As Congress weighs the future of CMS’ Acute Hospital Care at Home Program (AHCAH), advocates are urging lawmakers to authorize a five-year extension, instead of another two-year plan, to bolster currently limited hospital and Medicaid participation. Advocates say CMS guidance, practitioner flexibilities and heightened commercial coverage of hospital-at-home programs would also further support AHCAH participation.
A key lobbyist previously told Inside Health Policy a five-year extension of AHCAH is more likely to appear in an end-of-year legislative package than a shorter extension, citing indications from Senate Finance Chair Ron Wyden (D-OR)’s staff that the senator supports a five-year extension.
Both the House Ways & Means and Energy & Commerce committees advanced legislation extending the hospital-at-home initiative by five years. Lawmakers are also poised to authorize a two-year extension of Medicare telehealth flexibilities that have helped hospitals operate AHCAH programs and meet the requirement of giving patients 24/7 access to either in-person or virtual nursing care.
As of Oct. 21, CMS has authorized 368 hospitals –about 6% of all U.S. hospitals identified by the American Hospital Association–to operate AHCAH programs.
Additional CMS data suggest only a portion of those AHCAH-approved hospitals offer inpatient care in patients’ homes; just 105 out of 284 or about 37% of AHCAH-approved hospitals in 2022 reported at least one discharge through the program, according to a June 2024 report from Medicare Payment Advisory Commission.
Hospital staffers told MedPAC they struggled to start AHCAH programs because of uncertainty about the future of the CMS program, start-up costs, a lack of institutional support and workforce needs.
Meanwhile, Medicaid programs in 12 states – Oregon, Arizona, Texas, Oklahoma, South Dakota, Arkansas, Michigan, New York, Massachusetts, North Carolina, South Carolina and Florida – cover hospital-at-home services as of Sept. 30, Pippa Shulman, chief medical officer of Medically Home, told IHP. She said several state Medicaid programs are waiting for a congressional reauthorization of the AHCAH program before covering hospital-at-home services.
Shulman, along with the Bipartisan Policy Center, American Hospital Association and other groups, predict a five-year reauthorization would go further toward supporting hospital and Medicaid participation in the AHCAH program than a two-year extension.
A five-year AHCAH extension “can provide additional time for hospitals and health systems to make the necessary investments to stand up some of these programs and to also provide additional time to evaluate the results,” Jennifer Holloman, AHA’s senior associate director of policy, told IHP.
However, even with a lengthier AHCAH extension, hospital-at-home supporters say policymakers should support hospital uptake through guidance and practitioner flexibilities.
Additional CMS Support
In a July 2024 report, the Bipartisan Policy Center called on Congress to authorize funding for CMS to provide technical assistance to support hospitals and Medicaid agencies participating in the AHCAH program.
The technical assistance could include best practices for operating AHCAH programs and patient risk assessment screenings, BPC wrote. At the same time, BPC recommended CMS “strengthen regulatory guidance” with documents on escalation protocols for clinical deterioration, fall prevention, infectious prevention practices and the efficient use of telehealth and remote patient monitoring.
A CMS spokesperson said the agency has already “established a process to maintain the health and safety standards of care” for AHCAH, including guidance for hospitals “when there is evidence that there are clear gaps in communication and coordination of care that may lead to patient safety concerns.” They added the agency readily provides technical assistance to help facilities apply for AHCAH waivers at every stage of the application process.
The spokesperson did not comment on whether CMS sees a need for additional guidance and technical assistance to support hospital and Medicaid participation in the AHCAH program.
Holloman of AHA said CMS could continue to provide resources supporting upfront costs hospitals face when starting AHCAH programs. She added CMS could work with other agencies on policies supporting AHCAH programs such as expanding broadband internet access.
Congress has yet to reauthorize billions of dollars to an expired program expanding broadband internet access to low-income Americans through subsidies.
Practitioner Flexibilities
Aside from new CMS guidance, some hospital staffers say they would like additional types of practitioners to be allowed to care for patients in their homes.
Darcy Harris, physician executive director of Yale New Haven Health System clinical operations, said she would like Connecticut to allow community paramedics to care for patients in their homes. Community paramedics can care for AHCAH patients across the border in Massachusetts.
Allowing new types of practitioners to deliver acute care in patients’ homes “could help overcome barriers for more rural hospitals to participate in” the AHCAH program, wrote Allison Buffett, a senior policy analyst for BPC’s health program.
“However, it’s crucial to better understand why and how hospitals are adjusting their staffing to provide acute care at home and how these modifications impact the care quality, operational costs, and, most importantly, patient outcomes,” she wrote.
BPC has recommended CMS write a report to Congress on the cost and quality of AHCAH programs by September 2028 that includes staffing metrics and qualitative workforce data.
The CMS spokesperson noted that AHCAH-authorized hospitals cannot admit patients if they don’t also comply with state licensure requirements.
Commercial Coverage
Holloman of AHA and Collen Hole, innovation strategic advisor for AdvocateHealth, argue a five-year extension of the AHCAH program would also expand commercial coverage of hospital-at-home services. A permanent extension after the five years would go even further in unleashing commercial coverage, Holloman added.
Increased commercial coverage of hospital-at-home services could help hospitals pay for costly programs. Within one hospital, there could be Medicare beneficiaries who are eligible for hospital-at-home services but also patients with private insurance ineligible for such services, explained Mona Siddiqui, senior vice president of home & community services for Highmark Health.
“CMS may pay for hospital-at-home, but how are other payers paying for that as well?” Siddiqui asked.
Still, increased commercial coverage of hospital-at-home services alone wouldn’t solve every payment problem hospitals face.
Hole raised concerns that commercial payers are paying less for hospital-at-home services than services offered at hospitals because data, including some from CMS, suggest hospital-at-home programs reduce health care costs. But that line of thinking ignores the fact hospitals are currently struggling to pay for the high start-up costs for hospital-at-home programs, she said.
Siddiqui, meanwhile, noted while the AHCAH program covers hospital-at-home services, CMS does not cover skilled nursing facility services at home.
Some health systems are pausing, scrapping or delaying the launch of hospital-at-home programs despite a broader industry push to provide more healthcare in the home.
Health systems such as Tufts Medicine, Franciscan Health, Cone Health and UCSF Health pointed to high costs, a shortage of eligible patients and regulatory uncertainty as driving their decisions to curtail home-based hospital programs. But despite the hurdles, others are moving full-speed ahead with new programs or expansions.
CMS began letting health systems provide hospital-level care to patients where they live in March 2020 to free up beds during the COVID-19 pandemic. Under the Acute Hospital Care at Home waiver, Medicare reimburses hospitals at the same rate for home-based acute care as it does for care in a facility. The waiver expires at the end of December and Congress must decide to extend or end it.
The agency has approved 366 waivers across 138 health systems as of Oct. 10, according to a CMS spokesperson. While a CMS report released last month gave hospital-at-home a mostly positive review, health systems may not be actively enrolling patients or have suspended their programs for a variety of reasons.
Some health systems that received CMS waivers never even got their hospital-at-home programs off the ground.
University of California San Francisco Health scrapped plans to launch a program in May 2023 because the California Department of Health Care Services stopped licensing at-home acute care programs when the federal public health emergency expired, said Dr. Timothy Judson, the health system’s medical director of care delivery transformation.
Judson said in an email he still hopes to launch hospital-at-home because the health system doesn’t have enough beds.
“If the CMS waiver is extended, I certainly do hope that California will create a pathway for [hospital-at-home],” Judson said.
Greensboro, North Carolina-based Cone Health got a waiver from CMS in July 2022 to launch a program at Moses H. Cone Memorial Hospital in Greensboro, but is still in a planning phase, said a hospital spokesperson, who would not provide additional details on when or if Cone Health might launch a program.
Other health systems have backed away from plans to scale their hospital-at-home programs due to regulatory uncertainty.
For example, Franciscan Health in Crown Point, Indiana, launched its hospital-at-home program in 2021. An expansion is on hold until the system has more clarity on the federal waiver, as well as state licensing and accreditation requirements, according to a spokesperson.
