The Iowa-based health system provided no explanation for Vermeer's sudden departure, which came just days after UnityPoint announced COVID-19-related furloughs and layoffs.
UnityPoint Health President and CEO Kevin Vermeer abruptly resigned this week from the health system he has led for four years.
The West Des Moines, Iowa-based UnityPoint provided no explanation for Vermeer's sudden departure, which came just days after UnityPoint announced COVID-19-related furloughs and 15% pay cuts for executives.
Sue Thompson, MS, BSN, senior vice president of integration and optimization and CEO of UnityPoint Accountable Care, will serve as interim CEO while a national search is conducted for Vermeer's permanent replacement, UnityPoint said in a media release.
Vermeer had been with UnityPoint for more than 20 years, serving in a number of leadership capacities, including CFO in the Waterloo and Quad Cities regions and as CFO and then Chief Strategy Officer of the System.
Citing federal filings, the Des Moines Register reported that Vermeer's annual compensation in 2018, topped $1.7 million.
"We greatly appreciate Kevin's leadership and service over the past 20+ years," UnityPoint Board Chairman Randy Easton said. "Continued strong, innovative leadership is critical now more than ever before and we are fortunate to have Sue Thompson taking the helm during this time of transition."
Vermeer was credited with helping to develop UnityPoint's population health strategy, negotiating the Joint Operating Agreement with UW Health, forming partnerships in care financing, and creating a common set of FOCUS values for the health system's
At that time, Vermeer said UnityPoint walked away from the deal after the health system "concluded we can most effectively fulfill our mission by maintaining our existing corporate structure."
In addition to her experience as a bedside nurse, Thompson has more than 30 years of extensive leadership experience at UnityPoint Health in regional operations and clinical performance improvement. Most recently, she has played a part in UnityPoint Health's response to the COVID-19 pandemic and previously served as CEO of the system's Fort Dodge region.
Thompson began her career more than 30 years ago as a bedside nurse and has served in leadership roles for clinical and operational improvements across. Most recently, she has played a key role in UnityPoint Health's response to the COVID-19 pandemic, UnityPoint said.
UnityPoint is the nation's 13th largest nonprofit health system, with more than 30,000 employees, and 40 regional and community hospitals and other health venues across Iowa, western Illinois and southern Wisconsin.
The university self-disclosed the overcharges to NIH and HRSA by a professor at the T.H. Chan School of Public Health.
Harvard University will pay more than $1.3 million to settle allegations that its T.H. Chan School of Public Health overcharged the federal government for healthcare research-related grants,the Department of Justice said.
The overcharges, which Harvard self-disclosed, were for grants funded by the National Institutes of Health and the Health Resources & Services Administration between 2009 and 2014 for Donna Spiegelman, at the time, a professor of Epidemiology at Chan, DOJ said.
Specifically, DOJ said, Spiegelman and her team distributed their time across all grants for which they provided statistical support, without accurately accounting for the time they actually spent on particular grants.
DOJ said Spiegelman also overstated her time and effort on a HRSA-funded President’s Emergency Plan for AIDS Relief grant, on which she was a researcher.
This settlement also resolves allegations that Chan administrators either knew or should have known that Spiegelman's actions would result in overcharges to the federal government.
Chan didn't review Spiegelman's records to determine whether she and her team had overcharged grants, despite questions being raised for several years about these timekeeping practices.
A survey of more than 1,000 elderly adults found that 39% canceled or delayed non-essential medical treatment, 32% cancelled primary care and 15% cancelled an essential medical treatment.
More than half (55%) of adults age 70 or older have experienced disruptions in their medical care in the first month of social distancing for the coronavirus pandemic, a new nationwide survey shows.
The survey of 1,039 elderly adults, taken between April 10-15 by NORC at the University of Chicago, also found that 39% of respondents canceled or delayed non-essential medical treatment, 32% cancelled primary or preventive care and 15% cancelled an essential medical treatment.
"The first month of social distancing in America certainly saved lives, and yet it also created a situation where many older adults are not getting the care they need to manage serious health conditions," said Bruce Chernof, MD, president and CEO of The SCAN Foundation, which co-commissioned and designed the survey with The John A. Hartford Foundation.
