|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
Prosecuting the case against the COVID response
This week, in her debut as running mate to presidential candidate Joe Biden, California Sen. Kamala Harris gave a preview of one of the Democratic ticket’s key arguments for the fall campaign, making a full-throated, prosecutorial case against the Trump administration’s handling of the coronavirus pandemic. “The virus has impacted almost every country,” Harris said, “but there’s a reason it has hit America worse than any other advanced nation. It’s because of Trump’s failure to take it seriously from the start.” After receiving a briefing from public health experts on Thursday, Biden and Harris argued for a more comprehensive, aggressive national strategy to battle the virus, including major federal investment in contact tracing, a national mask mandate, and guaranteed free access to a COVID vaccine when it becomes available. The remarks came as the US experienced the deadliest day of the summer so far, with nearly 1,500 COVID fatalities on Wednesday, and a seven-day rolling average of over 1,000 deaths per day for the last 17 days. Meanwhile, a new analysis by the New York Times, using data from the Centers for Disease Control and Prevention (CDC), indicated that the true US death toll from COVID may be as much as 35 percent higher than the reported total of 167K—a finding based on “excess deaths” above normal levels since March.
As President Trump continued to urge schools to reopen for in-person instruction nationwide, the White House released new guidance for ensuring students’ safe return to school. The guidance encouraged social distancing, frequent handwashing, better ventilation of school facilities, and the use of outdoor settings wherever possible. Despite the President’s claim last week that children are “virtually immune” from the virus, a new analysis from the American Academy of Pediatrics and the Children’s Hospital Association showed that 97,000 children tested positive for COVID in the last two weeks of July alone, a 40 percent increase in the total number of known cases over that period. About 340,000 children have tested positive so far, representing about 9 percent of all US cases. As schools face pressure to reopen, those numbers are likely to mount, and early-opening school districts in Georgia, Tennessee, Indiana, and Mississippi are already struggling to keep schools open amid rising cases. Federal assistance to help schools deal with what seems like inevitable rounds of positive cases and closures is not forthcoming, however: after failing to reach a deal on another round of COVID relief, lawmakers have left Washington until September. US coronavirus update: 5.2M cases; 167K deaths; 64.6M tests conducted.
Sentara, Cone Health announce merger to create $11.5B system
On Wednesday, Greensboro, NC-based Cone Health and Norfolk, VA-based Sentara Healthcare announced plans to merge. (Cone Health is a member of Gist Healthcare.) The combination will create a $11.5B, 17-hospital system with over 2,400 doctors and advanced practice providers. The combined organization will be led by Sentara CEO Howard Kern; Cone CEO Terry Akin will serve as President of the system’s Cone Health division. Both systems bring health plan assets and experience managing risk, with Cone operating a 15,000-member Medicare Advantage plan as well as a long-running, successful Medicare and commercial ACO. Sentara owns Optima Health and Virginia Premier Health Plan, which together manage nearly 900,000 lives. Speaking with Gist Healthcare Daily’s Alex Olgin this week, Akin noted that synergies between the plans could create new, more affordable insurance options: “It gives us the opportunity to combine the provision of healthcare with the payment for that healthcare. And we think that will allow us to maximize value to those we serve, to individuals, and to businesses and across our communities. We look forward to a way to offer yet another option to people who are looking at how to fund their healthcare through various insurance products.” The combination bears watching to see if two like-minded, integrated systems with complementary health plan and contracting assets will be able to deliver strategic value and lower-cost solutions.
A new pilot program for rural healthcare
The Center for Medicare & Medicaid Innovation (CMMI) announced a new, voluntary payment program for rural providers, aimed at addressing healthcare disparities by providing a way for rural communities to transform their delivery systems. The new Community Health Access and Rural Transformation (CHART) model will test whether upfront investment, capitated payments, and regulatory flexibilities can enable rural providers to improve care quality and access while reducing costs. The model will have two different options. In the first, the Community Transformation Track, CMMI will give 15 “lead organizations” in rural communities up to $5M in upfront funding, and a stable revenue stream through capitated payments. Examples of eligible lead organizations include, but are not limited to, state Medicaid agencies, local public health departments, independent practice associations, and academic medical centers. In the second option, the Accountable Care Organization (ACO) Transformation Track, CMMI will select 20 “rural-focused” ACOs to receive advanced payments as part of participation in the Medicare Shared Savings Program. CMMI’s focus on rural providers comes at a critical time in the COVID pandemic—nearly 20 percent of Americans live in rural communities, and they tend to be older, suffer disproportionally from chronic diseases, and have less access to healthcare. Because of financial difficulties, one in four rural hospitals is potentially at risk of closure, and these facilities have reportedly had a harder time accessing COVID relief. Addressing the needs of these struggling rural providers—so critical to their communities’ well-being—is welcome and long-overdue.