Novel Coronavirus (SARS-CoV-2/COVID-19) https://www.aha.org/ en RAND’s solutions for lowering health care costs are ineffective and potentially harmful https://www.aha.org/news/blog/2021-03-05-rands-solutions-lowering-health-care-costs-are-ineffective-and-potentially <span class="title">RAND’s solutions for lowering health care costs are ineffective and potentially harmful</span> <span class="uid"><span>tjordan_drupal</span></span> <span class="created">Mar 5, 2021</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2019-10/rick-pollack-banner-900x400.jpg?itok=OKwgFu_e" width="900" height="400" alt="Rick Pollack in front of American Hospital Association seal and American flag" loading="lazy" /> </div> </article> </div> <div class="body"><p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">A recent report from RAND misses the mark on solutions to the cost of health care and draws its conclusions from the same recycled and incomplete studies.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Physicians, nurses and all health professionals do extraordinary and often heroic work that no other part of the health care system can. The COVID-19 pandemic is just one example of the essential and life-saving care provided at all times, 24 hours a day, 7 days a week. That means having at the ready highly trained personnel, novel drug therapies and advanced technologies to respond to anything from burns and cardiac failure to delivering a baby. </span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">During the past year, hospitals and health systems cared for their communities in all of these ways despite unprecedented financial challenges. A new <a href="https://www.aha.org/system/files/media/file/2021/02/KH-2021-COVID-Impact-Report_FINAL.pdf" style="color:#0563c1; text-decoration:underline">analysis</a> prepared for the AHA by Kaufman Hall and Associates forecasts that total hospital revenue in 2021 could be down between $53 billion and $122 billion from pre-pandemic levels. Hospitals and health systems have also experienced increases in many expenses due to COVID-19 in 2020 compared with 2019. This comes on the heels of years of price moderation, with the <a href="https://www.bls.gov/ppi/" style="color:#0563c1; text-decoration:underline">Bureau of Labor Statistics</a> finding hospital prices grew an average of just 1.9% each year over the last decade. </span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Against this backdrop, RAND puts forward ineffective and potentially harmful policy options that broadly fit into three categories: rate regulation, price transparency and increased competition. </span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Rate regulation: </span></b><span style="font-family:&quot;Arial&quot;,sans-serif">Rate regulation is not an effective strategy for reducing consumer health spending. One key reason rate regulation won’t work: Medicare rates do not cover the cost of providing care to Medicare patients. Medicare paid only 87 cents for every dollar hospitals spent caring for Medicare patients in 2019. This resulted in an <a href="https://www.aha.org/fact-sheets/2020-01-07-fact-sheet-underpayment-medicare-and-medicaid" style="color:#0563c1; text-decoration:underline">underpayment</a> of nearly $57 billion. Linking commercial prices to Medicare levels would pull desperately needed resources away from hospitals, especially when more than a quarter already experienced negative margins before the pandemic. </span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Price transparency: </span></b><span style="font-family:&quot;Arial&quot;,sans-serif">Hospitals and health systems vigorously support and are already working to help patients estimate and better understand what they will pay for care. In addition, new price transparency rules require hospitals to publish negotiated rates. RAND’s solutions would either add another layer of bureaucracy or require hospitals to shift gears <i>yet again</i> and publish these data in a different way.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Also, as the authors themselves note, price transparency is only effective if patients use the tools. Studies show consumers in high-deductible health plans, with the highest incentive to price compare, do not regularly shop around even when data and price comparison tools are available. That’s why hospitals are focused on bridging these gaps by developing tools that engage patients and promote financial literacy.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><b><span style="font-family:&quot;Arial&quot;,sans-serif">Increasing competition: </span></b><span style="font-family:&quot;Arial&quot;,sans-serif">The last prescription — to “increase competition” — is the weakest. RAND <a href="https://www.aha.org/2019-09-04-charles-river-associates-report-hospital-merger-benefits" style="color:#0563c1; text-decoration:underline">ignored findings</a> that are inconsistent with their point of view, such as hospital consolidation being linked to a 2.3% reduction in annual operating expenses and a 3.5% decline in revenues per admission. During the pandemic, many systems were able to redeploy staff when surges occurred, or to find new supply chains to deliver personal protective equipment and other supplies and to do outreach to underserved communities in a targeted manner.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Further, no credible argument about market power can dismiss consolidation among health insurers, as RAND does. Nearly 3 in 4 health insurance markets (74%) were <a href="https://www.ama-assn.org/delivering-care/patient-support-advocacy/competition-health-insurance-research" style="color:#0563c1; text-decoration:underline">highly concentrated</a> in 2019, according to the American Medical Association. At the same time, health insurers are injecting themselves into other parts of the supply stream by buying physician practices and pharmacy benefit managers. Researchers have drawn a <a href="https://www.healthaffairs.org/doi/abs/10.1377/hlthaff.2018.0054#:~:text=In%202018%2C%20Marketplace%20premiums%20were,insurers'%20lowest%2Dcost%20plans" style="color:#0563c1; text-decoration:underline">direct link</a> between insurer monopolies and higher premiums — a 2018 study of marketplace plans found premiums were on average 50% higher in areas with just one insurer compared to those with more than two insurers.