"As our nation grapples with when and how to reopen, the healthcare system will reckon with unaddressed medical needs and learn how to maximize new protocols to care for older adults with complex needs in flexible, person-centered ways," Chernof said.
The survey shows that respondents are primarily concerned (39%) about interruptions in their care regime, compared to other concerns, such as staying physically active (37%), support for daily living (39%) and finding mental stimulation (23%).
Nearly one-in-five respondents (21%) of respondents used telehealth since the start of the pandemic. Of those who did, 49% said it was about the same as an in-person visit, and only 4% said it was "much worse."
"Telehealth is a lifeline for many who need clinical care during this pandemic,” said Terry Fulmer, RN, president of The John A. Hartford Foundation.
"Healthcare organizations have stepped up quickly to help older adults get their care needs met with this important technology. Comfort levels with telehealth vary, but we are seeing rapid uptake in both urgent and primary care delivery. The survey results offer a promising glimpse into the future," Fulmer said.
The survey also found that:
23% said that their clinicians proactively checked on them in the weeks after confinement through telehealth, and 23% said their provider reached out to them since the start of the pandemic to check on their well-being, outside of a normally scheduled appointment.
83% said they are prepared to self-isolate for several months, if need be, to protect themselves and others. However, 33% said they've felt pangs of loneliness, and spend their abundant free time on hobbies, watching TV, chatting with families, and physical activities.
Healthcare professionals (61%) are seen as the most trusted sources on coronavirus information by seniors, followed by non-elected public health officials (53%). Elected state officials (33%), news sources (31%), church (20%), and elected federal officials (20%) fared considerably worse.
Monday's 8-1 ruling by the high court overturns a 2018 ruling from a federal appeals court.
The U.S. Supreme Court on Monday reversed an appeals court and said in an 8-1 ruling that the federal government must pay the $12 billion it owes health insurance companies that took part in the Affordable Care Act's "risk corridor" program.
"We conclude that §1342 of the Affordable Care Act established a money-mandating obligation, that Congress did not repeal this obligation, and that petitioners may sue the Government for damages in the Court of Federal Claims," Justice Sonia Sotomayor wrote in the court's opinion.
Speaking on background, a spokesperson for Health and Human Services said the department "is disappointed in the court's ruling."
"The "risk corridors" were a concession that the Obama administration made to health insurers who were wary of participating in the ACA's online exchanges that had removed critical enrollment eligibility restrictions such as a ban on pre-existing conditions.
The consolidated case—which was brought separately by Maine Community Health Options, Moda Health Plan Inc., and Land of Lincoln Mutual Health Insurance Co.—argue that the risk corridor obligated HHS to make payments for years 2014-2016 that the law intended "to induce insurer participation in the health insurance exchanges by mitigating some of the uncertainty associated with insuring formerly uninsured customers."
The payers had contended that because the amounts collected under the risk corridor program for 2014 "came nowhere close to what the government owed to insurers," the government paid out only 12.6% of the total owed for the year, prorating the funds it owed to each insurer.
Both the Obama and Trump administrations had argued that because Congress between 2015 and 2107 limited payments for the risk corridor program, the federal government had no obligation to pay.
Writing in dissent, Justice Samuel Alito said the majority's ruling "has the effect of providing a massive bailout for insurance companies that took a calculated risk and lost. These companies chose to participate in an Affordable Care Act program that they thought would be profitable."
Plaintiffs' attorney Mark Rust, who advised Land of Lincoln, said the ruling "has made it possible to trust in government promises, even if they are broken in the midst of discord and dis-function."
"Even though the delay in appropriations cost Land of Lincoln its business, at least the people of the state of Illinois are going to be made whole by the aggressive actions here of its liquidator," he said. "It should help all of us trust in the letter of the law again."
Monday's ruling by the high court overturns a 2018, 2-1 ruling from the U.S. District Court of Appeals for the Federal District, which had ruled that "although section 1342 obligated the government to pay participants in the exchanges the full amount indicated by the formula for risk corridor payments, we hold that Congress suspended the government's obligation in each year of the program through clear intent manifested in appropriations riders."
