Anthem, Humana Drop Nearly $140 Million To Launch New PBM

Anthem, Humana drop nearly $140 million to launch new PBM | Modern  Healthcare

Source: Modern Healthcare, by Nona Tepper

Want Fries With That Vaccine? Even at a Fast-Food Restaurant, Pop-Up Clinics See Slow Traffic

Want Fries With That Vaccine? Even at a Fast-Food Restaurant, Pop-Up  Clinics See Slow Traffic | California Healthline

Source: Kaiser Health News, by Anna Almendrala

A few months ago, the boxy, teal truck parked outside a McDonald’s in this Inland Empire city might have drawn hundreds of people willing to stand in line for hours under the scorching sun.

The truck is San Bernardino County’s mobile vaccine unit, which brings covid-19 vaccines directly to people. But on July 15, only 22 people got a covid shot during the four hours it sat there.

Roughly 12 feet away, more people were often seen waiting by a red canopy for free, government-subsidized smartphones, intended for low-income people, than were stepping up for the potentially lifesaving shots.

Barry Luque, a 37-year-old car wash worker who visited the red canopy that day for a free phone, was lured by the truck. He had been eligible for a covid vaccine since April but never got around to making an appointment. Had he not seen the truck in the parking lot on his day off, “this wouldn’t have gotten done,” he said.

It’s Luque’s job to guide drivers into the car wash, but his boss won’t let him take his mask off unless he can show proof he’s vaccinated.

“People come in from different lives, different styles, different moods at different times,” he said after getting his first dose of the Pfizer-BioNTech vaccine. “I’ve got to guide them carefully and gently, and it’s kinda hard for them to see the smile on my face.”

Luque and the other 21 people who got vaccinated that day — in addition to the scores of others who drove by or waited in the McDonald’s drive-thru line without seeking a shot — offer a snapshot of California’s stalling vaccination effort.

Some who finally got the shot, like Luque, were motivated by mandates from employers or are tired of wearing masks. Others want to visit other countries, and vaccinations may help ease travel or quarantine requirements. Some were persuaded, at long last, by family and friends.

Those who continued to hold out primarily cited potential side effects and distrust of the medical system.

Recent polling shows that no matter which tactics are used, a strong majority of unvaccinated people are unlikely to budge on getting a shot, creating an increasingly dangerous scenario as the highly contagious delta variant burns through the country. In California, about 2,800 people were hospitalized for covid or suspected covid — more than twice the number six weeks earlier — as of Wednesday.

About 61% of Californians age 12 and up were fully vaccinated by then, according to the U.S. Centers for Disease Control and Prevention, ranking the state 18th among other states and the District of Columbia.

But the overall rate masks deep disparities among, and even within, regions. In geographically and ethnically diverse San Bernardino County, about 47% of eligible residents were fully vaccinated as of Wednesday, with the lowest rates among young people, men, Latinos, Blacks and those who live in the poorest and unhealthiest communities. Statewide, the profile of unvaccinated people is largely the same.

One way local and state leaders are trying to get shots into residents’ arms is by hosting pop-up clinics that make covid vaccines more convenient and accessible for those who can’t or won’t sign up for an appointment.

San Bernardino County is organizing pop-up events at supermarkets, schools, churches and community centers. The state is also funding vaccine clinics, including 155 events at more than 80 McDonald’s restaurants in 11 counties as of Wednesday.

The pop-ups require significant resources and are showing diminishing returns. About 2,500 doses have been administered at the McDonald’s clinics so far — an average of 16 shots per event. The California Department of Public Health declined to say how much these events cost, saying it varies.

At the McDonald’s in San Bernardino, a city of more than 200,000 that serves as the county seat, eight staffers were on hand to check people in, administer shots and watch for side effects from 9 a.m. to 1 p.m. They also scheduled the necessary second dose for another local pop-up event.

Jeisel Estabillo, 36, hadn’t been vaccinated, even though she is a registered nurse who sometimes cares for covid patients at a hospital. She was one of the first people in the county to become eligible for vaccines, in December, but avoided getting a shot because she wanted to wait and see how it would affect others. She also tested positive for covid during the winter surge.

