Leapfrog Group: Patients report worse hospital experiences during COVID-19 pandemic, raising safety concerns

Leapfrog sees 'significant' infection increases across its largest-to-date  release of hospital safety grades | Fierce HealthcareSource: Fierce Healthcare, by Dave Muoio

The latest batch of hospital patient safety ratings from the Leapfrog Group shows a general decline among “several” hospital safety measures concurrent with the onset of the COVID-19 pandemic, according to the healthcare safety watchdog.

 

Released Tuesday, the scores are accompanied by a report from Leapfrog that highlights a “significant” decline in the experiences of adult inpatients at acute care hospitals during the pandemic, with many areas “already in dire need” prior to the pandemic deteriorating even further.

“The healthcare workforce has faced unprecedented levels of pressure during the pandemic, and as a result, patients’ experience with their care appears to have suffered,” Leah Binder, president and CEO of the Leapfrog Group, said in a statement.

 
 

Leapfrog’s twice-annual reports assess more than 30 patient safety measures and component measures compiled from the Centers for Medicare & Medicaid Services (CMS) and Leapfrog’s hospital surveys between July 2018 and March 2021. The most recent release assigns letter grades to nearly 3,000 U.S. general hospitals and is the second collection of scores to incorporate safety and experience data from the COVID-19 pandemic.

This time around, Leapfrog assigned 33% of hospitals an “A,” 24% a “B,” 36% a “C,” 7% a “D” and less than 1% an “F”—a roughly equivalent distribution to those given in the fall.

Eight states had 50% or more of its hospitals receive an “A” grade, with North Carolina (59.8%) and Virginia (59.2%) leading the way.

 

On the other end of the spectrum, Wyoming, West Virginia, North Dakota and the District of Columbia had zero hospitals that received an “A” from the watchdog.

As before, Binder said that the “significant variation in safety performance” across different facilities underscores the need for public access to hospital assessment tools “so patients can make the best decision for themselves and their loved ones.”

Alongside the scores, Leapfrog placed a spotlight on patient experiences in a report comparing Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) scores across more than 3,500 U.S. hospitals before (2019) and during (mid-2020 to mid-2021) the COVID-19 pandemic.

The group found statistically significant declines between the survey periods in the average percentage of hospital patients who gave the most favorable responses for nine of the 10 HCAHPS measures.

 

The greatest decline was seen among patients’ experiences with hospital staff responsiveness (a 3.7 percentage point decrease), followed by communication about medicines (a 2.9 point decrease), and cleanliness of the hospital (a 2.9 point decrease).

Leapfrog noted that these patient experience areas and others—like understanding care transitions (which already claimed the least favorable responses)—are directly tied to patient safety events and likely took a hit due to pandemic strains on the healthcare workforce.

“We commend the workforce for their heroic efforts these past few years and now strongly urge hospital leadership to recommit to improved care—from communication to responsiveness—and get back on track with patient safety outcomes,” Binder said.

The inpatient experience report is the second in a series of three such analyses from Leapfrog focused on patient experience during the pandemic. The first report, released in early April, focused on a decline in favorable patient ratings for communications about procedures across ambulatory surgery centers and hospital outpatient departments alike.

Leapfrog’s broader Hospital Safety Grade rankings are available online as a free resource for patients and their families. The organization said its analyses are independently assessed and peer-reviewed, with the methodology of the scoring available online for review.

The prior round of ratings highlighted “significant” declines in hospitals’ performance on preventable hospital-acquired infections. Those findings echoed similar concerns from patient experience intelligence firm Press Ganey and the Centers for Disease Control and Prevention.

Anthem to Tackle Rx Drug Abuse

Anthem Blue Cross launched the Pharmacy Home Program to help high-risk individual and group members reduce addiction to opioids and other prescription drugs. The program also aims to improve drug safety and healthcare quality by choosing a single home pharmacy for patients in the program. The program targets members who meet these criteria within a 90-day period:

  • Filled five or more prescriptions for a controlled-substance or filled 20 or more prescriptions, not limited to controlled substances.
  • Visited three or more health care providers for controlled substance prescriptions or 10 or more providers not limited to controlled substances
  • Filled controlled substances at three or more pharmacies or filled prescriptions for 10 or more pharmacies not limited to controlled substances.

The Pharmacy Home program notifies prescribers in writing of the decision to include the member in the program. The prescriber gets a three-month member prescription history. If the member does not change behavior within 60 days of the first letter, the member is asked to choose a single pharmacy location to fill all medications for a year, with a few exceptions. Those with a diagnosis or prescription history for HIV, sickle cell anemia, multiple sclerosis, cancer, hospice, and palliative care are exempted from the program.