The appeals court also rued that "the circumstances of this legislation and subsequent regulation did not create a contract promising the full amount of risk corridors payments."
Payers Cheer Ruling
America's Health Insurance Plans CEO Matt Eyles said the federal government was attempting to renege on "a clear commitment in the interest of building stable markets and making coverage more affordable for individuals and small employers."
"Health insurance providers kept their commitments while incurring substantial losses," Eyles said. "We appreciate that today’s Supreme Court 8-1 decision ensures that the federal government honors the obligations it made for services the private sector already delivered."
Margaret A. Murray, CEO of the Association for Community Affiliated Plans, said the ruling "upholds the integrity of the full faith and credit clause. It emphasizes the argument we have made all along—the government can't renege on an unambiguous commitment in federal law."
“ACAP-member plans entered the Marketplace with the clear understanding that risk corridor payments would take place as set forth in Federal law," Murray said. "The government reneged, but our plans didn't. They provided quality, affordable care to millions of Americans only to have the government leave them unpaid bills totaling hundreds of millions of dollars."
Murray said allowing the government to renege on its debts would have created a dangerous precedent.
"It's absurd to ask health plans – or anyone else doing business with the United States government – to price in the notion that Congress might arbitrarily walk away from commitments it makes in Federal law," she said. "We're relieved the Supreme Court agrees."
The estimates could be used as a reference point for policymakers and politicians trying to grapple with the costs of reopening the economy.
The cost of providing healthcare for Americans stricken with COVID-19 could hit $654 billion, depending upon how many people contract the disease, according to a new study in Health Affairs.
Using a "Monte Carlo simulation model" of the U.S. population, researchers from public health schools in New York and California estimate that the direct medical costs for a single, symptomatic COVID-19 infection would be a median of $3,045, incurred only in the course of the infection.
"At the beginning of each simulation run, we determine what percentage of the population ends up getting infected (i.e., the attack rate) with the age distribution of cases matching the reported age distribution of COVID-19 cases," the researchers wrote. "Each infected person then travels through a probability tree of different possible sequential clinical outcomes."
The researchers estimated that if 80% of the U.S. population was infected, that could result in 44.6 million hospitalizations, 10.7 million ICU admissions, 6.5 million ventilators used, and 249.5 million hospital bed days, at a total direct cost of $654.0 billion during the pandemic.
Using the same formula, if 50% of the U.S. population were infected, there would be 27.9 million hospitalizations, 4.1 million ventilators used and 156.2 million hospital bed days, costing about $408.8 billion.
If 20% of the population became infected, there would be a median of 11.2 million hospitalizations, 62.3 million hospital bed days, and 1.6 million ventilators used, costing $163.4 billion.
The researchers said their estimates could be used as a reference point for policymakers and politicians trying to grapple with the costs of reopening the economy, which could very likely result in more COVID-19 cases.
"Some have suggested herd immunity strategies for this pandemic," said lead author Sarah Bartsch, project director with the Public Health Informatics, Computational, and Operations Research team at the City University of New York Graduate School of Public Health and Health Policy.
"These strategies consist of allowing people to get infected until herd immunity thresholds are reached and the virus can no longer spread. However, our study shows that such strategies could come at a tremendous cost," she said.
The study was a combined effort of the PHICOR, the Infectious Disease Clinical Outcomes Research Unit at the Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, and Torrance Memorial Medical Center.
Federal officials say the object of the initial $30 billion blunderbuss distribution of funding was to get money to providers as fast as possible.
The federal government on Friday will begin doling out the remaining $20 million from a $50 billion CARES Act Provider Relief Fund dedicated to helping caregivers pay for the cost of the COVID-19 pandemic and related costs.
The first $30 billion was distributed with a blunderbuss starting with $26 billion on April 10 via direct deposits to any healthcare facilities and providers who got Medicare fee-for-service reimbursements in 2019. The remaining $4 billion of the expedited $30 billion distribution was sent on April 17.