Some health systems that launched programs when the COVID-19 pandemic created a huge influx of patients are finding it difficult to expand them as patient demand for care has returned to pre-pandemic levels.
That’s been a problem for St. Bernards Medical Center in rural Jonesboro, Arkansas. The health system launched its AcuteHealth at Home program in March 2021 with plans for it to grow, said a hospital spokesperson. While the program continues, St. Bernards paused an expansion because it can’t find enough eligible patients who live within 30 minutes of the hospital, as required under the federal waiver.
The costs of launching and scaling acute care-at-home programs can also be a challenge, given the financial resources required for the technology, staffing and ancillary services necessary to support home hospital programs.
Tufts Medicine paused its hospital-at-home pilot at Lowell General Hospital in Lowell, Massachusetts, last year due to financial constraints, a spokesperson said. The health system “remained confident in the benefits of the program,” but decided to focus its resources on a mobile integrated health program and a program directed at patients with complex health needs. The spokesperson said those programs are better at decreasing avoidable hospital admissions.
Executing hospital-at-home is difficult for some health systems, said Pippa Shulman, chief medical and strategy officer of Medically Home. The Boston-based company partners with health systems to provide the technology platform and some staffing for home-based hospital programs.
She said some health systems are able to provide 24/7 care at a small scale when they launch hospital-at-home programs, but struggle to provide services as they expand.
“You need to be able to [to provide care] for five patients, for 10 patients, and for 50 patients from when you start,” Shulman said. “That is the moral imperative. You have to make sure you deliver safe and effective care. You want people to tread carefully before they do this. It’s a big step.”
Even some health systems with successful hospital-at-home programs have encountered hurdles.
The University of Arkansas for Medical Sciences launched an acute care-at-home program last year at the UAMS Medical Center in Little Rock, Arkansas, in partnership with Contessa Health, a division of home health company Amedisys. The medical center has cared for approximately 200 patients at home during the first year of the program, but staffing has sometimes been a challenge, UAMS Medical Center CEO Dr. Michelle Krause said in an email.
“We have physicians available for video conferencing with patients, but Contessa has had difficulties securing nurses to visit patients and deliver supplies,” Krause said.
In an email, a Contessa spokesperson said nurses are vital to home-based care, but admitted staffing can be difficult. “No hospital-at-home program is immune from this constraint. Having a reliable partner in the nurse staffing arena doesn’t remove the hurdle, but significantly mitigates the headwind,” the spokesperson said.
Despite the challenges, some health systems still view hospital-at-home as a safe, viable and economical alternative to facility-based acute care.
AdventHealth Orlando is weeks away from launching its first hospital-at-home program, a year after receiving a CMS waiver, according to a spokesperson.
Advocate Health is also bullish on the concept. It offers hospital-at-home to patients at 10 Atrium Health hospitals in North Carolina. Atrium launched its first program in 2020 and expanded hospital-at-home prior to its merger with Advocate Aurora Health, said Colleen Hole, AdvocateHealth innovation strategic advisor. Hole said the health system has treated approximately 13,000 patients across North Carolina so far and is eager to expand the program to other states.
“To continue to build beds, which costs between $2 million and $5 million dollars per bed, is not cost-effective,” Hole said. “This model has proven that it will deliver excellent care without the time and expense of building [brick-and-mortar facilities].”
Patients who receive hospital care at home generally have lower mortality rates than their brick-and-mortar inpatient counterparts, according to a Centers for Medicare and Medicaid Services report on the Acute Hospital Care at Home initiative.
CMS said it’s difficult to conclude that the Acute Hospital Care at Home initiative resulted in lower Medicare spending overall as compared to brick-and-mortar inpatient care.
The COVID-19 initiative was extended past the end of the public health emergency, but is scheduled to expire at the end of this year. Congressional action is needed to extend the Acute Hospital Care at Home waivers.
The American Hospital Association supports the Hospital Inpatient Services Modernization Act, a bill that extends the waivers for five years through the end of 2029.
As of June, 331 hospitals, across 136 systems and 37 states, had been approved to provide acute hospital services to patients at home.
WHY THIS MATTERS
The CMS study examined the quality of care for patients treated in the inpatient hospital setting, as compared to individuals with similar conditions and characteristics treated at home. AHCAH patients were found to be meaningfully different from inpatients receiving services furnished by the same hospital facility, CMS said.
In general, AHCAH patients were more likely to be white and live in an urban location and less likely to receive Medicaid or low-income subsidies.
These different characteristics of the AHCAH population may be partially attributable to the inclusion and exclusion criteria developed by participating hospitals for the purpose of identifying patients appropriate for Hospital at Home care, CMS said.
CMS specifically looked at 30-day mortality rates, 30-day readmission rates, and Hospital Acquired Conditions. The study found that beneficiaries who received care under the hospital at home initiative generally had a lower mortality rate than their brick-and-mortar inpatient comparison counterparts.
Results of the 30-day readmissions metric analysis demonstrated some differences, with readmission rates being significantly higher in the acute care at home group for two MS-DRGs, but significantly higher in the inpatient comparison group for three MS-DRGs.
Hospital acquired condition rates observed for beneficiaries served for patients at home were lower than HAC rates observed in the brick-and-mortar inpatient comparison group for all six types of HACs evaluated, though the differences in these rates were not statistically significant, CMS said.
Patients in AHCAH were primarily treated for a relatively small set of conditions. The study found that the most common Medicare Severity Diagnostic Related Groups (MS-DRGs) and Major Diagnostic Categories (MDCs) treated through the AHCAH initiative included respiratory conditions, circulatory conditions, renal conditions and infectious diseases.
COST
The study focused on select metrics, including length of stay per episode, the Medicare spending in the 30 days after hospital discharge and hospital service utilization, including services provided in-person and virtually through telehealth.
The analysis shows that acute care at home inpatient episodes had, on average, a slightly longer length of stay than comparable brick-and-mortar inpatient episodes.
Additionally, there was, on average, lower Medicare spending for services furnished in the 30-day post-discharge period for at-home episodes, as compared to brick-and-mortar inpatient episodes, across more than half of the top 25 MS-DRGs in the acute care at home group.
The differences attributable to hospital at home patient selection criteria and clinical complexity, as measured across the two groups, make it difficult to conclude that the AHCAH initiative resulted in lower Medicare spending overall as compared to brick-and-mortar inpatient care.
PATIENT EXPERIENCE
CMS hosted four virtual listening sessions with patients and caregivers and collected anecdotal information through site visits, direct correspondence with patients and hospital program operators.
Overall, patients and caregivers had positive experiences with the care provided in the home setting. This positive feedback was mirrored by clinicians’ experiences providing care to patients at home, CMS said.
THE LARGER TREND
CMS said its study offers new insights and lessons learned for quality improvement efforts for the health and safety of inpatients in the home setting. It also offers opportunities to further develop more targeted measures of cost, quality and utilization.
Acute Hospital Care at Home waivers went into effect during the COVID-19 public health emergency. The Consolidated Appropriations Act, 2023 extended the waivers and flexibilities until the end of this year.
The CAA required CMS to conduct a study and analysis on the initiative and post such a report on a CMS website by September 30.
State Medicaid programs across the country failed to promote access to health-care services that could have supported better maternal and infant health outcomes, a federal watchdog agency said.
A report released this week by the US Department of Health and Human Services Office of Inspector General surveyed managed care organizations across 41 state Medicaid programs.
The watchdog found many states didn’t fully leverage Medicaid managed care coverage and access requirements to promote access to maternal health care. The report said many states didn’t require their managed care organizations (MCOs) to cover important types of maternal health providers.
The report comes as the US grapples with some of the worst maternal health outcomes in the developed world. The Centers for Disease Control and Prevention estimates American mothers die at a rate of 22.3 deaths per 100,000 live births, with non-Hispanic Black women fairing considerably worse, averaging 49.5 deaths under the same metric.
In contrast, Denmark, which has a similar GDP per capita as the US, averaged 4.7 deaths per 100,000 births.
The report also highlighted that some states didn’t require their MCOs to cover certified nurse-midwives, freestanding birth centers, and maternal-fetal medicine specialists even though Medicaid requires that states cover these providers if they are licensed or otherwise recognized by the state.
