The two health systems say the stronger ties will help each health system address the care needs of vulnerable populations in Alabama.
Ascension St. Vincent's and the University of Alabama at Birmingham Health System have formed a "strategic alliance" that they say "will increase access to high-quality, innovative medical care through multiple outlets and health programs."
In a media release, UABHS and Ascension St. Vincent's said the alliance, which will required regulatory approval, enhances their "longstanding relationship and affirms each organization's ability to help patients receive the right care in the right setting at the right time, including those who need highly specialized care."
Currently, Ascension St. Vincent's hospitals receive patients from UAB's Gardendale Emergency Department and UAB physcians perform surgery at Ascension St. Vincent's One Nineteen.
"As healthcare continues to evolve, it is important for health systems to work with each other to provide innovative, person-centered care," UAB Health System CEO Will Ferniany said. "Through closer alignment of each organization's many locations, specialties and expertise, the health systems will strive to better accommodate patients."
The alliance hopes to address and improve health disparities, including improving access to mental and behavioral health, and diabetes care, particularly for poor and underserved populations.
"These positive changes will strengthen our ability to better serve our community," said Jason Alexander, CEO, Ascension St. Vincent's and Ascension Providence. "Our expectation is that, through this alliance, both the UAB Health System and Ascension St. Vincent's will be better positioned to carry out our missions."
UABHS facilities will retain the UABHS or UAB Medicine brands. Ascension St. Vincent's facilities will be Ascension St. Vincent's.
Co-CEO Lloyd H. Dean will become the sole CEO at the Catholic health system, which was formed in February 2019 with the $29 billion merger of Dignity Health and CHI.
CommonSpirit Health Co-CEO Kevin E. Lofton is retiring at the end of June, the Chicago-based health system announced.
When Lofton retires, Co-CEO Lloyd H. Dean will become the sole CEO at the Catholic health system, which was formed in February 2019 with the $29 billion merger of Dignity Health and CHI.
Lofton, 65, was named CEO of Catholic Health Initiatives in 2003, and has a four decades-long resume as a healthcare executive.
"Kevin Lofton is an exceptional leader and one of the most influential in healthcare," CommonSpirit Board Chair Tessie Guillermo said in a media release, adding that Lofton will retire with the honorary title of CEO Emeritus.
"We have been lucky to be on this journey under the leadership and expertise of both Kevin and Lloyd as they worked side-by-side in the Office of the CEO. We are confident that under Lloyd’s leadership we will be well-positioned to transform how we deliver care across the 21 states we serve,” Guillermo said.
When the merger was finalized last February, Lofton and Dean were described by the heath system as "each a CEO in the Office of the CEO."
CommonSpirit has a footprint in 21 states, with more than 700 care sites and 142 hospitals, along with research programs, virtual care services, home health programs, and population health initiatives to tackle the root causes of poor health.
An investigation determined that some gowns made since September 2018 were produced in unapproved locations with unsanitary conditions.
Cardinal Health has announced a voluntary recall of 9.1 million surgical gowns that may have been contaminated at a contracted manufacturing plant in China.
Of the 9.1 million AAMI Level 3 gowns included in the recall, 7.7 million units were distributed to 2,807 facilities, and 1.4 million were not distributed, Cardinal Health said in a media release.
An investigation by the Dublin, Ohio-based medical supplier determined that some gowns were produced in unapproved locations with improper environmental conditions, were not registered with the U.S. Food and Drug Administration, and did not pass Cardinal Health standards.
"Based on the information we had, we determined it was necessary to proactively issue a hold for AAMI Level 3 surgical gowns produced by a contract manufacturer since September 2018. Those gowns are now subject to this voluntary recall," Cardinal Health said in a media release.
Cardinal Health quarantined the gowns, stopped distribution, and warned customers to remove the gowns from service. The medical supplier also terminated its contract with the gown manufacturer, which is no longer registered with the FDA.