But Estabillo changed her mind and visited the vaccine clinic with her father and teenage son because they plan to vacation in the Philippines next year and hope vaccination will reduce travel restrictions or quarantines.

Estabillo also likes that vaccinated people can forgo masks in most public places, although that perk may slip away as more California counties respond to the delta surge by calling on residents to mask up again indoors.

But Jasmine Woodson continued to hold out against the vaccine even though she was hired to provide security and direct traffic for the clinic. Woodson, 24, is studying to become a pharmacy technician and has been tracking vaccine news. She said she was alarmed by the brief pause in the administration of the one-shot Johnson & Johnson vaccine over concern about blood clots, and reports of rare heart inflammation linked to the Moderna and Pfizer vaccines. She also knows that no covid vaccine has been fully approved by the Food and Drug Administration, which puts her on high alert.

Woodson, who is Black, is also wary because these mobile vaccine events seem to take place only in low-income Black and Latino neighborhoods — a tactic public health officials say is meant to increase uptake in these communities.

“Every day there’s always something new. You’re not meant to live that long, so if you get it, you get it, and if you don’t, you don’t,” Woodson said of covid.

Maxine Luna, 69, who came to the nearby red canopy to get a phone, also was not swayed. A longtime smoker whose doctor has been pleading with her to get a covid shot, she fears side effects, mentioning a friend who battled two weeks of headaches, diarrhea and vomiting after getting vaccinated.

To mitigate her risk, Luna sticks close to her home, which she shares with her brother, who is vaccinated, and her sister and brother-in-law, who are not.

“We’re not out and about, we don’t go to shows, and we don’t go to crowded places,” she said.

Concern about side effects is the most common reason holdouts cite for not getting a covid vaccine, said Ashley Kirzinger, associate director of public opinion and survey research for KFF. (The KHN newsroom is an editorially independent program of KFF.) This is followed by fear that the vaccine is too new or hasn’t been tested enough.

Kirzinger said it’s important to acknowledge that some people simply can’t be persuaded.

“They don’t see themselves at risk for covid, they think that the vaccine is a greater risk to their health than the virus itself, and there’s really no incentive, no stick, no message, no messenger that’s going to convince these populations,” she said. “It’s going to be really hard to reach the goals set by public health officials, with the decreasing enthusiasm around the vaccine that we have seen in the past several weeks.”

$25,000 Signing Bonuses To Hospital Workers? Whatever It Takes.

Incentives, bonuses needed to attract workers | Modern HealthcareSource: Modern Healthcare, by Ginger Christ

430 Groups Demand Congressional Action On Permanently Expanding Telehealth Flexibilities

US capitol building

Source: Fierce Healthcare, by Robert King

More than 400 advocacy groups are calling for Congress to act quickly to permanently expand flexibilities for telehealth that could go away after the end of the COVID-19 public health emergency expected to run through 2021.

The 430 groups sent a letter to congressional leadership on Monday underscoring the urgency for action now amid concerns from providers that expanded telehealth access could expire abruptly after the emergency ends.

“Once it expires all bets are off,” Jen Covich Bordenick, CEO of the eHealth Initiative, told Fierce Healthcare in an interview. The initiative is one of the 430 groups that signed onto the letter.

At the onset of the pandemic, the Department of Health and Human Services removed several barriers to telehealth reimbursement under Medicare. The move helped fuel a massive explosion in telehealth use among providers as patients were afraid to get care for fear of contracting COVID-19.

Some of the initial barriers that were lifted include a requirement for an in-person visit from the patient before going through telehealth.

Other restrictions included a requirement that a provider be in the same geographic area as the patient.

“We want patients to access care wherever they are,” Covich said.

Lawmakers in both the House and Senate have introduced legislation to remove barriers such as the originating site requirement.

But it remains unclear when Congress could act on the issue, such as whether the fix is included in a major infrastructure push being negotiated now or during an end-of-year spending package.

Currently, the Senate is considering a roughly $1 trillion bipartisan infrastructure package and a $3.5 trillion package intended to pass via reconciliation, a procedural move that ensures budget bills can bypass a filibuster and pass via a simple majority.

