No direct patient care positions will be eliminated. The job cuts represent 0.6% of the health system's 41,000 employees.
Intermountain Healthcare announced Tuesday that it will trim 250 administrative positions from its 41,000-member work force in three states to lower overhead and reduce patients' medical bills.
"Intermountain is implementing these changes and some internal reorganization to help keep healthcare more affordable now and in the future," the Salt Lake City-based health system said in a media release. "Reducing overhead costs and improving efficiencies with administrative and business functions allows the system to preserve patient care positions."
When contacted, Intermountain officials declined to specify how much money the job cuts were projected to save, or how much of those overhead reductions were expected to reduce patients' costs. The 250 job cuts represent 0.6% of Intermountain's 41,000-member workforce in Utah, Idaho, and Nevada.
To get the 250 voluntary buyouts, Intermountain is offering voluntary buyouts for 750 employees in its "centralized business functions," ages 55 or older with 10 years or more at the health system. The buyouts will include additional pay and health benefits depending on length of service. Employees will have two weeks to choose whether to accept the buyout.
In addition to the buyouts, Intermountain is replacing only open positions that are critical for care delivery. There are now 50 open administrative positions that will not be filled.
"If the combination of voluntary separation and ongoing attrition does not reach the goal of reducing 250 business positions, Intermountain will use involuntary reductions," Intermountain said.
More than half (57%) people age 18-34 who were hospitalized for COVID-19 were Black or Hispanic.
Younger people hospitalized with COVID-19 have a one-in-five chance (21%) of ending up in the intensive care unit, according to a research letter published in JAMA Internal Medicine.
In addition, 10% of patients age 18-34 required mechanical ventilation and 2.7% died. By comparison, the death rate of those in the same age group hospitalized with heart attacks is half of that figure. The researchers also found that 57% of young people hospitalized for COVID-19 were Black or Hispanic.
"There was a significant rate of adverse outcomes," said study first author Jonathan Cunningham, MD, a Cardiovascular Medicine fellow at the Brigham. "Even though a 2.7% death rate is lower than for older patients, it's high for young people who typically do well even when hospitalized for other conditions."
The Brigham and Women's Hospital researchers used the Premier Healthcare Database to look at clinical records from 419 hospitals that treated 3,222 hospitalized COVID-19 patients aged 18-34.
Patients with cardiovascular risk factors represented 37% of the young people hospitalized, while 24.5% of patients had obesity and morbid obesity, 18.2% had diabetes and 16% had hypertension.
Patients with these comorbidities were also more likely to suffer adverse outcomes. For example, patients with morbid obesity comprised 41% of the hospitalized young adults who died or required mechanical ventilation.
For individuals with more than one of these conditions, risks for adverse outcomes were comparable to the risks faced by middle-aged adults, aged 35-64, who had none of these conditions, as observed in a study of 8,862 members of this population, the letter said.
The researchers stress that the dataset, which relies on hospital administrative claims, only lends insight into the adverse outcomes of hospitalized young people.
"We know nothing about the total denominator of patients who got an infection," said corresponding author Scott Solomon, MD, director of noninvasive cardiology in the Division of Cardiovascular Medicine at the Brigham.
"We think the vast majority of people in this age range have self-limited disease and don't require hospitalization. But if you do, the risks are really substantial," he said.
When the deal is finalized, Paladina will operate 350 clinics as the nation's second-largest direct primary care provider.
Direct primary care provider Paladina Health announced on Monday that it will acquire Healthstat, a provider for employer-sponsored health centers.
Financial terms of the acquisition were not disclosed.
Denver-based Paladina operates 120 clinics in the Midwest and Western U.S. Heathstat, based in Charlott, N.C., will add more than 230 clinics in 13 additional states, including in the Southeast where Paladina does not have a presence.
When the deal is finalized, Paladina will operate 350 clinics as the nation's second-largest direct primary care provider.
"Paladina Health and Healthstat share a common mission and vision to transform healthcare in America, and this integration expands our reach, scale and expertise to pursue our commitment on a truly national level," Paladina CEO Chris Miller said in a media release.
