Hannah Recht
@hannah_recht
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Data journalist, R developer.
Washington, DC
Joined October 2014
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Some pharmacists in Texas are already refusing to fill prescriptions to treat miscarriages or ectopic pregnancies because the drugs and procedures used to treat them are also used for abortions.
This isn't hypothetical, it's reality right now.
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A mom was kicked out of a Rockettes show because *facial recognition tech* at MSG identified her as working at a law firm involved in a suit dealing with the venue.
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NEW: The federal “test-to-treat” program is meant to be a one-stop shop to get covid treatment. But as cases rise again, people in large swaths of the country would have to drive more than 100 miles to reach the nearest participating clinic. 🧵
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CVS pharmacists are now prescribing Paxlovid directly - a move that many called for this spring and summer to make it easier to access. If you have covid and need treatment, some big restrictions to watch for: 🧵
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Today in uniquely American employer-based health insurance horror stories.
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::screams at the top of my lungs:: ZIP CODES ARE STRINGS OF ADDRESSES MAINTAINED BY THE USPS THAT DO NOT CONFORM TO STATE OR COUNTY BOUNDARIES AND ARE NOT SUITABLE FOR DATA ANALYSIS
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If you’re struggling to find local covid care: there’s a virtual option that’s cheaper than many and is available in all 50 states + DC. Assessments cost $25-55 and they can send prescriptions to a local pharmacy or ship overnight for $20.
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The covid test-to-treat program is dominated by CVS. So I asked: how easy is it to get an appointment there?
I’m a tech-savvy health reporter, fluent English speaker, and I still found it nearly impossible to figure out.
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Friendly reminder that the US is sequencing only a fraction of confirmed covid cases and is under testing for covid in general.
So please, I beg of you, don't make state maps or timelines of US omicron cases. The data is a tiny fraction of reality.
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If you try to book a CVS MinuteClinic appointment online to *get covid treatment* and mark a positive covid test on the screening form you’re not allowed to go to the clinic.
A spokesperson called that a software bug.
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I've joined
@KHNews
as a data journalist. I'm beyond excited to cover health care full time, now more than ever.
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I started clicking around vaccine websites in December. Immediately could see many were breaking accessibility rules. Then I opened my web inspector on registration portals. Horror. Teamed up with relentless
@LaurenWeberHP
& it was worse than we imagined.
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Important day 1 covid booster news: several insurance companies aren't fully set up to process the new booster code and coverage is being denied for patients at CVS.
Options are to pay out of pocket ($191) and submit for reimbursement or wait until it's fixed, hopefully soon.
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The distance between "you chose not to get vaccinated and covid is expensive so you should pay more for insurance" and "you have expensive chronic health conditions so you should pay more" is not long.
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🚨 New analysis: More than 600,000 Americans have lost Medicaid coverage since April 1.
The vast majority were removed for not completing paperwork, raising lawmakers’ and advocates’ alarm. 🧵
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Here's Cigna's form for covid rapid test reimbursement, which needs to be printed and either mailed or faxed. I wonder what percent of Americans own a printer?
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I also looked for covid testing appointments at every single CVS MinuteClinic shown on the test-to-treat map in DC, Maryland, and Virginia, just over 100 clinics total.
Only *half* listed any future testing appointments available.
Another software bug, per the spokesperson.
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The federal gvmt must make it easier to access covid test-to-treat, especially bc it’s for those at highest risk of complications, said
@KBibbinsDomingo
.
But “if you're just an average person trying to navigate this, it’s actually completely impossible.”
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Very little shocks me these days. Facebook tracking WITHIN a patient portal, that's next level.
"The Meta Pixel installed in the portal told Facebook the patient’s name, the name of their doctor, and the time of their upcoming appointment"
NEW: Some of the country’s top hospitals have been sending sensitive patient information to Facebook.
These hospitals may have violated HIPAA, experts say.
