Healthcare News of Note: More healthcare organizations mandating that employees receive the COVID-19 vaccine

• More U.S. hospitals and health systems are requiring COVID-19 vaccinations for employees amid efforts to end the pandemic.
• Most hospitals are still not fully compliant with CMS’s price transparency rule, opting to pay the maximum $300 per day noncompliance fee rather than face the potential costs of price disclosure.
• Orlando providers have implemented programs to help staff cope with traumatic events five years after the mass shooting at the Pulse nightclub.

Over the last couple of weeks, I’ve found these industry news stories that should be of interest to healthcare finance professionals.  

1. More hospitals requiring employees receive the COVID-19 vaccine

A June 11 article in Becker’s Hospital Review reported that more “hospitals and health systems are requiring COVID-19 vaccinations for employees amid efforts to end the pandemic.”

According to Becker’s, the following healthcare organizations have announced mandates. In the cases of community-wide hospital mandates, the hospitals would each set their own deadline, according to the article by Kelly Gooch, senior writer. Gooch provided a summary of the health systems’ mandates as follows:

“Maryland hospitals and health systems signed a statewide consensus statement to mandate COVID-19 vaccinations for their workers.”

According to an article in Maryland Matters, “Maryland’s 60 hospitals and healthcare systems banded together [June 9] to announce that they will require all employees and clinicians to receive COVID-19 vaccinations.”

Details of the vaccine mandates by the University of Maryland Medical System and Johns Hopkins Medicine, both based in Baltimore, are available in a separate June 11 Becker’s Hospital Review article.

“Hospitals in Washington, D.C., signed a districtwide consensus statement to mandate COVID-19 vaccinations for their workers,” Gooch wrote.

Update on Houston Methodist

“Houston Methodist employees had a deadline of June 7 at midnight to get the COVID-19 vaccine as part of the health system’s mandate.”

Gooch noted there was “nearly 100 percent compliance with 24,947 [Houston Methodist] workers being fully vaccinated” as of June 7.

The Washington Post excerpted from an internal message by Houston Methodist CEO Marc Boom, in which he wrote, “24,947 of Houston Methodist’s employees were fully vaccinated against the novel coronavirus by Monday’s deadline” but added that “178 employees did not get fully vaccinated and were suspended without pay for two weeks.”

Boom’s internal message also noted:

• The 178  full-time or part-time employees either did not get fully vaccinated or were not granted an exemption or deferral
• Of the 178 employees, 27 received one dose of vaccine.
• 285 employees received a medical or religious exemption.
• 332 employees were granted deferrals for pregnancy and other reasons.

Other hospitals mandating vaccines

Among the other hospitals listed in the article to mandate vaccines are:

“Indiana University Health in Indianapolis is requiring employees to be fully vaccinated by Sept. 1.

“University of Louisville (Ky.) Health is requiring team members and providers, including residents, fellows and rotating students, to be fully vaccinated by Sept. 1.

“Benefis Health System in Great Falls, Mont., said it made the vaccine mandatory for about 250 employees working in senior services. Employees who are not exempt are required to get their second doses by July 1.”

2. JAMA Internal Medicine report on Harvard Medical School research: 75% of top-grossing hospitals reviewed fail to comply with at least 1 price transparency rule

A June 15 article in Becker’s Hospital CFO Report reported, “Most hospitals are still not fully compliant with CMS’ price transparency rule, opting to pay the maximum $300 per day noncompliance fee rather than face the potential costs of price disclosure, according to research published June 14 in JAMA Internal Medicine.

“The rule, which took effect Jan. 1, aims to save Americans money by allowing them to price shop for healthcare services. It requires hospitals to post a machine-readable file with the negotiated rates for all items and services and display the prices of 300 shoppable services in a consumer-friendly format. 

“Researchers studied two groups of hospitals: 100 randomly sampled hospitals and the 100 hospitals with the highest revenues in 2017.

“Of the 100 randomly sampled hospitals, 83 percent failed to comply with at least one of the rule’s requirements. A little more than 50 percent of the hospitals had a cost estimator tool, but they all required patients to input their personal health information to access it.

“Of the 100 top-grossing hospitals, 75 percent failed to comply with at least one of the rule’s requirements, and 86 percent offered a price estimator tool.”

Researchers’ comments

A June 15 Healthcare Dive article provided some of the researchers’ written comments: “Selective compliance was especially pronounced for the 100 highest-revenue hospitals, a low proportion of which fully disclosed their negotiated rates despite high compliance with the price estimator tool requirement. Because patient-oriented price estimator tools make prices visible only for a given patient and insurance plan and not to payers or the public, selective compliance may fail to expose abuses of market power, affect price negotiations, or support broad analysis of price variation to the extent intended by the transparency initiative.”

Article author Rebecca Pifer wrote: “Researchers noted an important limitation of the study was its timing, as they analyzed websites about two months after the rule was implemented, and it kicked in during the coronavirus pandemic, when many providers were forced to shuffle resources to fight COVID-19.”

The researchers also were quoted as saying, “Compliance may increase over time, but the early selective compliance suggests reluctance that may persist.”

More oversight needed

The article also notes the support in Washington among a bipartisan group of lawmakers for more oversight of the price transparency rule. Suggestions by lawmakers included regular audits of hospitals and rethinking “enforcement tools, including the amount of civil penalty for noncompliance.”

3. Helping healthcare workers cope after treating victims of mass shootings

A June 10 article (login required) in Modern Healthcare reviews programs Orlando providers have put in place to help staff cope with traumatic events five years after the mass shooting at Pulse, a nightclub in Orlando.

“There have been more than 232 mass shootings in 2021, according to the Gun Violence Archive, and there were 600 mass shootings in 2020,” wrote article author Mari Devereaux. “Each incident killed or injured four or more people, not including the perpetrator.”

The article also provides insight on how the stigma surrounding mental healthcare for clinicians has to change as these events become more prevalent.

Devereaux quotes Megan Ranney, emergency physician at Rhode Island Hospital and associate professor at Brown University, as saying: “There’s a large stigma around mental illness in healthcare. Many boards of licensure actually ask whether you are currently or have previously been receiving care for mental illness or substance use. So you could potentially lose your license if you seek care in some states. There’s also a cultural issue of not admitting weakness.”

In the article, James G. Adams, MD, senior vice president and chief medical officer of Northwestern Memorial says, “Health system leadership needs to actively encourage clinical professionals to take part in a critical incident stress debriefing and promote a focus on mental health.”

Others, he said, “may need ongoing supportive counseling because these events can affect people personally and professionally.”

The article also chronicles the experience of Joseph Ibrahim, MD, trauma medical director for Orlando Regional Medical Center, who responded to an early-morning call about the Pulse mass shooting on June 12, 2016, where 49 people were killed and 53 others injured.