Centers for Medicare & Medicaid Services Administrator Seema Verma told reporters this week that the object of the initial funding was to get money to providers as soon as possible.
"From a broad level, the first tranche of dollars was put out with the aim of getting dollars out very quickly into the healthcare system," she said. "That's something that we heard from providers across the board. They wanted to make sure we got this out quickly," she said.
Even caregivers who shut their doors because of the pandemic were eligible for the funds if they provided diagnoses, testing, or care to patients with possible or actual COVID-19. The kicker is that HHS says it "broadly views every patient as a possible case of COVID-19."
Under the dispersal formula, providers were given a share of the money based on their total Medicare FFS reimbursement in 2019, which totaled $484 million last year.
Using the HHS formula, a provider can estimate their relief payment by dividing their 2019 Medicare FFS (not including Medicare Advantage) payments by $484 million and then multiplying that ratio by $30 billion. For example, a hospital that billed Medicare for $121 million in 2019 would get $7.5 million in relief. ($121,000,000/$484,000,000,000 x $30,000,000,000 = $7,500,000)
The funding scheme for the initial $30 billion payout irked safety net hospitals, community health centers and rural providers who said the formula didn’t necessarily get money into the hands of the pandemic's front-line providers, and didn't do much to help providers whose businesses were all but shuttered because of the virus.
America's Essential Hospitals said it appreciates the money, but urged the federal government remove red tape and focus "on ensuring funds reach the essential hospitals on the front lines of this public health emergency and caring for many low-income and uninsured patients."
The safety net hospital association also asked for more time to acquire data requested by the Department of Health and Human Services.
"We call on the department to extend its data submission deadline until it has resolved these technical issues and clearly and publicly communicated how it will use this information," AEH said. "We also urge the administration to streamline access to the various COVID-19 funding sources by minimizing application processes and requirements that create administrative burden."
The Remaining $20B
Starting Friday, CMS will issue more-targeted distribution of the remaining $20 million, augmenting allocations so that the entire $50 billion general distribution is meted out proportionally to providers' share of 2018 net patient revenue.
Ten billion dollars will be given to hospitals in "hot spot" COVID-19 areas, such as in New York, New Jersey, and areas of California.
In distributing the money, HHS says it will consider other factors such as patient mix, reflected in Medicare disproportionate share payments.
The remaining $10 billion will go to rural hospitals and health clinics, which have been in financial straits long before the coronavirus was around.
The distribution will be based on operating expenses, using a methodology that distributes payments proportionately to each facility and clinic, which CMS has acknowledged "are more financially exposed to significant declines in revenue or increases in expenses related to COVID-19 than their urban counterparts."
"NRHA is grateful to President Trump for relief provided today to the rural health care safety net," National Rural Health Association CEO Alan Morgan said. "Hundreds of rural providers were on the brink of closure, and this relief is absolutely critical."
An additional $400 million will be allocated to the Indian Health Service, starting next week and based on operating expenses.
Lawmakers say at-risk ACOs are being held responsible "for the enormous costs that we expect to result from the COVID-19 pandemic, which are outside their control."
Senate leaders are asking the federal government to "waive the shared loss repayment" for Medicare at-risked accountable care organizations that are grappling with "costs beyond their control due to the COVID-19 pandemic."
In a letter sent Tuesday to Centers for Medicare & Medicaid Services Administrator Seema Verma, Senate Finance Committee members Bill Cassidy, MD, (R-LA), and Sheldon Whitehouse, (D-RI), said that the methodologies for at-risk ACOs in the Medicare Shared Savings Program and other Alternative Payment Models hold responsible physicians and hospitals "for the enormous costs that we expect to result from the COVID-19 pandemic, which are outside their control."
"Some stakeholders estimate that the ongoing COVID-19 pandemic could cost Medicare between $38.5 billion and $115.4 billion over the next year, depending on factors such as severity of disease and hospitalization rates," the two senators said.
"Healthcare providers in value-based arrangements will feel the impact of these costs twice: once at the onset and again when their spending is evaluated in the context of their performance in MSSP or another APM," the letter said.
