Healthcare News of Note: Oracle’s $28.3 billion Cerner deal faces anti-competition scrutiny, and a pension fund sues Cerner for access to files related to the possible merger

Editor’s note: The article has been updated to reflect the correct date — Feb. 22  — that The Department of Justice and Federal Trade Commission had to review the merger between Oracle and Cerner.
 

• The Department of Justice and Federal Trade Commission had until Feb. 22 to review the $28.5 billion merger between Oracle and Cerner after the global software giant agreed to delay the closure of the deal.
• People living in rural areas that are predominantly Black, American Indian and Alaska Native are significantly farther from many hospital services than people living in largely white rural areas, according to results of a new study.
• Universal mental health assessments for nursing students and enhanced mental health services to support and monitor students should be a priority for universities, colleges and nursing faculty, according to a study.

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

1. Oracle’s $28.3 billion Cerner deal anti-competition deadline passes, while Cerner becomes the target of a pension fund lawsuit

The initial antitrust waiting period for Oracle’s $29.8 billion bid to acquire Cerner expired on Feb. 22, according to a Feb. 24 article in the Kansas City Business Journal.

“Having previously expected the sale to close on 15 February, Oracle has extended its tender offer for the Cerner acquisition until 16 March,” The Register reported in a Feb. 14 article.

”All other conditions remain the same, according to an Oracle press release and Securities and Exchange Commission (SEC) filings,” the article continued.

Two days later, a Bloomberg Law article reported Oracle’s $28.3 billion Cerner deal was the focus of a pension fund suit.

On. Feb. 16, Bloomberg reporter Mike Leonard wrote, “A pension fund sued Cerner Corp. in Delaware over concerns that the health technology company’s leaders deliberately ‘stymied potential bidders’ while engineering an unfair $28.3 billion sale to Oracle Corp. without making any effort to explore superior alternatives.

“The lawsuit seeks files from Cerner to explore allegations that its board and management steered the company into the Oracle transaction — which includes onerous deal protections like a $950 million termination fee — after spurning other approaches.

“They ‘expressed a clear preference for Oracle and did not follow reasonable steps to obtain a value-maximizing transaction,’ for reasons ‘that may become clear upon a review of the requested materials,’ according to the complaint filed [Feb. 15] in Delaware’s Chancery Court.”

2. Study shows spatial access to healthcare affects people in rural areas that are predominantly Black, American Indian and Alaska Native

People living in rural areas that are predominantly Black, American Indian and Alaska Native “were significantly farther from many hospital services than rural high White areas …,”  according to a Health Affairs article published in February.  

A team of investigators, led by Jan M. Eberth, wrote, “Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States.”

To determine such access, “our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care,” the authors added. 

Other significant findings included:

• Rural high Hispanic ZCTAs had more varied results but were significantly farther from ICUs.
• In urban areas, high minoritized group ZCTAs were generally closer to services.

“These patterns likely result from a combination of housing policies that restrict housing opportunities and federal health policies that are based on service provision rather than community need,” the authors wrote. “The findings also illustrate the difficulty of using a single metric — distance — to investigate access to care on a national scale.”

3. Study: Nursing students’ concerns about entering the field in the wake of COVID-19 could impact staffing ratios, nurse burnout and patient outcomes

Universal mental health assessments for nursing students and enhanced mental health services to support and monitor students should be a priority for universities, colleges and nursing faculty, according to authors of an article published in the Journal of Clinical Nursing in December.

The article reported that a subset of nursing students participating in a study expressed moderate to severe mental health problems.

“The purpose of this cross-sectional study was to examine [the] affective state (anxiety, depression), life satisfaction, level of stress and worry, media consumption and perceptions of pursuing a career in nursing amidst the COVID-19 pandemic in a sample of nursing students in the United States,” study authors wrote.

“Nursing students expressing concern about entering the field in the wake of the COVID-19 pandemic may have significant impact on staffing ratios, nurse burn-out and patient outcomes,” the authors added.

Anxiety and depression study highlights

Some of the survey results are as follows:

• Most students in the sample reported minimal anxiety and/or depression.
• A subset of nursing students reported moderate to severe mental health problems, including 18.7% of participants reporting moderate to severe anxiety and 19.8% reporting moderate to severe depression. (The authors note this finding is consistent with previous studies conducted by other researchers.)

How COVID-19 influenced nursing students

“How has COVID- 19 influenced  your  interest in pursuing a  nursing career?” was an open-ended question posed to study participants, netting interesting results.

“Almost half of students provided responses that fit into more than one theme or sub-theme, suggesting that the student experience of the COVID-19 pandemic is multifaceted and sometimes conflicting,” the authors wrote.

Although some study participants indicated COVID-19 did not influence their interest in pursuing a nursing career, other responses indicated the pandemic did influence some students’ interest.

Responses indicating the pandemic’s negative influence fell into these categories:

• Decreased interest in a nursing career
• Less confidence, fear of inadequate training or education
• Negative impact or drive

Responses indicating the pandemic’s positive influence fell into these categories:

• Increased interest in a nursing career
• A desire to be a part of a team
• A desire to help those in need
• Positive impact or drive

HFMA bonus content

• Register for HFMA’s 2022 Revenue Cycle Conference, March 16-18 in New Orleans. 
• Listen to the Voices in Healthcare Finance podcast episode, “Patients have access to more information than ever. How should providers be talking to them about it?“
• Read “Medicare’s much-hyped Direct Contracting model faces an uncertain future,” a Feb. 15 article by Nick Hut, senior editor with HFMA.