“It is a fully bipartisan issue,” said Krista Drobac, executive director of the Alliance for Connected Care, another group signed onto the letter. “That alone should bring it to the top of the agenda for Congress.”

Other groups who signed onto the letter include the American Medical Association, American College of Physicians and the Health Information and Management Systems Society.

Advocates also hope that any legislation approved by Congress gives regulatory flexibility to HHS and Centers for Medicare & Medicaid Services.

The agencies, for example, should determine which types of providers should get reimbursement from Medicare for telehealth services.

“Rather than have that in the legislation, we want CMS to make those decisions in regulation rather than having to go back to Congress to make changes,” Covich said.

Four Senators Call On Becerra To Back Importation Of Prescription Drugs From Canada

Four senators call on Becerra to back importation of prescription drugs from Canada

Source: The Hill, by Justine Coleman

A bipartisan group of four senators requested Health and Human Services Secretary Xavier Becerra’s support to allow less costly prescription drugs to be imported from Canada.

Sens. Amy Klobuchar (D-Minn.), Chuck Grassley (R-Iowa), Angus King (I-Maine) and Susan Collins (R-Maine) sent a letter to the secretary on Monday asking him to back policies permitting states and tribes to import certain prescription drugs from Canada.

In a letter, the senators argued that personal importation could deliver “a critical solution” to lowering medication costs, a goal of the Biden administration. The letter cited that almost 30 percent of adults say they don’t take their prescribed medications due to the cost.

“Americans should be able to obtain affordable medications, and expanding access to safe and affordable drugs in Canada can make a difference by providing direct relief to the millions of Americans who are struggling to afford the increasing cost of prescription drugs,” the letter reads.

“As the Administration considers options for lowering the cost of prescription drugs for patients, we urge your support for permanent solutions that will allow Americans to safely and personally import their medication,” the senators wrote.

The senators specifically called on Becerra to support the Safe and Affordable Drugs from Canada Act, reintroduced by Klobuchar and Grassley in February, that would permit drugs to be imported from the northern country.

The four lawmakers also referenced Biden’s executive order from earlier this month that instructed his administration to cooperate with states on developing programs for this Canadian importation.

Biden had previously campaigned on permitting cheaper medications to be imported.

Former President Trump also signed an executive order last year to accelerate plans to allow states to bring in specific drugs from Canada, although the imports haven’t started.

Democrats have ramped up pressure in Congress for drug pricing reforms with the majority in both chambers, particularly pushing to allow Medicare permission to negotiate prices to reduce medication costs.

But Republicans and the pharmaceutical industry have strongly opposed Medicare negotiation to lower costs, saying it would suppress innovation and research into new drugs.

Biden Says ‘Long COVID’ Could Qualify As A Disability Under Federal Law

U.S. President Joe Biden signs a proclamation on the anniversary of the Americans with Disabilities Act (ADA), as (L-R) artist Tyree Brown, Sen. Pat Leahy (D-VT), former Rep. Tony Coelho (D-CA), House Majority Leader Steny Hoyer (D-MD), U.S. Vice Presiden

Source: NBC News, by Lauren Egan

President Joe Biden announced Monday that serious long-term Covid-19 cases could qualify as a disability, making federal protections and resources available to those suffering from the disease.

Speaking at an event at the White House celebrating the 31st anniversary of the Americans with Disabilities Act, he said that lingering Covid symptoms, such as fatigue or brain fog, “can sometimes rise to the level of a disability.”

“We’re bringing agencies together to make sure Americans with long Covid who have a disability have access to the rights and resources that are due under the disability law, which includes accommodations and services in the workplace and school, and our health care system so they can live their lives in dignity,” Biden said.

The departments of Health and Human Services, Justice, Education and Labor released guidelines to help individuals experiencing effects of long-term Covid navigate federal benefits.

The guidance makes clear, however, that the so-called long Covid does not automatically qualify as a disability. The HHS guidance says that an “individualized assessment is necessary to determine whether a person’s long Covid condition or any of its symptoms substantially limits a major life activity.”

The guidance says people with long Covid could qualify for “reasonable modifications” at work or in schools, as well as community-based resources that help with medical care and housing.

