Hospitals Expect Higher Revenue And Expansions

Wall Street Journal: Health Care CFOs Expand Investment Plans, Strategic Partnering
Surveyed finance leaders project hospital revenue to grow significantly this year as volumes rebound compared to 2020, when elective procedures were cancelled, and consumers avoided care. At the same time, however, many of the interviewed leaders predicted that volumes may not reach pre-pandemic levels in the next 1–2 years. In addition, they were worried that a volume shift toward virtual visits may lead to lower payment rates, resulting in reduced profitability. Executives also pointed to increases in costs stemming from a pandemic-induced focus on physician and employee engagement, as well as compensation, supply chain challenges, and other fixed expenses. As a result, health system CFOs projected only a slight improvement in margins in the next year. For health plans, surveyed CFOs predicted bottom line headwinds from lower premium increases, pent-up demand for elective surgeries, and rebate pressures. (11/10)

The Boston Globe: Immunity Is Waning Among Nursing Home Staff And Few Have Received COVID Boosters, State Data Show
Nursing home leaders, still catching their breath from vaccinating staff ahead of a mid-October deadline set by the state, are now facing another sobering reality. Immunity is waning among many of their staff, and few have received a booster. That’s prompted a renewed push for the shots in nursing homes, which were ravaged early on in the pandemic and account for at least one-quarter of the nation’s pandemic deaths. As of Oct. 24, only 27 percent of eligible staff in Massachusetts nursing homes had received the extra shot, according to state data. (11/10)

Modern Healthcare: Employers Expanded Telemedicine Coverage Amid Pandemic
Employers increased access to telemedicine during the COVID-19 pandemic this year, according to survey results published Wednesday. Ninety-five percent of businesses with 50 or more workers offered at least some telemedicine coverage, up from 85% last year, according to the Kaiser Family Foundation's annual survey on employer benefits. Nearly half of employers surveyed expect telemedicine will continue to be an important access point. (Hellman, 11/10)

Modern Healthcare: Health Insurers' 2021 Looking Like A Rerun Of Last Year
This year is looking to be very similar to last year for health insurance companies: Older patients continue to defer care, COVID-19 costs are a burden and record profits are the end result. Reality isn't matching expectations. Health insurance companies predicted a flood of patients who'd gotten sicker as they put off care during the first year of the pandemic would rush back. The assumption that medical expenses would rise was built into higher premiums for this year. But insurance companies guessed wrong and utilization remains depressed. (Devereaux and Tepper, 11/10)

Georgia Health News: Patient Safety Ratings For Georgia Hospitals Show Decline Since Spring 
About 20 percent of Georgia hospitals got an “A’’ group in the Leapfrog Group’s autumn patient safety ratings, released Wednesday. That’s a lower percentage than in the spring, when 31.6 percent earned the top grade. The safety grades come out twice a year. They are meant to provide safety information to consumers so they can make informed decisions about where to seek care. Hospitals that get high grades heavily promote those results to potential patients and clients. (Miller, 11/10)

Stat: How A Virtual Mentoring Program Brings Care Closer To Rural Patients
By the time Sanjeev Arora’s patient had trekked the 200 miles to his office to treat the illness destroying her liver, it was too late. What had kept her away before — a long waiting list and monthly travel for the intensive hepatitis C treatment she needed — was now no match for the deep belly pain that had begun to interfere with her day job. But the disease had progressed too far, and the woman passed away months later. (Brodwin, 11/11)

Modern Healthcare: 5 Steps USPSTF Advises You Take To Address Racism
While industry stakeholders have issued statements and commitments about combatting racism in healthcare, few have provided clear guidance on curtailing the effects of bigotry. In a JAMA Network report published this week, the U.S. Preventive Services Task Force detailed steps to stop medical racism and ways to abate its impact when discrimination does happen. (Devereaux, 11/9)

On legal matters —

Stat: Kaleo To Pay $12.7 Million To Settle Charges Over Overdose Antidote
Kaleo, a small and controversial company, agreed to pay $12.7 million to resolve allegations that it used gifts to persuade doctors to prescribe its high-priced Evzio opioid overdose antidote, which led U.S. health care programs to overpay for the treatment. The federal government maintained that, from March 2017 through April 2020, Kaleo directed doctors to send Evzio prescriptions to certain pharmacies. In turn, the pharmacies submitted false paperwork to insurers suggesting patients had previously tried or failed less expensive alternative treatments. Kaleo also allegedly knew pharmacies dispensed its medication but did not collect co-payments from patients. (Silverman, 11/10)

CNBC: Elizabeth Holmes Theranos Fraud Case: Government Will Rest Next Week
In a surprise announcement, the government said Wednesday that it would likely rest its case next week against former Theranos CEO Elizabeth Holmes in her criminal fraud trial. “It is likely that the government will rest next week,” Jeffrey Schenk, an assistant U.S. attorney, said adding that the government would not have enough witnesses to fill the week. (Khorram, 11/10)

Also —

Kaiser Health News: Rural Hospitals Weigh Keeping Obstetric Units
As rural hospitals struggle to stay financially stable, their leaders watch other small facilities close obstetrics units to cut costs. They face a no-win dilemma: Can we continue operating delivery units safely if there are few births? But if we close, do we risk the health and lives of babies and mothers? The other question this debate hangs on: How few is too few births? (Huff, 11/10)