In the News

Seasonal Influenza Health Alert

Seasonal influenza activity is high across the United States. The Centers for Disease Control and Prevention (CDC) estimates that in the 2022-2023 season to date, there have been at least 13 million illnesses, 120,000 hospitalizations, and 7,300 deaths from influenza (Weekly U.S. Influenza Surveillance Report | CDC). While the Food and Drug Administration (FDA) has not indicated shortages of oseltamivir (generic or Tamiflu) in any of its forms (capsules, oral suspension), CDC has received numerous anecdotal reports of availability issues for generic oseltamivir in some locations [1]. This may continue to occur in some communities as influenza activity continues.

This Health Alert Network (HAN) Health Advisory provides clinicians and public health officials with guidance for prioritizing oseltamivir for treatment and information on other influenza antivirals that are recommended for treating influenza in areas where oseltamivir is temporarily unavailable.  

 

White House to Resume Program Sending Free COVID Tests by Mail

The Hill | By Nathaniel Weixel

The Biden administration is restarting its program to send free COVID-19 testing kits through the U.S. Mail to any households that request them.

The White House on Thursday said households can begin ordering a total of four at-home tests from the COVIDTests.gov website to be mailed directly to them for free, regardless of how many tests they have ordered previously. 

The tests will start to ship out the week of Dec. 19th, according to an administration official.

The White House first began sending out the kits last January during the peak of the omicron wave, but the program was halted at the beginning of September due to a lack of funding from Congress. Administration officials at the time indicated they were concerned the stockpile of tests would run out before the winter.

By the time the program ended, the federal government distributed an estimated 600 million tests.

Now, the program is restarting as part of the White House’s broader winter preparedness plan. According to a senior administration official, leftover American Rescue Plan money is being repurposed to purchase and distribute additional tests.

The administration has requested about $10 billion in COVID response money from Congress as part of the year-end government funding bill, but the prospects of it being included amid major GOP opposition are slim.

Public health officials have repeatedly warned that the U.S. will likely face another wave of COVID-19 infections as the weather gets colder and people travel and gather for the holidays. White House officials have said they are prepared for any potential surge in infections, noting that widespread vaccinations have made the virus far less disruptive than it was two years ago.

But it doesn’t seem to be convincing a checked-out public to get vaccinated. New COVID-19 booster shot uptake remains extremely low heading into the Christmas and New Year’s holidays, with fewer than 14 percent of the eligible population receiving a shot. In the meantime, infections, hospitalizations and deaths are all rising, according to data from the Centers for Disease Control and Prevention

Aside from mail-order tests, the winter plan will include distributing tests and masks at more locations, the White House said. 

Nursing homes and long-term care facilities will also see additional resources and flexibilities to help boost lagging vaccination rates, including allowing nursing home staff to administer shots. 

 

Home Health Spending Flat As Health Care Utilization Rebounds

Home Health Care News | By Robert Holly
 
Spending on home health care stayed mostly flat in 2021, a new analysis from the Office of the Actuary at the Centers for Medicare & Medicaid Services (CMS) reveals.
 
The steady spending on home health care last year came despite a sharp dip in government funding tied to the public health emergency (PHE). The decrease in PHE-related funding was generally offset by a rebounding of health care utilization across the board, according to the analysis, published online Wednesday by Health Affairs.
 
“Federal COVID relief funding had a greater impact on growth for nursing care facilities and home health care than it did for other professionals or dental services, as nursing homes and home health care agencies received a large amount of supplemental funding in 2020,” CMS statistician Micah Hartman said during a conference call with members of the media.
 
Specifically, national health expenditures on home health care totaled $125.2 billion in 2021, a year-over-year increase of less than 1%, according to the CMS analysis.
 
From 2015 to 2020, national health spending on home health care climbed from $89.6 billion to $125 billion. The largest year-over-year jump came in 2020, when spending increased by more than $12.6 billion over 2019 largely because of COVID relief.

