DCMedical News: Wednesday, June 10, 2020
DCMedical News-DCMN
Washington, D.C.
Wednesday, June 10, 2020
DCMedical News is published every day both the House and the Senate are in session and on pre-pandemic Regularly Scheduled Session days (see CQ calendar, below).
THE BIG STORY IN HEALTH CARE
Coronavirus News: (reference pages below under Reading & References)
Tracking by Johns Hopkins shows on 6-9 at 8:00 p.m. EST worldwide 7,185,573 confirmed cases; 408,954 deaths worldwide; 111,751 U.S. deaths (27%). Statista reports graphically on cases by State, here; where the number of cases are growing most rapidly, here; and assessment of how each nation’s government has handled the pandemic, here.
COVID-19 and Society
Hospitals and Other Health Care Providers to See More of that $175 Billion in COVID-19 Bailout Money
CQ reports “The Trump administration announced Tuesday [HHS announcement here] how $25 billion from COVID-19 response legislation enacted this spring will begin to be distributed to eligible providers serving low-income patients during the pandemic. The announcement comes less than a week after leaders from health committees sent a rare bipartisan, bicameral letter to Health and Human Services Secretary Alex Azar criticizing the delay in distributing the funds.”
The first round of CARES funds was distributed based on a hospital’s prior year Medicare volume, while the second was distributed based on hospital net revenue. Both measures favored larger and generally better financed hospitals, and were also received by private equity funds (here and here). Spreadsheets here for “high impact” COVID-19 funds, $12 billion total; here for provider relief, $46 billion total; here for provider relief plus payroll protection, $63 billion.
Now “HHS will distribute $15 billion to providers that participate in Medicaid or the Children's Health Insurance Program and have not received payments from the provider relief fund. In addition, $10 billion of provider relief funds will start going to safety net hospitals this week.” A delay of at least two weeks in actually distributing funds is built in; an estimated one million providers may qualify. “Safety net hospitals will receive their allocation of $5 million to $50 million through direct deposit. To qualify, a hospital must have a Medicare Disproportionate Payment Percentage of 20.2 percent or greater, profitability of 3 percent or less, and a level of average uncompensated care per bed of $25,000 or more.”
A new edition of “Frequently Asked Questions” about CARES funds is here, in response to what the industry has observed as frequently changing rules for distribution of those funds.
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Screening for Drug Use Disorder, Primary Care Once More into the Breach
The U.S. Preventive Services Task Force has upgraded its recommendation for drug use disorder screening. Advice for primary care practitioners appears in this week’s JAMA Internal Medicine (here), recounting three fundamentals: “First, valid screening tests for drug use are available. Second, treatments for drug use disorders (DUDs) are effective. Third, counseling adult primary care patients whose drug use is identified by screening does not decrease drug use.”
Pharmacists Working in Larger Numbers in Hospitals, Smaller Numbers in Retail Outlets
Drug Channels (here) analyses the pharmacist market in 2019, finding “Total pharmacist employment grew in 2019. Consistent with our previous analyses, the share of pharmacists who work at hospitals reached a new high. However, the number of pharmacists working in retail settings decreased.”
600 Health Care Workers Have Died to Date in the Coronavirus Pandemic in the U.S.
The Kaiser Health Network found (here) that “The tally includes doctors, nurses and paramedics, as well as crucial health care support staff such as hospital janitors, administrators and nursing home workers, who have put their own lives at risk during the pandemic to help care for others.” KHN and The Guardian are maintaining a count.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
WSJ Reports on Study of Emergency Department Crowding Increasing Mortality
The Wall Street Journal (here) reported on a study by Lindsey Woodworth of the University of South Carolina in the Journal of Health Economics (here) which found “10% alleviation of emergency department patient volume significantly lowers the average patient’s chance of mortality. Improvements appear to be realized both inside the hospital and after the patient has left.”
Private Equity Financing Compromises Financial Health of Health Care Services
A study in the Journal of the American College of Radiology (here) explores the downside of private equity-backed health services, finding “This crisis [Coronavirus pandemic] coincides with a period of substantial growth in the corporatization of U.S. health care services over the past decade, which includes hospitals, clinics, urgent care facilities, as well as both primary and specialty care practices. The private equity investment model has significant known downside risk. The reliance on leveraged buyout financing puts firms at a higher risk of downstream bankruptcy . . . the model of P.E. financing has amplified the risks of the current COVID-19 crisis, which has already led to salary cuts, layoffs, and bankruptcies across the healthcare industry.”
READINGS & REFERENCES
“Rethinking the Hospital for the Next Pandemic,” Wall Street Journal, here.
“Deep Partisan Divide on Coronavirus,” polling from the Kaiser Family Foundation, here.
Coronavirus Public Health Resources and References (alphabetical):
Association of American Medical Colleges Clinical Guidance Repository, here.
AMA resource page for physicians here. AMA guide to medical education and COVID-19, here.
American Public Health Association information here.
CDC information page here.
CMS (Centers for Medicare & Medicaid Services) Current Emergencies website, here.
Council of State Governments, here.
JAMA Network’s COVID-19 resource center here.
Library of Congress Coronavirus Research Guide, (here) from the In Custodia Legis blog of the Library of Congress (LoC), with links to Congressional Research Service (CRS) reports.
NIH information page here.
National Library of Medicine Coronavirus page here,
New England Journal of Medicine update here, New England Journal of Medicine Journal Watch here.
The Lancet COVID-19 Resource Centre here and real-time dashboard to monitor clinical trials, here.
The New York Times Coronavirus coverage, here.
State actions, Kaiser Family Foundation, here.
UC Hastings College of Law’s “The Source” (on health care prices and competition) COVID-19 page, here.
The White House open research dataset (CORD-19) here.
World Health Organization COVID-19 page here.
U.S. House of Representatives:
Members at https://www.house.gov/representatives
Committees and Members at https://www.house.gov/committees
U. S. Senate:
Committees and Members at https://www.senate.gov/committees
CQ 2020 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
June 11, 12, 15, 16, 17, 18, 23, 24, 25, 26
July 21, 22, 23, 24, 27, 28, 29, 30, 31
August, none
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.