News Briefs: Report finds unwillingness to get the COVID-19 vaccine drove healthcare job cuts in January

Of nationwide job cuts in January that stemmed from refusals to get the COVID-19 vaccine, the majority were in healthcare, according to a report.

Challenger, Gray & Christmas, Inc.,  a global outplacement and business and executive coaching firm, reported that there were 19,064 job cuts across industries in January. Of that total, 5,757 were workers who declined to get the vaccine. And among that subset, 4,934 worked for healthcare providers.

“Many employers who implemented vaccine policies last year gave workers until early January to comply,” Andrew Challenger, senior vice president with the firm, said in a news release. “This is a lot of people to cut, particularly in healthcare, where workers are increasingly leaving while those who remain battle intensifying burnout.”

A number of large health systems implemented vaccine mandates for staff in 2021, and more than a dozen states have required healthcare workers to be vaccinated or regularly tested. In addition, federal mandates are being phased in for healthcare staff from late January through late March, with the timing varying among states.

Healthcare had the most reported job cuts of any industry, with 5,053, followed by warehousing with 3,051. Healthcare also posted 10,166 open positions, second only to technology, which had 16,818.

340B survey results show the financial toll of drug manufacturer curbs on discounts

A new report finds that hospitals participating in the 340B Drug Pricing Program have been significantly impacted by drug manufacturer actions to restrict discounts.

The advocacy group 340B Health released survey results in late January showing that critical access hospitals (CAHs) especially have been affected by manufacturers’ efforts to curtail discounts on outpatient drugs purchased for distribution at contracted community pharmacies. A dozen manufacturers have issued such restrictions, although when the survey was conducted in November and December, only eight had taken that step — meaning the data don’t show the full scope of the ongoing losses, 340B Health said.

CAHs had lost 39% of their community pharmacy savings at the time of the survey of 510 hospitals, amounting to a median $220,000 per year.

Among larger and more urban 340B participants — such as disproportionate share hospitals, sole community hospitals and rural referral centers — the loss was 23%, or a median $1 million per year.

The discounts are the subject of four ongoing federal court cases between drug manufacturers and the Health Resources and Services Administration, which oversees the 340B program and has sided with providers in the dispute.

HHS’s OIG announces audit of providers’ COVID-19 billing practices

Hospitals that have received distributions from the Provider Relief Fund should be prepared this year for the prospect of a federal audit of their billing practices.

The Office of Inspector General (OIG) at the U.S. Department of Health and Human Services (HHS) has announced it will audit a sampling of funding recipients to ensure they did not balance-bill presumptive or actual COVID-19 patients. A prohibition against such billing is part of the Provider Relief Fund terms and conditions, a violation of which could expose providers to recoupment of funds.

“We will assess how bills were calculated for out-of-network patients admitted for COVID-19 treatment, review supporting documentation for compliance and assess procedural controls and monitoring to ensure compliance with the balance-billing requirement,” OIG states.

The fund’s terms and conditions state: “The [HHS] Secretary has concluded that the COVID-19 public health emergency has caused many healthcare providers to have capacity constraints. As a result, patients that would ordinarily be able to choose to receive all care from in-network healthcare providers may no longer be able to receive such care in-network.

“Accordingly, for all care for a presumptive or actual case of COVID-19, [the] Recipient certifies that it will not seek to collect from the patient out-of-pocket expenses in an amount greater than what the patient would have otherwise been required to pay if the care had been provided by an in-network Recipient.”

Research highlights health system characteristics associated with ‘overuse’ of healthcare

Higher bed counts, fewer primary care physicians and investor ownership are among the characteristics of health systems that tend to provide unnecessary healthcare services, according to a new study.

As reported in January in JAMA Health Forum, researchers with Johns Hopkins University examined 17 types of low-value services that took place at 3,745 hospitals and affiliated outpatient sites. Most of the 17 services were screening or imaging for specific conditions.

The facilities were associated with 676 health systems, and the services were provided to Medicare beneficiaries from July 2015 through December 2018.

Among noteworthy results:

• Bed count was one of the characteristics most strongly associated with overuse.
• Having a teaching hospital was associated with less overuse.
• Higher numbers of primary care physicians were associated with less overuse, while higher numbers of medical groups were associated with more overuse.
• Investor-owned health systems “were markedly overrepresented in the highest overuse categories.”
• Higher levels of uncompensated care were associated with less overuse.
• Health plan ownership was not associated with more or less overuse, nor was participation in federal value-based payment models.

Drug manufacturers reap $6.7 billion in provider relief funding, leaving no aid allotted for the latest surges

The Biden administration used nearly $7 billion from the Provider Relief Fund to pay drug manufacturers for COVID-19 vaccines and therapeutics during the second half of 2021, according to a report by STAT.

As a result, no money will remain in the fund after the ongoing Phase 4 general distribution, which covers expenses and revenue losses incurred between July 2020 and March 2021 and is set to total $17 billion. No distribution has been earmarked for expenses and losses sustained during either the delta or the omicron surge.

STAT noted that when accounting for the Trump administration’s diversion of $10 billion as part of Operation Warp Speed, $16.7 billion from the fund has gone to drug manufacturers. That’s more than 9% of the fund’s $178 billion total allocation as part of the March 2020 CARES Act and subsequent legislation.

An HHS spokesperson told STAT the diversions are a valid use of funds since the vaccines and therapeutics are sent to providers at no cost.