Welcome to the Fall 2021 issue of The Employers’ Voice!
I hope everyone is enjoying the great outdoors. While we were looking forward to celebrating the Forum’s 20th year anniversary with you in person at our upcoming September 17th All- Stakeholder meeting at the Eiteljorg Museum Ballroom, due to COVID-19 cases surging and our hospitals being full, we determined it safest for all to meet via Zoom. The day we all get together in person, I promise will be an absolute blow out as we’ll have much to celebrate. I miss seeing all of you. I hope you and your families stay healthy and happy.
Noted in this issue: Forum initiatives update, 2021 legislative policy highlights, COVID-19 vaccine updates, new member spotlights, hospital quality rankings, interesting news articles, and more. Enjoy!
President and CEO, Employers’ Forum of Indiana
Forum Initiatives Update
Forum Work Groups
Thank you to the 25 Forum volunteers who have been meeting monthly to address the following 3 work group charges. We look forward to hearing a report at the November 4th All- Stakeholder Forum meeting.
- Physician Payment Strategies
- Pharmacist Provider Status
- Hospital Value Website
Hospital Value Dashboard
Coming November 2021! The Forum received a grant to develop a first of it’s kind Hospital Value Dashboard. We are partnering with Mathematica to create an interactive web-based tool for all to use. Data sources include RAND 3.0 hospital prices, CMS hospital quality scores, Quantros quality reliability scores, and NASHP hospital cost findings. Users will be able to create customizable graphics and reports at the hospital level. Data sources will be updated quarterly to include RAND 4.0 findings when available in March 2022.
Assessing Hospital Price Transparency
We reviewed 119 Indiana Hospital web-based shoppable price transparency tools from the lens of a patient to assess how they compared to federal government requirements. Each hospital was scored out of 8 points. Each hospital executive was provided their score(s) along with feedback and an opportunity to make adjustments if they wished. The partnership has been terrific as most Forum recommendations were made. We have rescored hospitals and will publish the final report soon.
Next All-Stakeholder Meeting
Hospital Price Estimator Tool, Bundled Payments, and Vaccine Hesitancy
September 17, 2021
2:00 – 4 pm
Registration details for the All-Stakeholder meetings are sent to registrants electronically. For questions, please contact email@example.com
September 17, 2021
November 4, 2021
Visit our Meetings Page for an archive of past meeting materials and presentations.
CMS Proposes Rule to Increase Price Transparency, Access to Care, Safety & Health Equity (HHS Press Release)
CMS is proposing to set a minimum civil monetary penalty of $300/day that would apply to smaller hospitals with a bed count of 30 or fewer and apply a penalty of $10/bed/day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. Under this proposed 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.
Dr. Richard Feldman: Session falls short on health care bills (IBJ)
Read a brief summary of Indiana’s 2021 legislative session from Dr. Richard Feldman, a family physician, author, lecturer and former Indiana State Department of Health commissioner.
Governor Holcomb Makes Appointments to New APCD Board (Press Release)
In August, the Governor made seven appointments to the new All Payer Claims Database Advisory Board. The Forum was a strong advocate for the APCD state laws in 2020 and 2021.
Final Approval of $575 Million Settlement with Sutter Health Resolving Allegations of Anti-Competitive Practices (Press Release)
In August, a judge gave final approval for a landmark settlement that requires Sutter to pay $575 million in compensation, prohibits anticompetitive conduct, and requires Sutter to follow certain practices to restore competition in California’s healthcare markets.
Special Feature: COVID-19
Biden announces sweeping new vaccine mandates for businesses, federal workers (Washington Post)
President Biden announced sweeping new coronavirus vaccine mandates last week designed to affect tens of millions of Americans, ordering all businesses with more than 100 employees to require their workers to be immunized or face weekly testing. Read President Biden’s COVID-19 action plan.
More than 150 Houston Methodist workers fired, resign over refusal to get COVID vaccine (Modern Healthcare)
More than 150 employees at a Houston hospital system who refused to get the COVID-19 vaccine have been fired or resigned after a judge dismissed an employee lawsuit over the vaccine requirement. The case over how far health care institutions can go to protect patients and others against the coronavirus has been closely watched. Read the full story on Modern Healthcare.
