|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
The Biden administration’s booster strategy gets clumsily underway
After a confusing week of mixed messaging and conflicting opinions from the public health officials advising the Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC), late Thursday night CDC Director Dr. Rochelle Walensky announced her decision to recommend COVID booster vaccines for adults over 65, residents of long-term care facilities, and those younger than 65 with underlying medical conditions. Controversially, Dr. Walensky contradicted the CDC’s own Advisory Committee on Immunization Practices (ACIP) by also recommending that people who are at greater risk of COVID exposure due to occupation or institutional setting—including healthcare workers and teachers—receive a booster shot. Earlier Thursday, ACIP members voted down a recommendation to provide boosters to healthcare workers, despite the FDA’s endorsement of that approach earlier in the week.
By Friday morning, President Biden announced he would soon get a booster shot himself, urging those eligible to do so, and re-emphasizing the administration’s primary focus on delivering first doses to those still unvaccinated. There will be more to come on boosters: the FDA and CDC guidance only applies to those who received the Pfizer-BioNTech vaccine at least six months ago; boosters for the Moderna and Johnson & Johnson vaccines are still under review. This week’s saga caps a month of back-and-forth between public health officials, the White House, and the medical community, following Biden’s August promise—considered by many to be premature—that boosters would be broadly available starting September 20th. The inclusion of healthcare workers in the booster campaign is welcome news; we were flummoxed by ACIPs decision to bypass that critical segment, given mounting hospital staffing shortages amid the surging Delta variant. More broadly, we’re increasingly distressed by the relatively uncoordinated and poorly-managed communication approach of the Biden administration on vaccines—particularly following a campaign in which competence was touted as a key advantage over the previous administration.
Intermountain, SCL Health to create $11B system
Salt Lake City-based Intermountain Healthcare announced plans to merge with Broomfield, CO-based SCL Health to form a 33-hospital, $11B dollar system working in six states. The combined system will keep the Intermountain name, be based in Salt Lake City, and be led by Intermountain CEO Dr. Marc Harrison. Harrison said that the merger will accelerate the evolution toward population health and value, and “swiftly advance that cause across a broader geography”—a similar value proposition to the system’s previously proposed combination with South Dakota-based Sanford Health, which fell apart last December after Sanford’s CEO stepped down following his controversial comments about mask-wearing. Intermountain has long been regarded as a national leader in clinical quality, and its integrated payer-provider approach is often cited as a model for US healthcare. The merger with SCL Health will enable expansion of its SelectHealth insurance plan and integrated care model into Colorado, Montana and Kansas, including the fast-growing Denver metropolitan area, making the combined system a formidable player across the Mountain West. But as we’ve written before, achieving that vision will require a level of integration not often realized in similar mergers, and the burden of proof is on health systems to demonstrate that the merger will create meaningful value for patients and consumers. We’ll be watching closely to better understand their plans for lowering costs and improving access and quality for patients across the region.