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DID YOU KNOW: every time you join ZIP codes to ZCTAs and don't even realize that hospitals and college campuses and even big apartment buildings often have their own zips and don't acknowledge how mismatched it is, a unicorn loses its horn
that's how horses were created
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Since we couldn’t book online,
@rachanadixit
spent hours driving between CVS MinuteClinics to find out if a sick person could do test-to-treat that day.
3 of the 4 stores either didn’t have same-day appointments available or didn’t have covid antiviral pills in stock.
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And test-to-treat can be expensive at the for-profit chains that run most sites. CVS charges upwards of $100 for in-person or telehealth visits to examine patients for covid treatment.
People w/o insurance, out-of-network, or with high-deductible plans have to pay up.
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CVS is requiring patients to show liver and kidney function tests from the past year for pharmacists to prescribe Paxlovid directly.
The FDA does not require this and HHS officials have repeatedly called it unnecessarily burdensome for people without known kidney/liver disease.
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Sad news: my job as a data reporter is being eliminated. I have absolutely loved getting to analyze the American health care system for almost 4 years.
I'm on the market for a new role as a data reporter/news nerd, remote or DC-based. Please reach out with any leads!
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I’ve repeatedly asked HHS
@asprgov
for current data on covid therapeutic usage. Simply: how many doses of each drug have been sent out? How many have been used? National totals. The most basic data.
I still await and will continue to request that information.
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The covid antivirals’ EUA rules mean they can’t be prescribed by a pharmacist. So test-to-treat requires joint pharmacy-clinic setups that just *don’t exist* in many areas, as
@EPetenko
reported from Vermont
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New research shows huge disparities in Paxlovid use. Black & Hispanic people with covid were far less likely to get it than white patients, across all age groups.
I’ve reported on these access disparities for months
@khnews
. Here’s what you need to know 🧵
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CVS is charging $60 for these pharmacist Paxlovid prescription reviews, whether they find you eligible or not. They are not taking Medicare or Medicaid but commercial insurance might cover it.
Some states and big cities have FREE test to treat programs - check health dept first.
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For those far from clinics, some people with disabilities, and people too sick to leave home, telehealth could be the easiest test-to-treat option. A few local governments, including Los Angeles County and NYC, have launched virtual care initiatives.
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In America, a responsible patient always chooses the cheaper alternative to treating anaphylaxis (literal death.)
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when
@BrettKelman
told me how vaccination zip codes were just being assigned to counties 100% not even using geocorr my soul left my body and now you can scream with me!!! AHHHHHHHHHHHHHHHHHHHH!!! ZIP CODES DO NOT CARE ABOUT YOUR COUNTY BORDERS!!!! THIS IS NOT HOW ANYTHING WORKS!
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Here are some free local covid test to treat options - no copays, no $60 CVS fee:
DC:
MD:
MA:
CA:
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My latest: The covid treatment Paxlovid has been free so far.
But soon people who are at the highest risk of severe illness and are least able to afford the drug — the uninsured and seniors — may have to pay the full price.
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Well this article on test-to-treat is clearly resonating. If you've tried to get Paxlovid/molnupiravir recently and weren't able to, or have had trouble getting it for your patients I'd like to hear your story at hrecht(at)kff(dot)org. I may be slow to respond but I will read it!
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🚨New analysis 🚨 Most states are not releasing covid vaccine data by race. But in all states where they are, Black Americans are receiving covid vaccinations at dramatically lower rates than white Americans. A thread:
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If passed, these couple paragraphs of the giant Senate omnibus bill would mean that Medicare Part D would be able to cover Paxlovid and Lagevrio when they hit the commercial market next year, regardless of FDA approval timing. Seniors would otherwise have to pay the full cost.
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This is one of the more jawdropping stories I've read in a while. Read it.
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I gave a little tutorial on drive time analysis in R yesterday, here's the walkthrough if you're interested. Spatial analysis is hard but fun!
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Last month I tried to refill the asthma rescue inhaler I've used for years. My insurance required prior authorization and it just would not approve it. For a $50 generic.
This month, with new insurance, I was able to fill it no problem with a $5 copay.
Our system is so broken.