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CDC Expands Updated COVID-19 Vaccines to Include Children Ages 6 Months through 5 Years

Following FDA action, [December 9, 2022] CDC expanded the use of updated (bivalent) COVID-19 vaccines for children ages 6 months through 5 years. Children ages 6 months through 5 years who previously completed a Moderna primary series are eligible to receive a Moderna bivalent booster 2 months after their final primary series dose. Children ages 6 months through 4 years who are currently completing a Pfizer primary series will receive a Pfizer bivalent vaccine as their third primary dose.

Updated COVID-19 vaccines are formulated to protect against some of the more recently circulating viruses.

Most importantly, COVID-19 vaccines are critical to providing ongoing protection as immunity wanes and the virus continues to mutate.

The vast majority of children in this age group have not received any doses of a COVID-19 vaccine. CDC is working to increase parent and provider confidence in COVID-19 vaccines and improve uptake among the 95% of children who are not vaccinated or who have not completed the COVID-19 vaccine primary series. Parents should talk to their child’s health care provider to ensure their child is up to date on their COVID-19 and other vaccines.

 

2023 Executive Forecast: ‘Home Health Companies Must Be Operationally Nimble’

Home Health Care News | By Joyce Famakinwa
 
In a sense, home health leaders are entering 2023 with many of the same concerns they came into 2022 with. Additional ones may have been added, but not many have been taken away.

Staffing continues to be a pain point in a competitive labor market, and both COVID-19 and inflation are still factors.

While these concerns remain top of mind for home health executives, the dynamics surrounding managed care contracting and the expiration of public health emergency (PHE) waivers are also grabbing their attention as the year comes to a close.

As part of our annual tradition, Home Health Care News heard from six industry leaders and noted their takes on the biggest thing to watch for next year and what the focus of their organization will be moving forward. Their names and predictions are below, edited for length and clarity.

***

In 2023, the home health care industry will continue adapting to change. With the pending expiration of waivers from the public health emergency, new OASIS-E guidelines and increased audits, coupled with the expansion of Medicare Advantage, agency processes will be fluid and evolve as the year progresses. The number of changes will differentiate the 2023 year from others and the impact on already-strained staff will be significant. It will be essential to provide resources and structure to continue to train those staff members who are new to the industry as well as to support veteran clinicians as the demands of care delivery adjust.

Jet Health will continue to execute its mission to deliver the right care in the right setting to our patients, with a commitment to multiple service levels across all the markets we serve. We expect to be innovative by diversifying our clinical network with the addition of clinicians across areas of specialization as well as through the use of remote patient monitoring, telehealth and predictive analytics. These initiatives allow Jet Health to provide the best outcomes for its patients and to challenge clinicians to increase their knowledge and toolkits as both they and the company pursue growth opportunities.

— Stacie Bratcher, CEO of Jet Health

***

The industry’s ability to recruit and retain clinical home care talent will continue to be front and center in 2023, as the structural shortages impacting the health care workforce will likely take several years to normalize. In the coming year, the need to address widening health disparities remains extremely urgent. Meeting recruitment and retention challenges in home care, and securing sustainable Medicare, Medicaid and managed care reimbursements, are critical steps to ensuring vital access and advancing health equity in the communities we serve at VNS Health.

At VNS Health, we are focused on creating solutions that simplify the health care experience for the most vulnerable people in our service area. In particular, we’re expanding our care management and palliative care solutions and investing significantly in consumer experience improvements. A top priority for us in 2023 is meeting the wide-ranging needs of people with mental health challenges. By integrating evidence-based interventions into our existing home care programs and creating new, population-based solutions, we’re actively addressing this critical and growing health care need.

— Dan Savitt, president and CEO of VNS Health

***

The biggest change we see coming in 2023 are the dynamics surrounding managed care contracting. Given the pressures of inflation, fee-for-service rate reductions/stagnation and our value in reducing the total cost of care, I believe the community will push back strongly on payers to provide stability and value to us as partners who can increase quality for their members and lower total costs of care.

Internally, all hands are on deck to continue to improve the clinician experience. Streamlining documentation burden, after-hours care coordination and robust training and onboarding are all core focus areas for AccentCare as we enter the new year.

— Stephan Rodgers, CEO at AccentCare

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