Group Calls on Congress to Reform Mental Health Care

The National Alliance on Mental Illness (NAMI) is calling on the Senate to vote on S. 2680, the Mental Health Reform Act of 2016. The bill, which was was introduced by Senators Lamar Alexander (R-Tenn.) and Patty Murray (D-Wash.), is on the Senate calendar, awaiting action. The group presented petitions with 200,000 signatures at a Senate Summit on Mental Health. The bill would do the following:

  • Require audits of health plans that have five or more parity violations and reports to Congress on the result of completed federal parity investigations.
  • Require additional federal guidance to help plans comply with the parity law.
  • Require a federal action plan to enhance parity enforcement and a GAO parity study.
  • Authorize suicide prevention programs.
  • Address shortages in the mental health workforce.
  • Invest in early intervention programs.
  • Promote integration of primary and mental health care.
  • Strengthen community crisis response systems.

NAMI Chief Executive Officer Mary Giliberti said, “We are showing that Americans all across the country are raising their voices and calling for urgent congressional action to begin to address America’s broken mental health system. Too often, calls for national action following tragic events fall to the back burner as urgency fades. Yet, every day, hundreds of thousands of people [who are] affected by mental illness struggle because they do not have the services and support needed to help them recover and live productive lives.”

Group Proposes Replacement to Obamacare

With health care costs and insurance premiums rising, the National Center for Policy Analysis developed a plan to create accessible, affordable and high quality health care for many more Americans. NCPA senior fellow and author Devon Herrick said, “Our health care system is simply not sustainable under Obamacare. Reform is inevitable. The longer that takes, the more hard it will be on everyone, including consumers.”

Dr. Herrick outlines the following alternatives to the ACA:

  • Increased flexibility in health plan design.
  • Tax fairness regardless of where Americans get their health coverage.
  • Increased access to primary care by removing barriers to innovative medical practices and services.
    Reform of hospital regulations to better serve patients.
  • Reduced costs through price transparency to boost competition and innovation in medical services and prescription drugs.
  • Strengthened Medicare, Medicaid, and Veterans Health that better serve the needs of patients.
  • Changes in the financing of medical care so that people have control over their health care dollars and the means to pay for medical care over their lifetimes.

Groups Says California Should Reject the Anthem-Cigna Merger

Consumer Watchdog called on Insurance Commissioner Dave Jones to reject a proposed merger of Anthem and Cigna. Carmen Balber with Consumer Watchdog said, “Insurance industry consolidation has gone too far in California, costing consumers in the form of higher prices, reduced benefits, narrower networks, and fewer choices. It is no longer believable to claim that making the few insurance giants larger could benefit consumers. It’s time to draw a line in the sand. The only action that truly protects California policyholders is for the Dept. of Insurance to reject the Anthem-Cigna deal.” Nine metro areas in California will be among the hardest-hit in the nation if the merger is approved, and nearly every major population center in the state could be affected, according to an American Medical Association analysis using federal merger guidelines,” she said.

The following is a summary of a statement prepared by Consumer Watchdog: If the Anthem-Cigna merger proceeds, Anthem will gain a near-monopoly in the self-insured market at 69% of the market, meaning higher costs and less options for large companies that pay Anthem or Cigna to administer their health plans and employ nearly 4 million Californians. A merged Anthem-Cigna would surpass Kaiser to become the largest insurer in the state. Regulators cannot exact enough concessions from the companies to protect consumers from the negative impacts of an Anthem-Cigna merger.

Consumer Watchdog recommends these conditions for approving the merger:

  • Anthem should commit to not implementing rate hikes that regulators find to be unreasonable.
  • Anthem should be prohibited from upstreaming profits to its parent company while increasing premiums.
  • Anthem should have to disclose details of any administrative services payments to its parent company out of state. This would allow the public to determine whether the payments have been inflated to hide upstreaming of California policyholder money to shareholders.
  • Anthem should not be allowed to remove reserves from California or otherwise require California policyholders to pay for severance, retention, or other compensation packages for executives in connection with the merger.
  • Anthem should immediately submit its provider networks for review.
  • Anthem should commit to expanding network size for all plans that give consumers access to less than 50% of providers in the area.
  • Anthem’s filings with the Dept. of Insurance should be public documents. Grants of confidentiality should only be allowed sparingly, with explanation of the sensitive nature of the withheld documents, if at all.
  • Anthem should be subject to steep penalties for violating any provision of these undertakings, and revocation of approval if there is a pattern of violations.