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We found:
🚨 Almost all state vaccine websites had accessibility issues
🚨 In at least 7 states, blind residents told us they couldn’t register for the vaccine without help
🚨 Phone alternatives didn’t exist or weren’t helpful
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NEW: KHN finally got CDC data we requested months ago that details who’s being vaccinated by race and ethnicity, state by state, from federal, state & local programs.
Check out how your state is doing in our new analysis, w/
@rachanadixit
@LaurenWeberHP
.
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Today's health care adventure: after many phone calls, there is still literally no way to find out how much a fairly routine office procedure will cost me until after it's done and billed for.🤦🏻♀️
Knowing a boatload about health insurance does not help even a bit. America!
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Things I'm thinking about today:
Many people take trains/bus/rideshares to get to immunosuppressant infusions because they get Benadryl with their meds and can't drive home after. Plus all the usual reasons people have to take public transit, like money.
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This job listing is the first time I've ever heard the phrase "commercial determinants of health" and I am obsessed with it. What a great beat idea.
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The CVS direct prescription expansion of course follows their initial dominance of the covid Test to Treat program this spring - just massive market share in the Paxlovid prescription business.
But there have been a lot of new (free!) gvmt options added.
The covid test-to-treat program is dominated by CVS. So I asked: how easy is it to get an appointment there?
I’m a tech-savvy health reporter, fluent English speaker, and I still found it nearly impossible to figure out.
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According to the FAQ, to do this direct prescription screener you'll fill out an online form. If you show up in person be sent a text to the form and asked to go complete it outside.
For people without that tech access/ease remember your state gov may have a (free) phone option.
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CMS could publish their Medicare Advantage audits from 10 years ago, which show huge $ of overcharges. Instead they chose to go to court with KHN - and now have to share the records plus $63k in legal fees.
Happy
#FOIAFriday
to
@FredSchulte
, the legend.
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My first story for KHN, with
@LizSzabo
, looks at some of the next emerging COVID-19 hot spots and the social determinants putting the most vulnerable at risk
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States in the northeast are using Paxlovid to treat covid far more than other states — not because they have the more sick people but because they had better health care access to begin with, plus many created their own free covid test-to-treat programs.
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It would be nice to see a statement like: Political Leader X has covid. They will be out of the office this week, because they are sick and their political platform is that everyone deserves sick days. X will be taking those sick days instead of working through illness.
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Nerd alert: collecting and analyzing data for our investigation on public health has been a *journey*. Data on our public health system is pretty much the wild west; there’s basically no central data. Here’s how we did it…
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More free covid test to treat:
MI:
WI:
NYC:
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DCist staffers and fans: add ?redirect=no to the end of a URL to be able to view the article in "archive mode".
I hope they do the right thing and keep the site up indefinitely. Solidarity.
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I'm one of the unlucky ones whose insurance didn't go through and will be submitting for reimbursement later. As are most of the customers who got vaccinated at my store today.
If you got the new covid booster today, did your insurance go through?
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I am a Professional Knower of Health Insurance Things and I still find this section on the test reimbursement form for patient/dependent information very confusing. If you're filling it out for your kid you're still asked for spouse information, with no NA box to check?
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NEW DATA: The first round of the covid vaccine rollout is not reaching Americans equally. Rates for Black Americans are significantly behind. Story with
@LaurenWeberHP
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More than 6 months ago
@LaurenWeberHP
@annabarryjester
@MRSmithAP
started tracking public health leader departures in a spreadsheet with 19 names. They kept going.
181 have left since March. They represented 1 in 8 Americans.
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🎉 Local reporters: we've released a county-level data file so you can localize this story in your own area. Including population, demographics, income, insurance rates, and of course COVID-19 cases (latest available last night). Link in the story, halfway down.
My first story for KHN, with
@LizSzabo
, looks at some of the next emerging COVID-19 hot spots and the social determinants putting the most vulnerable at risk
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New: The Biden administration is now imploring states to slow Medicaid cuts.