"Both organizations have innovative, data-driven, patient-centric care models that are proven to reduce employer costs while improving health outcomes and employee satisfaction. Combining our companies makes both of us stronger and represents a huge step forward in fixing America's broken healthcare delivery model," Miller said.
The venture capital firm New Enterprise Associates is the primary backer for Paladina, and NEA General Partner Mohamad Makhzoumi said the "strategic acquisition enables Paladina Health to accelerate growth into new markets and further scale its operations across the country."
"With the added expertise, services and partnerships that Healthstat brings to the table, Paladina Health will be able to meaningfully amplify its impact with members and employers alike," Makhzoumi said.
The pay hike is projected to cost the health system $6 million a year, as part of a multi-phase 2020-2021 compensation plan for all employees.
More than 3,000 frontline, fulltime, parttime and contingent workers at Henry Ford Health System will get a "living wage" pay raise of $15 an hour starting on Monday, the Detroit-based health system announced Friday.
"There is a strong association between financial health and security and overall health, a reality that has been driven home over the last eight months for our team members who are on the front lines of the fight against COVID-19,'" Wright Lassiter, III, President and CEO, Henry Ford Health System, said in a media release.
"We are passionate about the need to do this and are thrilled to be able to make it happen, especially now," he said.
The minimum wage in Michigan is $9.65 an hour but will increase to $9.87 an hour in 2021.
For a 40-hour work week, $15 an hour amounts to more than $31,000 annually, which represents a 55% increase over the $20,000 annual earnings of minimum wage employees in Michigan.
The pay hike is projected to cost the six-hospital health system about $6 million a year. It's part of a multi-phase 2020-2021 compensation plan for all employees, including a general increase in the fourth quarter of 2020, and market adjustments for other positions.
Henry Ford had planned to provide the pay raises earlier this year until the coronavirus pandemic shut down much of the health system's elective and nonurgent services, resulting in layoffs for more than 2,800 employees in April, most of whom have since been brought back.
Employees in more than 100 job descriptions will get the raise, including janitors, maids, nurse assistants, food service workers, health screeners and clinic services reps, about 400 of whom are unionized.
Wake Forest Baptist Health and Wake Forest School of Medicine will become the academic core of Atrium Health.
Atrium Health on Friday finalized its acquisition of Wake Forest Baptist Health, creating an expanded 42-hospital health system with a footprint in four states.
Under the acquisition, first announced in April 2019, Wake Forest Baptist Health and Wake Forest School of Medicine will become the academic core of Atrium Health, which will build a medicine school in Charlotte, now the largest city in the nation without a 4-year medical school.
"As the healthcare field goes through the most transformative period in our lifetime, in addition to a new medical school, our vision is to build a 'Silicon Valley' for healthcare innovation spanning from Winston-Salem to Charlotte," said Eugene A. Woods, president and CEO of Atrium Health.
"Everything we do will be focused on life changing care, for all, in urban and rural communities alike. And we will create jobs that provide inclusive opportunities to enhance the economic vitality of our entire region," he said.
The merger comes just days after rival Novant Health gained approval from county commissioners in Wilmington, N.C., for the $1.5 billion acquisition of county-owned New Hanover Regional Medical Center.
Providers will begin repaying the $106 billion in advanced Medicare payments next spring.
Medicare providers will be given more time to pay back theAccelerated and Advance Payment Program funds they received during the coronavirus Public Health Emergency, the Centers for Medicare & Medicaid Services announced Thursday.
Under the original terms of the loans, providers were required to make payments starting in August. Now, the repayment will be delayed until one year after the AAP was received, CMS said.
Under thenew repayment terms, after the first year, Medicare will automatically recoup 25% of Medicare payments otherwise owed to the provider or supplier for eleven months. At the end of the 11 months, recoupment will increase to 50% for six months.
If a provider of medical supplier is unable to repay the total amount of the loan during the 29-month timeframe, CMS will slap a 4% interest penalty on outstanding balances.
The new repayment terms were authorized by the Continuing Appropriations Act, 2021 and Other Extensions Act, which was passed last week by Congress and funds the federal government through December 11.
CMS is also offering guidance on how to request an Extended Repayment Schedule (ERS) that allows providers or suppliers to pay debts over to five years in the case of extreme hardship.
