Hospital funding comes into focus as case counts continue to rise

During his daily press briefing, Pritzker said schools should continue to focus on e-learning as they consider the fall, adding “We don’t know what it will look like” at that point.

By Angela Simmons, Weekly Editor

Hospital funding for the coronavirus disease (COVID-19) has recently been made a focus as case counts continue to rise across the state and region.

The Illinois Department of Public Health (IDPH) announced 2,126 additional cases of COVID-19 and 59 additional deaths. Currently, IDPH is reporting a total of 43,903 cases, including 1,933 deaths, in 96 counties in Illinois.

The St. Clair County Health Department announced seven new cases today, a lower increase than previous days, for a total of 389 confirmed cases and 22 deaths. Samantha Bierman, the department’s Emergency Response Coordinator, cautioned that there are 109 pending tests, and the reported number doesn’t include pending tests.

“It does not mean we have reached our peak. As we do more testing, the labs are inundated, and we’ll have to wait for those results,” she said.

Bierman announced the numbers for long term care facilities in outbreak status. BRIA of Belleville has 12 positive cases and one death, Colonnade in O’Fallon has two cases and no deaths, Four Fountains has 24 positive cases and one death, Memorial Care Center has 15 positives and one death, St. Paul’s Home has five cases and no deaths, and Lebanon Care Center in Lebanon has four cases and no deaths.

St. Clair County Board Chairman Mark Kern said that he’s very concerned about the outbreaks in those facilities, and agreed with Bierman that the peak hasn’t been reached. “We’ve increased by 100 cases from this time last week,” he said, as he called the long term care centers “hot spots” in the county.

The St. Louis Metro region has been considered a hot spot by many leaders, and at his daily press briefing, Illinois Governor JB Pritzker said he had not been in contact with Missouri Governor Mike Parson about coordinated reopening efforts, but added that the county health departments in the region were working together.

Kern did say that the Metro East is “one big region” with residents working across state borders in both cases, and added that the Metro public transportation runs through the region “like a ribbon.” He said the county is keeping an eye on St. Louis city and county numbers, especially as the region tries to determine a possible peak.

According to the Missouri Department of Health and Senior Services, the St. Louis City has 1007 confirmed COVID-19 cases and 50 deaths, and St. Louis County has 2,794 confirmed cases and 127 deaths. Parson has said Missouri would begin reopening on May 4, but that county and city officials could determine local restrictions. St. Louis City Mayor Lyda Krewson and St. Louis County Executive Same page extended their stay at home orders indefinitely.

St. Clair County currently has 67 COVID-19 patients and patients under investigation (PUI) hospitalized, and six of those patients are on ventilators.

When asked about whether or not hospitals are being paid to specifically record deaths as COVID related, Bierman said “That is not information that is available to us.”

Recently, Minnesota State Senator Scott Jensen released recorded videos to his social media pages referencing hospitals recording higher counts of the virus to capture additional Medicare dollars under the CARES Act.

Jensen, a family physician for over 35 years, said “The healthcare world of coding and payments is complicated…especially in Medicare and medical assistance. Physicians are often provided with administrative advice as to coding diagnoses, procedures or telemedicine- that does not imply unethical behavior.”

It is true that under the CARES Act, Medicare payments are increased by 20 percent if a diagnosis of COVID-19 is present at patient discharge, according to releases from the American Hospital Association (AHA).

One release states “The CARES Act provided for a 20 percent add-on to the in-patient prospective payment system (PPS) DRG (diagnosis-related group) rate for COVID-19 patients for the duration of the public health emergency,” and then gives discharge codes to utilize the payment increase.

So far, $100 billion in funding has been provided “to reimburse hospitals and healthcare providers for lost revenues and expenses related to the outbreak,” including an initial $30 billion distributed based on “Medicare fee-for-service reimbursements from 2019.”

The U.S. Department of Health and Human services has a breakdown of the funding from the CARES Act on their website, including $10 billion in relief to highly impacted areas, and $10 billion in relief specifically for rural hospitals. The site offers directions for providers to enter their statistics to receive relief.

President Donald Trump signed a bill into law on Friday that will give an additional $75 billion in funding.

In response to the additional funding, the AHA said “Hospitals and health systems are in a unique position because of the loss of revenue from non-emergency medical procedures while incurring increased costs due to preparing and responding to this public health emergency as it continues to spread throughout the country. The initial CARES Act funds have begun to be used by hospitals and health systems to increase capacity and provide care, and in some cases to keep access to care available by keeping the doors open. This additional funding will help ensure that critical care can continue to be provided by front line providers throughout the country.”

Statewide, there are 4,595 COVID-19 and PUI hospitalizations with 1,267 of these patients in the ICU and 772 on ventilators.