IHA Daily Briefing: Sept 11

Friday, September 11, 2020 
IHA Fact Sheets: IPPS/LTCH & Hospice Final Rules
Illinois 25th in Commonwealth Fund Health Scorecard
State, Local Officials Seek Help on Census
Many Delay or Avoid Medical Care During Pandemic
Financial/Health Impact of Pandemic on Households
New Report on COVID-19 and Restaurants, Bars
IDPH Publishes Local County/School COVID-19 Data
State, National, Global COVID-19 Updates
Briefly Noted

IHA Fact Sheets: IPPS/LTCH & Hospice Final Rules
Today, IHA posted fact sheets summarizing highlights of the federal fiscal year (FFY) 2021 inpatient prospective payment system (IPPS) and long-term acute care hospital (LTCH) prospective payment system final rule. Hospital specific impact reports are forthcoming, and will be posted in the IHA C-Suite. 

IHA also posted a fact sheet summarizing the FFY 2021 Medicare Hospice Prospective Payment System final rule. 



Illinois 25th in Commonwealth Fund Health Scorecard
The Commonwealth Fund today released its "2020 Scorecard on State Health System Performance", an in-depth assessment of the 50 states and the District of Columbia based on 49 performance indicators on access and affordability, prevention and treatment, potentially avoidable hospital use and cost, and healthy lives.

Illinois ranks 25th overall in the scorecard (moving up one slot), with key indicators including:

  • Top-Ranked Indicators: uninsured children, children who are overweight or obese, hospital 30-day mortality;
  • Most-Improved Indicators: home health patients without improved mobility, nursing home residents with an antipsychotic medication, children without all recommended vaccines;
  • Bottom-Ranked Indicators: nursing home residents with an antipsychotic medication; preventable hospitalizations age 65 and older, hospital 30-day mortality rate age 65 and older; and
  • Indicators that Worsened the Most: hospital 30-day mortality, adults without all recommended vaccines, preventable hospitalizations ages 18-64.

Illinois moved up in the rankings of states in access & affordability and prevention & treatment; dropped in healthy lives and income disparity; and did not move in avoidable use and cost.

More information about the scorecard, including state-specific data and rankings, is available here.
 



State, Local Officials Seek Help on Census
With the 2020 Census scheduled to end on Sept. 30, state and local officials are urging residents to complete the questionnaire and asking providers to help. As of Sept. 3, it is estimated that nearly 500,000 households in Illinois have not yet completed the Census questionnaire.

The Illinois Dept. of Human Services’ Census Office (IDHS) is asking providers to reach out to those they serve and encourage them to complete the Census in one of several ways:

  • Online: Visit my2020census.gov and fill out the Census on a computer, tablet, or smart phone.
  • Phone: Call 844-330-2020 to fill out the Census over the phone. The U.S. Census Bureau offers assistance in 59 non-English languages, including American Sign Language.
  • Mail: Fill out the Census form received in the mail and return it, free of charge, to the U.S. Census Bureau.

With the state now working to rebuild communities, the social safety net and the economy from the impact of COVID-19 pandemic, IDHS notes that “Illinois is going to need every federal dollar allocated based on our population as determined by the census for the next ten years. Federal dollars support our schools, social services, hospitals, roads, and other public services. We cannot leave any potential federal funding on the table because our state is undercounted.”
 



Many Delay or Avoid Medical Care During Pandemic
A new Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention indicates that more than 4 in 10 U.S. adults have delayed or avoided medical care – including urgent or emergency care – during the COVID-19 pandemic, which might increase morbidity and mortality associated with both chronic and acute health conditions. Avoidance of urgent or emergency care was more prevalent among unpaid caregivers for adults, persons with underlying medical conditions, Black adults, Hispanic adults, young adults, and persons with disabilities. The report says that increasing accessibility of medical and telehealth services might help prevent delay of needed care.
 