My updated
@KFFHealthNews
analysis shows that more than a million Americans have been dropped in the past few months, 4/5 for incomplete paperwork.
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Today is my one year KHN-iversary, which in pandemic timing could really be anywhere from six weeks to six years, impossible to say. What a year to be on the health beat full time.
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The problem with a lot of the breakthrough covid data is that we have a ton of different vaccination data systems that don't speak to each other, so missing data and unvaccinated are almost impossible to tell apart without speaking to each and every infected person, which takes $
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Getting medical records transferred in 2020:
Receive form via email. Have to print out form and fill it out by hand (instructions specify so), scan it, send it back. Then they will fax my records.
Both offices use online patient portals.
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As rapid at-home covid tests take over experts are raising the alarm about significant undercounting. All over my twitter feed today.
Here's our story on that problem from September *2020* with
@rachanadixit
and
@LaurenWeberHP
New: Tens of millions of rapid antigen tests for COVID are on their way. But are they counted?
We surveyed all 50 states and found nearly half don't report their results or include them in case counts, with
@rachanadixit
@LaurenWeberHP
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Local reporters: I've published all of the underlying Medicaid unwinding reports that I used in this analysis, many got via records requests.
I hope they're useful. There is an important & different story to tell in every single state. Reach out with Qs.
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New: Nearly *1 in 6* Americans lost a local public health leader in the past year. At least 248 leaders of state and local health departments resigned, retired or were fired, the largest such exodus in US history. With
@MRSmithAP
&
@LaurenWeberHP
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Couple reasons why Evusheld usage is so low: 1. it's not being advertised nearly enough and can be really hard to find if you even know about it (a few of the data issues here have from March since been improved)
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28. 28. She was just 28.
“Adeline had an N95 mask and had her name written on it,” she said. “Adeline wore the same N95 for weeks and weeks, if not months and months.”
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Well this is exciting! Extra big shout out to data editors/spreadsheet therapists/FOIA queens/weeds nerds
@eklucas
and
@MeghanHoyer
plus the giant reporter dream team and so many others who made the series possible.
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NEW: Evusheld was already hard to find.
Then hundreds of providers were removed from a federal dataset last night, making the potentially lifesaving covid therapy for immunocompromised people even more difficult to locate.
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🚨New Medicaid unwinding data just in from South Carolina: 27k renewed, 112k canceled for not returning renewal paperwork + another 6k who were determined ineligible.
That's the highest termination % that I've seen yet, just above Kansas. Neither state has expanded Medicaid.
New: The Biden administration is now imploring states to slow Medicaid cuts.
My updated
@KFFHealthNews
analysis shows that more than a million Americans have been dropped in the past few months, 4/5 for incomplete paperwork.
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🎉 New open data: We're releasing the data behind our
@KHNews
/
@AP
U.S. public health investigation,
#UnderfundedUnderThreat
.
Journalists, use this data on public health spending & staffing for your own local investigation. There's so much to explore.
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If your article about the public transit mask changes is mostly about air travel...why. Mass transit is the day-to-day lifeline for more people, not airplanes and airports.
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About as many DC residents have died from covid in the past two weeks than from October through December combined 💔
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Absolutely not: asking me to fly out to teach a conference class without compensation and to pay $1,000+ for my own registration, travel and lodging. In a pandemic.
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Concept: an HGTV crossover series where the home inspector hosts go inspect the home flipper houses. Shows us all the hidden code violations. Retta can come too.
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DC pharmacies have used only 37% of their Paxlovid supplies, 21% of Evusheld, 20% of Bebtelovimab. Via new data from HHS, following months of FOIAs.
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Navajo Nation is roughly the size of West Virginia. The region has almost no ICU beds and more cases per capita than the Washington, DC area.
