Welcome to the Winter 2021 issue of The Employers’ Voice!
Dear Colleagues,
2021 flew by and like most of you, we were more productive than ever. Highlighted in this Issue of the Employers’ Voice is an update of Forum Initiatives, recent legislative policy highlights, National Hospital Price Transparency conference details, COVID-19 vaccine updates, and a bunch of news article links I thought might be of interest.
Wishing you and yours a healthy and happy holiday! Looking forward to seeing you in person in the new year!
Gloria Sachdev
President and CEO, Employers’ Forum of Indiana
Forum Initiatives Update
Hospital Value Dashboard (HVD)
Coming Spring 2022! The beta 1.0 launch of the Hospital Value Dashboard (HVD) was on November 4, 2021, and we continue to receive feedback from Forum members who volunteered to be part of the beta test. The HVD will display RAND 4.0 hospital prices, CMS hospital quality scores, NASHP breakeven price findings, and other information. Users will be able to create customizable graphics and reports. The HVD will be a national dashboard available to all in the country thanks to a generous grant the Forum received from Arnold Ventures.
National Hospital Price Transparency Conference
Due to massive amounts of data still being analyzed for RAND 4.0, our national conference is being postponed. Watch your email inbox for additional details. As in years past, we will be presenting an award for Leadership and an award for Innovation in the Healthcare space. Nominations for these awards are being accepted now by contacting Sara Otte (sara@employersforumindiana.org).
Insurer and Non-Profit Hospital Public Forums
A 2021 Indiana law that the Forum and Hoosiers for Affordable Health Care strongly supported requires select non-profit hospitals and insurers to have an annual public forum meeting by 12/31/21 to obtain feedback from the community about their performance and to discuss pricing of health services, including a rationale for high or increased pricing. Visit the Forum website for a schedule of these meetings: Upcoming Hospital and Insurer Public Forum Meetings, 2021.
Join the EFI Board in Helping Kenyan Families this Holiday Season
As we collectively work to improve our healthcare system, we humbly acknowledge how lucky we are compared to most families in lower-middle-income countries. In keeping with that spirit, the EFI Board of Directors is excited to share that they are directing their modest board honorariums to fund health insurance for the very first 100 families in Busia County, Kenya. Remarkably, the annual family premium is only $60 (yes, sixty).
This pilot universal health insurance program in Kenya is the first of its kind. It is being launched through a partnership of organizations, including the Academic Model Providing Access to Healthcare (AMPATH). AMPATH is a global network that builds partnerships between universities and academic health centers to strengthen health systems in low- and middle-income countries, train future global health leaders, and foster healthcare innovations to improve health worldwide. The AMPATH Consortium, comprised of 14 North American universities led by Indiana University, is part of this global network.
The pandemic has taught us that global health is connected to local health. We wish these and your families peace and good health over the holidays.
Just $60 will provide a family in Kenya with health insurance for a year.
Forum board members Christan Royer, David Kelleher, and Gloria Sachdev invite you to consider funding additional families.
You can submit donations in one of two ways:
Type EFI NHIF at the bottom of the form under Additional Comments.
Select IU-Kenya AMPATH Humanitarian Fund from the drop-down menu and type EFI NHIF in the Write in gift area.
Policy Highlights
CMS OPPS/ASC Final Rule Increases Price Transparency, Patient Safety and Access to Quality Care (CMS)
Beginning January 1, 2022, CMS will increase the penalty for some hospitals that do not comply with the Hospital Price Transparency final rule. Specifically, CMS is setting a minimum civil monetary penalty of $300 per day that will apply to smaller hospitals with a bed count of 30 or fewer, and a penalty of $10 per bed per day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. Under this approach, for a full calendar year of noncompliance, the minimum total penalty amount would be $109,500 per hospital, and the maximum total penalty amount would be $2,007,500 per hospital.
No Surprises Act Overview (CMS)
The No Surprises Act — which also takes effect January 1, 2022 — lays the groundwork to provide consumers with protections against surprise billing, including patients with job-based and individual health plans.
Special Feature: COVID-19
COVID-19 Vaccines
Biden Administration Announces Details of Two Major Vaccination Policies (White House)
President Biden announced sweeping new coronavirus testing and vaccine mandates over the past few months for federal workers and contractors, healthcare workers, and private businesses. These mandates would require certain individuals to be fully vaccinated by January 4, 2022, or submit to weekly testing. Failure to comply with the rules will result in steep monetary penalties for employers. The announcements were quickly followed by lawsuits from states, businesses, and other organization, with multiple courts now blocking the rules even as the first deadlines have arrived.
Learn more about these legal challenges and what they mean for employers: EXPLAINER: Must employers follow Biden’s vaccine mandates? (Associated Press).
Must Read:
Indiana Republicans File Bill to Limit COVID Vaccine Mandates
Proposed legislation that would restrict employer COVID-19 vaccine mandates is scheduled for a 9 a.m. public hearing on December 16, more than two weeks before the formal legislative session kicks off. Under HB 1001 employers would be prohibited from requiring COVID vaccines unless “no questions asked” religious, medical, and 6-month prior infection/recovery exemptions were allowed. Additionally, they would be required to allow employees to be tested weekly at no cost in lieu of vaccination. Read the full text of HB 1001.
Kroger Ending Emergency Leave for Unvaccinated Employees (The Hill)
Kroger will eliminate paid emergency leave for unvaccinated employees who contract COVID-19 and require some unvaccinated employees on the company’s health care plan to pay a $50 monthly surcharge.
COVID-19 in Indiana
U.S. hospitalizations continue to rise, driven by surges in four states, including Indiana. Per the CDC, Indiana now has the fourth highest number of COVID hospitalizations in the country.