Centene Completes Acquisition Of Health Net

Centene Corp. completed its acquisition of Health Net. Health Net is now a wholly owned subsidiary of Centene and is no longer a publicly traded company. Michael Neidorff, CEO of Centene said, “We are now the largest Medicaid managed care organization in the country. Centene expanded its government program offerings to include Medicare Advantage, as well as those offered through contracts with the Depts. of Defense and Veterans Affairs. Neidorff said, “The acquisition increases our scale across health insurance marketplaces while maintaining Health Net’s presence in the California commercial market.” He said that Centene also benefits from greater scale and a stronger financial profile.

California Insurance Commissioner Dave Jones said, “After thorough review…I concluded that this transaction provides an opportunity to bring new capital and resources from a major national health insurer largely outside of California to enable a California health insurer to continue to compete and offer consumers additional choices in California’s individual, small group, and large group commercial health insurance market.”

The following are conditions for the commissioner’s approval of the merger:

  1. Merger costs will not be imposed on California policyholders.
  2. Health Net will maintain and grow its commercial line of business in the small group and large group health insurance markets.
  3. Health Net Life will continue to offer products through Covered California.
  4. Centene and Health Net Life must provide sufficient networks of medical providers and timely access to medical providers and hospitals.
  5. Centene and Health Net Life must improve the quality of care delivered through their health insurance.
  6. An adequate distribution channel for Health Net health insurance must be maintained.
  7. Senior management for Health Net’s California operations must remain in California. Restrictions are placed on Centene’s ability to move Health Net Life out of state.
  8. Centene will make a $200 million infrastructure investment by establishing a California call center.
  9. Centene and Health Net will invest an additional $30 million in California’s low- and moderate-income neighborhoods, with investments prioritized for health facilities.

Jones said, “There are many reasons to be skeptical about health insurance mergers…Studies show that health insurance prices increased after mergers. This merger and the condition of the companies involved, however, present circumstances which led me to conclude that, with strong and comprehensive conditions, this merger was in the best interest of Californians.

Jones added, “Health Net Life Insurance, despite its name, is a health insurance company. Health Net Life has had declining market share and declines in covered lives in its commercial health insurance business. The merger with Centene provides Health Net Life with access to additional capital and resources to…compete successfully in a California market dominated by three much larger health insurers (Kaiser, Anthem Blue Cross of California, and Blue Shield of California) and several other national health insurers (United Health Care, Aetna, CIGNA).”

More Companies Increased Contributions to Help Employees Pay Premiums

HelathCareMoney

Companies are more likely to have added or increased contributions to their employees’ premiums this year compared to the last two years, according to a study by the Transamerica Center for Health Studies (TCHS). The study of 1,500 employers was conducted by the Harris Poll from August 14 to September 3. Forty-four percent of companies expect their healthcare costs to increase in the next 24 to 36 months.

Most employers are trying to keep constant their contribution to employees’ premiums (57%), deductibles (60%), and co-pays/coinsurance (58%). Thirty percent want to maximize their contributions to employees’ premiums to help manage health insurance costs. TCHS Executive Director Hector De La Torre said, “The anticipated increase in healthcare costs correlates to improved quality for many employers.” Forty percent expect the quality of health insurance they offer employees to improve in the next 12 to 36 months while only 10% expect the quality to decline. Companies are most concerned about managing healthcare costs related to cancer (71%), drug expenses (69%), and diabetes and obesity (68%).

Sixty-one percent of employers offer wellness programs. Forty-nine percent of employers that have had a wellness program in the past 12 months say that saving money was the motivation. Eighty-two percent of companies say their wellness program improved workers’ health; 80% say it improved productivity and performance, and 71% say it reduced healthcare costs. De La Torre said, “Providing the best healthcare benefit package possible remains the top healthcare-related priority for employers. Interestingly, employers that offer healthcare benefits are more likely to anticipate profitability, hiring and wage increases in the next two years.”

Health Plans Expect Group Premium Increase of 7.2% in 2016, 10.8% for Individual Plans

Health Plans Expect Group Premium Increase of 7.2% in 2016, 10.8% for Individual Plans
Premium rates  are expected to climb 7.2% for groups and 10.8% for individuals in 2016, according to Sherlock Company’s poll of 69 health plans. The health care cost trend is expected to be 6.6% for groups and 11.9% for individuals. The proportion of health insurance coverage paid  by consumers will increase 11% for groups and 15.6% for individuals.