CMS Administrator Seema Verma called the $106 billion in advance payments the federal government made to providers during the pandemic "a lifeline to help keep them afloat" as patient volumes, and non-urgent and elective procedures tanked and revenues dried up.
"CMS' advanced payments were loans given to providers and suppliers to avoid having to close their doors and potentially causing a disruption in service for seniors," Verma said. "While we are seeing patients return to hospitals and doctors providing care we are not yet back to normal."
CMS expanded the AAP on March 28 and paid more than 22,000 Part A providers, totaling more than $98 billion in accelerated payments. This included payments to Part A providers for Part B items and services they furnished.
In addition, more than 28,000 Part B suppliers, including doctors, non-physician practitioners, and Durable Medical Equipment suppliers, received advance payments totaling more than $8.5 billion.
Workers this year contributed an average of $5,588 to the cost of family coverage, with employers paying the rest, and that the average annual premium for single coverage rose 4%, to $7,470, according to the survey, which polled 1,765 public and private companies from January to July.
"Conducted partly before the pandemic, our survey shows the burden of health costs on workers remains high, though not getting dramatically worse," Kaiser Family Foundation President and CEO Drew Altman said in a media release.
"Things may look different moving forward as employers grapple with the economic and health upheaval sparked by the pandemic," Altman said.
Employer-sponsored health insurance covers about 157 million nonelderly people and is the largest source of health insurance in the United States.
Annual premium growth continues to outpace the year-to-year wage growth (3.4%) and is close to double the rate of inflation (2.1%), as measured by the Gross Domestic Product.
Since 2010, average family premiums have increased 55%, at least twice as fast as wages (27%) and inflation (19%), KFF said.
More than 8-in-10 covered employees (83%) have a deductible in their plan, up from 70% a decade ago. The average single deductible stands at $1,644, slightly down from last year's $1,655 average but up sharply from the $917 average of a decade ago.
These two trends result in a 111% increase in the burden of deductibles across all covered workers, KFF said.
Despite the dramatic cost growth and skimpier coverage, 83% of employers said they are satisfied with the choice of providers in their insurance plans, though 67% said the same about their mental health and substance abuse networks.
About 19% describe their mental health networks as somewhat or very narrow, potentially leaving workers with limited options at a time when worry and stress related to the pandemic is affecting many working Americans.
As the coronavirus pandemic enters its seventh month, a survey finds deteriorating mental health and rising stress among 96% of low-income residents.
Nearly one-third (31%) of Californians have delayed urgent or emergency care during the COVID-19 pandemic, and 36% of those with low incomes say their mental health has gotten "worse" or "a lot worse," according to a new survey.
The survey, conducted by the California Health Care Foundation and NORC at the University of Chicago – found that 96% of low-income Californians are struggling with the stresses of COVID-19 — including access to food, rent, and childcare.
"This has been a tumultuous year for all Californians, and we're seeing some serious warning signs about the toll it may be taking on the public's health," said Carlina Hansen, senior program officer on CHCF's Improving Access team.
"It is becoming increasingly clear how many vulnerable populations are delaying the healthcare they need — with consequences that should concern us all," Hansen said.
Seven million Californians — 18% of the state's residents — live in poverty.
"Large numbers of Californians with low incomes especially are under serious stress, whether due to declining incomes or concern about their loved ones' health," Hansen said.
The survey respondents reported nearly equal levels of worry about getting the coronavirus (41%) and suffering the pandemic's economic impacts (37%). The survey was conducted between June 24 and August 21.
More than two-thirds (65%) of respondents with low incomes and 76% of respondents of color who accessed healthcare during the pandemic said they used a phone or video telehealth visit.
Most (71%) called it a positive experience and like the option for phone or video visits, and 63% said they would pick a phone or video visit over an in-person visit when possible.
The survey also identified racism as a public health issue for many people of color, irrespective of the pandemic.
Nearly 7 in 10 Black respondents (69%) said they've experienced discrimination or unfair treatment because of their race or ethnicity, and 31% of people of color said their mental health was "worse" or "a lot worse" as a result of racial discrimination.
The survey, conducted between June 24 and August 21, polled 2,249 adults at various income levels about their health concerns, experience, and access prior to and during the pandemic.
