Today is the first day of open availability for all adult Missourians to receive a COVID-19 vaccination.
Since December, the state’s phase/tier system has been very useful in addressing risk-based vaccination — from vaccination of health care workers and seniors who have been greatly impacted, to disproportionately affected communities and critical workers. These efforts also helped decision-making during a period where vaccine allocation balanced the health and exposure risk with vaccine scarcity.
Hospitals had an outsized role in vaccination in early tiers and will continue to contribute toward widespread vaccination in the state. However, the growth in vaccine supply has allowed vaccinators to proliferate. In most communities, vaccine is becoming more widely accessible through patient care delivery channels. Convenience should help with vaccination uptake.
Data are an essential tool in understanding where we are in our recovery effort. Two recent reports help correlate the dashboard data into a compelling narrative about our collective efforts.
On March 30, MHA released hospitalization data by age group between August 2020 and late March 2021. The research found that COVID-19 hospitalization rates for Missourians ages 60 or older dropped markedly since the state’s peak in December 2020. At the same time, vaccination among the 60-and-older population — many of whom were eligible beginning in December — was more than three times the rate of Missourians ages 59 and younger.
This closing of the age gap is good news on a variety of levels. First, it is strongly suggestive of the efficacy of the vaccine, validates risk-based decisions on availability and signals that future surges may be less harmful to seniors. Second, the closing curves on hospitalization — which the vaccines are designed to protect against — provide a case-study of sorts against vaccine hesitancy in the balance of the adult population. Clearly, vaccination is moving the needle.
Vaccination is an essential component of another set of new research from the Hospital Industry Data Institute. This one evaluates the path to “herd immunity.”
In the March 23 Dashboard Spotlight, researchers used known rates of infection, Centers for Disease Control and Prevention estimates of latent infections, and known rates of vaccine series completion by Missouri residents to establish “crude estimates” for herd immunity in the state. Experts haven’t established a threshold for herd immunity for COVID-19 given all that is unknown about the infection itself. However, there is consensus that it may fall between 65% and 85% of the population. Using these brackets, 65% of Missourians will have some form of protection against COVID-19 by July 6. Following recent linear trends, the analysis suggests the mid-level estimate required for herd immunity of 75% would be reached by Sept. 22, and 85% of the population would have some form of protection by Dec. 22.
There is a lot of work to do between today and herd immunity. Given the recent reports of COVID-19 spread of new variants, achieving herd immunity is becoming more important. Within the past few days, hospitalizations have trended upward for the first time in months. The opening of vaccination to all adults will help increase vaccination and contribute to the chance of reaching herd immunity by the end of the year.
After a very difficult 2020 and a promising start in 2021, these data can provide that “light at the end of the tunnel” moment the entire health care community has been yearning for. Precautions against transmission will remain important, as will investments in vaccination for all approved ages. However, with more than 1.1 million Missourians fully vaccinated, and nearly one-third of Missourians initiating the process and today’s opening to all adults, it is hard not to feel positive.
Today, President Biden released his budget request asking Congress to provide a 16% increase ($769 billion) over current funding levels. The request would provide large increases to public health programs, low-income schools and efforts to fight climate change. It also includes the largest budget increase for the Centers for Disease Control and Prevention in 20 years in the amount of $8.7 billion, and a request of $6.5 billion to launch research projects within the National Institutes of Health.
A House committee approved a new version of House Bill 1291. The original version would have prohibited not-for-profit hospitals from denying medically necessary treatment to Medicaid patients based on their status as fee-for-service or managed care enrollees. The new version limits the scope of the bill to cases in which the hospital would be paid 100% of the fee-for-service payment in a single case agreement.
The Centers for Medicare & Medicaid Services issued the federal fiscal year 2022 proposed rules for the Medicare Inpatient Psychiatric Facility Prospective Payment System. MHA published an issue brief with additional details.
The Centers for Medicare & Medicaid Services issued the federal fiscal year 2022 proposed rules for the Medicare Inpatient Rehabilitation Facility Prospective Payment System. MHA published an issue brief with additional details.
The Centers for Medicare & Medicaid Services released the Medicare Skilled Nursing Facility Prospective Payment System, and hospice payment and policy updates for federal fiscal year 2022. CMS is estimating that SNF PPS payments will increase by $444 million. The major proposals include recalibrating the Patient Driven Payment Model, changes in the PDPM ICD-10 code mappings, updates to the SNF Quality Reporting Program and changes to the SNF Value-Based Purchasing Program. CMS is estimating that hospice payments are proposed to increase by $530 million, or 2.3%. Comments about these rules are due Monday, June 7. MHA soon will publish an issue brief for each payment system.
The Centers for Medicare & Medicaid Services released enrollment information for consumers who selected a Marketplace product during the special enrollment period. More than 528,000 new plan selections were made between Feb. 15 and March 31. In Missouri, 20,541 people have selected a Marketplace product.
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.
Preparedness resources: cybersecurity and post-acute sequelae of SARS-CoV-2
Outpatient Prospective Payment System Pricer file: April 2021
Program for Evaluating Payment Patterns Electronic Reports are available for long-term care hospitals, critical access hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, hospices and skilled nursing facilities
The interactive Vaccine Administration dashboard now is available with doses administered through April 8. This dashboard is accessible to authorized users of HIDI Analytic Advantage. If you need a user ID and password or have questions about accessing these dashboards, contact HIDI.
The Centers for Disease Control and Prevention and the Substance Abuse and Mental Health Services Administration announced federal funding now may be used in the purchase of rapid fentanyl test strips. This announcement comes in an effort to help curtail the spike in drug overdose deaths, which have been driven by the use of strong synthetic opioids, including fentanyl. According to a recent report from Morbidity and Mortality Weekly, from 2013 to 2019, the synthetic opioid-involved death rate increased 1,040%, from 1.0 to 11.4 per 100,000 age-adjusted.
Rapid FTS can be used to determine if drugs have been mixed or cut with fentanyl, providing valuable information to those who use drugs, as fentanyl may be mixed with another substance without their knowledge. The results may allow individuals to take steps to reduce their risk of overdose. Further, the use of rapid FTS may prove beneficial for communities by providing information on the use of fentanyl in the community’s illegal drug supply.
The next webinar for participants in the Outpatient Quality Reporting Program is offered at 9 a.m. and 1 p.m. Wednesday, April 21. The presentation will review the specifications manual plus tools and resources available to enhance successful program reporting. Registration is required.
MHA has learned some members are receiving excessive natural gas bills from suppliers for the February period associated with Winter Storm Uri. MHA can provide information and resources for affected hospitals. Please contact Jane Drummond for additional information if your facility has received such a bill.
Yesterday at the St. Louis Cardinals Opening Day, Dr. Shephali Wulff, infectious disease specialist at SSM Health, sang the National Anthem. Throughout the season, the Cardinals will be honoring local heroes who provided essential services during the COVID-19 pandemic.