Folks, I’m very, very excited to be joining
@statnews
later this month to continue my coverage of hospitals + insurance. I’ve long been an admirer of the brilliant work STAT puts out. This team of reporters and editors is truly at the top of their game.
I spent the past several months talking to more than three dozen parents and clinicians about how private equity investments have changed a popular form of autism therapy for
@statnews
. What I learned was striking. 1/10
.
@Intermountain
postponing surgeries amid
#COVID19
surge, 87% unvaxxed. Cases on hold incl patient at risk of deadly stroke.
"You are going to have to wait for that procedure b/c we don't have a bed b/c it is filled with an unvaccinated person w/COVID."
The bottom line, one parent said, is that bad autism therapy can injure & traumatize children. At best, it wastes crucial time in their development. It wastes parents' money. It wastes taxpayers' & insurers' money. "This is not a victimless crime." 9/10
Parents described being hounded to take their kids to upwards of 40 hours of therapy per week, even if the kids are in school & other forms of therapy. "I felt like she was hustling me for more hours." 4/10
There's also a lot of fraud in this sector, state and federal audits + lawsuits show. One person in Nevada, for example, billed for 65 hours of therapy in a single day, an obviously impossible feat. It's gotten so bad
@OIGatHHS
is working on a sweeping audit. 8/10
That turnover deprives kids with autism of something they need most: consistency. “You’d get used to somebody, they’d leave Friday and you’d expect to see them Monday and they’d never come back,” one parent told me. 7/10
More than 60 private equity firms, including giants like Blackstone & KKR, back a form of autism therapy called applied behavior analysis, or ABA. Investments reached a fever pitch in the latter half of the 2010s when more states mandated coverage. 2/10
#Hospitals
love to brag about cost cutting. What about translating that into lower
#prices
for patients? They'd rather change the subject. via
@modrnhealthcr
NGL, I was feeling pretty mad yesterday talking to fellow moms about their experiences pumping while traveling for work. Turns out, pumping in bathroom stalls is routine. It's something women accept & we don't talk about it. I had no idea. 🧵
Clinicians described constant pressure to maximize therapy hours. There are billing quotas & rewards for top billers. One therapist felt like "a billing machine." Another said she was "run into the ground." 5/10
More than 50 ppl have thanked me for calling attn to this issue--even fellow moms who pumped at JPM! I thought I was the only one!
If you also pumped at
#JPM24
or previous JPMs & feel comfortable talking, please shoot me an email: tara.bannow
@statnews
.com.
Kidney disease patient faced paying $5,000 for each infusion of a drug her insurer refused to cover.
The same drug the insurer had covered for her in the past. A drug that had sent her into remission for years.
“It’s mind-boggling.”
via
@statnews
The therapy is meant to be highly individualized to each client, but sources told me the big chains often use "cookie cutter" treatment plans to save money on time-intensive assessments. 3/10
There's also constant turnover in the field. Clinicians said they left big PE-owned chains because they felt burned out, mistreated, underpaid. One large chain settled a lawsuit last year that it failed to fully pay workers & didn't provide lunch breaks. 6/10
If you've found yourself wondering "What the heck is Change Healthcare anyway?", you may want to give
@bobjherman
's latest a read. It's a look at what Change does and why the cyberattack outage is having such sweeping impacts.
via
@statnews
Medicare wants to stop publishing some
#hospital
safety data next year
“They just gave hospitals a huge gift, and they just created an incredible amount of risk for patients checking into a hospital today.”
via
@statnews
Hundreds of docs have quit since HCA took over 6 NC
#hospitals
. "I couldn’t in good faith take care of patients somewhere I didn’t think was safe," one oncologist told me.
They've joined local leaders, nurses, & patients in an open revolt.
via
@statnews
The American Hospital Association is known for being a lobbying powerhouse.
Now, the group is dipping its toes into a decidedly different arena:
#VentureCapital
investing.
My first story for
@statnews
! -->
We need to talk about why Sidibe v. Sutter, the federal antitrust case whose trial started this week, is important, worth your attention & bigger than
@SutterHealth
. 1/10
Medicare has officially ditched its plan to hide
#hospital
patient safety data next year following significant backlash from patient advocates.
via
@statnews
UnitedHealth is setting up a loan program to pay providers during the outage caused by the Change cyberattack, which could last weeks
Nice scoop from
@brittanytrang
@statnews
After years of splashy headlines announcing
#venturecapital
funds, many
#hospital
systems are quietly dialing back. I talked to VC execs who left hospitals b/c their work had dried up. As one source put it, "Heads were going to roll."
via
@statnews
Another day, another study debunking
#hospital
merger claims. New
@JAMA_current
study finds health systems have much higher prices & only marginally better quality.
