Healthcare News of Note: Pandemic-era declines in patient experience confirmed by Leapfrog Group Hospital Safety Grade report

• A study shows areas of patient experience that were already in dire need of improvement before the pandemic began, like transitioning care once out of the hospital, communicating about medications and hospital staff responsiveness, worsened the most during the pandemic.
• UnitedHealth Group is preparing to fend off a Department of Justice challenge to its planned acquisition of Change Healthcare.
• A team of researchers developed machine learning models to cull data from the National COVID Cohort Collaborative (N3C) EHR repository in an attempt to understand long COVID, accurately identify who has it and identify treatments.

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

1. Leapfrog Hospital Safety Grade: Pandemic-era declines in patient experience confirmed

“Patient safety lapses associated with the pandemic time frame” have been “uncovered and further confirmed” by Leapfrog’s Spring 2022 comparison of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results between a pre-COVID and mid-COVID period. 

“Areas of patient experience that were already in dire need of improvement before the pandemic began, like transitioning care once out of the hospital, communicating about medications, and hospital staff responsiveness, worsened the most during the pandemic,” wrote the authors of the Leapfrog Group’s recent Hospital Safety Grade report. The group assigns a letter grade to nearly 3,000 U.S. general hospitals based on more than 30 measures of patient safety.

Percentage declines

“To evaluate hospital performance on HCAHPS for this report, Leapfrog looked at the percent of survey respondents who chose the most positive response for a given item,” wrote the authors. “Patient experience worsened significantly during the pandemic in all domains examined through HCAHPS, with one exception: quietness of the hospital.”

Examples from the Adult Patient Care Group of the study comparing patient experience during the pandemic with pre-pandemic scores:

Hospital staff responsiveness

• 67.1% pre-pandemic
• 63.4% mid-pandemic

Communicating about medications

• 64.1% pre-pandemic
• 61% mid-pandemic

Transitioning care out of the hospital

• 52.1% pre-pandemic
• 50.2% mid-pandemic

Highlights across all states

A majority of hospitals (57%) scored a “B” or above, with findings showing:

• 33% of hospitals received an “A”
• 24% received a “B”
• 36% received a “C”
• 7% received a “D”
• Less than 1% received an “F”
• The 5 states with the highest percentages of “A” hospitals are North Carolina, Virginia, Utah, Colorado and Michigan
• The 4 states with no “A” hospitals are Wyoming, West Virginia, the District of Columbia and North Dakota

2. UnitedHealth Group takes steps to fortify its planned purchase of Change Healthcare

Despite formal opposition from the U.S. Department of Justice (DOJ), UnitedHealth Group (UHG) is pushing forward with efforts to acquire Change Healthcare.

In April, UHG announced that the merger agreement between its subsidiary Optum and Change was being extended to the end of 2022.

“The extended agreement reflects our firm belief in the potential of our combination to improve healthcare, and in our commitment to contesting the meritless legal challenge to this merger,” Optum and Change said in a joint statement.

In addition, in a filing with the U.S. Securities and Exchange Commission, UHG announced plans to sell Change’s claims-editing business to a private equity firm if the deal goes through.

Such a step would be an attempt to address one of DOJ’s apprehensions about the prospective merger: that the proposed transaction would remove “United’s only major rival for first-pass claims editing technology … and give United a monopoly share in the market,” according to a DOJ statement.

DOJ also expressed concern that the merger would give UnitedHealthcare access to “a vast amount of its rivals’ information to gain an unfair advantage and harm competition in health insurance markets.”

DOJ filed suit to stop the merger. The case is scheduled for Washington, D.C., federal court starting the week of Aug. 1.

“Quality health insurance should be accessible to all Americans,” U.S. Attorney General Merrick B. Garland said in a written statement. “If America’s largest health insurer is permitted to acquire a major rival for critical healthcare claims technologies, it will undermine competition for health insurance and stifle innovation in the employer health insurance markets.”

Optum and Change countered that their combined entity “will connect and simplify the core clinical, administrative and payment processes healthcare providers and payers depend on to serve patients. Increasing efficiency and reducing friction will benefit the entire health system, resulting in lower costs and a better experience for all stakeholders.”

— Nick Hut, HFMA senior editor

3. Researchers use big data to understand long COVID-19 and identify people who could develop it

A team of researchers developed machine learning (ML) models to cull data from the National COVID Cohort Collaborative (N3C) EHR repository in an attempt to better understand long COVID, accurately identify who has it and identify treatments, according to authors in a preprint of the study, “Who has long-COVID? A big data approach.”

“We examined demographics, healthcare utilization, diagnoses, and medications for 97,995 adult COVID-19 patients,” wrote the study authors. The researchers used that data and a cohort of 597 long-COVID clinic patients to train three ML models to identify potential long-COVID patients among the following groups:

• All COVID-19 patients
• Patients hospitalized with COVID-19
• Patients who had COVID-19 but were not hospitalized

“Patients flagged by our models can be interpreted as ‘patients likely to be referred to or seek care at a long-COVID specialty clinic,’ an essential proxy for long-COVID diagnosis in the current absence of a definition,” wrote the study authors. “We also achieve the urgent goal of identifying potential long-COVID patients for clinical trials. As more data sources are identified, the models can be retrained and tuned based on study needs.”

According to a UCHealth article, the paper was recently peer-reviewed and accepted for publication by Lancet Digital Health.

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