In the News

Five Reasons Biden Might be Wrong About the Pandemic Being Over

The Hill | By Joseph Choi

President Biden boldly claimed in an interview over the weekend that the pandemic is over, but public health experts — and U.S. statistics — put those remarks in serious doubt.

Coronavirus cases and deaths in the U.S. have been on a steady decline in recent weeks following a slight rise due to the BA.5 omicron subvariant.

However, tens of thousands of new cases are still being recorded daily, hundreds of Americans are still dying of the virus every day and enthusiasm for immunization has all but stagnated. 

In his “60 Minutes” interview, Biden acknowledged the U.S. still has “a problem with COVID,” but pointed to the fact that people were not wearing masks at the event he was attending as evidence that the pandemic phase of COVID-19 is over.

He sought to walk back the remarks on Tuesday, saying the pandemic is “not where it was.”

But he has maintained the core of his argument: COVID-19 has reached a new, less severe phase. 

Many have been waiting for the pandemic to become endemic.

For a virus to be considered endemic, it would still exist within communities, but it would not severely impact medical providers and health systems. 

Available information paints a picture of a country that, while making strides in combating the outbreak, is far from being in the clear. 

Cases 

While cases are declining, they are still far from being the lowest they have ever been throughout the pandemic. 

Case rates for COVID-19 currently stand at a seven-day moving average of about 55,000 cases per day, a marked decline from the hundreds of thousands of infections that were seen at the start of this year when the omicron wave peaked. 

This rate is still more than twice what the U.S. saw in April before BA.5 rose in dominance.

Since the start of the pandemic, case rates reached their lowest in June 2021 when they dipped below 12,000 per day for a few weeks. 

Half of all U.S. counties are currently considered to have low COVID-19 community levels, according to the Centers for Disease Control and Prevention (CDC). Another 36 percent of counties have medium COVID-19 community levels, and 13 percent have high community levels.  

This leaves half the communities in the country in a place where mask wearing is still recommended by the CDC in some situations, particularly for those at high risk for severe illness. 

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HHS Rolls Out First National Family Caregiver Strategy

McKnight’s Home Care | By Diane Eastabrook

The Department of Health and Human Services unveiled its first national strategy to support family caregivers on Wednesday. Among the list of actions HHS recommended is the creation of a job classification for direct care workers and standardized training and accreditation across states.

“Supporting family caregivers is an urgent public health issue, exacerbated by the long-term effects of the COVID-19 pandemic,” HHS Secretary Xavier Becerra said in a statement. “This national strategy recognizes the critical role family caregivers play in a loved one’s life. I know the importance of this first-hand, as someone who cared for my late father and navigated the challenges associated with caregiving.” 

The national strategy lists 350 actions the federal government will take to help family caregivers over the next year and 150 actions that can be adopted by state and local governments, as well as the private sector to build a safety net for family caregivers. They include:

  • Increased funding to state, tribal and local health departments to embed family caregiving into public health infrastructure and planning
  • Incentives for healthcare systems to incorporate family caregivers into healthcare decision-making
  • Expansions to Medicare benefits, including respite care, adult day services and meals
  • Financial support for caregiving initiatives through federal funding opportunities, including expansion of Older Americans Act and the Elder Justice Act funding opportunities
  • Federal passage of family leave and expansion of FMLA to include smaller employers

The strategy is the result of the RAISE Family Caregivers Act, signed into law in 2018, which required HHS to come up with an action plan to aid family caregivers within 18 months of its passage. It was developed jointly through advisory councils and included input from family caregivers.

An estimated 53 million Americans provide informal, and typically unpaid, care to older adults and disabled people, according to the National Alliance for Caregiving and AARP. A 2015 study by AARP estimated family caregivers provide approximately $470 billion in unpaid care annually. 

poll released last week found one-third of family caregivers surveyed worried about juggling work and caregiving duties, while nearly half said using paid caregiving would reduce their emotional and physical stress.

 

Lawmakers Zero in on Immigration to Address Caregiver Crisis

McKnights Home Care | By Diane Eastabrook

Momentum could be building in Washington to address the troubled immigration system as a way to solve the nation’s caregiver crisis. 

