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progress in protecting Amazon’s store. This included the importance of informa- tion exchanges in the private sector to stop counterfeiters across retailers, partnering with customs to protect the borders, and the need for increasing resources for law enforcement to prosecute counterfeit- ers. That blueprint is driving productive dialogue and helping shape data sharing pilots and potential legislation.
Study confirms effectiveness of No Surprises Act
AHIP and Blue Cross Blue Shield Associa- tion (BCBSA) released a survey and analysis which found that in the first two months of 2022, the NSA prevented more than two million potential surprise medical bills across all commercially insured patients. The analysis also found that should this trend hold, more than 12 million surprise bills will be avoided in 2022.
“The No Surprises Act ended the practice of surprise medical billing in most circum- stances, providing relief for millions of patients who faced surprise medical bills they did not expect at prices they could not afford,” said Matt Eyles, AHIP president and CEO. “Health insurance providers applaud the Administration and Congress for taking this important step. But more work needs to be done to ensure a broken bone doesn’t break the bank.”
Among other provisions, the NSA established a process for resolving dis- agreements on what a health plan will pay the out-of-network provider or facil- ity, culminating in independent dispute resolution (IDR). Since taking effect at the beginning of 2022, a key question of inter- est to federal policymakers has been how many claims may be disputed through IDR each year and what impact that will have on the affordability of healthcare. he find- ings of the AHIP-BCBSA survey provide critical information which demonstrates how many patients and consumers have already benefited from the S and how important the current IDR process will be in establishing predictability in overall costs. “There is no room for surprise medical bills in a healthcare system that puts people first, said im eck, S president and CEO. “As recently as last year, an emergency visit to the hospital may have left patients on the hook for steep, surprise medical bills. The No Surprises Act has not only put an end to this loophole, but it has proided undeniable financial protection to millions of Americans.”
Voters have also expressed support for
protections against surprise medical bills. A recent poll conducted by Morning Consult on behalf of the Coalition Against Surprise
Medical Billing (CASMB) found that 79% of voters are concerned that lawsuits from physician and hospital organizations could delay or overturn the patient protections included in the NSA.
Hospital and healthcare margins continue to struggle Hospitals and health systems experienced a challenging April as they attempted to stabilize after the winter Omicron surge and amidst a new spike in COVID-19 cases, according to the latest National Hospital Flash Report from aufman Hall. Following a brief rebound in March, hospitals and health systems experienced significant decreases in patient olumes and revenue, with expenses lessening only slightly in April. he median aufman Hall ear-o- Date Operating Margin Index was -3.09% in March, which also marked the fourth straight month of negative actual operat- ing margins this year. The median change in operating margin was down 38.1% from March, and down 76% from April 2021. Patient volumes and days declined in April. Patient days were down by 5.7% compared to March and 1.8% compared to April 2021. Adjusted patient days dropped 6.5% from March to April but were up 1.8% compared to April 2021. Adjusted discharges decreased 3.3% from March and decreased 0.3% compared to April 2021. “Hospital patients in 2022 are likely
sicker, harder to discharge, and more expensive to treat than hospital patients in 2021,” said Erik Swanson, a senior vice president of Data and Analytics with aufman Hall. Fewer patients who are sicker and more expensive weigh heavily on hospitals’ operating margins, putting a strain on both expenses and revenue.” Lower patient volume resulted in poor revenue performance in April, the analy- sis shows. Gross operating, inpatient, and outpatient revenues all dropped approxi- mately 7% from March levels, however, all are up year-to-date compared with the same period in 2021—with gains of 6.6%, 5.3%, and 8.5%, respectively.
Expenses dropped 4.3% from March but remain high compared to 2020 and well above pre-pandemic levels. As in other areas of the economy, labor shortages and supply chain challenges contributed to expense levels. According to the analysis, expenses grew 8.3% since April 2021 and 9.6% year-to-date compared with the same period in 2021.
The National Hospital Flash Report draws on data from more than 900 hos- pitals. Data from the report come from Syntellis Performance Solutions.
Premier adds AI technology to long-term care facilities PINC AI, the technology and services platform of Premier, Inc., announced it is extending its technological capabilities to long-term care (LTC) facilities, providing the same level of clinical surveillance used in the acute setting.
Paper records and low-tech methods of collecting data and coordinating patient care are still widely used in LTC facilities. It has become evident, particularly during the COVID-19 pandemic, that LTC facili- ties need robust, clean and actionable data in order to better prevent infections and provide high-quality care to their residents. In fact, due to the disproportionate impact of I-19, oer one in fie I-19 deaths occurred in a LTC facility since March 2020. PINC AI clinical surveillance capabilities provide a comprehensive, real-time work- flow solution for infection preentionists and clinical pharmacists. The technology can help detect, manage, control and alert to improper treatment of infection-related conditions during COVID-19 and beyond by enabling:
• Automated alerts, including COVID- specific alerts, for patients suspected or confirmed for infections.
utomated flags on patient records to allow for robust tracking of patients in an outbreak group.
• Comprehensive documentation forms, including a custom set specific to I- 19 and routine infections such as Meth- icillin-resistant Staphylococcus aureus (S), lostridium difficile (. diff) and urinary tract infections (UTIs). • Electronic submission of infections to the Centers for Disease Control and Preven- tion’s (CDC’s) National Healthcare Safety Network (NHSN) system.
Infection prevention has never been more crucial in the LTC setting due to the emergence of COVID-19. Regulations have been issued that require routine screening and reporting of COVID-19 cases, and the Centers for Medicare & Medicaid Services (CMS) now requires reporting the data to NHSN. Most LTC facilities do not have a centralized or dedicated infection pre- vention team, which, combined with the additional reporting requirements, increases the need for electronic health records (EHRs) and clinical surveillance technology to provide the data required to help prevent and control infection in at-risk populations.
PINC AI clinical surveillance technology designed for LTC is scheduled to be avail- able beginning in October of 2022. HPN
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