Big hospitals spend little on charity care • UnitedHealth invests in affordable housing
“Hospitals that are rich and charge a lot provide very little charity care,” says Gerard Anderson, a professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “Hospitals that are poor and don’t charge as much provide proportionally more.”
Collectively, the largest area hospitals saw charity care expenses fall 1 percent as revenues rose 3 percent in 2019, compared with the previous year. The pre-pandemic figures add fuel to the debate over whether nonprofit hospitals are providing enough charity care to justify property tax exemptions worth hundreds of millions of dollars. READ MORE.
UNITEDHEALTH GROUP FUNDS AFFORDABLE APARTMENTS IN BRONZEVILLE: UnitedHealth Group is providing $15.4 million—more than half the total cost—for the construction of a 53-unit building of affordable apartments in the Bronzeville neighborhood.
“We are committed to providing housing to our communities’ most vulnerable people and dedicated to helping Chicagoans live healthier lives,” UnitedHealthcare of Illinois CEO Tom Kunst said in the statement.
UnitedHealth Group’s funding comes from a $100 million investment in the Health & Housing Fund, a partnership with nonprofits Stewards of Affordable Housing for the Future and NAHT. UnitedHealth Group’s investment in the Bronzeville building allows the health insurer to realize benefits of low-income housing tax credits provided by the city, said Kemena Brooks, senior project manager. READ MORE.
CAHILL—WALGREENS CHAIRMAN PESSINA NEEDS TO LET NEW CEO DO HER JOB: If Stefano Pessina wants Roz Brewer to succeed, he should get out of her way, writes Crain’s columnist Joe Cahill.
Pessina will hand Brewer the CEO title at Walgreens Boots Alliance on March 15, but he’s not giving up all his power. In his new role as executive chairman, he’ll retain considerable say in big decisions at the Deerfield-based drugstore chain.
Pessina’s continuing presence in senior management sows doubts about Brewer’s authority. When an outgoing CEO hangs around in an executive role, fundamental questions arise about who’s in charge and who’s accountable for the company’s performance. The arrangement also suggests a lack of confidence in a new CEO. Read the column here.
COUNTYCARE HAS HIGHEST QUALITY MEDICAID MCO IN STATE: Cook County’s Medicaid managed care organization CountyCare got the best quality scores of all Medicaid MCOs in the state, interim CEO Aaron Galeener said Friday.
As a result, Illinois will assign the insurer 50 percent of beneficiaries that don’t specify a plan, which is expected to drive membership growth. With more than 374,000 enrollees, CountyCare has 15 percent of the market, according to the latest state data. It’s the only Medicaid managed care plan available solely in Cook County. —Stephanie Goldberg
COOK COUNTY HEALTH DATA SHOWS COVID‘S DEVASTATING IMPACT ON LATINO COMMUNITY: Hispanics were 40 percent more likely to be hospitalized from COVID-19 compared to non-Hispanic Blacks and whites, according to a report from Cook County Health researchers published in the January issue of PLOS ONE.
Halfway into the two-month study, three-quarters of all hospitalized COVID-19 patients at Cook County Health were Hispanic, according to a statement.
“The rapid and disproportionate increase in COVID-19 hospitalizations among Hispanics after the shelter-in-place mandate indicates that public health strategies were inadequate in protecting this population,” Dr. Bill Trick, study principal investigator and associate chair of research at Cook County Health said in the statement. “These individuals were unable to shelter in place because their employment (or employers) did not allow for remote work.”
BIDEN ADMINISTRATION DELAYS DRUG RE(BA)TE RULE: The U.S. Department of Health and Human Services on Friday delayed a rule that would bar pharmacy go-betweens from keeping rebates paid by drugmakers under Medicare Part D.
The policy was set to take effect on Friday but is now scheduled to begin Mar. 22. Still, the Biden administration may not move forward with the plan following a memo last week from White House Chief of Staff Ron Klain directing agencies to freeze new regulations that haven’t taken effect.
The Pharmaceutical Care Management Association sued earlier this month to block the rule from taking effect, saying it threatens pharmacy benefit managers with “significant criminal and civil liability” for negotiating rebates with drug companies.
The rule would replace the current system, which bases rebates on a drug’s list price, with fixed administrative fees. The Trump administration hoped the regulation would lower drug prices by cutting into the profits of pharmacy benefit managers, companies that process and pay prescription drug claims for employers and health plans. It revived the rule last fall after abandoning it in 2019. Modern Healthcare reports.
Prescription drug pricing is a rare area that draws bipartisan support. Rebate reform and limits on copays are considered low-hanging fruit in prescription drug legislation, because the powerful pharmaceutical lobby supports both, David Whitrap, spokesman for the Institute for Clinical and Economic Review, told Crain’s in November.
LEAPFROG LOOKING INTO PREVENTING DIAGNOSTIC ERRORS: Hospital safety grading non-for-profit The Leapfrog Group has launched a two-year initiative on preventing diagnostic errors, in partnership with Evanston-based Society to Improve Diagnosis in Medicine.
The not-for-profit watchdog best known for its hospital safety grades is hoping the project will raise awareness in the industry about diagnostic errors and encourage providers to focus on addressing them. Diagnostic errors are among the most common mistakes in medicine and a leading cause of malpractice claims but there has historically been little research and concentrated efforts by providers to solve the problem.
“We think it’s one of the most overlooked aspects of patient safety in the U.S.,” said Leah Binder, CEO of the Leapfrog Group. “We know from research there is a significant problem with diagnostic errors that harm patients.” Read more in Modern Healthcare.
CMS REJECTS EXEMPTIONS FOR OFF-CAMPUS OUTPATIENT CENTERS: The Centers for Medicare and Medicaid Services may claw back millions of dollars in payments after the agency denied reimbursement rate cut exemptions for hospitals’ off-campus outpatient facilities.
CMS rejected more than 60% of the mid-build exceptions, which would preserve hospitals’ higher reimbursement rates if they had the documentation to prove their off-campus outpatient departments were being constructed when the Bipartisan Budget Act was passed in 2015.
Without the exception, these facilities’ reimbursement rates drop to 40% of the full Outpatient Prospective Payments System rate; they would also be liable for overpayments issued starting Jan. 1, 2018, if they billed via OPPS. Conversely, hospitals that received the exception but were not reimbursed at the full OPPS rate may have been underpaid.
The Chicago-based American Hospital Association is amid a legal battle with the HHS regarding its site-neutral payment policy, which seeks to level payments for evaluation and management services delivered at hospital-owned outpatient departments and independent physician clinics. More from Modern Healthcare.
PEOPLE ON THE MOVE:
• Dr. Daniel Sullivan has been appointed chief physician executive for Edward-Elmhurst Health, replacing Dr. Sanjeeb Khatua, who left the west suburban system in December to become president and CEO of Unitiy Point Clinic in Iowa. Sullivan was most recently Chief Medical Officer of Elmhurst Hospital, a position now filled by Dr. Kimberley Darey, medical director of the Elmhurst Hospital Family Birthing Center.
• Carla Varner has been appointed chair of the board of directors at the Chicago-based American Brain Tumor Association. Varner, who has served on the ABTA board since 2014, is the chief legal officer and managing director of Chicago financial services firm Franklin Monroe Administrative Services, LLC. Dr. Mitchel S. Berger and Danny Monson have been elected to the association’s board.