IHA Daily Briefing: Feb. 4

AHA Issues Rural Health Report
Coalition Works to Save Flex Scheduling in Chicago
Sen. Durbin Develops Plan to Stop Drug Price Hikes
Gov. Pritzker Takes Executive Action for HIV Epidemic
IHA Showcase: Last Week to Submit a Project

AHA Issues Rural Health Report
This afternoon, the American Hospital Association (AHA) released a rural health report—Challenges Facing Rural Communities and the Roadmap to Ensure Local Access to High-quality, Affordable Care—outlining the persistent, recent and emergent challenges that threaten rural hospitals’ ability to maintain access to healthcare services in their communities. The report underscores the importance of local access to essential health services, as well as the economic impact rural hospitals have on their communities.

According to the North Carolina Rural Health Research Program, 95 rural hospitals closed between 2010 and 2018. In addition, an August 2018 Government Accountability Office report found more than twice the number of rural hospitals have closed during the last five years than the previous five-year period.

The report notes that not only are rural hospitals struggling with low patient volumes and geographic isolation, they also are confronted with issues such as economic fluctuations, increased regulatory burden and the opioid epidemic.

New models of care can offer alternative ways of delivering and paying for health care services in rural communities. However, rural communities need comprehensive solutions. The AHA believes that federal policies must be updated for delivering care in the 21st century and new investments must be made to protect access to care in rural communities such as:

  • Fair and adequate reimbursement that updates Medicare and Medicaid payment rates to cover the cost of care;
  • New models of care that improve financial predictability, and include rural providers in the movement toward value-based care;
  • Regulatory relief from antiquated and burdensome requirements that do not improve patient care;
  • Expanded access to telehealth and broadband services, and ensuring health information technology costs and compliance requirements are addressed to ease the burden on rural hospitals;
  • Workforce programs targeting rural areas that continue to be hard-hit by provider shortages; and
  • Prescription drug price concerns, including unsustainably high drug costs and attacks on the 340B program, which supports vulnerable communities.

According to the report, the challenges faced by rural hospitals are complex, requiring policymakers, providers and communities to work together, innovate and leverage unique strategies to pave the way for the future of rural health care. The federal government must play a principal role by updating policies and investing new resources in rural America.

An infographic is available here.

Coalition Works to Save Flex Scheduling in Chicago
IHA, as part of a coalition with the Chicagoland Chamber of Commerce, Illinois Hotel & Lodging Association, Illinois Restaurant Association and Illinois Retail Merchants Association, is opposing the Chicago Fair Work Week Ordinance proposal. This ordinance would require Chicago employers to:

  • Post work schedules at least two weeks in advance;
  • Pay their employees at least one hour of “predictability pay” in the event that the work schedule changes or if work hours are added or subtracted;
  • Pay employees no less than time-and-a-half if work hours are cancelled or reduced within 24 hours’ notice; and
  • Prohibit outsourcing of jobs.

The coalition of employers, employees and community groups, called “Work Your Way”,  today issued a press release and launched an online public relations campaign. The coalition is engaging city council members on the negative effects the ordinance would have on the Chicago business community, conveying employee support for current working practices, highlighting the loss of flexibility from the proposal, and activating local, ward-based coalition members to engage directly with their aldermen. The coalition aims to educate Chicago City Council members, the Mayor’s Office, and the Chicago news media about the negative impact of the ordinance on employees and their families, small businesses and Chicago’s ability to compete, and to strongly urge them to maintain flexible scheduling options in the city.

Visit the coalition’s website, and engage its social media efforts on Facebook and Twitter to show your support.

Sen. Durbin Develops Plan to Stop Drug Price Hikes
In an effort to address the rising cost of prescription drugs for patients, providers and taxpayers, U.S. Sen. Dick Durbin (D-IL) joined local hospital leaders on Friday to unveil new legislation to help prevent sudden, steep price hikes for prescription drugs. The Forcing Limits on Abusive and Tumultuous (FLAT) Drug Prices Act of 2019, which Durbin will formally introduce in the Senate this week, would penalize drug manufacturers who increase their prices above a certain amount within a short time period.

