Healthcare News of Note: CMS offers new guidance on making healthcare price transparency information searchable

• CMS issued new guidance for developers and consumers of the machine-readable files required through the Transparency in Coverage rule after an investigation into hospital pricing websites showed code was used to block information from showing up on search engines.
• A recent study reports nurses who lose their jobs or are forced to leave the profession because of a substance use disorder, mental health problem or chronic pain are at risk for suicide.
• Hospitals need better incentives to beef up their stockpiles of personal protective equipment and other supplies in case of an emergency such as the COVID-19 pandemic, witnesses told a Senate panel.

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

1. CMS provides new guidance on price transparency for developers and consumers

An April 14 Modern Healthcare article reported, “CMS issued new guidance on Github for ‘developers and consumers of the machine-readable files required through the Transparency in Coverage rule’ after an investigation into hospital pricing websites revealed hundreds were using code to block information from showing up on search engines.

“The new guideline, first posted March 23, says that all files uploaded by health plans and health insurers must be in formats ‘available to the public without restrictions that would impede the re-use of that information.’ On the platform experts are answering questions and providing examples of file layouts and data displays compliant with current price transparency regulations.”

“Prior to the guidance some files were being tagged with code written to keep search engines like Google from indexing names and prices listed on hospital websites,” wrote author Matti Gellman. “The Wall Street Journal first reported that hundreds of hospitals embedded this code into their sites so that web crawlers could not pick it up, making it difficult for consumers to access.”

The article also states, “On the new guidance released on Github, CMS says they expect hospitals to comply with these requirements. However, the agency did not disclose specific guidelines for hospitals on Github.”

The Github site offers health systems and hospitals more details on price transparency, including:

• Background information
• Developer documentation
•  Required data types
• Required flat files
• File naming convention 
• Discussion board

2. Study: Job loss seen as No. 1 cause of nurse suicides

An April 14 MedPage Today article reported, “Nurses who lose their jobs or are forced to leave the profession because of a substance use disorder, mental health problem, or chronic pain are at risk for suicide, according to a study published last week in the Journal of Nursing Regulation.

The study’s other conclusions were:

•  Alternative-to-discipline programs for nurses with substance use disorder need to be improved and standardized.
• Earlier or more complete treatment for mental illness may help prevent suicide in this population.

“Previous research by [the study’s lead author] Judy Davidson and her colleagues, including a 2020 study in Worldviews on Evidence-based Nursing, found nurses in the U.S. had higher rates of suicide than the gender-matched population,” wrote MedPage author Shannon Firth. “Female nurses in that study were 1.4 times more likely than females in the general population to complete suicide.

“Separately, a study published in JAMA Psychiatry on [April 14] by University of Michigan researchers confirmed nurses’ heightened risk of suicide, while also questioning previous research on trends in physician suicide.”

According to the JAMA Psychiatry report, the findings indicate the following:

• The suicide incidence rates per 100,000 in 2017-18 among women were 17.1 for nurses, 10.1 for physicians, and 8.6 for the general population.
• The suicide incidence rates per 100,000 in 2017-18 among men were 31.1 for nurses, 31.5 for physicians, and 32.6 for the general population.
•  The suicide risk compared with the general population was significantly increased for nurses but not for physicians.

3. Lessons from the pandemic: Hospitals need incentives to grow PPE stockpiles

An April 14 MedPage Today article reported, “Hospitals need better incentives to beef up their stockpiles of personal protective equipment (PPE) and other needed supplies in case of an emergency such as the COVID-19 pandemic, witnesses told a Senate panel on [April 14.]

“‘What we’ve noticed is that they don’t have supply on hand for much more than a few days,’ Elizabeth Zimmerman, former associate administrator of the Office of Response and Recovery at the Federal Emergency Management Agency (FEMA), said during a Senate Homeland Security & Governmental Affairs Committee hearing on lessons learned from the pandemic. Hospitals use ‘just in time’ inventory, she continued, ‘so that they can get the supplies they need for their day-to-day operations to come in, and they don’t have to also have a huge warehouse to store them. They rely on the private sector for doing that.’”

Joseph Nimmich, a former deputy administrator at FEMA, told the committee: “The national stockpile is a good thing, but it’s not the only thing we can do,” MedPage author Joyce Frieden wrote. “‘In addition to bringing supply manufacturing onshore and better understanding the Defense Production Act, I think we could look at ways of incentivizing hospitals and medical facilities to keep 110% of what their daily requirements are, and that 10% the federal government or the state could reallocate to other areas,’” he said. “‘You’ve now distributed your stockpile across the nation, and it’s closer to where you’re going to need it whenever you need it.’”

Other supply chain factors addressed during the Senate hearing were:

• The need for the government to develop a way to track where large supplies of PPE are in the system to redistribute it quickly
•  Bringing manufacturing back to the U.S. not only for active pharmaceutical ingredients but also for precursor chemicals
•  Early development of diagnostic tests for new pathogens across the private sector and in the academic sector to make a variety of tests available earlier