Monday Roundup

David Ermer–Congress, COVID-19, HIPAA Privacy and Security Rules, U.S. Healthcare–

Federal News Network reports on the Postmaster General’s testimony before the House Oversight and Reform Committee today. The article explains

The Postal Service has dealt with staffing issues as a result of the coronavirus pandemic. About 40,000 postal employees have contracted COVID-19 or have shown symptoms that have required them to quarantine. Several dozen employees have died.

[Postmaster General] DeJoy said employee availability during the pandemic peaked in July, but warned that staffing has been down by about 3-4% on average. The Philadelphia and Detroit metro areas, he added, are “significantly below normal route run rates” — in some cases 20% below normal staffing rates.

The Wall Street Journal discusses new thinking on public health measures to control the infection rate without shutting down businesses. Better late than never.

The experience of the past five months suggests the need for an alternative: Rather than lockdowns, using only those measures proven to maximize lives saved while minimizing economic and social disruption. “Emphasize the reopening of the highest economic benefit, lowest risk endeavors,” said [Harvard epidemiologist] Dr. [Michael] Mina.

In other words use social distancing, good hygiene and mask wearing and avoid super spreader events.

Research by Dr. Mina and others has shown that “super-spreader” events contribute disproportionately to infections, in particular dense indoor gatherings with talking, singing and shouting, such as at weddings, sporting events, religious services, nightclubs and bars.

Dr. Mina wrote this month on the importance of is “a shift in [COVID-19 testing] strategy toward a cheap, daily, do-it-yourself test that he says can be as effective as a vaccine at interrupting coronavirus transmission — and is currently the only viable option for a quick return to an approximation of normal life [pending a vaccine]. He advocates applying the nasal or saliva sample to a paper strip that would tell you whether or not you have the COVID-19 infection. This is a step beyond this month’s saliva test advances that must be delivered to a lab. Forbes provides more background here.

Here are a couple of updates on progress being made in the COVID-19 vaccine development process from Fierce Healthcare and MedCity News.

The Department of Health and Human Services announced today that its Office for Civil Rights (“OCR”), which enforces the HIPAA Privacy and Security Rules,

issued amended guidance on how the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule permits covered health care providers (e.g., hospitals, pharmacies, laboratories) and health plans to contact their patients and beneficiaries who have recovered from COVID-19 to inform them about how they can donate their plasma containing antibodies (known as “convalescent plasma”) to help treat others with COVID-19. OCR added health plans to the June 2020 guidance that explains how HIPAA permits covered health care providers and health plans to identify and contact patients and beneficiaries who have recovered from COVID-19 for individual and population-based case management or care coordination. The guidance also emphasizes that, without individuals’ authorization, the providers and health plans cannot receive any payment from, or on behalf of, a plasma donation center in exchange for such communications with recovered individuals.

Let’s wrap up the round up with two healthcare provider survey stories —

Hospital operating margins are severely depressed, down 96% since the start of the year through July compared with the first seven months of last year, not including the financial aid from the federal government, according to the latest report from Kaufman Hall.
When factoring in federal relief funds, operating margins were down 28% for the January to July period compared with the same period last year.
However, there appear to be signs of recovery. When zeroing in on operating metrics month-over-month from June to July, operating margins did improve 24%, which the consultant group said is likely due to a backlog in patient demand.

  • A friend of the FEHBlog called to his attention this Healthcare Innovation Group report on a Physicians’ Foundation survey of physician sentiments about COVID-19.