Media Coverage of Medical Debt Lawsuits Prompts Hospital Reversal

August 31, 2021 - Schools are reopening and mask mandates are returning in what should make for interesting conversations during Labor Day barbecues and celebrations.

Convalescent Plasma Unable to Halt COVID-19 Progression

COVID-19 convalescent plasma given to high-risk outpatients within one week of the onset of coronavirus symptoms does not prevent disease progression, according to a New England Journal of Medicine study.

The randomized, multicenter clinical trial enrolled 511 patients at 48 emergency departments in 21 states being treated for COVID-19 symptoms. All patients were 50 years of age or older and had one or more risk factors for disease progression.

Researchers found that disease progression occurred in 30 percent (77 patients) in the convalescent plasma group and 31.9 percent (81 patients) in the placebo group. Five patients in the convalescent plasma group and one patient in the placebo group died. READ MORE

Media Scrutiny of Medical Debt Lawsuits Lead to Decline

Media exposure, public awareness, and patient advocacy led to fewer patient medical debt lawsuits in Virginia, a recent study published in JAMA suggests.

The study follows a popular 2019 analysis published in the same journal that found over a third of Virginia hospitals filed an aggregate of 20,054 warrant in debt lawsuits and 9,232 wage garnishment cases over unpaid patient medical debt. In addition, the analysis indicated that the hospitals “pursued patients for inflated medical charges in court and garnished paychecks from US residents with low income.”

Researchers from the 2019 analysis reconvened to determine how media exposure and newfound public awareness of the patient medical debt lawsuits impacted hospital billing practices in Virginia. Using court records from 2018 through 2020, researchers found that the number of patient medical debt lawsuits filed by Virginia hospitals declined by 59 percent. More specifically, there was a 55-percent decrease in warrant in debt cases and a 66-percent decrease in wage garnishments. READ MORE

Medicaid Expand Increases Access and Reduces Spending

Medicaid expansion states have experienced higher access to health insurance coverage and lower state Medicaid spending, a report from the Menges Group found.

The researchers compared Medicaid expansion states and non-expansion states, using data from the Centers for Disease Control and Prevention (CDC) and the US Bureau of Labor Statistics. By the end of the time period that the researchers analyzed (2014 through 2019), 37 states and the District of Columbia had adopted Medicaid expansion.

The analysis focused primarily on four outcomes to assess the impact of Medicaid expansion programs: healthcare coverage access, state, federal, and overall Medicaid costs, the death rate of beneficiaries under the age of 65, and employment and unemployment rates. READ MORE

Rural Hospital Eds Struggle with Telehealth Reimbursement

Despite having a high need for telehealth use, rural hospitals see a significant lack of emergency department telehealth services due to telehealth reimbursement barriers and low patient volumes, according to a JAMA Health Forum report.

Many patients who seek care at small, rural emergency departments are frequently referred to urban health systems to receive specialty care. Some smaller hospitals struggle with costs to begin with due to low usage by patients and transferring patients to another center only hurts their finances further.

Telehealth costs and reimbursement are significant barriers for small hospitals. Researchers noted that implementing a telehealth program can cost anywhere from $17,000 to $50,000 for equipment and internet connectivity. On top of that, the average annual subscription fee is $60,000, with additional maintenance and connectivity expenses between $3,000 and $8,000 each year. READ MORE

Hospitals Largely Ignored Population Health Lessons of COVID-19

Although most hospitals across the country suffered due to the impact of COVID-19, in Numerof’s sixth annual State of Population Health Survey report, research indicates that few hospitals took away any lessons regarding mitigating business risk in fee-for-service.

Around 300 healthcare executives responded to the survey. Once again, a vast majority (99%) reported they expected their organization to have some revenue in models with upside gain and/or downside risk in two years, even though their expectations have regularly fallen short in past years.

When asked whether they thought the pandemic would accelerate at-risk contracting, survey participants were evenly split among the three answers: “agree” at 39 percent, “neutral” at 30 percent, and “disagree” at 31 percent. Similarly, when asked whether capitated models would be more attractive due to COVID-19, 36 percent agreed, 31 percent were neutral, and 33 percent disagreed. READ MORE

Cash Incentives Not Promoting Prevention in Marginalized Populations

Financial incentives do slightly impact patient engagement with preventive care and screenings, but not so much for the most marginalized of populations experiencing social determinants of health, according to data published in JAMA Network Open.

Through a literature review of randomized control trials involving adults over age 50 eligible for colorectal cancer screenings, the researchers found modest gains in screening access when patients got some financial payout.

Overall, financial incentives yielded a 33.5 percent colorectal cancer screening rate, while mailed patient outreach yielded a 30 percent colorectal cancer screening rate. But when looking at specific patient demographics, the team observed downticks in financial incentive impact, particularly when there were more low-income patients or patients from racial and ethnic minority groups. READ MORE