HURRICANE MILTON
Hundreds of Florida hospital evacuations, as well as nursing homes, rehab centers and freestanding ED centers, occurred during the second hurricane as health officials deployed hundreds of ambulances and buses to transport patients out of harm’s way. While hospitals are coming back online since the hurricane made landfall, health care workers in Florida are struggling to deal with the fallout from the second hurricane in less than two weeks, the Washington Post reported. While no hospitals were damaged during the first hurricane, many health care workers’ homes were affected. According to Fierce Healthcare, the CMS has committed to accelerate and advance Medicare payments for providers in the state, while some private insurance plans have said they will ease prior authorization requirements and allow early refills on 30-day medication supplies for patients affected.
HEALTH CARE SUPPLIES
Widespread IV fluid shortages may lead to cancelled procedures
Blame it on last month’s hurricane: Premier Inc., a health care purchasing organization, took a poll of its provider members and found that 86% were experiencing shortages of IV fluids after September’s Hurricane Helene severely damaged a Baxter facility in North Carolina. According to FierceHealthcare coverage, that Baxter facility is one of the top suppliers to U.S. hospitals of both IV fluids and dialysis solutions. Almost all of Premier’s surveyed members say they are now receiving less than half of what they ordered, with more than half saying they now have only a 10-day supply or less of IV fluids vs. a two- to three-week supply, which is typical. While most of the providers surveyed are trying to conserve supplies, about 12% are already cancelling elective procedures, with more poised to do so if shortages persist. Becker’s Hospital Review reported that the American Hospital Association is urging the Biden administration to declare a national emergency around the IV solution shortage to prioritize the production of IV fluids and allow hospitals to prepare solutions in-house.
PATIENT SAFETY
Is it time for a new model to reduce hospital-acquired conditions?
Hospital-acquired conditions—infections, falls, pressure ulcers—now cost more than $48 billion to treat in the U.S. every year and affect close to 4 million hospitalized patients. Currently, the CMS punishes hospitals that have high rates of such conditions by withholding reimbursements and levying penalties. But in a new article in the Journal of Patient Safety, safety advocates—including expert Peter Pronovost, MD—write that they want to flip that punitive model to tamp down hospital-acquired conditions and save U.S. health care about $35 billion a year. Instead of penalizing hospitals that do a poor job, they argue that the CMS should track hospital-acquired conditions through EHR data, identify centers of excellence that are reducing harm rates through the use of clinical guidelines, and then reward hospitals for those reduced rates. The authors point out that investing in preventing hospital-acquired conditions through reward-based incentives would be less expensive than treating those conditions, with the added benefit of keeping patients safe.
PPE
National stockpile getting 250 million medical gowns
In another sign that medicine is returning to a post-pandemic “normal,” the federal government will pay six U.S. companies $350 million to replenish the supply of medical gowns that were drawn down from the Strategic National Stockpile during covid. A MedPage Today report said the move is one of the last steps to restore the reserve of personal protective equipment that was in such short supply during the early days of the pandemic. Officials at that time noted that the supply of PPE had not been maintained in the years leading up to the pandemic, which left physicians and nurses scrambling for makeshift ways to protect themselves. About 250 million gowns will be placed into the stockpile, which should provide a 90-day supply for future emergencies.
PRIVATE EQUITY
Report looks at impact of investors on ED physicians, patients
A report in Vox talked to ED physicians about their experiences working in groups that had been purchased by private equity investors, and the picture isn’t pretty. The story follows one ED physician named “John” who quit several jobs to flee investor-owned groups but who kept taking jobs with new groups that were then bought by private-equity firms. Physicians said that they regularly had their hours cut, particularly when patient volumes fell, making their income unpredictable. ED physicians also said they were penalized if they didn’t see patients within 25 minutes of arriving, which led to ordering “kitchen sink” workups that weren’t always necessary or appropriate. The Vox story looks at the history of private equity’s entrance into emergency care and the effect on not only physicians, but patients. The report said that private equity operates about one-quarter of the nation’s EDs, with large numbers in Florida, Texas and other parts of the South and Southwest.
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