The Centers for Medicare & Medicaid Services (CMS) has recently given new flexibilities to Medicare Advantage (MA) plans to provide supplemental benefits that address long-term services and supports (LTSS) needs and social determinants of health (SDOH) among their members. However, limited information is available about the extent to which plans have provided or plan to provide these expanded supplemental benefits. Furthermore, Medicaid managed care plans may be concurrently offering similar benefits to Medicaid beneficiaries. This potential duplication is particularly relevant for dual eligible beneficiaries accessing services from Medicare and Medicaid managed care plans. This report synthesizes information gathered from an environmental scan and case studies to provide an overview of early implementation of the expanded supplemental benefits.

This research was conducted under contract #HHSP233201600021I between HHS’s ASPE/BHDAP and Research Triangle Institute. Please visit https://aspe.hhs.gov/topics/long-term-services-supports-long-term-care for more information about ASPE research on long-term services and supports (LTSS), or BHDAP at https://aspe.hhs.gov/about/offices/bhdap.

Available Report

• Comparing New Flexibilities in Medicare Advantage with Medicaid Long-Term Services and Supports: Final Report

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The daily total of patients who acquired COVID-19 while in the hospital hit a record of about 4,700 in January — when omicron peaked — according to an analysis of federal data from The Wall Street Journal. [Becker's Hospital Review 2.18.2022]

This figure peaked at about 1,100 patients during the delta wave, and reached 2,050 during the peak of the pandemic's first winter surge in 2020. 

Thomas Tsai, MD, a public health researcher at Cambridge, Mass.-based Harvard University, who helped the Journal review HHS data, said the proportion of patients with hospital-acquired COVID-19 as a share of all non-coronavirus patients closely aligns with case numbers in their surrounding communities. The data indicates the overall percentage of patients who contract COVID-19 in the hospital doubles on days when surges reach their highs compared to days when cases are at low points. 

In New York, for example, hospitals reported a daily peak of 620 patients in January, or 2.2 percent of total non-coronavirus caseload, who caught COVID-19 while there, coinciding with a time when communitywide cases were high. 

Despite all the precautionary measures hospitals take, such as routinely screening patients and screening staff, "the hospital itself is not an island," Dr. Tsai told the Journal, adding that when there is a surge, there is a high chance that people with undetected infections will bring the virus inside hospitals, making it hard to keep track. "That's where the fire skips the fire line," he said.  

An analysis of COVID-19 hospitalizations at four U.S. healthcare systems from March 20 to Aug. 21 put incidental admissions around 26 percent.  

HHS stopped collecting and disclosing data on the number of patients who developed COVID-19 while in the hospital in mid-2020. 

It has since published daily statewide totals for the total number of patients without the virus and those who caught it while admitted. Not all hospitals are required to report both figures every day, which makes it difficult for researchers to calculate the totals. 

Researchers said the data is likely an undercount, in part because facilities don't have to report patients testing positive after less than two weeks while admitted or after being discharged.

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New daily COVID-19 hospitalization rates in the U.S. have decreased 41% over the last two weeks, with 51 states seeing hospitalization rates trend downward and 0 states still seeing hospitalization rates trend upward, according to according to data tracked by The New York Times.

Data is taken from HHS and was last updated Feb. 23, 2022. States are listed in order of hospitalization rate percent increase over the last two weeks. 

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Only 28% of the U.S. population has been fully vaccinated and received a booster dose, according to a CNN analysis, and new vaccinations have hit an all-time low. (CNN)

Rumblings suggest the CDC may relax its indoor masking guidelines for states as early as next week, basing the recommendations on a new formula that includes severe cases. (NBC News) [MedPage 2.16.2022] 

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Poverty in early childhood correlates with lower school achievement and reduced earnings as an adult. It is also associated with differences in brain structure and electrical brain activity. Brain activity exhibits repetitive patterns at various frequencies. More low-frequency activity has been associated with behavioral, attention, and learning problems. Higher-frequency activity has been associated with better language, cognitive, and social-emotional scores. [NIH Research Matters 2.15.2022]

Some evidence suggests that children from lower-income families tend to have more low-frequency activity and less high-frequency activity than those from higher-income families. But it’s not clear whether poverty causes these changes in brain activity or is merely associated with other factors that cause them.

To find out, researchers created the Baby’s First Years study, a randomized controlled trial of poverty reduction in early childhood. In this study, 1,000 low-income mothers of newborns received a cash gift for the first several years of their children’s lives. The size of the gift was randomly chosen to be either $333 or $20 per month. The mothers could spend the money in ways that made the most sense to them, with no strings attached. 

The ongoing trial is led by Drs. Kimberly Noble of Teachers College, Columbia University, Katherine Magnuson of the University of Wisconsin, Madison, and Greg Duncan of the University of California, Irvine. It is supported in part by NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The first results from the trial appeared in the February 1, 2022, issue of Proceedings of the National Academy of Sciences.

