Only 14% of hospitals comply with federal price transparency rules

 

• An analysis of 1,000 U.S. hospitals found that only 14.3% were complying with federal price transparency rules and about 38% of hospitals posted a "sufficient amount of negotiated rates" on their websites.
• The PatientRightsAdvocate.org analysis follows a report in July 2021 that showed only 5.6% of 500 random hospitals were in compliance with the rules that were introduced at the start of 2021.
• "The largest hospital systems are effectively ignoring the law with no consequences," the 61-page report said, noting that only two hospitals of 361 at three of the largest hospital systems were in compliance.

Price transparency in healthcare has been an objective among policy experts and economists to encourage a more competitive and efficient market for medical treatment, as the CMS forecasts national health spending to grow at an average rate of 5.4% through 2028. Health plans and other payers have designed online tools to steer their beneficiaries to low-cost options for medical procedures and for pharmaceuticals. 

That hasn't stopped many hospitals from charging widely varying fees for procedures even within in the same hospital. In some cases, some patients would have received a better rate by having no coverage, according to a New York Times article in July. 

A federal price transparency rule required hospitals to post all prices online starting Jan. 1, 2021, with a list of standard charges for all items and services for all payers and all plans, as well as discounted cash prices and a standard list or price estimator for the 300 most common procedures. The hospital industry had challenged the rule through lobbying and litigation.

PatientRightsAdvocate.org, a nonprofit organization dedicated to systemwide healthcare price transparency, said its analysis raises the need to penalize and enforce against noncompliance, and illustrates why clearer pricing is necessary.  No hospitals have been reported to have been issued a penalty for noncompliance, the report said.

The group said that widespread availability of hospital pricing data combined with July's transparency rules regarding health coverage will "unleash the benefits of competition to foster a functional marketplace in healthcare and health coverage."

The report said only two of 361 combined hospitals at three of the largest hospitals systems — HCA Healthcare, CommonSpirit Health and Ascension — were estimated to be in compliance with the federal standard.

HCA spokesman Harlow Sumerford said its hospitals have "worked diligently and have completed our implementation of these requirements. Our hospital websites have a consumer-friendly Patient Payment Estimator tool that provides relevant information to help patients understand what their out-of-pocket costs may be for hospital care, including those that are uninsured. In addition, we have posted contracted rates with third party payers using one of the machine-readable file formats listed in the regulations to provide the five types of 'standard charges.'"

Spokespeople at CommonSpirit and Ascension weren't immediately available for comment.

https://www.healthcaredive.com/news/only-14-of-hospitals-comply-with-federal-price-transparency-rules-advocac/618706/

Connecticut’s absurd COVID order endangers nursing home patients — again

 Administrators of Connecticut’s 209 nursing homes and long-term care facilities were stunned at the start of this year when the state’s Department of Public Health (DPH) told them they must start accepting patients infected with COVID-19 to relieve pressure on overflowing hospitals.

It was like déjà vu all over again for those who worked in nursing homes during the early days of the pandemic, when deaths from COVID in states like Connecticut, New York and New Jersey were highly concentrated in elderly care facilities.

Despite being one of the most vaccinated groups, people over the age of 65 account for three-quarters of the total deaths from COVID. A combination of close quarters and patients with compromised immune systems made the virus spread like wildfire through nursing homes.

The National Centers for Disease Control and Prevention recommends that any state considering “relief health care” facilities, such as nursing homes, must ensure that transferred COVID patients won’t compromise those facilities’ ability to prevent the spread of the virus internally.

Former New York Gov. Andrew Cuomo ignored the science, forcing nursing homes to take COVID-positive patients at the start of the pandemic. But he reversed his mandate only six weeks later after seeing the deadly consequences. A New York State Bar Association study published last June showed that this six-week period alone caused “several hundred and possibly more than 1,000 deaths of nursing home residents.”