"Our top priority is the safety of patients and healthcare workers. We apologize for the hardship caused by the recall, and are doing everything we can to help resolve this issue for our customers and the patients they serve," Cardinal Health said.
To address any supply shortages created by the recall, Cardinal Health said it would increase production of similar gowns, and would identify alternative products, including those made by "industry partners who offer competing products."
PSI coordinated with three pharmaceutical manufacturers – Insys, Aegerion, and Alexion – to facilitate paying kickbacks to Medicare patients taking their drugs.
The not-for-profitPatient Services Inc. foundation will pay $3 million to resolve allegations that it acted as a conduit that paid Medicare patients illegal kickbacks from drug makers, the Department of Justice said.
"Pharmaceutical companies cannot use foundations to funnel drug co-payments disguised as routine charitable donations, all to prop up excessive drug prices," Andrew E. Lelling, U.S. Attorney for the District of Massachusetts.
"PSI allegedly operated as a vehicle for specific pharmaceutical companies essentially to pay kickbacks at the ultimate expense of the American taxpayers who support the Medicare program," Lelling said.
DOJ said the amount of the settlement was based on PSI's ability to pay.
HealthLeaders' attempts to contact PSI for comment on Wednesday were not successful.
The government alleged that Midlothian, Virginia-based PSI coordinated with three pharmaceutical manufacturers – Insys, Aegerion, and Alexion – to facilitate paying kickbacks to Medicare patients taking their drugs, which are violations of the False Claims Act.
"PSI allegedly worked with these companies to design and operate certain funds that funneled money from the companies to patients taking the specific drugs the companies sold," DOJ said "These schemes allegedly minimized the possibility that the companies' contributions to the funds would go to patients taking competing drugs made by other companies and undermined the nature of these contributions as bona fide donations."
The ruling means the case would not reach the Supreme Court until this fall, at the earliest.
The U.S. Supreme Court on Tuesday shot down a request by a coalition of 20 states for a fast-track review of a Texas-led lawsuit challenging the constitutionality of the Affordable Care Act.
The California-led coalition of attorneys general defending the Affordable Care Act had asked the high court for an expedited review of the Fifth Circuit Court's ruling last month that sent Texas v. U.S. back to the trial judge.
The one-sentence denial means the case could go back-and-forth between the trial court and the appeals court for much of the year, and be heard by the Supreme Court in October, just weeks ahead of the presidential election.
A spokesperson for Texas Attorney General Ken Paxton said he would not comment on the ruling.
In a Twitter post, California Attorney General Xavier Becerra said: “We hope that the Court will grant review of our defense of the ACA because the lower court’s decision is wrong and creates uncertainty about the future of the Affordable Care Act. The health and wellbeing of millions of our loved ones who rely on the ACA for healthcare is too important. We will do everything in our power to keep fighting for them."
New York Attorney General Letitia James, one of 20 AGs defending the ACA, said that, while the Supreme Court refused to expedite its review, it could still hear arguments during its next term, which begins in October. If that occurs, the high court could rule on the case by July, 2021.
"Day after day, President Trump makes false statements, sends misleading tweets, and spouts outright lies about Obamacare and the many protections the law has provided to millions across the country," James said in a media release.
In a 2–1 decision December 18, the Fifth Circuit Court of Appeals agreed with the trial court that the ACA's individual mandate is unconstitutional, but it sent the rest of the expansive law back to the U.S. District Court for the Northern District of Texas for a more detailed analysis of which ACA provisions, if any, should be severed from the mandate and upheld.
ACA defenders howled at the ruling. Protect Our Care Chair Leslie Dach said the delay means that "Donald Trump and the Republican Party have succeeded in their quest to spare themselves the political consequences of their effort to take away health care from 20 million Americans and protections for 135 million Americans with pre-existing conditions."
"Instead, the healthcare millions of Americans remains under attack and the same judge who already declared the entire law null and void will remain in the driver’s seat,” Dach said.
African-Americans treated at non-minority hospitals experienced a 3% decline in mortality each year, compared to no decline in mortality when treated at minority-serving hospitals.