While most people who have been infected with Covid recover within weeks, some suffer from lingering symptoms. The long-term effects are wide-ranging, including such problems as joint pain, fevers, fatigue, double vision and even hair loss.

Little medical treatment exists for long-haul Covid patients. The World Health Organization and the Centers for Disease Control and Prevention have said they are working to better understand the recovery phase of the illness.

Fauci Says Virus Has ‘Peaked’ For The Vaccinated: ‘We Have Two Kinds Of America’

Dr. Anthony S. Fauci, President Biden’s chief medical adviser, in Washington on Tuesday.

Source: Fox News, by Peter Aitken

Dr. Anthony Fauci said there seem to be “two kinds of America” as some people remain skeptical of COVID-19 vaccines even in the face of the more severe delta variant.

The delta variant has ripped through the unvaccinated population in America, with Centers for Disease Control Director Rochelle Walensky claiming the variant is “spreading with incredible efficiency and now represents more than 83% of the virus circulating the United States.”

The individuals who are hospitalized with infection are largely those who are unvaccinated – about 99% of individuals, according to Kristen Choi, an assistant professor at UCLA School of Nursing.

“It’s kind of like we have two kinds of America,” Fauci said on CNN’s “State of the Union.” “We have the very vulnerable unvaccinated part, and we have the really relatively protected vaccinated part, so if you were vaccinated, you were really in a very different category than someone who’s not vaccinated.”

A recent poll showed that around 80% of unvaccinated Americans say that they probably will not or definitely will not get the shot. Recent vaccination efforts have slowed as America achieved 57.1% vaccination of its eligible population – Americans aged 12 or older.

Republican Gov. Kay Ivy of Alabama recently told reporters that the unvaccinated people are living “a horrible lifestyle of self-inflicted pain.”

The persistence of hesitancy has “frustrated” Fauci, who thought the rise of the delta variant would push more people to get the shots. Instead, leaders are “practically pleading” with unvaccinated individuals.

“What I would really like to see is more and more of the leaders in those areas that are not vaccinating to get out and speak out and encourage people to get vaccinated,” Fauci said. “I was very heartened to hear people like Steve Scalise come out and say, ‘hey, we need to get vaccinated.’”

“Even Gov. DeSantis right now in Florida is saying the same thing,” he added.

About a month ago, President Biden and other leaders tout numbers that indicated the virus was in retreat, and Fauci said that it is retreating – but for vaccinated people only.

Florida’s hospitalization rate jumped by about 65% since last week and nearly tripled since June 14, according to FOX 13 Tampa Bay. The state’s vaccination effort has stalled at around 58% of adults fully vaccinated.

To help those individuals, Fauci has suggested that even vaccinated people may need to consider wearing face masks in public indoor spaces.

“The CDC agrees with that ability and discretion capability to say, you know, you’re in a situation where we’re having a lot of dynamics of infection,” Fauci explained. “So even if you are vaccinated, you should wear a mask.”

However, he stressed that the decision should be a “local” one.

Biden’s Latest Order Could Boost Private Equity, End State Licensing

Biden order may boost healthcare private equity, end state licensingSource: Modern Healthcare, by Michael Brady

Vaccine Mandates More Likely Once FDA Grants Full Approvals, Health Experts Say

Vaccine mandates more likely once FDA grants full approvals, health experts  say

Source: NBC News, by Shannon Pettypiece

The United States could see a wave of Covid-19 vaccine mandates as soon as the Food and Drug Administration grants full approval to one or more of the shots, public health experts predicted.

The three vaccines authorized by the FDA for emergency use against the coronavirus have proven safe and effective under that expedited review process and in the real world, and doctors and the nation’s top public health officials have said there’s no need for anyone to wait to get inoculated.

But as the pace of vaccinations lags and concerns about the highly-contagious delta variant grow, the official regulatory signoff would remove a significant legal and public relations barrier for businesses and government agencies that want to require vaccinations for their employees and customers, former health officials from the Biden and the Obama administrations said.

“I think once the vaccines go through full FDA approval, everything should be on the table, and I think that everything will be on the table at the level of municipalities, states, employers, venues, government agencies,” said Andy Slavitt, who stepped down as President Joe Biden’s Covid response coordinator last month and remains in close contact with administration officials.

