Inflation Cools
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The Bureau of Labor Statistics (here) reports that the year-over-year rate of inflation was 4%. For medical and health services, “The medical care index increased 0.1 percent in May, after being unchanged the previous month. The index for hospital services rose 1.0 percent over the month, after a 0.5-percent increase in April. The prescription drugs index increased 0.1 percent in May, while the physicians' services index declined 0.5 percent.” Fitch reports (here) that “the 2023 average hourly earnings growth of 4.7 percent still outpaces the 2.4 percent average increase in hourly pay for healthcare workers from 2010 to 2019.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
Who Is An Independent Contractor?
The National Labor Relations Board (decision here) has again modified the basis for determining who is an independent contractor under the National Labor Relations Act.
The Board found that the makeup artists, wig artists, and hairstylists who work at the Atlanta Opera, who had filed an election petition with the Board seeking union representation, are not independent contractors, excluded from the Act, but rather are covered employees.
The Board expressly rejected the holding that “entrepreneurial opportunity” for gain or loss should be the “animating principle” of the independent-contractor test. Rather reliance will be placed on traditional common-law factors, often of import in determining whether health care professionals and support staff are independent, or employed.
Residents in Unions at Mass General Brigham
Residents and Fellows at Mass General Brigham voted 3-1 to unionize. WBUR News (here) reported that “It's the latest in a string of victories for the Committee of Interns and Residents, an affiliate of the Service Employees International Union (SEIU), which has been adding members at hospitals across the country.”
“The new bargaining unit will represent about 2,500 resident physicians and fellows across several of the system's hospitals, including Mass General, Brigham and Women’s, Faulkner, Newton-Wellesley, Salem, McLean, Spaulding and Mass Eye and Ear.”
“The Committee of Interns and Residents represents 27,500 doctors in training across the country, and it’s growing rapidly — by more than 10,000 members in the past two years. Over the past year, nine residency programs with a total of more than 7,000 residents and fellows joined the union. They include Montefiore Medical Center, Stanford Health Care, George Washington University and University of Pennsylvania.”
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Telehealth Outpatient Therapy, a Pandemic Hold-Over
CMS has announced (here) that, until the end of the year, hospitals can bill for outpatient physical therapy (PT), occupational therapy (OT), speech-language pathology (SLP) services, Diabetes Self-Management Training (DSMT), or Medical Nutrition Therapy (MNT) provided at home to beneficiaries through telecommunication technology by hospital-employed staff.
The Hospital Without Walls Initiative, which allowed hospitals to bill for services furnished by hospital-based staff to beneficiaries in their homes using telecommunications technology, has ended, but in some circumstances, hospitals will permanently be allowed to continue to bill for mental and behavioral health services provided in patients' homes through telecommunications technology.
Not the Picture You Want on Capitol Hill
The Hill schedules a discussion on "Profit Over Patients: How the Big Business of Hospitals Harms Consumers," followed by a film screening of "InHospitable," which examines "how the profit-seeking practices at one hospital impacted an entire community.” Contact: 202-407-8010 events@thehill.com. Note: The documentary will be released in select theaters on September 30.
Minority Group Patients in Top Hospitals Still Receive Inferior Care
The Leapfrog Group and the Urban Institute report (Modern Healthcare, here) that “Black and Latino patients were more likely to experience adverse safety events than white patients at any hospital, regardless of whether the facility earned an "A" on safety or an "F."
“Across all hospitals, Black and Latino patients experienced 34% higher rates of sepsis after surgery than white patients, and Black patients experienced 51% higher rates of dangerous blood clots as surgery-related complications, the research found.”
Discharges “Clogged,” 1000-1200 Patients Stranded in Massachusetts Hospitals Every Day
Discharge of patients from acute general hospitals is backed up due to shortages in aftercare, long term and home care resources, according to a study from the Massachusetts Health & Hospital Association (here, Boston Globe report here, other news reports here, here, press release from MHHA here). “The majority of those people are waiting for a nursing home that can take them. In other cases, patients are waiting to continue their recovery at a rehabilitation center, or waiting to confirm in-home care.”
Hospital Bills Confuse and Compromise Older Patients
The Consumer Financial Protection Bureau (CFPB) reports (here) that “In 2020, nearly four million adults ages 65 and older reported having unpaid medical bills, even though 98 percent of them had health insurance coverage. Nearly 70 percent of these older adults with unpaid medical bills also reported having medical insurance coverage from two or more sources.”
Also, “The reported amount of unpaid medical bills among older adults increased by 20 percent between 2019 and 2020, from $44.8 billion to $53.8 billion. Yet older adults reported fewer doctor visits and lower out-of-pocket expenses in 2020 than in 2019. Older adults face a complex billing system with a high likelihood of errors and inaccurate bills. Complaints submitted to the CFPB involving Medicare commonly cite inaccurate billing as a source of unpaid medical bills in collections. Consumers who reported having multiple sources of insurance were especially likely to note problems with inaccurate billing.”
MEDICARE, MEDICAID, AND COMMERCIAL HEALTH INSURANCE
Post-Partum Medicaid and CHIP Coverage
New York is the 35th state to increase comprehensive health coverage to 12 months after pregnancy. CMS announcement here.
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Notes to Fred Hyde, MD, JD, MBA, news@dcmedicalnews.org
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