Hospital intensive care units with a larger percentage of African-Americans and Hispanics in their patient mix have not improved outcomes at the same pace as hospitals serving primarily white patients, a new study shows.
Researchers at Beth Israel Deaconess Medical Center in Boston examined trends in ICU mortality and length of stay in 200 hospitals from 2006 through 2016 and found a steady annual decline of 2% in ICU deaths at non-minority hospitals.
The same improvement in mortality rates was not seen at minority-serving hospitals, which the researchers defined as a hospital with a 25% or greater mix of African-Americans and Hispanics in their patient censuses.
However, African-Americans treated at non-minority hospitals experienced a 3% decline in mortality each year, compared to no decline in mortality when treated at minority-serving hospitals.
Minority-serving hospitals also reported longer lengths of ICU stay and critical illness hospitalizations than non-minority hospitals, according to the study, which did not speculate on the reasons for the disparity.
"Although our analysis does not resolve the reasons for differences in outcomes, it identifies minority serving hospitals as an area of great need," said study lead author John Danziger, MD, a nephrologist at BIDMC.
"Focusing research efforts to further address these inequalities is critical in mitigating the disadvantages minorities face and ultimately closing the healthcare divide," Danziger said.
The Dublin, Ohio-based medical supplier said took the action after learning of unsanitary 'environmental conditions' at a plant in China.
Cardinal Health is asking healthcare providers to stop using some types of surgical gowns and packs after learning of potential "cross contamination" at its manufacturing plant in China.
"We are advising customers to discontinue use and segregate all affected surgical gowns and procedure packs that include these affected surgical gowns from your current inventory," Cardinal Health said in a letter to customers this month.
"At this time, we cannot provide sterility assurances with respect to the gowns or the packs containing the gowns because of the potential for cross-contamination," Cardinal Health said. "The safety of our products is a responsibility we take very seriously. As such, we decided to issue the voluntary product hold."
The Dublin, Ohio-based medical supplier said took the action after learning of unsanitary "environmental conditions" at a plant in China that manufactures the supplier's AAMI Level 3 surgical gowns.
The notice affects certain lots of bulk non-sterile and single-sterile Cardinal Health™ surgical gowns.
"We have initiated an investigation, placed a hold on potentially affected product inventory, and are working with the U.S. Food and Drug Administration to address this issue. Cardinal Health intends to initiate a product recall and will provide you with instructions soon," the letter stated.
The proposed rule removes an Obama-era referral policy that the Trump administration says discriminates against religious providers.
The Department of Health and Human Services has unveiled a proposed rule that would remove a mandate that faith-based providers refer patients to other providers for services they won't offer for religious reasons.
"President Trump's administration is taking historic action to protect religious social service providers from discrimination in federal regulations," HHS Secretary Alex Azar said in a media release.
"Americans of faith play an essential role in providing healthcare and human services to so many vulnerable people and communities, and President Trump is dedicated to removing every unfair barrier that stands in the way of this important work," he said.
The proposed rule, released Thursday to coincide with Religious Freedom Day, removes what the Trump administration claims is a discriminatory Obama-era policy that requires religious providers of social services, but not other providers of social services, to make referrals.
HHS is one of nine federal departments, including the Department of Education and the Department of Justice, that were named in a Trump executive order to remove what it said were unfair barriers in federal policies that singled out faith-based groups.
The HHS proposed rule said the "burdens" imposed on faith-based organizations by the Obama administration were not required by law and were imposed only on religious social service providers.
"They are in tension with recent Supreme Court precedent regarding nondiscrimination against religious organizations," HHS said.
The proposed rule would also eliminate the requirement that religious organizations post notices of referral mandates, which is not required of secular organizations.
"By compelling religious organizations, but not secular organizations, to post special notices and make referrals, the alternative-provider requirements placed burdens unequally on religious organizations and cast unwarranted suspicion on them," HHS said.
The proposed rule also mandates that HHS will not discriminate against faith-based organizations when selecting award recipients.