Many institutions, including colleges and universities, have long required certain immunizations. Still, the suggestion of Covid vaccine mandates, whether by local governments for school children or by businesses for their customers, has so far been met with sharp resistance — primarily from conservative lawmakers and activists.

At least 20 state legislatures have passed bills or are considering measures that would ban businesses and state and local governments from placing restrictions on unvaccinated people. Even so, some colleges, concert venues and employers have already started requiring Covid vaccinations.

But the expedited review process for Covid vaccines has been cited as a safety concern by some people yet to get vaccinated and as a legal hurdle for organizations that have hesitated to put a mandate in place.

Institutions that have put vaccine requirements in place have already faced lawsuits, with opponents arguing that the statute creating the emergency use authorization indicates people should have the option to refuse a treatment. One such lawsuit by health care workers at Houston Methodist was thrown out last month.

But with the new delta variant spreading and hospitals once again filling up, there is a renewed sense of urgency by public health officials to find ways to reach the nearly 1 in 3 eligible Americans who have yet to get their first dose. Pfizer, maker of the first vaccine authorized for emergency use in the United States, said Friday it expects the FDA to grant full approval by January 2022 at the latest. Acting FDA Commissioner Janet Woodcock has said a decision should come well before then.

Health officials said they believe vaccine requirements could be that last push for people who haven’t made getting vaccinated a priority or have been indifferent about needing it.

“Shame on us if we sit here in July and don’t do something to increase the vaccination rates and then we can’t open schools or have a situation where, God forbid, the economy takes another hit because businesses have to shut back down,” said Kathleen Sebelius, who served as health and human services secretary under President Barack Obama.

Biden’s administration has so far resisted any vaccine requirements, opting instead to offer incentives. But Slavitt said he expects that to change with full FDA approval.

He said he believes some federal agencies should then begin requiring vaccinations for their employees, including members of the military, health care workers at Veterans Affairs hospitals and nursing homes, and other federal workers in close contact with the public, like airport security screeners.

“I think every government agency ought to rethink what’s appropriate,” Slavitt said. “There are a number of people in surveys, by the way, who say precisely these words, ‘I’m not going to take it, unless it’s required.’”

White House press secretary Jen Psaki declined to say Friday whether the administration was considering making the vaccine a requirement for the military or the federal workforce. The federal government already requires members of the military to get certain vaccinations. Immigration applicants must also be vaccinated against a range of ailments.

It is unclear how much authority the Biden administration could have as far as requiring vaccinations beyond the federal workforce. No federal vaccination mandate has ever been tested in court and none has ever been issued for the general population. Instead, much of the power to require vaccinations has rested with state and local governments following a Supreme Court ruling in 1905 that upheld a city board of health law requiring all adults get vaccinated against smallpox.

Just a handful of major companies, businesses and venues have put in place any vaccine mandates so far. Delta Air Lines and United Airlines are among the few companies requiring new employees to get vaccinated, but the policy doesn’t apply to current employees.

Several other companies, like BlackRock, have said only vaccinated employees can return to the office but have yet to say what will happen with unvaccinated ones. Madison Square Garden and Yankee Stadium have both limited their events to vaccinated attendees, but many other venues have only encouraged guests to get vaccinated.

Even hospitals and nursing homes have been hesitant about making vaccines compulsory for employees. Among nursing home employees, the rate of vaccination is below that of the general population and in some states, including Florida and Georgia, the vaccination rate is under 50 percent for workers, according to data from the Centers for Medicare and Medicaid Services.

“I do think it is a responsibility of employers and others that have the ability to mandate it at their sites,” Zeke Emanuel, a health adviser in the Obama administration, said of requiring vaccines for health care workers. “It is not like it is easy, but this is a moment of leadership and sometimes when you are a leader, you have to do hard things.”

Hundreds of colleges have required students to be fully vaccinated against Covid before returning to campus, but it’s unclear how those mandates will be enforced and there has already been pushback, including lawsuits. A federal judge on Monday upheld Indiana University’s vaccine requirement. Most colleges already had vaccine requirements in place for other diseases.