The sample was disproportionately representative of low-income Californians, and respondents were limited to those who accessed care since March 2019."This is impacting everything from mental health to other health issues," Hansen said. "Even in the midst of the pandemic, this survey highlights the next health crisis brewing among some of the state's most vulnerable groups."
The Joint Commission's new Quick Safety advisory weighs in on virtual care during the COVID-19 pandemic
A new Quick Safety advisory issued this week by The Joint Commission offers providers tips to ensure the safe and efficient use of telehealth services during the coronavirus pandemic.
Telehealth has proven to be particularly effective during the pandemic because it promotes social distancing, allows for remote monitoring of COVID-19 patients, reduces the need for personal protective equipment, and helps access care for patients with transportation barriers.
"Telehealth has provided a safe option for many high-risk patients during COVID-19 by allowing them to seek medical care while avoiding unnecessary exposure to the pandemic," said Christina Cordero, project director, Department of Standards and Survey Methods, The Joint Commission.
Still, The Joint Commission notes that barriers to effective telehealth care delivery remain, particularly for patients who aren’t technologically savvy or who have connectivity issues.
Cordero offered these four tips to help providers improve telehealth services during the public health emergency.
Establish metrics for success, such as the number of patients seen via telehealth, reductions in no-shows and clinical outcomes, and make sure your telehealth vendor can provide easy access to data that supports the metrics.
Develop protocols for virtual care and determine standards for the specific symptoms and conditions that can be managed virtually.
Train staff on the telehealth workflow, define roles and responsibilities for staff and patients, and explain new processes. Include staff feedback into scheduling.
Provide real-time access to patient data and collection of remote patient monitoring into the electronic health record, especially data on temperature and pulse oximetry, blood pressure and glucose.
"While telehealth does not come without its own set of barriers and challenges, its benefits can be maximized when health care organizations consider safety actions and strategies to provide safe and quality care through telehealth," Cordero said.
The addition of two new patient visits per day or three returning patient visits was profitable for all specialists.
Physicians who use medical scribes can book up to 20% more patient visits in a workday, with the increased productivity paying for the cost of the scribe, a study released Tuesday finds.
Corresponding author Neda Laiteerapong MD, associate professor of Medicine at the University Chicago Medicine, said that adding a scribe to the medical staff gives physicians more time to treat patients, add new patients, and schedule more return visits.
"The idea that you have to see more patients can be really scary," Laiteerapong said. "But the idea is that you're actually spending that time more focused on the patient. A scribe allows doctors to focus on thinking and talking and listening, and not on the typing and clicking and ordering. I don't know anyone who became a doctor to do those things."
The study, which was published Tuesday in Annals of Internal Medicine, did an economic evaluation of 30 specialties, physician assistants, and nurse practitioners and found that the cost of employing a medical scribe can be offset within a year, after which increased profits follow.
"Scribes can help a practice add up to 20% more visits, which increases patient satisfaction," Laiteerapong said. "That is valuable to patients, who have increased access, and to providers who are able to do what they were trained to do, which is take care of patients, not paperwork."
The increased number of new patients varied with specialties, from 0.89% per day in cardiology to 2.78 new visits per day with orthopedic surgery. The addition of two new patient visits per day or three returning patient visits was profitable for all specialists.
"We found that an average of 1.3 new patient visits per day (295 per year) was required to recover the cost of a scribe at the one-year point," Laiteerapong added. "And for returning patient visits, it's two or three patients per day."
Researchers assumed that every patient visit would be reimbursed by Medicare and estimated the number of additional visits needed to have 90% certainty of breaking even one year after hiring a scribe. That break-even point could be even faster in practices with higher mixes of privately insured patients
The number of new patients or return visits needed to recoup costs is lower for specialists who order a lot of lab testing and radiology, and higher for others.
The study was done before the coronavirus pandemic and Laiteerapong conceded that that could prove problematic.
"Obviously, having an extra person in the room is not something that many physicians can do these days," she said. "But with modern technology, there can be a device in the room listening to the conversation and transmitting it electronically. So, a scribe working in another space can still have the notes 90% done when the physician leaves the room."