Only one state out of the 41 queried reported it requires its MCOs to cover all four types of health professionals whose services are optional Medicaid benefits (lactation consultants, community health workers, doulas, and non-nurse midwives) the watchdogs asked about in the survey.
The OIG recommended the Centers for Medicare & Medicaid Services take steps to ensure that all states cover required maternal health services for people enrolled in MCOs.
The watchdog also asked the CMS to clarify states’ requirements to maintain network adequacy standards for OB/GYNs and that the agency support states in tailoring their network adequacy standards to better address maternal health-care needs. Those standards can also include appointment wait times and distance standards.
Under President Biden’s and Vice President Harris’s Inflation Reduction Act, some people with Medicare will pay less for some Part B drugs because the drug’s price increased faster than the rate of inflation.
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 54 drugs available through Medicare Part B. The drugs will have a lowered Part B coinsurance rate from October 1, 2024 – December 31, 2024, since drug companies raised prices for each of these 54 drugs faster than the rate of inflation. Over 822,000 people with Medicare use these drugs annually to treat conditions such as cancer, osteoporosis, and pneumonia. Since April 1, 2023, people with Medicare have seen savings on over 100 drugs thanks to Inflation Reduction Act’s Medicare Prescription Drug Inflation Rebate Program.
“The President’s lower cost prescription drug law continues to put money back in the pockets of seniors and people with disabilities,” said HHS Secretary Xavier Becerra. “President Biden and Vice President Harris promised to lower prescription drug costs – and they have delivered.”
“No one should have to choose between paying for their health care or putting food on the table,” HHS Deputy Secretary Andrea Palm said at an event announcing the updated list in Pennsylvania today. “The Inflation Reduction Act is all about bringing down the price of health care and making sure the American people benefit.”
Because of the Biden-Harris lower cost prescription drug law, the Inflation Reduction Act, which established the Medicare Prescription Drug Inflation Rebate Program, some people with Medicare who use these drugs in the last quarter of 2024 may save between $1 and $3,854 per day. For example, someone taking a drug called Kymriah, which treats cancer, could save as much as $3,000.
“The Biden-Harris Administration is dedicated to ensuring people with Medicare have access to their prescription drugs, and the Inflation Reduction Act continues to deliver on our goal to improve affordability,” said CMS Administrator Chiquita Brooks-LaSure. “Discouraging price increases above the rate of inflation by drug companies and negotiating lower prices on some of the most expensive and most frequently used drugs in the Medicare program delivers on our promise to bring savings to Medicare enrollees.”
The Medicare Prescription Drug Inflation Rebate Program is just one of the Inflation Reduction Act’s prescription drug provisions aimed at lowering drug costs. In August, the Biden-Harris Administration announced it had reached agreements for new, lower prices for all 10 drugs selected under the first round of the Medicare Drug Price Negotiation program. If these new prices had been in effect last year, Medicare would have saved an estimated $6 billion. Once these prices take effect in 2026, people with Medicare Part D are expected to save an estimated $1.5 billion in total out-of-pocket costs.
In addition to the negotiated prices, another major cost-savings benefit begins in 2025, when all people with Medicare Part D will benefit from a $2,000 cap on annual out-of-pocket prescription drug costs. In 2024, some enrollees who have high drug costs are already seeing their annual out-of-pocket costs capped at about $3,500.
The Inflation Reduction Act requires drug companies to pay rebates to Medicare when prices increase faster than the rate of inflation for certain drugs. CMS intends to begin invoicing prescription drug companies for rebates owed to Medicare no later than fall 2025. The rebate amounts paid by drug companies will be deposited in the Federal Supplementary Medical Insurance Trust Fund, which will help ensure the long-term sustainability of the Medicare program for future generations.
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), today announced that some Medicare enrollees will pay less for 54 drugs available through Medicare Part B.
New Jerseyans and their employers spent more than $7,900 per person on health care in 2021, a study released Thursday by the Murphy administration found, 15% higher than the national average and a sharp jump from the years before COVID-19.
The increase in spending was driven by higher prices, the authors said, noting that consumers didn’t visit hospitals or doctors’ offices much more frequently.
“It supports pretty much what we’ve all been feeling and hearing,” said Laura Waddell, health care program director for New Jersey Citizen Action, a consumer group. “Health care affordability has been (an issue) for a long time now and it’s been affecting all of us in so many ways.”
The study was one of four reports released by the Murphy administration as part of its Health Care Affordability, Responsibility and Transparency Program, or HART, for short. The program, launched in 2021, is expected to provide data that can help guide policymakers.
It’s one of a series of laws and initiatives that have been rolled out both statewide and nationwide since the Affordable Care Act began in 2010 in a bid to increase access to health care and slow down the fast-rising costs.
Still, many consumers say they remain squeezed. A 2022 survey by the nonprofit health researcher Altarum found nearly three in five New Jerseyans reported being burdened by health care costs within the last year, without signs that health outcomes are improving, the authors said.
The Murphy administration has set out to slow down the rate of health care spending hikes to 3% by next year and 2.8% by 2026.
Is it attainable? One study of New Jersey residents who are between the ages of 18 and 64 and are covered by commercial insurers found:
CHARLESTON, W.Va. (AP) — For decades, Jeff Card’s family company was known for manufacturing the once ubiquitous tin boxes where people could buy newspapers on the street.
Today, reach into one of his containers and you may find something entirely different and free of charge: Naloxone, the opioid overdose reversal drug.
Naloxone distribution containers have been proliferating across the country in the more than a year since the U.S. Food and Drug Administration approved its sale without a prescription. Naloxone, a nasal spray most commonly known as Narcan, is used as an emergency treatment to reverse drug overdoses.
Such boxes — appearing in neighborhoods, in front of hospitals, health departments and convenience stores — are one way those supporting people with substance use disorder have sought to make Narcan, which can cost around $50 over the counter, accessible to those who need it most. Not unlike little free libraries that distribute books to anyone who wants one, the metal boxes used formerly as newspaper receptacles aren’t locked and don’t require payment. People can take as much as they think they need.
Advocates say the containers help normalize the medication — and are evidence of steadily reducing stigma around its use.
Sixty Narcan receptacles were distributed across 35 states in honor of Thursday’s “Save a Life Day” — a naloxone distribution and education event started by a West Virginia nonprofit in 2020. Containers were purchased from Card’s Texas-based Mechanism Exchange & Repair, which still serves newspaper customers but has expanded to manufacturing other products amid the newspaper industry’s decline.
“It’s fortunate and unfortunate,” said Card, who started making the Narcan containers over two years ago. “Fortunate for us that we’ve got something to build, but unfortunate that this is what we have to build, given how bad the drug problem is in America.”
Opioid deaths were already at record levels before the coronavirus pandemic, but they skyrocketed when it hit in early 2020. The U.S. Centers for Disease Control and Prevention estimated there were about 85,000 opioid-related deaths in the 12 months that ended in April 2023. But since then, they fell. The CDC estimate for the 12 months that ended in April 2024 was 75,000 — still higher than any point before the pandemic.
The reasons for the decline are not fully understood. But it does coincide with Narcan, a medication that’s been hard to get in some communities, becoming available over the counter, as well as with the ramping up of spending of funds from legal settlements between governments and drugmakers, wholesalers and pharmacies.
The U.S. Food and Drug Administration approved use of Narcan to treat overdoses back in 1971, but its use was confined to paramedics and hospitals for decades. Narcan nasal spray was first approved by the FDA in 2015 as a prescription drug, and in March, it was approved for over-the-counter sales and started being available last September at major pharmacies.
“That took the barriers away. And that’s when we realized, ‘OK, now we need to increase access. How can we get naloxone into the communities?’” said Caroline Wilson, a West Virginia social worker and person in recovery who coordinated this year’s Save a Life Day.
Last year, all 13 states in Appalachia participated in the day spearheaded by West Virginia nonprofit Solutions Oriented Addiction Response. Community organizations in hundreds of counties table in parking lots, outside churches and clinics handing out Narcan and fentanyl test strips and training people on how to use it. They also work to educate the public on myths surrounding the medication, including that it’s unsafe to have in easily accessible places. Narcan has no effect on people who use it without opioids in their system.