Last week, both Republican and Democratic senators acknowledged that current immigration policy is making it difficult to recruit and retain foreign healthcare workers during a hearing in Washington. Sen. Alex Padilla (D-CA), chairman of the Senate Judiciary Subcommittee on Immigration, Citizenship, and Border Safety, said there continues to be a backlog in processing green cards for critical healthcare workers and caps on employment-based visa categories.

“Many of the federally recognized central workers that we relied on at the peak of the COVID-19 pandemic still risk uncertainty with their legal status in America,” Padilla said during the hearing. “In our hour of need, the United States is effectively discouraging potential healthcare workers from trying to come to and work in the United States. That needs to change.”

Last year, Padilla and Sen. Richard Durbin (D-IL) introduced the Citizenship for Essential Workers Act, which established a mechanism for immigrants who worked as essential workers during the COVID-19 pandemic to apply for and obtain permanent resident status. To be eligible, the workers must have earned income at any time during the pandemic that was deemed essential by the Department of Homeland Security or a state or local government. New York is one state that deemed home- and community-based caregivers as essential under a bonus program the state enacted over the summer. 

Home care advocates, including the Home Care Association of America and LeadingAge, have been aggressively advocating for immigration reform as a way to address the shortage of caregivers. However, both groups favor the establishment of a new visa category for direct care workers that might allow agencies to either sponsor workers living outside the U.S. now or currently working here under another visa category.

An estimated 30% of the nation’s 2.3 million home care workers are immigrants, according to PHI National which tracks the direct care industry. 

 

Telehealth Better Than In-Person Visits on Some Quality Measures: Study

Modern Healthcare | By Mari Devereaux
 
Telehealth visits for primary care can be comparable in quality to in-person visits, suggesting remote testing and screenings are valuable tools to augment patient care.
 
The finding follows a study of more than 500,000 patients across 200 outpatient care sites in Pennsylvania and Maryland who either had exposure to telemedicine or only had in-person visits between March 1, 2020, and November 30, 2021.
 
The report examines the care quality performance of telemedicine and in-person patient groups for 16 Health Care Effectiveness Data and Information Set measures selected across five domains of primary care: cardiovascular, diabetes, prevention and wellness, behavioral health and pulmonary. 
 
In 13 of 16 medication, testing and counseling-based measures, exposure to telemedicine was associated with similar or significantly better quality performance. The study was published in JAMA Network Open.
 
Higher quality scores for telemedicine prove that remote care is worth the cost of reimbursement just like in-office care, said Dr. Derek Baughman, an author of the study and medical director at Barksdale Air Force Base and Medical Clinic. 
 
“This isn't just one or two measures, it's showing that for most of the measures, we're providing at least comparable quality,” he said. “We're not making these measures worse.”
 
For all counseling and testing-based measures—including vaccinations, cardiovascular disease and diabetes testing and screenings for depression and cancer—telehealth care encounters were more likely to meet HEDIS quality benchmarks than solely in-person patients. 
 
The results are examples of clinical domains where telemedicine could be used as an alternative to in-office care, Baughman said. Prioritizing telehealth visits for chronic disease management and preventive care could lead to better quality outcomes as well as more affordable care.

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Audit of Cares Act Provider Relief Funds by CMS

The Health Group 

The 2022 OIG Work Plan includes the audit of CARES Act Provider Relief Funds.  The Work Plan includes the following:

“The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act appropriated $175 billion for the Provider Relief Fund (PRF) to support health care providers affected by the COVID-19 pandemic.  In April 2020, the Health Resources and Services Administration began distributing the funds through general distributions to Medicare providers based on 2018 net patient revenue and targeted distributions for certain provider types (e.g., providers in areas particularly impacted by COVID-19, skilled nursing providers, and providers in rural areas).  Providers such as hospitals may be eligible for PRF payments from the general and targeted distributions.  We will select for audit a statistical sample of providers that received general and/or targeted distributions.  Our objective is to determine whether providers that received PRF payments complied with certain Federal requirements, and the terms and conditions for reporting and expending PRF funds.”

The process has begun as selected providers are being notified of upcoming audits.  The OIG audit notification letter includes the following:

“To expedite completion of our work, we request that you have the documentation pertinent to your entity’s use and reporting of PRF payments available at the time of our meeting. We appreciate your cooperation in this matter and will make every effort to minimize any disruption to the work of your office.”

 
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