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October 2020

Study: Healthcare software algorithms inadvertently infuse racism into care

An investigation by health news website STAT News found that a common method of using analytics software to target medical services to patients is infusing racial bias into decision-making about who should receive stepped-up care (Source: “From a small town in North Carolina to big-city hospitals, how software infuses racism into U.S. health care,” STAT News, Oct. 13).

While a study published last year documented bias in the use of an algorithm in one health system, STAT found the problems arise from multiple algorithms used in hospitals across the country. The bias is not intentional, but it reinforces deeply rooted inequities in the American health care system, effectively walling off low-income Black and Hispanic patients from services that less sick white patients routinely receive.

These algorithms are running in the background of most Americans’ interaction with the health care system. They sift data on patients’ medical problems, prior health costs, medication use, lab results and other information to predict how much their care will cost in the future and inform decisions such as whether they should get extra doctor visits or other support to manage their illnesses at home. The trouble is, these data reflect long-standing racial disparities in access to care, insurance coverage, and use of services, leading the algorithms to systematically overlook the needs of people of color in ways that insurers and providers may fail to recognize.

Child vaccine declines amid COVID-19 shutdowns could lead to outbreaks of illnesses

Economic shutdowns implemented to slow the spread of the coronavirus may indirectly lead to outbreaks of other deadly diseases in the coming months, health experts are warning (Source: “COVID shutdowns may lead to outbreaks of measles, mumps as childhood vaccinations decline,” Columbus Dispatch, Oct. 10).

With more people staying home, fewer children got their vaccines for dangerous diseases such as measles, mumps, rubella and pertussis this year.

More than 90% of people need to be vaccinated for a disease to establish herd immunity and prevent an outbreak. In April, pediatric vaccines dropped by more than 45% across Ohio compared to April 2019, according to the state’s Immunization Registry.

And if outbreaks of measles or other diseases occur, Ohio and its health departments could be at a disadvantage financially and manpower-wise. Health departments in Ohio receive less state and federal funding for emergency preparedness than nearly every other state and the District of Columbia, according to HPIO analysis. The state ranks 48th for emergency preparedness dollars per capita in HPIO’s 2019 Health Value Dashboard.

Ohio hits record for daily COVID-19 cases

Ohio reported more cases of coronavirus Friday than ever before in a single day (Source: “Ohio reports new daily record for COVID-19 cases as state death toll nears 5,000,” Columbus Dispatch, Oct. 9).

Another 1,840 Ohioans tested positive for COVID-19, the state reported Friday, bringing the statewide total to 166,102. The figure was 721 cases higher than a three-week average of 1,119, according to the state health department. The previous record high for cases was 1,733 reported on July 30.

The average positive test rate for Ohioans the past seven days rose to 3.4% Wednesday, the most-recent day for which data is available, according to the state health department.

Workers facing higher out-of-pocket costs, premiums for employer-sponsored coverage

A new survey from the Kaiser Family Foundation shows annual premiums for a family now top $21,000, and deductibles have more than doubled since 2010 (Source: “Workers With Health Insurance Face Rising Out-of-Pocket Costs,” New York Times, Oct. 8).

The high cost of health care is persisting during the pandemic, even for people who have maintained job-based insurance.

The average annual cost of a health plan covering a family rose to $21,342 in 2020, according to the latest survey by the Kaiser Family Foundation, a nonprofit group that tracks employer-based coverage. Workers paid about a quarter of the total premiums, or $5,588, on average, with their employers picking up the rest of the cost.

While premiums rose only slightly from the 2019 survey, the increase in premiums and deductibles together over the last decade has far outpaced both inflation and the growth in workers’ earnings. Since 2010, premiums have climbed 55 percent, more than double the rise in wages or inflation, according to the foundation’s analysis.