Connecticut Gov. Lamont (right) is taking a page out of ex-NY Gov. Cuomo’s book by urging nursing homes to take in patients discharged from a hospital “regardless of COVID-19 status.”

Reuters; Getty Images

While neighboring Connecticut never stopped allowing infected patients in, most nursing homes required two negative COVID tests at least 24 hours apart before they were willing to accept any new patient or one discharged from a hospital looking to free up capacity.

This all changed with Connecticut’s DPH memo this year, urging nursing homes to take in patients discharged from a hospital “regardless of COVID-19 status.” After pushback from nursing home administrators, a spokesperson for Connecticut Gov. Ned Lamont clarified that he was not forcing them to take COVID-positive patients, but they needed to call DPH and explain why if they didn’t.

One medical director at a Connecticut nursing home lamented on social media that “if the hospital makes a referral of a COVID positive person and we decline, we are immediately reported to DPH and have to justify the decision.” Like the bully on the school playground saying — “Go ahead, I double dare you” — only this time lives are at stake. 

Tragically, the impact of Lamont’s policy has been immediate. Data released last week show that close to 100 (98) residents died in Connecticut nursing homes in the four weeks since these facilities were encouraged to take COVID-infected patients — almost four times the number who died in the four weeks preceding the order.

A man visits his mother through her apartment window at her Windsor, Conn., nursing home during the height of the pandemic on May 14, 2020.

AP

Meanwhile, the number of nursing home residents infected with the virus more than doubled during this time period — from 965 to 2,378. In contrast, infection rates, hospitalizations and COVID-related deaths in Connecticut’s general population declined during this same period as Omicron continued to subside.

Sensing the criticism this unwanted spike in cases might bring, the governor hastily issued another executive order, this time mandating that everyone entering nursing homes show proof of vaccination or a negative COVID test before being allowed in — except of course for the COVID-positive hospital patients rolling into nursing homes every day!

Lamont and his DPH have other choices available to them if they are willing to think creatively. They could use the $6 billion in federal COVID money sent to Connecticut to set up separate recovery centers for recovering COVID-positive patients — taking the strain off hospitals while keeping these patients isolated and free from transmitting the virus to others. 

Families of patients who died of COVID in New York nursing homes protested loudly against Cuomo’s policy in 2020. Connecticut families should demand better, too.

AP

They could offer short-term bonuses or temporary pay raises to qualified health care workers who are retired or on leave to incentivize them to go back to work now and help get us through this peak. They could look to recruit healthcare workers from other parts of the country less impacted by the current COVID wave to come to Connecticut and help.

At a minimum, they could change the current biweekly reporting of nursing home infections and deaths to a daily report to get an early read and react before it’s too late.

One thing we’ve learned is that “one size does not fit all” when it comes to COVID.  While Connecticut and other Northeastern states rejoice about overall Omicron rates coming down, the data shows that infections and deaths in Connecticut nursing homes are still a major concern. It’s not too late to do something about it, if state leaders have the courage to act now.

A former executive at General Electric and CFO of UBS Investment Bank, Bob Stefanowski was the 2018 Republican candidate for governor of Connecticut and is now a candidate in the 2022 Connecticut gubernatorial election.

https://nypost.com/2022/02/12/connecticut-nursing-homes-endangered-by-covid-order-again/

What Is It Like On a Royal Caribbean Cruise Ship Right Now?

 The pandemic has made taking a cruise a somewhat different experience. Covid has impacted most areas of life around the world, but cruises have been affected more than most travel. All U.S. cruise lines including Royal Caribbean (RCL) - Get Royal Caribbean Group Report, Carnival Cruise Lines (CCL) - Get Carnival Corporation Report, Norwegian Cruise Line (NCLH) - Get Norwegian Cruise Line Holdings Ltd. Report, and even Walt Disney's (DIS) - Get Walt Disney Company Report cruise line stopped sailing from March 2020 through July 2021 (with Disney waiting a little longer to come back). 

