved legislation establishing that the 988 dialing code should be used for mental health-related emergencies. The line went live this month. Now, by dialing 988 individuals will have 24/7 access to trained crisis counselors who can help people experiencing mental health-related distress such as thoughts of suicide, a substance use crisis, or any other kinds of emotional distress.
So what’s the big deal? 988 offers 24/7 trained counselors to talk with people who have suicidal ideations, mental health crises, substance abuse crises or any other emotional crisis. This new hotline focuses the appropriate resources to patients in times of need.
So what now? The message must be spread far and wide that 988 is the new 911 for mental health crisis conditions. People can call or text 988 or chat via 988lifeline.org to connect with a counselor.
Thanks for reading the Top 10 Big Deals in Healthcare!
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Have a wonderful rest of the week!
-Dr. N. Adam Brown
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