CDC Recommends 3rd Vaccine Dose For Immunocompromised People (NPR)
The Centers for Disease Control and Prevention is officially recommending that people with weakened immune systems get a third shot of either the Pfizer-BioNTech or Moderna vaccine. Read the full recommendation and guidelines on the CDC website.
COVID-19 Vaccines in Indiana
Meet Hardy Sikand
Job Title: CEO
Organization: Indiana Spine Group
Welcome to being a new member of the Forum! What made you decide to join?
Over the years I’ve seen the tremendous impact the Forum has had on local healthcare decision-making by leading employers. The advocacy on behalf of Forum members at the Statehouse has been impressive. As a mid-size employer and as a medical group, I want our organization to be an active participant in this much-needed process.
As a provider CEO, what are the top two changes you would like to see occur in our marketplace?
As a medical group, some relaxation of the tremendous overhead burdens placed on medical practices from payer organizations (i.e. pre-certification process, referral coordination, billing reviews, etc.). Annual growth in expenses, with no offsetting revenue increase on professional fees, lead to an unsustainable long-term business model. Second, further statewide growth in the direct-to employer/provider relationships. Such alignments will lead to enhancements in quality, cost, patient satisfaction metrics if properly structured.
What does your perfect Saturday look like?
Sleeping in just a little later than 5:00 am, trying to stay away from e-mail as much as possible (losing battle), but mostly time spent with family.
Welcome to Our Newest Members
We are pleased to welcome Patoka Valley Health Care Cooperative (PVHCC) and the Indiana Spine Group, our newest Forum members! PVHCC is a southern Indiana-based corporation that represents 54 member companies, covering over 12,000 employees. Indiana Spine Group, headquartered in Indianapolis, IN, represents 28 providers practicing in 13 cities across Indiana.
Eskenazi Health Ranked #1 Hospital in Indiana in Charitable Care by Lown Institute
Congratulations to Eskenazi Health for being ranked #1 hospital in Indiana to provide charitable care. This analysis was conducted by the Lown Institute, who assessed nearly 2,400 private non-profit hospitals in the country by comparing each hospital’s spending to the value of its their tax exemption. See the full results.
CMS 5-Star Rated Indiana Hospitals for June 2021
Congratulations to the 13 Indiana hospitals who received a 5-Star CMS Rating in June 2021!
See the results.
In the News
An Employer-Provider Direct Payment Program Is Associated With Lower Episode Costs (Health Affairs)
Making Employer-Sponsored Insurance More Affordable (Health Affairs)
Contributor: Do Health Plans Have a Plan to Help Employer-Purchasers Get Better Value? (AJMC)
Large Self-insured Employers Lack Power to Effectively Negotiate Hospital Prices (AJMC)
Health Care Industry
Health Spending for 60-64-Year-Olds Would Be Lower Under Medicare Than Under Large Employer Plans (KFF)
Supreme Court upholds ObamaCare in 7-2 ruling (The Hill)
Profits swell when insurers are also your doctors (Axios)
Gov. Holcomb announces Governor’s Public Health Commission Group to be led by former State Sen. Luke Kenley, former public health commissioner Dr. Judy Monroe (Press Release)
Hospitals and Insurers Didn’t Want You to See These Prices. Here’s Why. (New York Times)
‘It would be a behemoth’: Employer group raises concerns about proposed Spectrum- Beaumont merger (Becker’s Hospital Review)
Lists: Largest Not For Profits in Indiana (Indiana Business Journal)
How the New Price Transparency Rules are Affecting Stakeholders (Managed Healthcare Executive)
States Probe Business Practices of Pharmacy Benefit Managers (The Wall Street Journal)
Walmart to offer own low-cost brand of insulin (The Hill)
Ohio pharmacists, care provider say program is a national model (Ohio Capital Journal)
‘It’s creative and we certainly need the help’: CVS, Walmart, Walgreens grow consumer presence with counseling services (Becker’s Health IT)
Expanding Access to COVID 19 Therapeutics (U.S. Department of Health & Human Services)
AMA: Most physicians now work outside of private practice (Modern Healthcare)
Lutheran Health Network names new CEO (Becker’s Hospital Review)
Physicians who post COVID-19 vaccine misinformation may lose license, medical panel says (Becker’s Hospital Review)
Innovcare to Develop Primary Care Facility (Inside Indiana Business)
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