THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
- Gun violence, the leading cause of death among US children, claims more victims. Only 10 days after a racially motivated mass shooting that killed 10 in a Buffalo, NY grocery store, 19 children and two teachers were murdered on Tuesday at an elementary school in Uvalde, TX. The Uvalde shooting was the 27th school shooting, and one of over 212 mass shootings, that have occurred this year alone. Firearms recently overtook car accidents as the leading cause of childhood deaths in the US, and more than 45,000 Americans die from gun violence each year.
The Gist: Gun violence is, and has long been, a serious public health crisis in this country. It is both important to remember, yet difficult for some to accept, that many mass shootings are preventable. Health systems, as stewards of health in their communities, can play a central role in preventing gun violence at its source, both by bolstering mental health services and advocating for the needed legislative actions—supported by a strong majority of American voters—to stem this public health crisis. As Northwell Health CEO Michael Dowling said this week, “Our job is to save lives and prevent people from illness and death. Gun violence is not an issue on the outside—it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is. If you were hesitant about getting involved the day before…May 24 should have changed your perspective. It’s time.”
- Progress on the COVID vaccine front for children. Three doses of the Pfizer-BioNTech COVID-19 vaccine were shown to be 80 percent effective at preventing symptomatic COVID in children aged six months to five years old, according to the companies’ preliminary trial results. Food and Drug Administration (FDA) experts will meet in mid-June to review the data and make an authorization recommendation for both the Pfizer and Moderna vaccines for the nation’s youngest kids. This news comes on the heels of the FDA’s approval of a Pfizer vaccine booster shot for kids ages five though 11 years, though so far only 28 percent of that age group has been fully vaccinated.
The Gist: The nearly 19 million children under the age of five are the largest remaining group still ineligible for a COVID vaccine in the US. However, an approved vaccine won’t do any good until it’s in a child’s arm, and fewer than one in five parents of children under five plan to vaccinate their child right away. Vaccine access for young children is particularly important to reduce COVID outbreaks in childcare facilities, and to enable parents to return to work, but more messaging and assurance, most critically from pediatricians and community advocates, will be necessary to convince hesitant parents.
- Surgeon General releases advisory on health worker burnout. US Surgeon General Dr. Vivek Murthy issued a report drawing national attention to the issue of burnout in the healthcare workforce, elevating it to one of his office’s top priorities (alongside COVID-19, health misinformation, and youth mental health). Caregiver burnout was already rising prior to COVID, but stress of the pandemic, resulting workforce shortages, and rising workplace violence have pushed it to crisis levels. The report outlines the systemic causes of the mounting burnout crisis among US healthcare workers, up to half of whom report experiencing symptoms of burnout, and lays out solutions for how each healthcare sector can support workforce sustainability.
The Gist: We appreciate the spotlight that Dr. Murthy is shining on the healthcare workforce crisis. While the report and solutions offered are unlikely be revelatory to most healthcare leaders, we hope it increases the potential for meaningful national action and funding for programs to support healthcare workers. However, real long-term sustainability requires rethinking job structure and support for doctors, nurses and others on the care team, and redesigning the work to meet the needs of a new generation of clinical workers—a much larger effort that lies beyond the scope of these recommendations.
Plus—what we’ve been reading.
- Understanding the impact of the growing dominance of Medicare Advantage (MA). A recent piece in JAMA argues that policymakers need to be proactive in addressing how the rise of MA enrollment will affect the Medicare program as a whole, including its role in national quality and utilization measurement, rural healthcare access, and graduate medical education. The ability to monitor care delivered to the traditional, fee-for-service Medicare beneficiary population has been critical for assessing cost growth and shifting care patterns, distributing subsidies, and basing MA payments—all things that will become increasingly difficult as traditional Medicare becomes both smaller and less representative of the entire Medicare population.
The Gist: Traditional Medicare has been a springboard for national healthcare policy goals and industry-wide innovations. However, consumers’ preference for, and policy shifts supporting, the growth of Medicare Advantage are proving to be unstoppable. Providers must prepare for a future in which a shrinking minority of beneficiaries are enrolled in traditional Medicare. If current trends continue, Medicare policymakers must bolster ongoing support for medical education, and build a higher standard of transparency and quality reporting for MA carriers and providers to maintain the sustainability of one of the country’s greatest healthcare data resources.