Slavitt said one compromise employers could offer those who are firmly against getting vaccinated would be to requiring them to get tested several times a week.

Biden’s administration has been supportive of private companies putting vaccine requirements in place and his chief medical adviser, Dr. Anthony Fauci, said July 11 he believes there should be more vaccine mandates at the local level.

The Biden administration’s strategy has focused heavily on trying to make vaccinations more accessible, spreading information about the vaccines and warning about the risks of not getting the shots.

“We know that some employers, hospitals, health systems, colleges, universities and local leaders have chosen to take this step, and we expect others to do so as well,” Psaki said regarding vaccine requirements. “But our role we’re playing from here is continuing to go community by community, person to person, making sure we are meeting people where they are to get the vaccine out.”

Last week the White House turned to the pop star Olivia Rodrigo to try to reach younger people, who have the lowest vaccination rates. The surgeon general also released a report on the influence that misinformation on social media has had on vaccination efforts. Biden said Friday that those social media platforms, including Facebook, were “killing people” by allowing lies about the Covid vaccines to spread on their websitesHewalked back the criticism Monday, saying those posting the false information were to blame.

The rate of vaccinations has fallen by half since June 1, when the administration declared a “month of action” to redouble efforts as the delta variant spread. By the end of last week, new cases had risen 70 percent over the past seven days with the bulk of infections in four states with relatively low vaccination rates, and the number of deaths had increased by 26 percent to 211 a day, according to the CDC.

“We’ve got a chance to really continue the progress, the incredible progress that’s been made since January,” Sebelius said. “But we also have some real warning signs across the world that we should pay close attention to.”

Report: Only 5% Of Hospitals Fully Compliant With Controversial Price Transparency Rule

Report: Only 5% of hospitals fully compliant with controversial price  transparency rule | FierceHealthcare

Source: Fierce Healthcare, by Robert King

A new analysis found only 5.6% of hospitals were fully compliant with a major price transparency rule, with most failures centered on not posting payer-negotiated prices.

The analysis released Friday by the group PatientRightsAdvocate.org is the latest evidence of widespread noncompliance with the rule, which went into effect back in January.

“These findings align with previous research indicating that hospitals are undermining the rule with incomplete information, burdensome access restrictions, code to block prices from being displayed on search engines and tools to obfuscate access to mobile app developers and to patients,” the analysis said.

Another problem has been price estimator tools that don’t enable meaningful accessible comparison of discounted cash prices, researchers said.

The group examined a random sample of 500 hospital websites out of the roughly 6,000 facilities subjected to the rule’s requirements.

Only 5.6% of the websites were compliant with all the rule’s requirements. It found that 471 facilities did not post a complete machine-readable file of standard charges.

A large majority (80.6%) of hospitals did not publish payer-specific negotiated charges that were clearly associated with each payer and plan, a controversial requirement of the rule. It found that 258 hospitals (51.6%) didn’t publish any negotiated rates at all and 198 hospitals (39.6%) didn’t publish any discounted cash prices.

The rule required hospitals to also publish 300 shoppable healthcare services in a list or an estimator tool. The group found that 96 hospitals presented them in a “consumer-friendly display for customary charges. However, a significant number of these hospitals presented incomplete data fields and were therefore noncompliant.

There were 378 hospitals that posted a price estimator tool. However, the tools were inconsistent and limited researchers’ ability to determine if the tool was compliant with the rule.

The analysis is the latest finding that many hospitals are not complying with the new rule. A study published last month found that 83 out of 100 randomly sampled hospitals were not compliant with the regulation.

The Centers for Medicare & Medicaid Services has sent out warnings to some hospitals for noncompliance. There is a $300-per-day penalty for hospitals for each day they aren’t fully following the regulation.

But the analysis posits that the penalty is nowhere near enough.

“Scaling the penalty to $300 per hospital per bed per day and robustly enforcing the rule will result in a meaningful financial incentive for hospitals to comply, while providing proportional fairness to smaller and rural hospitals,” the group said.

PatientRightsAdvocate.org also wants CMS to scrap the requirement for a price estimator tool and instead require hospitals to provide “guaranteed price quotes.”

Last Updated 07/28/2021

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