"It's extremely costly and hard to say it's worth it."
via
@statnews
Let this sink in: 9 out of 10
#healthcare
companies
@MoodysInvSvc
considers financial stressed are owned by private equity firms.
“Clearly the private equity industry is realizing this in a very painful way, that you can’t do this.”
via
@statnews
Anyway, here's the follow-up article to my column on pumping at
#JPM24
. Please educate yourself & better support moms.
Or, if it's helpful to think about it this way: Better support babies in getting the crucial nutrients they need.
via
@statnews
Trump Administration failed to implement almost 90% of
#COVID19
guidance from GAO, per new report.
Watchdog agency said it's "deeply troubled."
via
@modrnhealthcr
This has long been a source of friction between hospitals and med schools. My interviews w/~20 people indicate some feel it's heading toward a breaking point. Please give my latest
@statnews
story a read!
Several studies out yesterday encapsulate a lot of what's happening in the
#healthcare
industry. For the first time, the majority of doctors now work outside of physician-owned practices for
#hospitals
and companies like
@Optum
, per the
@AmerMedicalAssn
Doctors should not diagnose patients with "excited delirium"--often used to justify excessive force by police--or use ketamine to sedate agitated individuals, per new
@AmerMedicalAssn
policies
via
@MHSjohnson
Non-profit convinces
#hospitals
to donate old medical debt & then collects on it, touting a gentle, 'white glove' approach
"I can't tell you exactly what side of the line it's on, but it's very close to the line, that's for sure."
via
@modrnhealthcr
Over the years, I’ve noticed hospitals transferring large amounts of money to their affiliated medical schools. That seemed curious. With all the debt people take on to go to med school, shouldn’t these places be swimming in cash?
This
@isabellacueto
lede!
"Near the corner of busy Santa Monica Boulevard and Corinth Avenue, underneath lines of skinny palm trees and against an almost perpetually bright-blue sky, a hot pink billboard declared: Hot girls have IBS."
via
@statnews
Hip & knee replacements tend to go better & cost less when performed by high-volume surgeons, new study finds
“The idea in medicine that there’s a quality-costs trade-off...that just doesn’t seem to be the case." -
@ZekeEmanuel
via
@statnews
Insurance giant
@UHC
is dropping copays for life-saving drugs like insulin & epinephrine in some plans.
It's good for patients, and also happens to bode well for UHC's bottom line.
The lastest from
@bobjherman
& I: via
@statnews
Best pitch eva: Hey Tara, saw your article about
#RealEstate
investment trusts, and thought you might be interested in our new study about how Republicans are more likely to diet for weight loss than health.
Leading up to
#JPM24
, I got an email from
@MorganHealth
's new flack: Would I interview its CEO? Morgan is JPM's 2nd employer-sponsored healthcare outfit. The 1st, Haven, failed spectacularly.
Morgan's message today: We're still a thing.
via
@statnews
My colleagues
@statnews
did some amazing reporting in 2022. That said, there are plenty of stories we wish we'd written that others handled beautifully.
I give you, our jealosy list:
A top Sutter Health exec said during federal testimony yesterday that Sutter isn’t required to provide free care to be a nonprofit. She’s right (with caveats).
Why? Follow me down this rabbit hole, my friend:
via
@modrnhealthcr
#LISTEN
: Modern Healthcare Hospital Operations Reporter Alex Kacik spoke with Finance Reporter Tara Bannow to discuss how the framework of the COPA could spur more hospital mergers and acquisitions.
#podcast
#MHBeyondtheByline
Catholic health system
@Ascensionorg
sold $306M worth of
@R1RCM
stock weeks before its value plunged 50%. Two top Ascension execs sit on R1's board.
"The timing looks a little too perfect."
via
@bobjherman
@statnews
.
@jpmorgan
analyst Gary Taylor wins hearts of journalists everywhere by asking
@SeemaCMS
why CMS rules come out on Friday afternoons. She chuckles: "We've actually tried to move them up. It's gotten better."
#JPM20
.
@CFPB
reports $88B in medical debt on credit reports, vow crackdown on abusive practices
"I am concerned the credit reporting system is being weaponized as a tool of coercion to get people to pay medical bills they may not even owe."
via
@modrnhealthcr
Exciting news! STAT is launching a brand new newsletter next month called Health Care Inc. Reporters
@bobjherman
and
@TaraBannow
will bring you lively conversation that follows the flow of money through the
#health
care industry.
Update:
#Houston
’s Harris County says it may need to close its
#COVID19
test sites if Trump admin pulls support. Says it hopes gov’t reconsiders “during this critical time.”
Trump administration is ending funding for 13
#COVID19
testing sites, including seven in Texas.
@RepSylviaGarcia
, whose district includes Houston metro, said
@fema
withdrawal would be "harmful and irresponsible."
via
@modrnhealthcr
DOJ says sweeping fraud scheme in Texas involved dozens of doctors & front companies, all profiting off lab tests.