This year, with the effort expanding to 35 states and a theme of “naloxone everywhere”, the group sent out 2,000 emergency kits containing one Narcan dose to be placed in locations like convenience store bathrooms or parks. The 60 tin newspaper boxes — which sell for around $350 apiece — were purchased with grants.
Aonya Kendrick Barnett’s harm reduction coalition Safe Streets Wichita installed one of the Kansas’ first Narcan receptacles — which she refers to as “nalox-boxes” — in February. The boxes, now sold by a few different companies, can look different, too. Some look like newspaper boxes, while others look like vending machines.
Since installing a vending machine Narcan container — which just requires a zip code be entered on the keypad to access the medication — it’s distributed around 2,600 packages a month.
“To say, ‘Hey, we have a 24-hour vending machine, come over here and come get what you need — no judgment,’ is so bold in this Bible belt state and it’s helping me break down the the stigma,” she said.
Kendrick Barnett said there’s no place for judgment when it comes to what she calls live-saving health care: “People are going to use drugs. It’s not our job to condemn or condone it. It’s our job to make sure that they have the necessary health care that they need to survive.”
The Save a Life Day box her organization received is going to go in front of their new clinic, scheduled to open in October.
In Erie, Pennsylvania, 74-year-old stained glass artist Larry Tuite said he grew concerned seeing overdoses increasing in his city. He began leaving Narcan packages on the windowsills of 24-hour markets in town that sell products like pipes and rolling papers. He was shocked at how quickly they disappeared.
“As many as I give out, I run through them really quickly,” said Tuite, who keeps cases of the drugs stacked along the walls of his studio apartment.
The Save a Life Day container, which he got permission to put outside one such store, has helped him to disperse even more Narcan. At least a dozen people have been saved by the medication he’s distributed, he said.
Tasha Withrow, a person in recovery who runs a harm reduction coalition based out of Putnam County, West Virginia, said Narcan wasn’t something she ever had access to when she was using opioids.
“People can just reach in and grab what they need — we didn’t have that back then,” she said, while stocking a container in a residential neighborhood earlier this week. “To actually see that there is some access now — I’m glad that we’ve at least moved forward a little bit in that direction.”
The Health Resources and Services (HRSA) is awarding nearly $75 million in funding for health care services in rural areas, including for opioid treatment and recovery programs, maternal health initiatives and rural hospitals, HHS announced Tuesday (Sept. 24).
A statement on the awards says they support key factors driving rural health disparities. A full list can be found on HRSA’s website.
For substance use disorder in rural communities, HRSA is awarding nearly $54 million to 18 organizations for uses including creating access points for treatment, supporting the behavioral health workforce and collaborating with social services.
About $9 million is being awarded to five organizations in southern states to expand access to health care services before, during and after pregnancy.
HRSA is also providing about $12 million In funding for technical assistance to rural hospitals to help them add services and improve financial sustainability of facilities that often struggle to remain solvent.
“The Biden-Harris Administration believes health care should be available to everyone regardless of where they live. That’s why we are investing heavily in rural communities, which have historically lacked resources and access to health services” HHS Secretary Xavier Becerra said.
Rep. Carol Miller (R-WV) and several other sponsors recently introduced legislation to permanently authorize the Rural Communities Opioid Response Program, a HRSA program that provides grants for substance abuse disorder treatment facilities in rural areas and is currently not codified in law.
“The Rural Communities Opioid Response Program provides funding to rural communities that are in need of recovery facilities, and the program should be authorized to provide certainty for communities and providers,” Miller said in a statement. “I thank my colleagues for partnering with me on this bipartisan issue to establish addiction prevention services in the most rural areas of the United States.”
The Supreme Court’s overturn of Chevron deference in June is expected to boost hospitals’ latest effort to get the federal D.C. district court to overturn CMS’ cuts to disproportionate share hospital payments, after the same court rejected similar arguments in a previous case when the Chevron doctrine was still in place.
Daniel Hettich, a health care partner at King & Spalding specializing in Medicare reimbursement litigation, told Inside Health Policy that “the answer is pretty clearly yes” when it comes to the hospitals having a greater chance of succeeding in this litigation.
However, how much of an increased chance the hospitals have is still unclear, according to Hettich, who says he’s unsure if the SCOTUS decision is a complete “gamechanger,” or instead simply moves the needle a bit in the hospitals’ direction.
Shannon Medical Center, along with 79 other hospitals across the country, filed a complaint against HHS in the D.C. district court earlier this month. The hospitals claim retroactive rulemaking under the Part C Days Final Rule, which allowed the government to reduce DSH payments retroactively through a change to the Medicare fraction, is unlawful.
“The Part C Days Final Rule is arbitrary and capricious, an abuse of discretion, and otherwise contrary to the Medicare Act and Supreme Court law,” the complaint says.
The plaintiffs also argue against multiple rulings by the Provider Reimbursement Review Board (PRRB), and they are asking the court to reverse PRRB’s dismissal of their appeals. PRRB argues the plaintiffs filed their appeals with the Board prematurely, resulting in dismissal. The court must decide whether the plaintiffs were in the right to appeal to PRRB before it decides whether CMS was acting within its authority.
According to Hettich, current Medicare statute allows for retroactive rulemaking only under certain limited circumstances. When the Chevron doctrine of courts deferring to agencies’ interpretations of vague statute was still in place, CMS would just have to prove that its actions fit under its own interpretation of the statute. Now it’s up to the court to decide whether CMS’ actions were reasonable.
Hettich believes SCOTUS could potentially be interested in this case, as it explores questions about the “hygiene” of the administrative state. However, if HHS loses this suit and appeals, the case might not get SCOTUS review as this doesn’t typically happen unless there is a circuit split, Hettich told IHP.
Another health care attorney told IHP that this case, Shannon Medical Center v. Becerra, does not exist in a vacuum, as other recent cases have dealt with the same hotbed issues, such as Lake Region Healthcare Corporation v. Becerra and the latest Allina Health System v. Becerra litigation.
House Budget Committee Republicans advanced a bill along party lines Wednesday (Sept. 25) that would codify the responsibilities of the Congressional Budget Office’s Panel of Health Advisers, reduce the number of members on the panel, and give the House and Senate Budget Committee chairmen and ranking members the same authority as the CBO director to appoint the advisers — a move committee Democrats blasted as an attempt to politicize the panel.
The HEALTH Panel Act (H.R. 9686), introduced last week by Reps. Buddy Carter (R-GA) and Michael Burgess (R-TX), would formally establish the Panel of Health Advisors to provide technical expertise in health-related areas and enhance the CBO’s analyses, cost estimates and studies on health care issues and policies.
During the markup, both bill sponsors emphasized that CBO’s cost estimates are crucial in determining whether a health care bill can move forward, which underscores the importance of keeping the Panel of Health Advisers nonpartisan.
“Myself, along with other members of this committee, are concerned that the vesting [of] sole appointment authority in one individual [means] the panel is not inclusive of different ideological positions and fails to accurately represent a range of stakeholders with expertise across the health care sector,” Carter said.
Democrats on the committee unanimously opposed and voted against the legislation during Wednesday’s markup. While both parties have plenty of complaints about CBO, Republicans’ political intention is to “cook the books” in how the CBO handles health care issues, according to Rep. Lloyd Doggett (D-TX).
“Stacking the panel with a number of additional industry representatives will not produce more accurate estimates, and it will certainly politicize one of the few institutions that we can turn to for objective analysis and accountability on our work,” Doggett said during the markup.
This comes two weeks after the Panel of Health Advisers met behind closed doors to discuss multi-cancer screening tests, cell and gene therapies, the long-term budgetary impacts of preventive services and vertical integration in health care markets.
Currently, the Panel of Health Advisers has 22 members, all appointed by the CBO director. However, under the new bill, the panel would be reduced to 15 members, with appointments made by the chairs and ranking members of the House and Senate Budget Committees along with the CBO director. The legislation specifies that these members must have expertise in fields like health finance, economics, actuarial science or other health-related areas.