A poll released this month by the National Association of ACOs found that more than half of ACOs in MSSP said they'll "likely" leave the program amid fears of getting stuck with massive financial losses to cover the cost of the COVID-19 pandemic. This year's application deadline for MSSP and APM is May 31, but ACOs can withdraw from the program before that with no penalty.
In their letter, Cassidy and Whitehouse thanked Verma for activating CMS's "extreme and uncontrollable circumstance policy," under which ACOs can get some relief during the pandemic. However, the senators said policy would only "partially address the costs associated with the COVID-19 pandemic and the total financial impact to ACOs."
CMS plans to prorate the 2020 annual losses based on the duration of the public health emergency. For example, if the emergency lasts six months, ACOs would be responsible for half of the losses for the year.
"The policy does not adequately adjust losses for ACOs in hard hit COVID areas and still holds ACOs accountable for the abnormally high costs of providing care during a global pandemic," the Senators said, adding that adjusting ACO benchmarks, risk scores and quality bonuses "will be impractical."
"Therefore, to ensure that risk-based ACOs that have taken on risk for the total cost of care due to longstanding encouragement and program requirements instituted by CMS are not unduly penalized by the COVID-19 pandemic, we urge you to waive the shared loss repayment for ACOs for performance year 2020," the letter said.
The two senators also recommended that CMS push back the May 31 MSSP termination date for at-risk ACOs "in order to provide immediate assurances to ACOs about CMS' intent to formalize in regulation a 2020 waiving of losses."
Less than 40% of physicians said they were treating COVID-19 patients. However, 60% of physicians who were not treating those patients said they'd be willing to.
More than 20% of physicians report that they've either taken a pay cut or been furloughed by the coronavirus pandemic, including 30% of physicians who are not treated COVID-19 patients, according to a new survey commissioned by The Physicians Foundation.
Of those physicians who've taken a financial hit or a furlough, 18% said they were treating COVID-19 patients, and 30% said they were not, according to the findings in an online survey of 842 physicians, conducted last week by Irving, Texas-based physician recruiters Merritt Hawkins.
"Prior to the pandemic, physicians were already facing a number of stress factors eroding their morale and potentially limiting patient access to their services," Merritt Hawkins said. "The coronavirus is likely to add to these stresses, and more attention therefore needs to be paid to physician well-being, both during the current crisis and after it has been contained to help ensure an adequate and engaged physician workforce."
Less than 40% of physicians said they were treating COVID-19 patients. However, 60% of the physicians who were not treating those patients said they would be willing to, which Merritt Hawkins said suggests "that the physician workforce has extra capacity to bring to bear on the pandemic, with (that) many doctors willing to assume the risk, responsibilities and (presumably) the rewards of treating those infected with the virus."
While two-thirds (66%) or respondents said they would continue to practice medicine as they are now, 34% said they would make changes, including 14% who said they'd seek a different practice, 7% who said they'd close their practice temporarily, 5% who said they'd retire, and 4% who said they'd leave private practice and work for a hospital.
The survey also found that 48% of physicians are using telehealth to access patients, up from 18% in a 2018 Merritt Hawkins survey.
"The emergence of the virus has clearly accelerated the use of technological platforms used to treat patients remotely," Merritt Hawkins said.
Thirty-six percent of the respondents were primary care physicians, and 66% were surgeons, diagnosticians, and other specialists, which corresponds with the percentages in the nation's physician workforce.
The merger, under which Akron, Ohio-based Summa would become a wholly owned subsidiary of Beaumont, was announced in January.
Beaumont Health and Summa Health have postponed their merger plans while the coronavirus pandemic rages, the two health systems announced.
"Both Summa and Valmont are all hands on deck with the COVID-19 crisis," Beaumont CEO John Fox told reporters Tuesday. "We didn't plan this, but we are deferring until we have a little more clarity about the impact of this crisis.
"They are doing the same things we're doing. We talk multiple times during the week as they try to navigate through their own version of the surge that they'll experience in northern Ohio," Fox said.
The merger, under which Akron, Ohio-based Summa would become a wholly owned subsidiary of Beaumont, was announced in January, about six months after the two health systems entered negotiations. Beaumont and Summa have combined revenues of $6.1 billion, operate 12 hospitals in Ohio and Michigan, and employ about 45,000 people.
