US Pauses Distribution of Eli Lilly COVID-19 Antibody; Ground Ambulance Rides Lead to Surprise Billing

June 29, 2021 - United States officials have paused the distribution of Eli Lilly’s COVID-19 antibody therapy after it proves ineffective against variants. New research shows the ground ambulance rides are leading to surprise billing for Americans. Plus, Congresswoman Cheri Bustos talks about the importance of social determinants of health to recent legislative action.

Pandemic Further Fueled Physician Practice Acquisitions

Hospitals and corporations now own nearly half of physician practices in the US, underscoring a long-standing trend of physician practice acquisitions by hospitals and other corporate entities, reveals a new study emailed to RevCycleIntelligence.

The study conducted by Avalere on behalf of Physicians Advocacy Institute (PAI) examined physician practice acquisitions between January 1, 2019, and January 1, 2021. Researchers found that hospitals and other corporate entities acquired 20,900 physician practices over the two-year period, representing a 25 percent increase in corporate-owned practices overall.

Additionally, 12 percent more physicians were employed by hospitals and other corporations during the period, with 48,400 physicians leaving independent practice to become employees of hospitals and corporate entities. What’s more, about 22,700 of that shift from independent practice occurred at the start of the COVID-19 pandemic in early 2020. READ MORE

Congress Keen on Incorporating Social Determinants of Health into Legislation

Congresswoman Cheri Bustos (IL-17) is hopeful about the Social Determinants Accelerator Act, a bill she’s cosponsored to help get funding directly to communities to address social determinants of health.

Among other proposed legislation, the bipartisan bill got airtime late last week during a hearing of the House Committee on Energy & Commerce. Specifically, the hearing touched on appropriations for a pilot program born out of the legislation.

The Social Determinants Accelerator Act, originally introduced in the 116th Congress in July 2019 and reintroduced since, sets out to allocate money directly to state, local, and Tribal governments so they can develop their own social determinants of health interventions.

“We've worked really, really hard to make sure that we have bipartisan support of this,” says the Congresswoman. READ MORE

US Pauses Distribution of Eli Lilly’s COVID-19 Antibody Due to Ineffectiveness

The Assistant Secretary for Preparedness and Response (ASPR) recently paused all distribution of Eli Lilly and Company’s COVID-19 antibody treatment.

CDC identified that the combined frequencies of the Brazil coronavirus variant, SARS-CoV-2 P.1/Gamma variant, and the South African coronavirus variant, B.1.351/Beta variant, now exceeds 11 percent and is trending upward throughout the US.

Overall data suggested that bamlanivimab and etesevimab administered together are not effective against either the P.1 or B.1.351 variants. These assays use “pseudotyped virus-like particles” that help determine the susceptibility of the live SARS-CoV-2 variant viruses.

Half of Emergency Ambulance Rides Lead to Surprise Billing

Ground ambulance rides, which were excluded from the No Surprises Act, continue to contribute to surprise billing in the US, a Peterson-Kaiser Family Foundation brief found.

Experts analyzed 2018 large employer health plan claims data to assess the rate of surprise billing for ground ambulance rides. They also included data from the National Hospital Ambulatory Medical Care Survey from the same year, which encompassed data on ambulance rides with an emergency department as their destination.

Slightly more than half of the emergency ground ambulance rides (51 percent) and four out of ten non-emergency ground ambulance rides resulted in an out-of-network charge. Such charges often lead to surprise bills for patients. Overall, the researchers estimated that approximately 1.5 million privately insured patients annually may receive a surprise medical bill. Ten percent of emergency visits for privately insured patients involve a ground ambulance. READ MORE

Mass General Brigham Looks to Improve Patient Data Quality  

Mass General Brigham has announced the launch of a campaign to collect more accurate and complete demographic data from the hospital’s more than one million adult primary care patients. This demographic data will consist of information such as ethnicity, age, and medical history.

The hospital’s current data for patient's race/ethnicity/language has about a 20 percent rate of missing data depending on the location. Mass General Brigham’s new goal is to have a less than 5 percent rate of missing data across the primary care population.

“Without quality data, our decision-making falls flat about how we equitably distribute programs and services,” said Mass General Brigham Senior Medical Director for Health Equity Allison Bryant, MD, MPH. READ MORE

End of Pandemic State of Emergencies Raises Questions for Telehealth Services

Healthcare providers in some states are scrambling to determine what their telehealth platforms can and can't do in the wake of expiring state emergency declarations.

Florida Governor Ron DeSantis allowed his state’s state of emergency to expire this past weekend after extending it several times, ending a number of emergency measures aimed at expanding connected health coverage and access to deal with COVID-19. As a result, providers can no longer use audio-only telehealth platforms, such as the phone, to treat patients unless they’re on Medicare.

In Alaska, residents had found it easier to get telehealth appointments with doctors because the state had an emergency provision in place that allowed out-of-state care providers – many of them based in Washington – to treat them without a license. That ended with the end of the emergency order. Now out-of-state providers have to have an Alaskan license, which takes a while to get and costs upwards of $800. READ MORE