Under the legislation, members would serve three-year terms with a limit of two terms, and initial appointments would have staggered terms to ensure continuity. The CBO could also require panel members to disclose potential conflicts of interest and sign confidentiality agreements to protect sensitive government information.
The bill, which now heads for a full House vote, would require the panel to meet at least once a year and produce an annual report on its activities. This report would include recommendations approved by at least nine members, which the CBO director must take into account when conducting cost estimates or studies. The report would also be shared with the Budget committees of both the House and Senate.
CBO Director Phillip Swagel cautioned against legislation giving Congress a larger role in CBO appointments during a House Budget Committee hearing two weeks ago focused on improving CBO. He warned that this type of legislation could introduce political dynamics and undermine the panel’s non-partisan, expert-driven mission.
“Its experts (are) non-political, and I would worry about moving it, even inadvertently, toward the political side,” Swagel said.
Carter pushed back against similar critique during Wednesday’s hearing, arguing that the panel is “already defined by politicization and crippled with political bias” since the CBO director is currently the only one who selects its members.
Carter said during the markup that Federal Election Commission filings reveal over 80% of current panelists who made political contributions in the past five years donated exclusively to liberal candidates or left-leaning organizations, with not a single member contributing to conservative candidates or right-leaning groups.
A Biden administration final rule aimed at driving down the cost of prescription drugs in Medicaid may face legal challenges despite having dropped several contentious provisions from the proposed version, lawyers say.
The rule from the Centers for Medicare and Medicaid Services (RIN: 0938-AU28) seeks to strengthen oversight and transparency around how drug companies negotiate prices with Medicaid. The CMS clarified several statutory ambiguities that the it says have allowed drug companies to pay lower rebates to states and ultimate increase the cost of prescription drugs.
The agency had expressed concerns that manufacturers were misclassifying their drugs in the Medicaid Drug Rebate Program, leading to lower rebates to state Medicaid programs and higher drug prices overall.
Under the rebate program, drug manufacturers agree to provide state Medicaid programs with the lowest price they can possibly offer for a drug. In exchange, Medicaid agrees to cover most of the manufacturers’ drugs, and drug companies get access to the program’s large pool of beneficiaries. Certain low-income hospitals, health centers, and specialized clinics are also entitled to Medicaid’s reduced prices.
The final rule takes aim at clarifying the meaning of various definitions pertinent to payment negotiations between states and manufacturers under the rebate program, including terms like “covered outpatient drug,” “market date,” and “noninnovator multiple source (N) drug.”
The agency had also proposed reinterpreting terms like “best price,” “manufacturer,” and “vaccine,” but stopped short of finalizing these revisions.
The final rule also provides the CMS with more authority to take corrective action when misclassification of drugs by pharmaceutical companies is discovered.
It makes clear CMS’s “zero-tolerance approach” to any type of misreporting and raises the stakes for any errors in drug pricing or product reporting, said Margaux Hall, a senior partner at Ropes and Gray.
William Sarraille, a health-care attorney and regulatory consultant, predicted the agency’s move to redefine established terms will spur litigation from drug companies.
He pointed to what he called the CMS’s attempt to gut the “limiting definition” of covered outpatient drugs as one example of a provision that would likely get shot down in court.
“That ‘limiting definition’ says that manufacturers don’t have to pay Medicaid rebates on outpatient drugs that are ‘bundled’ for payment purposes with other items or services,” said Sarraille.
“So, for instance, if an outpatient drug is used in an ambulatory surgery and the surgery is paid by the payor on an all-inclusive, bundled basis, combining the charge for the surgical room, the supplies used, and the drug, the manufacturer doesn’t owe a Medicaid rebate for the drug,” he said.
“I think this provision is clearly inconsistent with the statute, and that CMS will lose. But it’s willing to throw the dice to try to generate more Medicaid rebates,” Sarraille said.
Notably absent in the final version of the CMS rule were provisions that would have required manufacturers of the most expensive drugs in the drug rebate program to complete surveys detailing proprietary information such as production expenses, research costs, and international pricing to verify drug costs.
Manufacturers that failed to comply with the information requests within 90 days would have been imposed fines of up to $100,000.
The agency had previously claimed the surveys were “critical to ensure that pricing information associated with these products is accurate so that State Medicaid programs receive the full rebate amounts to which they are entitled.” It didn’t share its reasoning behind the decision to not finalize the policy.
The proposed survey requirement had spurred warnings of legal challenges.
“CMS did say that the agency received many comments on some of the more controversial proposals, and perhaps those comments persuaded the agency that it needed to further consider the lawfulness and policy consequences of various proposals,” Hall said.
Sarraille said that it’s likely the agency understood that it risked acting in a manner that was “ultra vires,” or “beyond the powers” afforded to it by Congress.
“CMS is trying to give the state Medicaid agencies a means to press for IRA-like price concessions,” he said, referencing the 2022 Inflation Reduction Act’s creation of the Medicare Drug Price Negotiation Program.
“But neither the Medicaid Act nor the IRA gave CMS that authority. CMS cannot do what Congress never gave it the power to do,” said Sarraille.
The rule still contains some “sea-changes” for industry to contend with, said Hall. Some drugmakers may feel pain points if the final rule goes into effect, she predicted.
For instance, “if companies had drugs that are subject to bundled payment, under this rule, for the first time, they may be assessed Medicaid rebates,” Hall said.
Manufacturers will also face new time constraints for challenging Medicaid rebate assessments.
Drugmakers will have a 12-quarter period to initiate disputes, request hearings, or conduct audits for state-invoiced units on both current and fully paid rebates under the new policy.
This timeframe begins on the last day of the quarter in which the state invoice was postmarked, according to an analysis of the rule by Sidley Austin LLP.
In the past, “there used to be no such time limit,” she said.
Hall said she expects companies will scrutinize the rule to determine whether its provisions are consistent with statute. “If not, they will consider tools to respond, including perhaps litigation,” she said.
The Food and Drug Administration will hold a meeting of its Digital Health Advisory Committee on Nov. 20-21, according to a notice published in the Federal Register.
The purpose of the meeting is to discuss premarket performance evaluation, risk management, and postmarket performance monitoring for generative AI-enabled devices, according to the notice.
House Republicans are searching for a new plan to avert a government shutdown in 15 days, a move that could shine the spotlight on expiring health provisions during the lame duck session.
However, even a short-term continuing resolution would delay the start of new initiatives at the Health and Human Services Department that rely on new appropriations. The National Institutes of Health has warned in the past it would have to dole out grants below the original amount until the government finalizes spending plans.
House Speaker Mike Johnson Johnson’s (R-La.) pitch for a stopgap funding bill through March 28, 2025 — paired with a GOP bill to require voters to show proof of citizenship — sputtered last week. He delayed a vote that was initially planned for Wednesday. The Speaker told reporters he’d work through the weekend to build consensus on a plan.
House Appropriations Chair Tom Cole (R-Okla.) said he planned to talk with Johnson in person about the next steps. Top GOP members of Cole’s committee have said they’d prefer a stopgap into December, rather than March, Jack Fitzpatrick and Ken Tran report.
“The CR battle seems to be playing out in a predictable manner with a bare bones funding resolution into December the most likely outcome,” Duane Wright, a senior government analyst for Bloomberg Intelligence, told Bloomberg Government.
“This sets the stage for a number of expiring health provisions to be front and center for lawmakers,” he added.
Wright said he’s keeping an eye on extending programs that allows patients to receive acute care at home instead of the hospital and Medicare payment cuts to clinical labs. “We think both will be addressed. This package could include the House-passed Biosecure Act, if it’s not included in the annual defense policy bill.”
A growing number of hospitals in New Jersey are embracing protocols shown to improve the birthing experience for mothers and could help reduce the state’s troublesome racial disparities in maternal and infant health outcomes.