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2. Evusheld doses are provided free of charge but you can still face a big bill for the administration fee if you have private insurance or are uninsured. Several people told me they had to skip it because of cost, as CNN reported too:
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🚨 Only 23 states release covid vaccine data by race. In every single one of them, Black Americans are still being left behind in the covid vaccine rollout. A thread on this updated analysis with
@LaurenWeberHP
, and the data we still need:
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They don't tell you that a big part of data journalism is going into Google streetview and doing a lil stroll around a building and saying ah nope that is not a nursing home like the database says, that is a Walmart
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New investigation: Health insurers & medical systems across the US are breaking disability rights laws by sending blind patients inaccessible medical bills and notices, with
@LaurenWeberHP
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We analyzed tons of public health data for our investigation. This one will stick with me. Epidemiologists track diseases and figure out what causes them. But 72% of local health departments in the U.S. don’t have one on staff.
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Covid surging in Florida again isn't surprising, especially given how they've slashed public health spending in the past decade - our report from last summer
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In predictable news: the DC case rate continues to rise less than 3 weeks after dropping the mask mandate and Thanksgiving
DC reports 126 new coronavirus cases today and a weekly case rate of 162 new cases per 100k residents.
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*existential scream* PLEASE PUT YOUR COVID DATA ON YOUR OPEN DATA PORTAL, IT IS A THING THAT EXISTS, DO NOT JUST DUMP IT INTO TERRIBLE DASHBOARDS WITHOUT A DATA DOWNLOAD BUTTON
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While you're all screaming along with me about terrible data, may I shamelessly interest you in my current data screamcry:
HHS isn't even telling *county health departments* which nursing homes, veterans health facilities, and more are using Paxlovid
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Last night around 10:30pm DC Health revealed there were 6,728 self-reported covid rapid test positives in the past 3 months that were never included in the case totals, including from schools.
We reported on this issue nearly *a year and a half ago*.
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yes I did prepare* for election week
* bake a batch of cinnamon rolls for the freezer to have on demand cinnamon rolls every day this week
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More dramatically, I had monthly knock down drag out prior auth fights with Old Insurance over a $1300/month generic pill that had a coverage limit and prior auth. Their system glitched every month and I'd have to get an emergency override.
New Insurance covers it w/o limits. $5.
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Much of the most important 2020 Census data for small areas will be unavailable or unusable and plans are to do the same for more surveys going forward. Data pros have been screaming about this for years, but almost nobody outside the field is listening.
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If we return from break and Slack is down I think that means we get 6 more weeks of vacation
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Some more free state health dept covid test to treat programs. Some counties and cities have resources too, def look up your state + local health depts if you have covid and need affordable care.
NH:
NV:
WA:
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If your Medicaid coverage is ending and you think there was a mistake, reach out to the state Medicaid office. If you do that before your cancellation date, you can stay covered during an appeals process. You may even have extra time to complete forms after that date.
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A well-staffed and well-funded public health department doesn't need to hire an expensive private consulting firm to analyze the remaining unvaccinated by Census tract.
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Stat I can't stop thinking about: In New Hampshire, 13% of people who got cutoff notices for Medicaid in first month of renewals have asked for extra time to finish paperwork & keep coverage.
4/5 of the ppl there & most states who were dropped didn't complete paperwork in time.
🚨 New analysis: More than 600,000 Americans have lost Medicaid coverage since April 1.
The vast majority were removed for not completing paperwork, raising lawmakers’ and advocates’ alarm. 🧵
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New investigation out today: As
#COVID19
surges, states are cutting health departments’ budgets. Welcome to the boom-bust cycle of funding for public health. With
@LaurenWeberHP
@laura_ungar
@MRSmithAP
@annabarryjester
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Not even 12 hours later, the first state localization of our kids' covid vaccine data is out. Absolutely LOVE to see it. Publish your data and code, folks.
Earlier today,
@KHNews
' reporters
@hannah_recht
and
@rachanadixit
published a data-driven story on vaccination rates amongst 5 to 11 year olds nationwide.
They *also* published the underlying data and encouraged folks to localize it.
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The tiny silver lining of being laid off was being able to enroll with new health insurance that doesn't have me fighting multiple prior authorization nightmares every single month. The time saved! The stress relief! Yes employer sponsored insurance was cheaper but at what cost?
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