Cruising has returned from U.S. ports, but it's not quite the same experience cruisers had before the pandemic. Some of the changes are minor hassles, while others may make some people consider delaying their trip until the pandemic goes away -- something that may not fully happen.

Protocols have been changing -- and will change again soon for Royal Caribbean and Norwegian passengers -- but much of the altered experience has been consistent since cruises from U.S. ports resumed in July.

Royal Caribbean requires that all passengers 12 and older be fully vaccinated before they get on board. That means they must be two weeks past their second shot of the Moderna or Pfizer vaccine or two weeks past a single shot of the Johnson & Johnson vaccine.

None of the three major cruise lines requires that passengers get a booster shot to be considered fully vaccinated. Royal Caribbean asks passengers to upload their vaccine cards before their cruise using its app so they can be verified. Passengers must also answer some health questions in the app which become available roughly 24 hours before your cruise.

In addition to proof of vaccination, all cruisers must take an approved Covid test, no earlier than two days before their cruise. It's two days, not 48 hours, meaning that if you depart on a Sunday, you can take your test either Friday or Saturday. Assuming you test negative, a printout of your results (or a version shown on your phone) must be shown at the port before you can boardOnce at the port cruisers generally have to stick to their allotted check-in time. That policy seems more strict than it was before the pandemic but it has been very strict on some cruises and not enforced on others. In addition, you will have to wear a mask once you enter the port facility, generally removing it briefly for a picture or to show that you match the picture you took before your cruise.

Once you get to the front of the line you will be asked to show your Set-Sail Pass (Royal Caribbean's name for your ticket). your passport (or, in some cases, other acceptable forms of ID), your proof of vaccination, and your test results. On some cruises, you will have to show these multiple times. For others, it may only be once.

Assuming you have all of those things you can board the ship. That generally requires one more scan of your Set-Sail Pass and then it's time to board.

During this entire time and as you board and once you are on the ship, you will be wearing a mask. As of early February, Royal Caribbean passengers -- regardless of vaccine status -- must keep their masks on in all public indoor areas unless they are stationary and eating or drinking.

From a practical point of view, most passengers remove their masks once stationary in any venue that serves food or drinks. Royal Caribbean has not been strict on this, which may be because as of Feb. 15 the cruise line will allow vaccinated passengers to remove their masks in areas that are only for vaccinated passengers. Those include mot bars and restaurants, as well as the casino.

Currently, smoking has been prohibited in the casino and the company has not said whether it will return when the mask rules loosen.

Masks are not required while outside (though they're technically suggested in crowded areas nor do you gave to wear them at Royal Caribbean's private island, Coco Cay.

At the various ports, mask rules and whether you need to carry your proof of vaccination vary by locale and the cruise line does not set those rules.

In addition to the mask rules, there are some other things that are different onboard, though it does vary somewhat by ship:

• A printed Cruise Compass (the onboard schedule) may not be delivered to your room. In some cases, they can be requested from your room steward and, in others, they are available at guest services.
• Menus in some locations are only available via scanning a QR code. In most of the main dining venues and the main dining room, printed menus are still generally being used.
•  Some events that don't allow for social distancing are not available. These include some parties, laser tag, the Quest (a sort of adult scavenger hunt), and select other events.

In addition, crew members testing positive have led to some shows being canceled or modified. And, because ships are sailing with reduced capacities (though some have returned to nearly normal) hours may vary compared to pre-pandemic at venues like the Windjammer buffet.

Cruising on Royal Caribbean (or Carnival, Norwegian, or Disney) right now requires a level of flexibility. The rules may change based on what happens with Covid. Ports or activities could be canceled and things may not be exactly as you plan for them to be.

https://www.thestreet.com/investing/what-is-it-like-on-a-royal-caribbean-cruise-ship-right-now

French COVID protest convoy defies Paris stay-away order

 

A convoy protesting COVID-19 restrictions breached police defences and drove into central Paris on Saturday, snarling traffic around the Arc de Triomphe and on the Champs Elysees, as police fired tear gas at demonstrators.