By the end of this year, staff at more than a dozen birthing centers will have been trained in a shared decision-making tool called TeamBirth, according to the New Jersey Health Care Quality Institute, a nonprofit leading the initiative in the state. Nearly 90% of preventable medical errors are the result of gaps in communication and teamwork, according to Ariadne Labs, a partnership involving Massachusetts’ Brigham Health and Harvard’s school of public health that has introduced the model at more than 150 hospitals nationwide.
At least 9 out of 10 mothers who experienced a TeamBirth delivery said they felt involved in decisions, informed and educated about their options and that their choices were respected, according to a survey of nearly 2,000 people scheduled to be publicly shared Monday by the Quality Institute. Women who did not participate in the model were as much as 20% less satisfied with the experience, the survey found.
“Our survey results show that birthing people feel more informed and heard. More feel that their choices are respected,” said Adelisa Perez Hudgins, the institute’s director of quality. “That is considerable and a reason that more New Jersey hospitals are committing to TeamBirth.”
New Jersey has struggled to reduce its maternal mortality of nearly 26 fatalities per 100,000 births, based on the most recent federal analysis of data from 2018 through 2021. It also faces glaring racial disparities that leave Black women nearly seven times — and Hispanic women three times — more likely to die during pregnancy, childbirth or the postpartum period, when compared with white women.
The TeamBirth model was particularly powerful for Black women, with those involved 35% more likely to report feeling empowered, when compared to Black moms who were not in the program, the Quality Institute found.
The institute’s announcement comes on the heels of a new study that found Black mothers who had not scheduled a surgical, or cesarean birth, are 25% more likely to deliver by C-section than white, non-Hispanic woman. The analysis, by the National Bureau of Economic Research, is based on New Jersey data covering nearly 1 million births from 2008 through 2017 and echoes previous research that showed racial disparities in birth practices.
“The findings in this study are wholly unacceptable and deeply disturbing,” first lady Tammy Murphy said in a news release last week. Murphy has championed efforts to improve maternal health and reduce racial disparities under the Nurture NJ campaign. The push includes a free nurse home-visit program available to all new moms regardless of income, insurance coverage or immigration status; the creation of a new maternal health authority to oversee the work, and programs to train culturally competent doulas, or birth coaches, to help women advocate for themselves before, during and after delivery.
“This research is critical to supporting the ongoing development of new initiatives that will continue to make a difference for families in New Jersey,” Murphy said.
While C-sections are an important option in some pregnancies, experts agree that surgical birth should be limited to critical cases. The procedure carries risks, including the potential for infection and blood clots for the mother, and can lead to breathing problems, allergies and other health challenges for the baby. C-sections also may involve longer recovery time, when compared to a vaginal birth, and can limit a woman’s delivery options in the future. The higher likelihood of surgical births among Black women likely contributes to overall maternal health disparities, experts suggest.
New Jersey has worked to reduce its overall rate of cesarean births. That effort includes work by outside advocates like the Quality Institute and a dedicated focus on maternal care by the New Jersey Hospital Association, which represents the state’s 43 hospital birthing centers. It also includes policy changes at the state level. In 2017, 3 out of 4 New Jersey hospitals with labor and delivery practices failed to meet the target rate of 24% for medically unnecessary C-sections established by national experts, according to The Leapfrog Group, a nonprofit watchdog that monitors health care quality. In one facility, 60% of the babies were delivered surgically at that time.
By 2022, half of the birthing hospitals in New Jersey were below this recommended threshold and C-section rates ranged from 9.6% at Inspira Medical Center in Elmer to 37.7% at St. Mary’s General Hospital in Passaic, according to Leapfrog data distributed by the Quality Institute. A Hospital Association report from late 2022 shows that these changes in pregnancy care enabled an estimated 10,000 New Jersey women to avoid unnecessary surgical births over five years. Statewide, the rate for all C-sections was just under 28% by 2021, it showed.
The Hospital Association report — “Path to Progress,” created by maternal health providers working as the New Jersey Perinatal Collaborative — also showed the racial distortions in C-section deliveries continued. By 2020, Asian women comprised 29% of all surgical births in the state and Black women made up almost 29% more, with Hispanic women accounting for 25% and white mothers adding just over 23%, the data showed. (New Jersey’s population is roughly 54% white, 21% Hispanic, 15% Black and 11% Asian.)
Cathy Bennett, the Hospital Association’s president and CEO, said birthing hospitals’ intentional focus on racial disparities is “yielding results. Even in the midst of the unprecedented challenges of the pandemic, New Jersey’s C-section rate for Black persons declined 5.3% between 2018 and 2022.”
Hospitals have worked together under the banner of the Perinatal Collaborative to implement various strategies that involve both proven clinical standards “along with a strong focus on patient and family engagement and communication,” Bennett said, work that continues as part of the state’s Nurture NJ strategy.
In New Jersey the decline in C-sections has been driven by a growing awareness about maternal health challenges and the racial disparities, better clinical training and improved communication among the birthing team and patient, experts note. The TeamBirth model builds on that, with structured huddles for the hospital’s care team that include the person giving birth. A whiteboard is used bedside to highlight the mother’s wishes and keep everyone on track. In the past, clinical decisions were traditionally dominated by a medical hierarchy that did not always involve the patient, the Quality Institute notes.
The TeamBirth model has also been shown to drive down unnecessary C-sections in at least one location, according to a report from Ariadne Labs. At a hospital in Oklahoma the rate of these surgical procedures dropped from 33% to 24% once the model was introduced, the group said, and the protocol is equally popular with mothers of different races, from varying economic backgrounds and geographic locations.
Linda Schwimmer, president and CEO of the Quality Institute and board chair for Leapfrog, said the shared-decision model is also impacting outcomes in New Jersey, in addition to improving the birth experience for moms. “We are seeing improvement on this front — especially for Black women. This work is essential to changing things for all pregnant people and families in New Jersey,” she said.
The following hospital and health system CFO moves have been shared with or reported by Becker’s this year:
Aug. 23-Sept. 13
1. Brenda Baker was named vice president of finance and CFO of Norfolk, Neb.-based Faith Regional Health Services.
2. Denver health tapped April Audain as CFO.
3. Teresa Batchelor was named CFO of UT Health Athens (Texas).
4. Tadd Richert was appointed as CFO of Chicago-based CommonSpirit’s mountain region.
5. Winterset, Iowa-based Madison County Health Care System tapped Audra Ford as its CFO.
6. Tony Fortmann was named CFO of Independence, Iowa-based Buchanan County Health Center.
7. Minot, N.D.-based Trinity Health appointed Jason Hotchkiss as CFO.
8. Alabaster, Ala.-based Shelby Baptist Medical Center tapped Marc Nakagawa as its new CFO.
9. Onel Rodriguez was named CFO of Riverside (Calif.) Community Hospital, a 517-bed facility part of Nashville, Tenn.-based HCA Healthcare.
10. Leslie Flake, BSN, exited her role as CFO of Orlando (Fla.) Health.
11. Charleston, S.C.-based Roper St. Francis Healthcare tapped Becky Tucker as CFO.
Aug. 9-Aug. 21
1. Douglas Winner was named CFO of DuBois, Pa.-based Penn Highlands Healthcare.
2. Westwood, N.J.-based Hackensack Meridian Pascack Valley Medical Center tapped Thomas Bisignani as CFO.
3. Ernest Ngirimana was appointed vice president and CFO of Atlanta-based Emory Healthcare’s physician division.
4. Lynchburg, Va.-based Centra Health tapped Rob Tonkinson as senior vice president and CFO.
5. Romaine Layne was named CFO of West Palm Beach, Fla.-based St. Mary’s Medical Center and Palm Beach Children’s Hospital, part of Dallas-based Tenet Healthcare.
6. TriStar Hendersonville (Tenn.) Medical Center appointed David Solomon as CFO.
7. Sherri Hitchcock was tapped as CFO of McDonough District Hospital in Macomb, Ill.
8. Andrew McMullin was named CFO of Las Vegas-based West Henderson Hospital, part of Las Vegas-based The Valley Health System.
Aug. 5-Aug 7
1. Justin Inglett was named CFO of Memorial Satilla Health in Waycross, Ga., part of Nashville, Tenn.-based HCA Healthcare.