Study: Flu vaccine cut child ED visits by up to 60%

The 2018-19 influenza vaccine reduced flu-related hospitalizations and emergency department visits among children by 40% to 60%, a new study shows (Source: “Flu vaccine cut childrens' hospital stays, ED visits by as much as 60%, study finds,” Beckers Hospital Review, Oct. 6)

Published in the journal Pediatrics, the study estimated vaccine effectiveness against flu-related hospitalizations and ED visits among U.S. children. Researchers found that the vaccine's effectiveness against any flu-related hospitalizations was 41% and 51% against flu-related ED visits. Vaccine effectiveness increased to 61% against ED visits related to the A(H1N1)pdm09 strain of the flu, which was initially predominant during the 2018-19 season.

Researchers tested children 6 months to 17 years with the flu at seven pediatric hospitals.

Study: Few Ohioans have COVID-19 antibodies

A study released yesterday by the Ohio Department of Health and Ohio State University found that, as of July, the prevalence of COVID-19 antibodies in Ohio was relatively low (Source: “Coronavirus: Antibody study shows prevalence low in Ohio adults, many still susceptible,” Dayton Daily News, Oct. 2).

The results of the antibody study, which included 720 randomly selected volunteers, found that 0.9% had active COVID-19 and 1.5% had evidence of antibodies when tested over 20 days in July. Blood samples and nasal swabs were collected to test for the presence of antibodies and active COVID-19. Given Ohio’s population size, those percentages would equal about 101,700 active COVID-19 cases and 169,500 Ohioans with antibodies, which means more than 11.1 million out of 11.3 million Ohioans would still be susceptible to getting the virus.

Also yesterday, Gov. Mike DeWine announced that there are 11 counties at level 3 in the weekly COVID-19 Ohio Public Health Advisory System map, the most the state has had at one time since September. There were four counties that moved up to level 3, including Richland County, which is also on a watch list for counties near level 4.

Ohio overdose deaths in May highest in at least 14 years, ODH reports

Drug overdoses killed more Ohioans in May than in any month in at least 14 years, a potential side effect of the coronavirus pandemic that leaders fear could flare up again before things get back to normal (Source: “Amid pandemic, May was Ohio's deadliest overdose month in more than a decade,” Columbus Dispatch, Oct. 1). 

At least 532 Ohioans died of an overdose in May, preliminary statistics from the Ohio Department of Health's mortality database shows. By comparison, 381 Ohioans died of an unintentional drug overdose in April, according to state data.

The May data is still incomplete; county coroners have six months to investigate, meaning overdose deaths could still climb for that month, according to ODH.

Gov. Mike DeWine said his administration plans to announce a strategy to get money into communities struggling with the opioid epidemic. Incidents of drug abuse and mental health issues have increased during the pandemic, causing them to become a reoccurring topic in the governor's bi-weekly COVID-19 briefings.

DeWine announces plan for Medicaid managed care rebidding

Gov. Mike DeWine’s administration has unveiled plans for a long-awaited overhaul of the $28 billion Medicaid health-care program covering more than 3 million Ohioans (Source: “Wellness, quality of health care for poor Ohioans centerpiece of new Medicaid approach,” Columbus Dispatch, Oct. 1).

The Ohio Department of Medicaid seeks to update its managed-care setup with a focus on population health, meeting the needs of children with complex needs and reducing administrative hurdles for patients and health-care providers.

The state invited privately operated managed-care organizations to submit applications for new managed care contracts by Nov. 20. Contracts will be awarded early next year with a new system in place in 2022. About 90% of Medicaid beneficiaries are enrolled in managed care.

Medicaid Director Maureen Corcoran said the plan is largely based on input solicited by the department from beneficiaries, physicians, hospitals and other health care providers, along with managed-care plans over the last 18 months.

The director referred to concerns with the current system which has forced some families with children in need of intensive and costly services, either in their home or residential settings, to relinquish custody so they qualify for Medicaid because they can’t afford the cost on their own.

Under the plan, Ohio Rise, so-called multi-system youth would qualify for modified eligibility requirements, allowing them to receive assistance while remaining in their family’s custody.