One exec involved couldn't contain her glee, writing to colleagues: "WOWIE!!!!! HOW DO WE GET SOME MORE OF THAT???!!!!!!!”
via
@statnews
#DemDebate
focused a lot on health insurer profits, so
@modrnhealthcr
compared across industries & found they’re not the highest by a lonnng shot. Guess who is.
To be fair, it took becoming a mom myself to realize how complicated this all is. Pumping/breastfeeding is truly like a second job on top of your full-time job. I wish I had understood this earlier & sincerely hope I didn't downplay anyone else's experiences before I understood.
Great healthcare industry analogy
@modrnhealthcr
‘s Leadership Symposium from Intermountain’s
@DanForUtah
: It’s like a massive game of Hungry Hungry Hippos. Marbles going across the table and you’re cranking to get as many as possible. “But at some point, the marbles run out.”
#Hospital
mergers that used state immunity to dodge federal antitrust scrutiny eventually raised prices between 39% & 51%, new study finds. Meanwhile,
@FTC
is not pleased.
"When the gloves get taken off, they fully exercise their market power"
@statnews
Today a federal judge for the 1st time questioned pharma lawyers in person about their bid to stop
#Medicare
from negotiating
#drugprices
. It didn’t go well for them,
@john_wilkerson
reports.
“I don’t find their argument compelling,” the judge said.
In fact, many of the almost 100 ppl who reached out thanking me for drawing attention to this issue didn’t want to share their stories on the record for fear of harming their careers. Let that sink in.
Happy
#JPM24
! I'm at the nonprofit
#hospital
track this morning. Starting w/
@CommonSpirit
, whose CFO says insurers are partly to blame for system's big financial losses in recent years. Says denials rising, insurers not complying w/contracts. "We're working feverishly on this."
Sadly, that means I’m leaving
@modrnhealthcr
after almost five years. Really going to miss this smart, dogged team that I’ve learned so much from. This newsroom covers a lot of ground and its reporters are experts in their coverage areas.
Let's be real: Despite all the marketing & chatter around value-based care, healthcare's supposed transition to paying to keep people healthy has so far been a lot more talk than action.
ICYMI:
@bobjherman
and I did a deep dive into Welsh Carson, a private equity firm that’s heavily involved in
#healthcare
, w/holdings in senior care, pharmacy, insurance, microhospitals, etc.
Lots of important stories to tell about the healthcare industry: The constantly evolving payment landscape, how private equity is changing things, the shift away from hospital care, etc. Stay tuned.
Federal law protects patients from surprise medical bills for almost everything *except* ground ambulances.
@bobjherman
& I, in collab with our friends at
@tradeoffspod
, dug into on the possible fixes being explored:
via
@statnews
Patients, doctors press
@FTC
&
@TheJusticeDept
to follow through on their plan to beef up
#hospital
merger scrutiny
"Unregulated industries are riding roughshod over working people. It's got to stop."
via
@statnews
Society values babies immensely. As we should. And we have a mountain of data that explains why breastfeeding is important for babies’ health. And yet, there's precious little support to help women help babies. We're just expected to get it done & shut up about it.
Get yourself some PF Changs and then head down the hall for a doc visit! New
@JLL
report predicts
#healthcare
tenants in retail locations will double by 2022 via
@modrnhealthcr
Why do Hispanics in the U.S. live longer than white people? One hypothesis is their tight-knit families + community networks. "One is never alone."
A fascinating read!
I looked at the Hispanic paradox--the finding that Hispanic people on average live longer than white people--at the many attempts to debunk it (which have failed), and what a new generation of researchers is now learning about it says about health.
This morning,
@Centene
's CEO told me
#hospitals
typically buy health plans to keep beds filled, not lower costs. Feel like health system leaders might feelings about this?
#JPM19
#JPM2019
Ahead of
#JPM24
,
@brittanytrang
& I looked at who profits the most in
#healthcare
: drug & devicemakers, b/c they shoulder the most risk.
That said, profit is increasingly going to middlemen who don't fund risky studies or even store meds. via
@statnews
.
@UPMC
CFO Robert DeMichiei says lots of health systems have talked about rev cycle and growth, but "we need to be zealots about cost." UPMC tracks cost per everything (OR hour, claim) and is trying to lower all of them.
#JPM19
#JPM2019
BREAKING: Jury finds
@SutterHealth
did NOT engage in illegal all-or-nothing contracts & did NOT force insurers into contracts that prevented them from sending patients to non-Sutter hospitals. Background on federal case:
Story to come
@modrnhealthcr
.
Friday rule drop! Biden administration is mostly sticking to its guns on the No Surprises Act, holding that median contracted rates should be first consideration in payment disputes.
via
@statnews