Summa Health spokesman Mike Bernstein said the merger has cleared all federal and state regulatory hurdles and that Summa's board of directors "is working closely with Beaumont to finalize the path forward and the appropriate timing to combine our organizations."
"That said, the immediate priority is for both Summa and Beaumont to focus first and foremost on caring for our patients, employees, physicians and communities as we are impacted by the COVID-19 pandemic," Bernstein said.
"We must prioritize efforts to ensure the health and safety of all those we serve during this difficult time and we remain committed to finalizing all necessary details to close this transaction when appropriate."
Fox said he doesn't know how long the merger will be delayed.
"We can't turn a blind eye to the pandemic," he said. "Going through the merger process and all those activities we thought was an unnecessary distraction, given that we were working seven days a week, 16 hours a day to deal with the pandemic. And so was Summa. It's kind of like you had a plan to do something, but the house is now on fire. So, we're going to deal with the fire."
Fox's announcement Tuesday that the merger would be delayed followed his announcement that the health system would temporarily lay off 2,475 employees, eliminated another 450 jobs, and slashed executive pay to staunch the financial "hemorrhaging" created by the coronavirus pandemic.
In the first quarter ending March 31, Beaumont's net income was -$278.4 million, a plummet of $407.5 million over the first quarter of 2019. Operating revenue fell to $1.07 billion, a $78.2 million decrease over the $1.15 billion reported in the first quarter of 2019.
Net operating income for the first quarter of 2020 was –$54.1 million, a $91.7 million decrease compared to the same time last year.
The first-quarter losses mounted even though the virus impacted the health system for the last two weeks of March, and Beaumont officials warned the losses could be much worse in the second quarter.
In the first quarter of 2020, Beaumont's net income was -$278.4 million, a free-fall of $407.5 million over Q1 2019.
Beaumont Health has temporarily laid off 2,475 employees, eliminated another 450 jobs, and slashed executive pay to staunch the financial "hemorrhaging" created by the coronavirus pandemic.
Beaumont began caring for COVID-19 patients five weeks ago, and nearly all inpatient and outpatient surgeries and other non-COVID-19 medical services were shut down, while the number of patients seeking care unrelated to COVID-19 fell off after March 16.
In the first quarter ending March 31, Beaumont's net income was -$278.4 million, a plummet of $407.5 million over the first quarter of 2019. Operating revenue fell to $1.07 billion, a $78.2 million decrease over the $1.15 billion reported in the first quarter of 2019.
Net operating income for the first quarter of 2020 was –$54.1 million, a $91.7 million decrease compared to the same time last year.
The first-quarter losses mounted even though the virus impacted the health system for the last two weeks of March, and Beaumont officials warned the losses could be much worse in the second quarter.
In a media availability on Tuesday announcing the cuts, Beaumont CEO John Fox, who will take a 70% temporary pay cut to his base salary, likened the health system's dilemma to "a tale of two cities."
"An absolutely outstanding performance by clinical teams who I cannot be more proud of in terms of how they responded without hesitation and handled more COVID-19 positive patients than any other system in Michigan by far," he said. "The other piece of that is by doing the most, we are also hemorrhaging the most in terms of cash, and we have to deal with that piece of the puzzle."
Fox declined to say how much he earns, saying "I'm not going down that rabbit hole" to multiple media requests on Tuesday. The Detroit Free Press reported that Fox's compensation was $5.6 million a year in 2017. Other top executives at the Royal Oak, Michigan-based health systems will take temporary cuts of up to 45%.
In addition to the layoffs and the salary cuts, Fox said the health system was forced to permanently eliminate 450 positions, most in corporate and administrative services, owing to uncertainty in the healthcare sector "well after the COVID-19 initial surge subsides."
"We must adjust the way we operate our organization moving forward," he said. "This pandemic has changed the delivery of healthcare, and we will be treating patients with this virus until we get a vaccine."
Beaumont, the state's largest health system, has 38,000 employees and operates eight hospitals across southeast Michigan.