The figure for individuals refers largely to out-of-pocket cost sharing. Because of buy-downs, actual premium rate increases are expected to be lower.

AIDs Group Slams Outrageous Drug Prices

The AIDS Healthcare Foundation (AHF) says that a lack of regulation and greed are to blame for soaring specialty drug prices. Drug companies have increasingly introduced specialty medications at astronomical prices including Gilead’s $1,000-per-pill Sovaldi or $94,500 cost of Harvoni. Turing Pharmaceuticals CEO Martin Shkreli made headlines when his company raised the price of Daraprim over 5,000% after acquiring the rights to the drug. AHF president Michael Weinstein said, “The one upside of Martin Shkreli’s price hike is that it unleashed a firestorm of criticism…over the pharmaceutical industry’s greed on drug pricing that has been festering for years. Turing’s…CEO’s greed is likely to go down in history as the straw that broke the camel’s back on drug pricing.”

Turing purchased the 62-year-old Daraprim in August from Impax Laboratories for $55 million. The medication is used to treat toxoplasmosis in AIDS patients. Overnight, the company priced the drug at $750 per pill until widespread public outrage prompted Shkreli to announce a yet-to-be-determined price reduction.
Daraprim used to be available through the federal government’s 340B drug discount program at $1 per 100 tablets—one penny per pill. The vast gap between the price that government agencies were allowed to pay for Daraprim compared to cost charged to private insurers underscores the need for increased government oversight and regulation of drug company pricing, according to the AHF.

Presidential candidate Hillary Clinton vowed to release a plan to reform the specialty drug market, declaring on Twitter that she wants to put an end to profiteering. Weinstein said, “We call upon the other candidates…to detail how they would show leadership in addressing the issue of drug costs that the majority of Americans consider to be a top concern.” AHF is sponsoring two state ballot initiatives in California and Ohio to give the states increased bargaining power to get lower drug prices.

Group Calls on Senate to Prevent Secret Pharma Money

Section 3041 of the 21st Century Cures Act would remove reporting requirements over pharmaceutical industry payments to doctors and associations that take place in the context of Continuing Medical Education (CME). The UNITE HERE union sent letters to the Senate Committee on Health opposing the legislation. They say it would allow millions of dollars’ worth of pharmacy industry gifts to doctors’ conferences to happen behind closed doors. The bill just passed the House and is expected to be introduced in the Senate soon.

Aside from healthcare providers and pharmaceutical reps, hospitality workers are among the only people who witness the pharmaceutical industry’s presence at CME events. If Section 3041 becomes law, the rest of the public will never see what UNITE HERE members see. In the past two months, UNITE HERE has collected over 9,000 signatures on a petition to the Accreditation Council for Continuing Medical Education (ACCME) to eliminate pharmaceutical money from CME.

UNITE HERE says it is concerned about ballooning costs for its members’ healthcare plans. Prescription drugs, devices, and biologicals are a major factor in rising healthcare costs and the union is concerned doctors may be unduly influenced by contributions from the pharmaceutical industry to prescribe more expensive drugs when more affordable, generic alternatives are available. The letter was also signed by the director and the program manager of PharmedOut, a Georgetown University Medical Center Project that promotes rational prescribing. UNITE HERE represents 270,000 workers in North America who work in the hotel, gaming, food service, manufacturing, textile, distribution, laundry, transportation, and airport industries. For more information, visit NoMoreDrugMoney.org/Senate.

Last Updated 05/25/2022

Arch Apple Financial Services | Individual & Family Health Plans, Affordable Care California, Group Medical Insurance, California Health Insurance Exchange Marketplace, Medicare Supplements, HMO & PPO Health Care Plans, Long Term Care & Disability Insurance, Life Insurance, Dental Insurance, Vision Insurance, Employee Benefits, Affordable Care Act Assistance, Health Benefits Exchange, Buy Health Insurance, Health Care Reform Plans, Insurance Agency, Westminster, Costa Mesa, Huntington Beach, Fountain Valley, Irvine, Santa Ana, Tustin, Aliso Viejo, Laguna Hills, Laguna Beach, Laguna Woods, Long Beach, Orange, Tustin Foothills, Seal Beach, Anaheim, Newport Beach, Yorba Linda, Placentia, Brea, La Habra, Orange County CA

12312 Pentagon Street - Garden Grove, CA 92841-3327 - Tel: 714.638.0853 - 800.731.2590
Email:
Jay@ArchApple.com
Copyright @ 2015 - Website Design and Search Engine Optimization by Blitz Mogul