According to a Washington Post article from Dec. 8, COVID-19 hospitalizations are rising in the U.S., driven by surges in four states – Michigan, Pennsylvania, Ohio, and Indiana. These four states, which also have some of the highest per capita current hospitalization numbers, are responsible for almost half the country’s increase in COVID hospitalizations.
In a Nov 30 joint statement, the Indiana Hospital Association (IHA), Indiana State Medical Association (ISMA), and the Indiana State Nurses Association (ISNA) “urged Hoosiers who are not yet vaccinated to get their shots this holiday season to relieve pressure on the health care system and ensure safe gatherings.” They found that:
- COVID-19 hospitalizations are rising dramatically in Indiana, increasing 66% over the past three weeks and approaching 75% of the peak of the pandemic Indiana faced last November
- The vast majority of these hospitalizations are unvaccinated individuals
- The increasing complexity of medical conditions and number of ER visits are also on the rise, putting further strain on the system
We all need to be thinking about what we can do as individuals and organizations to get these numbers under control. One of the most important things we can do is convince vaccine-hesitant individuals to get vaccinated. Check out the links and resources below for tips and strategies to support your efforts:
The below COVID-19 dashboards provide up-to-date data related to COVID-19 vaccines including vaccination rates, hospitalizations, breakthrough cases, and more.
Member Spotlights
Meet Kate Fisher
Sr. Director, Global Health and Wellness Strategy
Cummins Inc.
Tell us about your current role at Cummins and a priority healthcare endeavor.
I lead global health and wellness at Cummins, where our vision is to make health and well-being part of all that we do. With the COVID-19 pandemic came an urgent need to address mental health. In late 2020 we launched our It’s OK mental health initiative, focused on destigmatizing and normalizing discussions around mental health and wellness globally. Every month we talk about mental health and wellness topics like resiliency, stigma, stress, grief/loss and happiness, translating into 23 languages. We engage leaders and employees to share their stories, and offer webinars, classes and interactive tools to help everyone at Cummins know that It’s OK to experience emotions across the mental health spectrum, to talk about it and to seek help when needed.
If you had a magic wand and could fix a single healthcare issue, what would it be?
Coordination of quality care. While cost and access are always concerning, what alarms me the most is our fractured health care system in which someone may receive care with absolutely no roadmap on how to best continue that care. We encourage people to get annual exams but what next? Often there is a breakdown on how to seek specialty care, manage conditions and understand quality in care. While the market offers services to mitigate some of these issues (and we at Cummins are utilizing, like a navigator and a surgical quality program), the system remains siloed and fractured.
What is your favorite holiday entrée and dessert?
This is a difficult question…I love all food! But since the holidays beckon decadence, I make a modern version of my husband’s favorite childhood entrée: Chicken Divan. As for dessert, I live just outside of Detroit where we have an abundance of Lebanese food and culture. Lebanese baklava is, hands down, my favorite treat any time of year.
In the News
Must Read: The Commonwealth Fund’s 2020 Scorecard on State Health System Performance
See how all 50 states and the District of Columbia are ranked on 49 measures of access to health care, quality of care, service use and costs of care, health outcomes, and income-based health care disparities. You can view the data virtually, download the full report as a PDF, or download two-page summaries for each state.
Employers
125 unvaccinated employees leave IU Health (Becker’s Hospital Review)
Video: The Pitfalls of Cost Sharing for Healthcare (Healthcare Triage)
2021 Employer Health Benefits Survey (KFF)
Strategies to Control the Rising Cost of State Employee Health Care (Office of Vermont State Auditor)
Advancing Primary Care: A Purchaser Playbook for Action (NAHPC)
Fiduciary Check In: Rights & Responsibilities Related to Service Provider Disclosure (NAHPC)
Self-Insured Healthcare Plans Lead The Fight Against High Hospital Prices (Medium)
Health Care Industry
2019 Health Care Cost and Utilization Report (Health Care Cost Institute)
Too little, too late: 500K nurses are leaving the bedside by the end of 2022 (EBN)
New Health Equity Scorecard: State-by-State Scorecard of Racial and Ethnic Disparities Finds All States’ Health Systems Are Failing People of Color (The Commonwealth Fund)
Healthcare Affordability State Policy Scorecard (Altarum)
Hospitals
Non-Profit Charity Hospitals Make “a Handsome Profit” on Cancer Drugs, New Report Says (WFMZ)
How & Why I Was Overcharged by Penn Medicine & My Blue Cross Health Plan (Drug Channels)
256 hospitals warned about violating CMS price transparency rule (Becker’s Hospital Review)
State Health Care Purchasers Can Push Hospitals To Comply With Federal Transparency Requirements (Health Affair)
2021 Winning Hospitals: Cost Efficiency (Lown Institute Hospitals Index)
Study finds wide variability in hospital Medicare charges, cost-efficiency at Indiana hospitals (Indy Star)
Vaccination-related employee departures at 50 hospitals, health systems (Becker’s Hospital Review)
Insurers
Variation In Use And Content Of Prescription Drug Step Therapy Protocols, Within And Across Health Plans (Health Affairs)
Health Insurance Coverage in the United States: 2020 (U.S. Census Bureau)
Pharmacy
Lilly CEO says letting Medicare negotiate drug prices would bring research cuts (IBJ)
ICER Identifies Most Significant 2020 US Drug-Price Hikes Not Supported by New Clinical Evidence (Icer)
CVS Health announces steps to accelerate omnichannel health strategy (CVS Health)
Walgreens, VillageMD make health clinic push (IBJ)
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