Protesters in cars, campervans, tractors and other vehicles had converged on Paris from Lille, Perpignan, Nice and other cities late on Friday, despite warnings from Paris authorities that they would be barred from entering the capital.

Inspired by horn-blaring "Freedom Convoy" demonstrations in Canada, dozens of vehicles slipped through the police cordon, impeding traffic around the 19th century arch and the top of the boutique-lined Champs Elysees, a magnet for tourists.

Inside the city's limits, motorists in the "Freedom Convoy" waved tricolour flags and honked in defiance of the police ban.

On the Champs Elysees, clouds of tear gas swirled through the terraces of bars and restaurants.

Riot police also threw tear gas grenades to keep order at an authorised street protest where demonstrators, including some "Yellow Vests" railed against President Emmanuel Macron's coronavirus vaccine pass rules and the cost of living.

On the Champs Elysees, police used tear gas into the evening as sporadic scuffles continued and one person who collapsed on the sidewalk was brought to hospital for checks, police said.

France requires people to show proof of vaccination to enter public places such as cafes, restaurants and museums, with a negative test no longer being sufficient for unvaccinated people.

"We can't take the vaccine pass any more," said Nathalie Galdeano, who had come from southwest France by bus to participate in the protests.

Police said that they had arrested 54 people, handed out 337 fines by and stopped 500 vehicles trying to get into Paris in the morning. The Interior Ministry said about 32,000 people participated in protests nationwide, including 7,600 in Paris.

Less than two months from a presidential election, Macron's government is eager to keep protests from spiralling into large-scale demonstrations like the anti-government Yellow Vest revolt of 2018.

That movement began as a protest against fuel taxes and grew into a broader revolt that saw some of the worst street violence in decades and tested Macron's authority.

Grievances expressed by protesters in the "Freedom Convoy" extend beyond COVID restrictions, with anger simmering over a perceived fall in standards of living amid surging inflation.

Police had mobilised more than 7,000 officers, set up checkpoints and deployed armoured personnel carriers and water cannon trucks in preparation for the protests.

Separately police also said they had arrested five protesters in southern Paris in possession of sling shots, hammers, knives and gas masks.

Canadian truckers protesting a vaccine mandate for trans-border traffic have paralysed parts of the capital Ottawa since late January and blocked U.S.-Canada crossing points. Canadian police began clearing protesters blocking a key bridge linking Canada and the United States on Saturday.

https://www.marketscreener.com/news/latest/French-COVID-protest-convoy-defies-Paris-stay-away-order--37978780/

TD Bank To Surrender Convoy Donations To Court As Organizers Turn To Crypto

 Canada's TD Bank says it plans to surrender approximately $1 million in un-refunded GoFundMe donations to the Freedom Convoy, as well as some $400,000 the group had accepted through direct donations.

On Friday, TD told CTV news that it would apply to surrender the funds to an Ontario court.

"TD has asked the court to accept the funds, which were raised through crowdfunding and deposited into personal accounts at TD, so they may be managed and distributed in accordance with the intentions of the donors, and/or to be returned to the donors who have requested refunds but whose entitlement to a refund cannot be determined by TD," said spokeswoman Carla Hindman.

The Convoy, meanwhile, plans to fight for their donations - and is now looking to raise funding via cryptocurrency.

Convoy lawyer Keith Wilson said that the group planned to fight to retrieve any money they had raised — and could be seen in a video promoting the group’s next play: a cryptocurrency fundraiser that has raised almost US$1 million.

“We will be taking expedited legal steps to have the restrictions on the donated funds lifted as soon as possible,” Wilson said in an email to CTV News. -CTV

"The principle philosophy of what Bitcoin is is freedom," says one organizer in a Facebook video. "For everyone who had their voice stolen by “GoFraudMe”, “GoFundMe,” you should feel solace that there are now alternatives."

