Unlike the balance of the population, only a portion of the state’s kids can access vaccine protection. Those ages 12 and younger aren’t eligible for any of the vaccines.This week’s COVID-19 Data Spotlight highlights one of the most troubling new trends in the pandemic so far — a spike in cases among young Missourians.
Last week, the American Academy of Pediatrics and the Children’s Hospital Association released a report finding children accounted for 22% of new COVID-19 cases in the U.S. during the week ending Aug. 26. The data represents a quintupling of pediatric cases nationally in a month — from less than 40,000 during the last week of July to more than 200,000 new cases during the last week of August.
Similarly, Missourians ages 17 and younger have averaged approximately 12% of total COVID-19 cases statewide throughout the pandemic. In the first week of September, more than 25% of new cases were in this age group — a 113% relative increase. All other age groups had receding cases proportionally.
There is emerging evidence that an association exists between total vaccine coverage and pediatric cases. However, Missouri’s vaccination rates continue to trail the national average at about 46% completion statewide. This week, Boone County was the first county in the state to surpass 50% fully vaccinated — well short of herd immunity levels. And, among the younger Missourians eligible for vaccination, uptake has been slow with only 32% of 12- to 17-year-olds fully vaccinated.
In the closing days of August, kids and young adults generally returned to school. Many returned to in-person rather than virtual classrooms. This likely is correlated with new reports throughout the state of significant numbers of students in isolation and quarantine. Local districts are charged with setting policies to protect students and faculty, and balance student achievement and safety. And, variation between institutions is significant. For a closer look at COVID-19 cases by school district, view the new dashboard created by the Missouri Department of Health and Senior Services, MHA, Missouri Department of Elementary and Secondary Education, and Missouri School Boards’ Association.
A spike in demand for acute pediatric care could quickly overwhelm the system. A story in yesterday’s edition of The New York Times included this sobering statistic: “The average pediatric ICU in the U.S. has 12 beds.”
Missouri’s kids aren’t just small adults. Hospital capacity to treat all critically ill kids is limited. Moreover, two-thirds of young eligible Missourians aren’t vaccinated, and many, many more aren’t eligible.
Vaccination is the path out of the pandemic. We haven’t yet fully embraced that path as a state, or recognized that we vaccinate not just for ourselves, but for our communities. Perhaps we’ll see an uptick in uptake when we realize that we’re vaccinating for the kids — because they can’t.
P.S. — As we are all painfully aware, tomorrow marks the 20th anniversary of 9/11 — a horrific event that lead to a 20-year war. As health care professionals whose missions are to serve our patients and communities, it is a time for reflection and respect for those who perished, responded, survived and served.
In This Issue
MHA Submits CY 2022 Medicare Physician Fee Schedule Payment And Policy Updates
White House Releases COVID-19 Action Plan
HHS Announces $25.5 Billion In COVID-19 Provider Funding
MHA Distributes Analysis Of Final Medicare Inpatient PPS For FFY 2022
RHIhub Updates CAH Topic Guide FAQs
MLN Connects Provider eNews Available
NIH HEALing Communities Study Reveals Worsening Disparities In Opioid Overdose Deaths
CMS Releases Updated IPFQR Abstraction Paper Tools
MHA published and submitted comments for the calendar year 2022 Medicare physician fee schedule payment and policy updates. The Centers for Medicare & Medicaid Services will accept comments until 4 p.m. Monday, Sept. 13.
Late yesterday afternoon, the White House released a COVID-19 response plan, “Path Out of the Pandemic: President Biden’s COVID-19 Action Plan,” detailing the next steps for the nation in the fight against the pandemic. The following are highlights of this diverse plan.
increasing vaccinations through mandated vaccination of federal employees and requiring private employers of more than 100 employees to be vaccinated or face weekly testing to be reported to the U.S. Department of Labor and Centers for Disease Control and Prevention
protecting those who already are vaccinated through booster and third doses of the vaccine following U.S. Food and Drug Administration and CDC approval
keeping children safe by encouraging vaccination for those ages 12 and older, ongoing studies of COVID-19 vaccines in children ages two to 12 years of age, and calling on governors to force all teachers and administrators to be vaccinated
increasing testing and masking by expanding the use of the Defense Production Act to increase production of COVID-19 ‘rapid’ tests and increasing the affordability of at-home testing kits
protecting our nation’s economic recovery through increasing small business loans from a maximum of $500,000 to $2 million under the Economic Injury Disaster Loan program to mitigate losses due to COVID-19
improving the care for those who get sick using surge response teams with the use of military health teams, and increasing the average weekly pace of shipments of low- or no-cost monoclonal antibody treatments by as much as 50% beginning next week
The U.S. Department of Health and Human Services, through the Health Resources and Services Administration, announced that $25.5 billion in new relief funding is being made available for health care providers affected by the COVID-19 pandemic. Of the total, $8.5 billion will be available for providers who serve rural Medicaid, Children’s Health Insurance Program or Medicare patients as prescribed by the American Rescue Plan Act. An additional $17 billion will be paid as Provider Relief Fund Phase 4 payments to a broad range of providers who can document revenue loss and expenses associated with the pandemic. Phase 4 payments will be based on providers’ lost revenues and expenditures between July 1, 2020, and March 31, 2021.
HHS also announced a 60-day grace period “to help providers come into compliance with their PRF reporting requirements.” Although the Thursday, Sept. 30, deadline is not changing, HHS states that it will not initiate collection activities or similar enforcement actions for noncompliant providers during the grace period.
MHA released a summary and analysis of the federal fiscal year 2022 Medicare Inpatient Prospective Payment System final payment and policy updates. The analysis includes the financial effects of market basket updates, the budget neutrality adjustment, reductions mandated by the Affordable Care Act, Medicare disproportionate share changes, quality-based payment adjustments and coding adjustments. Results are illustrated in national, Missouri, health system and individual hospital groupings. Inpatient PPS hospitals in Missouri are projected to receive an estimated 2% increase in Medicare payments. Although footnoted, the effects of the Medicare sequestration are not included. Policy and analytic studies, prepared for distribution by the Hospital Industry Data Institute, are available for download to authorized users of HIDI Analytic Advantage.
The Rural Health Information Hub updated its Critical Access Hospital Topic Guide FAQs to include information on 340B eligibility and the Rural Emergency Hospital designation.
The Centers for Medicare & Medicaid Services issued updates to MLN Connects Provider eNews. eNews includes information about national provider calls, meetings, events, announcements and other MLN educational product updates. The latest issue provides updates and summaries of the following.
In a recent HEALing Communities Study conducted by the National Institute on Drug Abuse and the Substance Abuse and Mental Health Services Administration, data reveal a 38% increase in the rate of opioid overdose deaths from 2018 to 2019 for Non-Hispanic Black individuals. Fatal overdoses amongst Black people continue to increase, while the rates for other race and ethnicity groups held steady or decreased.
Fatal overdoses amongst Black individuals are driven largely by heroin and illicit fentanyl use. The study authors note that these data add to the evidence of increasing disparities in opioid overdose deaths by race and ethnicity, and highlight the importance of access to timely, local data to inform effective community-tailored strategies to reduce these deaths.
The Centers for Medicare & Medicaid Services announced the availability of two updated Inpatient Psychiatric Facilities Quality Reporting Program paper tools for data to be submitted in the summer of 2022. The paper tools provide an optional, informal abstraction mechanism to assist inpatient psychiatric facilities in the collection of data for the IPFQR Program.
Appendix for the Non-Measure Data Collection Tool in Microsoft Excel format
Guidelines for the Reason for IPF Admission element of the Transition Record with Specified Elements Received by Discharged Patients measure