An Urban Institute study found that 31 states saw a decline in premium costs for their lowest-price silver plan.
Premiums fell by an average of 3.5% for Affordable Care Act lowest-cost silver plans in 2020, signaling that the marketplace is stabilizing after uncertainty and price spikes in 2017 and 2018, according to a report from the Urban Institute.
Premium reductions were found in 31 states, according to the report, which looked at lowest-priced silver plans for a 40-year-old nonsmoker from 2017-2020.
The study found that premiums have stabilized in the past two years, and that more insurers are participating in the marketplaces. However, the study raised concerns about affordability for unsubsidized plans, especially in uncompetitive markets.
In 2018, the average silver plan premium increased by 30%, followed by a 0.4% decrease in 2019, as the ACA weathered challenges that included numerous legal challenges, funding cuts, and the elimination of the individual mandate penalty in 2017.
For 2020, lowest silver premiums saw an average 3.5% drop, with the average premium is $426, ranging from a low of $298 in Minnesota to a high of $871 in Wyoming.
Most low-cost silver premium states had more competition, often in the form of at least one Medicaid insurer, several non-Medicaid insurers, or a state reinsurance program. States with higher premiums frequently had little competition.
"The individual market has clearly stabilized since the disastrous premium spikes of 2018, but some markets remain uncompetitive, and affordability is a problem across the board for the unsubsidized." said Kathy Hempstead, senior policy adviser at the Robert Wood Johnson Foundation.
The study used lowest-cost silver plan because it is the entry-level price for standard coverage and qualifies for cost-sharing reductions. The lower-cost plans also have high enrollment.
In addition, CMS said 20 additional health insurance companies are participating in the Federal Health Insurance Exchange in 2020, bringing to 175 the total number of issuers, up from 132 in 2018.
The kickbacks took the form of free 'resupply services' for provider-customers who pushed their CPAP products.
ResMed Inc. has agreed to pay $39.5 million to settle whistleblower allegations that the San Diego-based medical equipment maker paid kickbacks to providers that sold its continuous positive airway pressure (CPAP) therapy machines, the Department of Justice announced Wednesday.
The settlement, the terms of which were first announced in July, 2019, stems from allegations made by five whistleblowers, including former sales reps for ResMed. The company will pay $37.46 million to the federal government and more than $2 million total to various states to settle five Medicaid-related cases. The whistleblowers will share more than $6.2 million.
The kickbacks took the form of free "resupply services" for provider-customers who pushed their product. ResMed charged service fees to those who sold competitors' CPAP machines.
Resupply services track patients' adherence to their CPAP therapy, identify replacement frequencies permitted by insurance, monitor patients' resupply cycles, and get patients permission to order new supplies.
“Improper kickbacks don’t always involve bags of cash or free trips to Hawaii,” said Stephen Hasegawa, a whistleblower attorney for former ResMed sales rep Thomas Baker.
"Services provided by vendors also can be kickbacks if they have some value to customers," Hasagawa said.
"Resupply is an important part of a CPAP equipment provider’s business," said Hasegawa, a partner at Phillips & Cohen LLP. "Customers who use resupply services tend to increase their resupply orders, so it benefits both the entities that sell to patients as well as those who manufacture sleep apnea equipment."
In a statement, ResMed said it had "not violated any laws" and that its "business practices are conducted in full accordance with U.S. laws and regulations."
"That said, we are pleased to put this matter behind us and avoid the expense, inconvenience, and distraction it would cause to gain the favorable outcome we deserve," the company said. "This settlement – the broad terms of which were disclosed in ResMed’s Q4FY19 earnings statement four months ago – is in the best interest of ResMed’s customers, investors, employees, and most important, millions of patients worldwide whose quality of life relies on the products and services ResMed provides."
"This settlement does not impact our ability to sell products in the United States, nor does it impact the reimbursement of our products by federal health programs. We have always acted in good faith with patients and our valued customers, and we do not expect this to impact our relationship with either."