According to Ontario court filings, Ottawa Police cited the video in their affidavit, referencing the convoy's crypto fundraising strategy.

According to the Globe And Mail, more than $500,000 has been raised by one Bitcoin wallet.

TD's move is the latest hurdle faced by the Convoy - which has occupied Ottawa and other border crossings for approximately two weeks in protest of vaccine and mask mandates - sparking protests worldwide in solidarity, as well as a state of emergency declared by Ontario Premier Doug Ford on Friday.

As CTV notes, of the roughly $10 million raised via GoFundMe, just $1 million was deposited before the fundraising site decided to cancel the campaign and refund the remainder.

Two subsequent fundraisers launched on Christian crowdfunding site GiveSendGo have reached more than $9 million as of this writing.

Late Thursday, however, the Ontario Superior Court froze funds from these accounts, after the province's Attorney General alleged that the funds would further the criminal act of 'mischief on the streets' of Ottawa.

GiveSendGo says the order doesn't apply and is still collecting funds.

https://www.zerohedge.com/geopolitical/td-bank-surrender-convoy-donations-court-organizers-turn-crypto

Denmark officials see no reason to give more COVID vaccines

 Health authorities in Denmark said Friday that they were considering “winding down” the country’s coronavirus vaccination program in the spring and see no reason now to administer a booster dose to children or a fourth shot to anymore residents at risk of severe COVID-19.

The Danish Health Authority said in a statement outlining its reasoning that the third infection wave in the European nation was waning “due to the large population immunity.”

“The very high vaccine coverage in Denmark, especially with the third shot, means that we can cope with increasing infection without getting serious illness,” the government agency said in a statement.

Last month, the Danish government said it was offering a fourth vaccine dose to older adults and other vulnerable citizens because the pandemic situation had worsened amid the rapid spread of the omicron variant of the coronavirus.

But a Health Authority assessment concluded that three shots had provided good protection to nursing home residents and people over age 85, and the agency decided it was unnecessary to provide them with additional shots right now.

Bolette Søborg, a unit manager and chief physician with the authority, said the approaching end of winter, when time spent indoors makes it easier for the virus to spread, is another reason to hold off on fourth doses.

Only a handful of countries worldwide have started offering fourth shots or announced plans to do so.

Denmark expanded its vaccination program to children ages 5-11 in November, when the delta variant was dominant and there was a fear youngsters could infect older generations. Health authorities said Friday that they were “now starting to plan to round off the current vaccination program for all target groups, including the program for children aged 5-11.”

More than 80% of the population has received two shots while 61.3% have had a booster, according to official figures.

The agency said it was looking at “winding down the entire general vaccination program later in the spring.”

“We will of course follow the epidemic closely, and we are ready to change our decision if, contrary to expectations, there is a fourth spring wave or new worrying variants this spring,” the agency statement said.

Denmark scrapped most pandemic restrictions this month after officials said they no longer considered COVID-19 “a socially critical disease.” Officials said that while omicron is surging in the Scandinavian country, the variant was not placing a heavy burden on the health system.

This week, the country reported a slight drop in new weekly cases.

https://apnews.com/article/coronavirus-pandemic-health-denmark-europe-pandemics-7d45f190a96e4d22e62c40345a1c39b3

'Everything is on the table' -Trudeau on ending blockades

 "Everything is on the table because this unlawful activity has to end and it will end," Trudeau told reporters. "I can't say too much more now as to exactly when or how this ends because, unfortunately, we are concerned about violence."

"We are a long way from ever having to call in the military... it is not something we are seriously contemplating at this time," he later added.

Ontario declared a state of emergency on Friday and threatened to fine and jail protesters who have been blocking a key U.S. trade corridor for four days, damaging auto production and drawing calls for action from the White House.

https://news.yahoo.com/everything-table-trudeau-ending-blockades-201859441.html