Financial/Health Impact of Pandemic on Households
A new survey by NPR, the Robert Wood Johnson Foundation and Harvard's T.H. Chan School of Public Health finds nearly half the households in the U.S. – 46% – report facing serious financial problems during the pandemic in the four largest U.S. cities, including Chicago, and among Latino and Black households. Chicago-specific findings include:

  • More than one in three (35%) Chicago households report using up all or most of their savings; nearly three in ten (28%) report serious problems paying their credit card bills, loans, or other debt; one in four (25%) report serious problems paying their mortgage or rent; and more than one in five (23%) report serious problems paying for their utilities;
  • Majorities of Black (69%) and Latino (63%) households in Chicago report having serious financial problems, as well as a majority of households with annual incomes below $100,000 (59%);
  • About half of Chicago households (51%) report having lost their jobs, been furloughed, or had wages or hours reduced since the start of the coronavirus outbreak; and
  • More than one in five Chicago households (23%) report someone in their household has been unable to get medical care for a serious problem when they needed it during the coronavirus outbreak, and a majority of these households (55%) report negative health consequences as a result.

The five-part polling series was conducted among more than 3,400 U.S. adults in July – August 2020 to examine the most serious health and financial problems facing households across America prior to the expiration of federal coronavirus support programs.



New Report on COVID-19 and Restaurants, Bars
A new Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention indicates that going to locations that offer on-site eating and drinking options are associated with COVID-19 positivity. In an investigation of symptomatic outpatients from eleven U.S. healthcare facilities found that adults with positive SARS-CoV-2 test results were approximately twice as likely to have reported dining at a restaurant or going to a bar or coffee shop than were those with negative SARS-CoV-2 test results.

The report authors say that eating and drinking on-site at locations that offer such options might be important risk factors associated with SARS-CoV-2 infection. Efforts to reduce possible exposures where mask use and social distancing are difficult to maintain, such as when eating and drinking, should be considered to protect customers, employees, and communities.
 



IDPH Publishes Local County/School COVID-19 Data
The Illinois Dept. of Public Health (IDPH) is now publishing weekly numbers of new cases among Illinoisans less than 20 years old in each county to assist local schools and health departments in making decisions about in-person learning. The numbers on the IDPH website, “Metrics for School Determination of Community Spread,” include the test positivity rate, new cases, youth case increase, and new cases per hundred thousand people.
 



State, National, Global COVID-19 Updates
The Illinois Dept. of Public Health (IDPH) announced today 2,145 new COVID-19 cases and 32 deaths. The total number of cases in the state is 257,788 in 102 counties, with a total of 8,273 deaths. IDPH says that in the past 24 hours, 56,661 test specimens have been processed, with a positivity rate of 3.78%. The preliminary seven-day statewide positivity rate from September 4 to September 10 is 3.9%. Statewide COVID-19 hospitalizations in the past 24 hours increased from 1,609 patients to 1,619 patients. Of that figure, 359 patients were in the ICU, with 155 patients on ventilators.

IDPH today also reported 30 counties are considered to be at a warning level for COVID-19: Bond, Bureau, Cass, Clinton, Coles, Crawford, DeKalb, DuPage, Effingham, Greene, Grundy, Hancock, Henderson, Jackson, Jasper, Jersey, Lawrence, Madison, McLean, Monroe, Morgan, Pulaski, Schuyler, Shelby, Stark, St. Clair, Tazewell, Vermilion, Washington, and Williamson. A county enters a warning level when two or more COVID-19 risk indicators that measure the amount of COVID-19 increase.

Today’s Centers for Disease Control and Prevention (CDC) figures show more than 6.38 million confirmed and presumptive positive cases of COVID-19 in the U.S., with 191,353 deaths.

Today’s WHO Coronavirus Disease Dashboard shows more than 27.9 million COVID-19 cases globally, with more than 905,000 deaths. The Region of the Americas (includes the U.S.) continues to lead the world with more than 14.4 million cases and more than 501,000 deaths.
 



Briefly Noted
The Dept. of Healthcare and Family Services (HFS) yesterday issued a notice informing those hospitals eligible for Graduate Medical Education payments under the Hospital Assessment Program of an error which occurred in July and August and of payment corrections being made in September. Only hospitals which receive GME supplemental payments may be affected. For more details, see an IHA memo (password required). 

The Illinois Dept. of Public Health this week reported the first confirmed human case of West Nile virus in Illinois for 2020. A DuPage County resident in her 40s became ill in mid-August.

About 33.2 million Americans, or 10.3%, lacked health insurance in 2019, according to new data released this week by the Centers for Disease Control and Prevention. That compares to the 30.4 million, or 9.4%, who were uninsured at the time they were contacted through the National Health Interview Survey in 2018.