“Health care is still too expensive for too many working families, and the soaring cost of prescription drugs is one of the major reasons why,” Durbin said. “That’s why I am introducing a new bill next week in Washington, which will prevent large price spikes for prescription drugs. Whether it’s the overnight price hikes by greedy Wall Street executives, or the year-over-year increases for decades-old medications like insulin, these price-gouging practices must end. It’s long past time Congress puts patients before Pharma, and I hope 2019 will be the beginning of real change.”

Currently, pharmaceutical companies are awarded “monopoly periods” of five to 12 years by the U.S. Food and Drug Administration (FDA) for new drug approvals. During this time, FDA agrees not to review cheaper, generic alternatives. According to Sen. Durbin, too often, pharmaceutical companies use this monopoly period—where no generic competition is allowed—to bilk taxpayers and patients with excessive price increases.

The FLAT Prices Act would reduce this FDA-granted exclusivity period for a drug whose price increases more than 10 percent in a year, or similar amounts over a multi-year period. Drug manufacturers would be required to self-report their price spikes to the Department of Health and Human Services (HHS), and they would have the opportunity to provide an appeal to justify such a price increase. Failure to report such a price hike would incur additional reductions in market exclusivity.

In the Sen. Durbin press release, IHA President and CEO A.J. Wilhelmi said, “The skyrocketing price of prescription drugs is preventing patients from accessing the medicine they need and threatening the ability of hospitals to provide the highest quality care to their patients. IHA and the Illinois hospital community applaud Sen. Durbin’s ongoing leadership on this issue and we look forward to partnering on this effort to advance solutions to address the high cost of prescription drugs, including sudden and exorbitant price increases.”

Gov. Pritzker Takes Executive Action for HIV Epidemic
Last week, Gov. Pritzker took executive action to strengthen the state’s commitment to ending the HIV epidemic that has affected nearly 40,000 Illinois residents. Through the executive order, the state will change course and take advantage of opportunities to improve treatment by:

  • Investing in Programs and Services to End the Epidemic. Investments will include prevention measures the Rauner administration had discontinued, including funding for increased HIV testing, PrEP, the African American HIV/AIDS Response Act and other public health initiatives. Additionally, people living with HIV along with their healthcare providers will be invested and supported in achieving undetectable viral loads; and
  • Monitoring Viral Load Metrics. The Illinois Department of Public Health and the Department of Healthcare and Family Services, in conjunction with the contracted Medicaid managed care organizations (MCOs), shall, within 90 days of the effective date of this Executive Order, deliver a report to the Governor containing a plan for the MCOs to share data with the State in accordance with all laws and regulations governing health privacy, including a viral load metric, so that the State can monitor progress to ensure Illinoisans living with HIV have access to the healthcare they need to keep their viral loads at zero.

With Medicaid providing health insurance for 23,748 Illinoisans living with HIV in FY17, the state-run program is the largest payer for HIV care in the state and a vital partner in ending the HIV epidemic.

"While 1,375 people were newly diagnosed with HIV in 2017 alone and unacceptable health disparities in communities of color continue, over the past few years we've seen HIV prevention funding dry up, HIV testing rates go down, and HIV prevention and treatment agencies lay off staff," said Governor J.B. Pritzker. "Now is not the time to back down from this fight. Now is the time to double down. This executive order defines the state's commitment to the HIV epidemic and serves as a first step in ensuring the state is good partner in this fight."

IHA Showcase: Last Week to Submit a Project
Ensure your hospital or health system is represented at IHA’s 4th annual Quality Advocacy Showcase by submitting a quality improvement project before Friday’s deadline. The showcase is your chance to educate state legislators on your hospital’s accomplishments in advancing quality healthcare and patient safety.

The event will be held Wednesday, April 3 at the Illinois State Capitol Rotunda in Springfield. For the showcase, IHA will produce one professionally designed 30-by-42-inch poster per facility at no cost to members. Posters will be displayed in the rotunda and adjoining hallways for an impressive display of the quality improvement work of Illinois’ hospital community.

We’re looking to build on the excitement and engagement of last year’s showcase—with 91 posters displayed—with an even bigger turnout this year. Encourage your organization’s quality leaders to submit a project by this Friday.