2. Todd Radosevich has been appointed assistant vice president of Orlando Health West Region and CFO of St. Petersburg, Fla.-based Orlando Health Bayfront Hospital.
3. Bayonne, N.J.-based CarePoint Health System tapped Shamiq Syed as CFO.
July 29-July 30
1. Chase Hammon was appointed CFO of Downers Grove, Ill.-based Duly Health and Care.
2. Texas Health Hospital Frisco, part of Arlington-based Texas Health Resources, named Adam Proctor entity finance officer (CFO).
3. Ryan Kennedy was tapped as CFO of Lewes, Del.-based Beebe Healthcare.
4. Dulles, Va.-based StoneSprings Hospital Center, part of Nashville, Tenn.-based HCA Healthcare, appointed Julia Safina as CFO.
5. Cheyenne Holland was named CFO of Randolph, Vt.-based Gifford Health Care.
July 18-July 24
1. Paula Littleton was appointed CFO of Osage Beach, Mo.-based Lake Regional Health System.
2. Dothan, Ala.-based Flowers Hospital and Medical Center Enterprise (Ala.) named Tyler Adkins market CFO.
3. Harvey Torres was tapped as CFO of Amarillo, Texas-based Northwest Texas Healthcare System, part of King of Prussia, Pa.-based Universal Health Services.
4. Salem, Va.-based Lewis-Gale Medical Center, part of Nashville, Tenn.-based HCA Healthcare, named Chase Walters assistant CFO.
5. Washington, D.C.-based Risant Health appointed Bryce Bach, partner at Oliver Wyman, as the company’s CFO.
6. Greg Anderson was named CFO of Birmingham, Ala.-based Princeton Baptist Medical Center.
7. Cincinnati-based Bon Secours Mercy Health tapped Gabriel Bahala as CFO of Mercy Fairfield (Ohio) Hospital.
July 15-July 17
1. Victor Sprague was appointed CFO of the Cincinnati-based Jewish Hospital and Mercy Kings Mills Hospital in Mason, Ohio. The two hospitals are part of Cincinnati-based Bon Secours Mercy Health.
2. Ed Chabalowski is retiring as vice president of finance and CFO of Hershey, Pa.-based Penn State Health’s Berks and Lancaster counties.
3. Penn State Health named Randy Morris vice president and CFO of its community Hospitals.
4. Stacey Malakoff will retire as executive vice president and chief financial and administrative officer of New York City-based Hospital for Special Surgery at the end of 2025.
June 25-July 9
1. Katie Clement was named CFO of Rexburg, Idaho-based Madisonhealth.
2. Justin Voelker was tapped as CFO of Renton, Wash.-based Providence’s Inland Northwest Washington service area.
3. Baptist Memorial Hospital-North Mississippi in Oxford appointed Robyn Dorris CFO.
4. Cameron Meyer was named CFO of Hutchinson (Kan.) Regional Healthcare System.
5. HCA Florida Poinciana (Fla.) Hospital, part of Nashville, Tenn.-based HCA Healthcare, named Nathalie Espinales CFO.
6. Boone County (Iowa) Hospital tapped Chris Torres as CFO.
7. Margaret Fontana exited her role as CFO of Rawlins, Wyo.-based Memorial Hospital of Carbon County.
June 11-21
1. Abelardo Núñez was named CFO of USC Arcadia (Calif.) Hospital. He will succeed Bill Grigg who is retiring after 12 years in the role.
2. Columbia-based University of Missouri Health tapped Greg Damron as CFO.
3. Samantha McMillian was appointed CFO of Twin County Regional Healthcare in Galax, Va.
4. Kirkland, Wash.-based EvergreenHealth tapped Bill Howe as CFO.
5. Jason Rohr was appointed CFO of Wooster (Ohio) Community Hospital.
6. Effingham Health System in Springfield, Ga., named Antoine Poythress COO and CFO.
7. Medical City Frisco (Texas), part of Nashville, Tenn.-based HCA Healthcare’s Medical City Healthcare in Dallas, appointed Andy Kelly as CFO.
8. Phillip Childree was named CFO of Johnson City, Tenn.-based Ballad Health’s Southwest Virginia market.
9. New York City-based Mount Sinai Health System tapped Vincent Tammaro as executive vice president and CFO. Mr. Tammaro will succeed Stephen Harvey.
June 3-10
1. Lisa Lee was named CFO of Delta (Colo.) County Memorial Hospital, also known as Delta Health.
2. South Charleston, W.Va.-based WVU Medicine Thomas Hospitals tapped Rachel Jones as CFO.
3. Sanford, N.C.-based Central Carolina Hospital appointed David Munton CFO June 3.
4. William Rodrigues was named CFO of Saint Clare’s Health, part of Ontario, Calif.-based Prime Healthcare.
May 24-31
1. Nikki Hutchinson was appointed CFO of Cincinnati-based Mercy Health’s Lima (Ohio) market May 20. Ms. Hutchinson succeeded Tim Rieger, who retires July 12.
2. Greg McCulloch was promoted to president of Adventist Health Sonora (Calif.) after serving as the hospital’s CFO since 2014.
3. New York City-based Montefiore Health System executive vice president and CFO Colleen Blye added chief business officer to her title.
4. Portland-based MaineHealth CFO Albert Swallow III will retire in early 2025.
5. Minneapolis-based Allina Health named Doug Watson as CFO. Mr. Watson had served as the system’s interim finance executive since January.
6. Stella Chen was named associate CFO of Los- Angeles-based Cedars-Sinai.
May 20-22
1. Brett Esrock, executive vice president, CFO and COO of Rockledge, Fla.-based Health First, left the organization after an external candidate for the CEO role was hired.
2. Ty Renbarger was named CFO of Fort Wayne, Ind.-based Parkview Health effective June 3. Mr. Renbarger will succeed Jeanne’ Wickens, who is retiring after serving as the health system’s CFO for eight years.
3. Albuquerque-based Lovelace Health System appointed George Wiley as CFO of Lovelace Medical Center in Albuquerque and Heart Hospital of New Mexico, part of Lovelace Medical Center, effective May 28.
4. Tampa, Fla.-based Moffitt Cancer Center named Joana Weiss CFO and executive vice president.
5. Julia Puchtler was named CFO of Philadelphia-based University of Pennsylvania Health System, effective July 1. Ms. Puchtler will succeed CFO Keith Kasper, who will become chief administrative officer for the health system.
6. Lexington, Ky.-based UK HealthCare tapped Mark Steward as associate CFO of health system operational finance.
May 13-May 16
1. Sonia Baughman was named CFO of Las Vegas-based MountainView Hospital, part of Nashville, Tenn.-based HCA Healthcare.
2. Benjamin Baggi was tapped as assistant CFO of Medical City Fort Worth (Texas).
3. Los Angeles-based MLK Community Hospital appointed Steven Ciampa as its permanent CFO.
4. Bharadwaj “Brad” Mantha was named vice president and CFO of Kinston, N.C.-based UNC Health Lenoir, effective June 10.
5. Opelousas (La.) General Health System promoted CFO Jim Juneau to executive vice president of business strategy and finance.
May 1-May 10
1. Jeff Daneff was appointed CFO of Chicago-based CommonSpirit’s California Central Coast market.
2. Ernest Borjas was named assistant CFO of AllianceHealth Durant (Okla.) and AllianceHealth Madill (Okla.), both part of Franklin, Tenn.-based Community Health Systems.
3. Keene, N.H.-based Cheshire Medical Center CFO Dan Gross retired.
4. Craig McDonald was tapped as vice president and CFO of Porterville, Calif.-based Sierra View Medical Center. Mr. McDonald will assume the role in June and replace current CFO and vice president Doug Dickerson, who is retiring.
5. Salem (Mo.) Memorial Hospital District named Kayla Chamberlain CFO on May 1.
April 29-April 30
1. Drew Hartmann was tapped as CFO of Jacksonville, Fla.-based HCA Florida Memorial Hospital, effective May 20.
2. Saurabh Tripathi was appointed executive vice president and CFO of St. Louis-based Ascension April 29. Mr. Tripathi will succeed Liz Foshage, who is retiring in September.