Full article here> 

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Currently, no federal entity specifically approves respiratory protective devices intended for the public, the report notes. It recommends HHS designate a laboratory to oversee standards development, assessment, and approval of respiratory protective devices for the public. The laboratory should research factors that affect the design and appropriate use of devices, including facial characteristics, fit, and breathability. It should consider the unique needs of children, older adults, and people with certain health conditions. [THE NATIONAL ACADEMIES PRESS]

Full article here> 

The report also recommends that Congress revise the Occupational Health and Safety Act of 1970 to give OSHA the authority to ensure respiratory protection for workplaces that are currently outside its jurisdiction. Pending revisions to the 1970 legislation, OSHA should adopt the broadest permissible interpretation of “employees” and “employers” to expand coverage of its respiratory protection requirements. The categories of workers who could be covered under expanded definitions include gig economy workers, unpaid volunteers, domestic workers in residential settings, and some independent contractors. 

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Education on how to access mental health services will be provided in Illinois schools under a plan approved Wednesday by a Senate committee. [Health News Illinois 2.10.2021]

The proposal, sponsored by Sen. Mike Simmons, D-Chicago, requires elementary and secondary schools to educate students on how and where to find mental health resources.

“Our youth have been so resilient during these past few years, but many of the broader issues amplified by the COVID-19 pandemic have put a severe strain on the mental health of our young people,” Simmon said in a statement after the plan was unanimously approved by the Senate’s Education Committee. “It’s imperative that we prioritize the mental health and well-being of our young people and center the experiences they are voicing and actually living through.” 

The plan now heads to the full Senate.

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A House committee on Wednesday approved a plan to create a uniform statewide drug take-back program that would be funded and operated by drug manufacturers. [Health News Illinois 2.10.2022]

The plan would require licensed manufacturers to create programs, independently or jointly with other manufacturers, by July 2023. Every program must include promotion, education and public outreach about the proper collection and management of covered drugs.

House sponsor Jennifer Gong-Gershowitz, D-Glenview, told members of the House’s Prescription Drug Affordability & Accessibility Committee that the proposal builds on an existing take-back program in Illinois by shifting the cost onto manufacturers - as well as ensuring the program exists in more rural communities.

Alec Laird, vice president of government relations for the Illinois Retail Merchants Association, said the proposal includes collection take-back in rural areas that did not previously have access, as well as more collection points for retail, solid waste agencies, sheriff and police departments.

Gong-Gershowitz said the plan has been amended since first introduced in 2019, with changes bringing on board retail merchants, the Illinois Environmental Council and the broader environmental community.

PhRMA, which opposed the initial plan, filed as "no position" under the amended plan.

Rep. Deanne Mazzochi, R-Elmhurst, questioned why the plan does not go after distributors or the pharmacy benefit managers, rather than manufacturers. She also raised questions about the overall effectiveness of such programs.

“I'm not necessarily convinced that these take-back programs are accomplishing much of anything once you get beyond opioids and certain types of drugs that are scheduled drugs where you may actually be concerned about them getting into the wrong hands because they have addictive capabilities or have particular toxic activity or something along those,” she said.

Others raised concerns on how the plan will affect generic drugs. Ashlie Van Meter, senior director of state government affairs for the Association for Accessible Medicines, said they oppose the plan as written. The funding mechanism should be based upon a “reasonable market share” based on revenue within the state, Van Meter said.

“If it's the generics paying for most of this, it's going to increase the cost of drugs in Illinois,” Van Meter said. “It's going to potentially lead to lower availability to patients for medicines that they need at affordable prices.”

Gong-Gershowitz said a provision in the proposal states manufacturers may not charge an increase in the cost of covered drugs to recoup the costs of a drug take-back program, though Van Meter countered that such clauses have been overturned in other states as a violation of the Dormant Commerce Clause. 

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In honor of Black History Month. Black Healthcare Leaders: Theodore K. Lawless, MD

Theodore K. Lawless, MD: born 1892, was an internationally regarded dermatologist and the first African-American to hold a faculty post at what’s now Northwestern University Feinberg School of Medicine. After his post-graduate studies, which led him from Columbia University to Harvard Medical School to Europe, Dr. Lawless began clinical research at Northwestern University in 1924. He was the Elizabeth J. Ward Fellow in Dermatology from 1928 to 1936, and then he served as a member of the Northwestern University Feinberg School of Medicine faculty until 1940. 

Today, roughly 6 percent of physicians in the United States are African American.  

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The 2022 Annual Healthcare Leadership Awards are open for nominations. Check out the awards and deadlines here. 

Need help in determining who to submit for these stellar awards? Check out the 2021 Annual Healthcare Leadership Award winners here. 

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