Healthcare Roundup: Moody’s Healthcare Predictions, Universal Healthcare Bill Failure in CA & More

Moody’s Predictions for Healthcare in 2022:

Moody’s Investors Service is expecting several trends in healthcare this year, according to a recent report from the credit rating agency.

One of Moody’s predictions is that health insurers’ revenues and profitability will likely suffer this year. If Congress ends the public health emergency, which suspended eligibility requirements for Medicaid, 4 million people will be cut from the program. Moody’s said insurers would try to transition those individuals to Affordable Care Act coverage, but while ACA enrollment was likely to remain high, profitability of the exchanges was likely to remain lower than before the pandemic due to increased competition and COVID-19 expenses, with “long COVID” expected to cost insurers $22 billion.

Moody’s is also expecting health system finances to take a hit.  Medicaid redeterminations and Medicare growth will result in lower reimbursement rates, it said. The shift to lower-cost sites of care, increased use of telehealth and staff shortages will also cut into health systems’ bottom lines.

 Moody’s outlook for senior housing facilities is more optimistic, with occupancy rates expected to rise by up to 6 percent this year and return to pre-pandemic levels by 2023, courtesy of a decline in the number and severity of coronavirus cases and new treatments. Increasing competition among workers no longer eligible for supplemental employment benefits will also drive down the facilities’ labor casts.

Moody’s also predicts there won’t be as many medical device megadeals as there were last year, when the number of $5 billion-plus acquisitions hit a record high of 99. Instead, smaller deals will be dominant this year.

Finally, Moody’s expects the federal No Surprises Act to hit physician staffing firms’ revenue hard, particularly ER staffing companies, which are out of most commercial insurance networks, and air ambulance carriers, a large percentage of which are also out-of-network. (MODERN HEALTHCARE)

Universal Health Care Measure Fails in CA:

The author of a universal healthcare bill in California (AB 1400) opted not to bring the measure up for a vote last week after determining that it didn’t have enough support to pass. Having now failed to meet the state’s Jan. 31 deadline for passage, the bill can’t become law this year. (HILL)

Most False Claims Act Settlement Funds Came from Healthcare Providers in 2021:

Nearly 90 percent of the False Claims Act settlement proceeds collected by the U.S. Department of Justice in fiscal 2021 were paid by healthcare companies. The more than $5 billion in funds came from fraud and false claims against a variety of providers, including hospitals, managed care providers, drug makers, medical devices, doctors and labs. (MODERN HEALTHCARE)

GA Considering Minimum Medical Spending Level for Medicaid Insurers:

Tucked inside a mental healthcare bill (HB 1013) introduced by Georgia House Speaker David Ralston is a provision that would require Medicaid managed-care companies that don’t spend 85 percent of what they receive in premiums on medical care and quality improvements for patients to remit money to the state. Georgia is one of just a few states that doesn’t currently set a minimum level of medical spending for its Medicaid insurers. (ATLANTA JOURNAL-CONSTITUTION, STATE NET)

Lengthy Waits for Nursing Home COVID-19 Tests:

Slow turnaround times for PCR tests, combined with the limited supply of rapid antigen tests, have hindered nursing homes’ efforts to contain the Omicron variant. As of mid-January, 25 percent of nursing homes that sent tests to a lab waited an average of three days or more for results. (KAISER HEALTH NEWS)

Court Awards Medicare Patients Right to Appeal for Nursing Home Coverage:

A federal appeals court panel issued a ruling last month that will allow Medicare recipients to appeal for nursing home coverage if they are admitted to a hospital for inpatient care but are later switched to outpatient observation care. The ruling came in connection with a class-action lawsuit filed against the U.S. Department of Health and Human Services in 2011. (KAISER HEALTH NEWS)

VA, WV Govs Seeking Health Worker Vax Mandate Waiver:

West Virginia Gov. Jim Justice (R) and Virginia Gov. Glenn Youngkin (R) have requested a limited waiver from the federal vaccine mandate for health workers. In a letter to the Biden administration, the governors asked for some flexibility for rural and state-run facilities, such as latitude on enforcement, broader conscience exemptions, or a delay of six months. (ASSOCIATED PRESS)

Momentum Continues to Build for Congressional Action on Mental Health:

Ranking members of both parties on the U.S. Senate Committee on Health, Education, Labor, and Pensions, signaled at a hearing last week their intention to work on bipartisan mental health legislation this year. Bipartisan support has been growing for such action as the toll the pandemic has taken on Americans’ mental health has become more apparent. The Senate’s Finance Committee started work on its own bipartisan package last fall. The House Bipartisan Addiction and Mental Health Task Force released a package of 66 measures in September. And the House Ways and Means Committee also held a hearing on mental health last week. (ROLL CALL)

Biden to Recommence Federal Battle against Cancer:

President Biden is relaunching the cancer moonshot effort he began as vice president six years ago. But the goal of the new White House Cancer Moonshot will not be to “cure” cancer as it was in the past but rather to cut the cancer death rate by 50 percent within 25 years. Also unlike the push during the Obama administration, the new program doesn’t call for additional cancer research funding. It will instead establish a White House “Cancer Cabinet” focused on expanding prevention and screening, assisting cancer patients and caregivers, and reducing racial disparities in treatment outcomes. (STAT)

-- Compiled by KOREY CLARK