3. Newport, Vt.-based North County Hospital tapped Fred Schaffner CFO.
4. Kristin Kearney’s CFO role of Tower Health Medical group, part of West Reading, Pa.-based Tower Health, expanded to include CFO of Reading Hospital in West Reading, Pa.
5. Tower Health promoted Rob Ehinger from senior vice president of financial operations to associate CFO.
6. Doug Hoban resigned May 22 as CFO of Salem (Mo.) Memorial Hospital District, citing personal reasons.
7. Opelousas (La.) General Health System named Shelly Soileau as CFO, effective June 3.
April 18-April 25
1. Justin Kats was named CFO of Fransciscan Health Crown Point (Ind.) and Franciscan Health Michigan City (Ind.), both part of Mishawaka, Ind.-based Franciscan Health, effective April 8.
2. Caldwell, Idaho-based West Valley Medical Center, part of Nashville-based HCA Healthcare, tapped Jared Rucks as CFO.
3. Stephen “Jan” Grigsby Jr. was appointed vice president and CFO of Brunswick-based Southeast Georgia Health System on April 29.
4. Reno, Nev.-based Renown Health tapped Anna Loomis as CFO, effective July 1.
5. Cheryl Sadro was named senior vice president and CFO of Baltimore-based Johns Hopkins Medicine.
April 2-April 17
1. Dallas-based Tenet Healthcare’s Saint Vincent Hospital in Worcester, Mass., and Tenet’s Massachusetts market has named Jeffrey Thomas as CFO.
2. Jonathan Armstrong was tapped as CFO of AdventHealth DeLand (Fla.), part of Altamonte Springs, Fla.-based AdventHealth.
3. Rob Chestnut was named CFO of Lawrence, Kan.-based LMH Health on May 20. CFO Mike Rogers was terminated in November after nearly a month on the job for lying about his identity and felony record.
4. Annapolis, Md.-based Luminis Health named Stephanie Schnittger CFO.
5. Cortez, Colo.-based Southwest Health System tapped Adam Conley as CFO.
6. Jeanne McKerrigan has been named CFO of Scottsbluff, Neb.-based Regional West Health Services.
March 22-March 28
1. Dave Recupero resigned as CFO of Kern Valley Healthcare District, based in Mountain Mesa, Calif., on Feb. 12. Amy Smith, the district’s controller, will work with accounting firm Wipfli to develop financial reports.
2. McCook, Neb.-based Community Hospital CFO Sean Wolfe has been selected as interim CEO of Chadron (Neb.) Community Hospital and Health Services. Mr. Wolfe will serve in both roles at once.
3. Michael Ducote has been named CFO of Gainesville-based North Texas Medical Center.
4. Mattoon, Ill.-based Sarah Bush Lincoln Health System has tapped Sean Fischer as its vice president of finance and CFO.
5. Duluth, Minn.-based St. Luke’s co-President and CFO Eric Lohn retired April 12. Nicholas Van Deelen, MD, co-president of St. Luke’s, was promoted April 15 to sole president of St. Luke’s and of Wausau, Wis.-based Aspirus Health’s Minnesota Region following Mr. Lohn’s departure. Chris Johnson, vice president of strategy and finance, was also promoted April 15, to interim COO.
6. Paul Perrotti was named CFO of Montrose (Colo.) Regional Health.
7. Stephen Kuhn was promoted from CFO to CEO of River Park Hospital in Huntington, W.Va. Mr. Kuhn had served as interim CEO since November.
March 19-March 21
1. HCA Florida Lake City (Fla.) Hospital, part of Nashville, Tenn.-based HCA Healthcare, appointed Kim Williams CFO.
2. Renton, Wash.-based Providence has named Alice Galstian CFO for philanthropy in its South division, effective March 25.
3. Cincinnati-based Bon Secours Mercy Health CFO Debbie Bloomfield, PhD, is retiring at the end of 2024 and will begin transitioning from her role on July 1. Travis Crum, BSMH’s current senior vice president of finance, will take over as CFO on July 1.
4. Fayetteville, Tenn.-based HH Lincoln Health has tapped Tammy Cob as CFO.
5. Atlanta-based Grady Health System CFO Anthony Saul has been promoted to a dual CFO, COO position.
March 1-March 18
1. Washington, D.C.-based George Washington University Hospital has tapped Maia Healy as CFO.
2. Alice Pope has been named executive vice president and CFO of Winston-Salem, N.C.-based Novant Health.
3. Jon Vitiello was named CFO of Chesterfield, Mo.-based St. Luke’s Hospital.
4. Nacogdoches (Texas) Memorial Health’s CFO, Rhonda McCabe, was promoted to CEO of Nacogdoches Memorial Hospital.
5. Durham, N.C.-based Duke University Health System tapped Lisa Goodlett as CFO on March 4.
6. Medical City Decatur (Texas) named Lucy Hedari CFO on March 1. Ms. Hedari had served as the hospital’s interim president of finance since December.
7. Margaret Fontana was tapped as CFO of Rawlins, Wyo.-based Memorial Hospital of Carbon County.
Feb.1-Feb. 27
1. Medical City Arlington (Texas) tapped Nathan Tindall as its CFO.
2. Marley Koons was promoted from CFO to CEO of Lakin, Kan.-based Kearny County Hospital.
3. Warrenton, Va.-based Fauquier Health has appointed Janelle Padgett as CFO.
4. Julie Leonard has been named CFO of Libby, Mont.-based Cabinet Peaks Medical Center.
5. Bellin and Gundersen Health System has tapped John Ceelen as its new CFO. Bellin and Gundersen Health System formed in December 2022 from the merger of La Crosse, Wis.-based Gundersen Health and Green Bay, Wis.-based Bellin Health.
6. Brentwood, Tenn.-based Lifepoint Health has named Bill Ziesmer its new CFO of its Western division.
7. Orange City, Fla.-based AdventHealth Fish Memorial has tapped Jennifer Ambs as CFO.
8. Bradley Bond has officially been named CFO at Cleveland-based University Hospitals, succeeding Michael Szubski, who retired after more than 15 years in the job.
Jan. 1-Jan. 31
1. Nashville, Tenn.-based HCA Healthcare’s CFO, Bill Rutherford, retired. Mike Marks assumed the role of HCA’s executive vice president and CFO on May 1.
2, Zach Riggins has been appointed CFO of Independence, Mo.-based Centerpoint Medical Center.
3. Sean Mills was named CFO of Johnson City, Tenn.-based Ballad Health’s Northern region.
4. Hamilton, N.Y.-based Community Memorial Hospital tapped Tracy Frank as CFO.
5. Carla Chandler was named vice president and market CFO for Danville, Pa.-based Geisinger.
6. Springfield, Ill.-based Hospital Sisters Health System tapped Michael Scialdone as senior vice president and CFO.
7. Michael Cropp, MD, president and CEO of Buffalo, N.Y.-based Independent Health, passed his president title on to Jim Dunlop, the independent, nonprofit health system’s current executive vice president and CFO.
8. Wausau, Wis.-based Aspirus selected Jerry Yang to succeed its CFO Sid Sczygelski.
9. Ric Magnuson exited his role as CFO of Minneapolis-based Allina Health in April.
10. Troy (Ala.) Regional Medical Center names Kathy Hill its CFO.
11. Raju Iyer has been named senior vice president and CFO of Sacramento, Calif.-based Sutter Health.
12. Sioux Falls, S.D.-based Sanford Health appointed Scott Wooten as CFO.
13. Kevin Benson departed his role as CFO of Thermopolis, Wyo.-based Hot Springs Health.
14. Burlington, Mass.-based Tufts Medicine tapped Andrew DeVoe as CFO. Mr. DeVoe replaces Tufts’ former CFO Susan Green.
15. Chuck Robb, former senior vice president and CFO of Kansas City, Mo.-based Saint Luke’s Health System, was named CFO of St. Louis-based BJC Health System.
16. Vickie Magurean was named CFO of Tamiammi-based HCA Florida Kendall Hospital.
17. Inverness-based HCA Florida Citrus Hospital named Jordan Fulkerson CFO.
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