</span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="font-family:&quot;Arial&quot;,sans-serif">Even RAND acknowledges their prescriptions could do more harm than good. Co-author and RAND policy researcher Christopher Whaley said in a statement: “Regulating commercial hospital prices is a direct way to create significant reductions in spending, but doing so could potentially lead to hospital closures, erode quality, and face daunting political hurdles.” </span></span></span></span></p> <p><span style="font-size:12pt"><span style="font-family:&quot;Times New Roman&quot;,serif"><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">The AHA will continue to lead the health care field on affordability and value.&nbsp;The </span></span><span lang="EN" style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">AHA supports new approaches to delivering higher-quality care at lower cost through innovative alternative payment models, as well as </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">efforts to transform the delivery system to ensure the right care happens at the right time in the right setting.&nbsp;</span></span><span lang="EN" style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">Today’s health care system is rife with administrative burden. The hospital field faces duplicative regulation and compliance burdens, along with myriad requirements from insurance plans, each of which have different claims processing, recordkeeping and medical necessity requirements. An AHA </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"><a href="https://www.aha.org/guidesreports/2017-11-03-regulatory-overload-report" style="color:#0563c1; text-decoration:underline">study</a></span></span><span lang="EN" style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif"> found that health systems, hospitals and post-acute care providers spend nearly $39 billion a year on administrative costs — costs not associated with the delivery of patient care — to support compliance with federal regulations. The AHA is also advocating for lower drug prices, </span></span><span style="font-size:11.0pt"><span style="font-family:&quot;Arial&quot;,sans-serif">liability reform, further reducing barriers to communication and collaboration among providers, and improving access to health care coverage, especially behavioral health care, among other things.&nbsp; &nbsp;&nbsp; </span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><span style="background:white"><span style="font-family:&quot;Arial&quot;,sans-serif">As we emerge from this epidemic, we should focus on how to bolster hospitals and health systems to prepare them for future pandemics, not layer on more unhelpful regulations. RAND’s omissions and missteps take away from the value this report might otherwise offer in charting a path forward. </span></span></span></span></span></p> <p><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><i><span style="background:white"><span style="font-family:&quot;Arial&quot;,sans-serif"><span style="color:#333333">Rick Pollack is president and CEO of the American Hospital Association.</span></span></span></i></span></span></span></p> </div> <div class="field_author"> <span>Rick Pollack</span> </div> <div class="field_topics"> <div><a href="/topics/price-transparency" class="topic" hreflang="en">Price Transparency</a></div> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/leadership" hreflang="en">Leadership</a></div> <div><a href="/topics/cost-management" hreflang="en">Cost Management</a></div> </div> <div class="field_type">Blog</div> Fri, 05 Mar 2021 17:33:18 +0000 tjordan_drupal 675969 at https://www.aha.org AHA Outlines Initial Policy Priorities for Biden Administration https://www.aha.org/lettercomment/2020-12-11-aha-outlines-initial-policy-priorities-biden-administration <span class="title">AHA Outlines Initial Policy Priorities for Biden Administration</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Dec 11, 2020 - 02:34 PM</span> <div class="body"><p>The Honorable Joseph R. Biden<br /> President-elect of the United States<br /> 1717 Pennsylvania Avenue, N.W.<br /> Washington, DC 2006</p> <p>Dear President-elect Biden:</p> <p>On behalf of the American Hospital Association’s (AHA) nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, we congratulate you on being elected the 46th President of the United States of America. We share your important goal of quickly and aggressively ending the COVID-19 pandemic, which has tested our country and our health care system like never before. This must be our nation’s highest priority. We stand ready to tackle this daunting challenge together.</p> <p>Our member hospitals and health systems, along with our doctors, nurses and other team members, have been on the front lines of the pandemic, working tirelessly to provide the best care for our patients, families and communities. Given our unique role, we have repeatedly shared publicly the importance of wearing masks, washing hands and practicing social distancing. In addition, we have engaged with local and state officials to assist with testing and contact tracing. Currently, we are gearing up to support widespread deployment and administration of COVID-19 vaccines and therapies. Our hospitals and health systems are deeply committed to collaborating with you and your Administration to tackle these unprecedented challenges and to end the public health crisis.</p> <p>We believe our joint focus should be on providing relief, ensuring a smooth recovery, and rebuilding a better health care system for the future. In addition, we need to address ongoing challenges that have been further exasperated during the pandemic, including issues related to health equity, workforce resilience and behavioral health.</p> <p>This letter outlines a set of priority recommendations that we urge you to implement during your first 100 days in office as they require immediate attention. We will share a&nbsp;more extensive set of recommendations in the new year to help advance health in America.</p> <h3>Relief</h3> <p>To ensure that America’s hospitals can continue to fight the pandemic, we urge your Administration to help ensure they have the resources they need to care for their communities. Hospitals and health systems are projected to lose more than $320 billion in 2020 alone due to COVID-19. They have faced enormous costs to maintain proper personal protective equipment (PPE), ensure adequate supplies and equipment, safeguard sufficient staffing, purchase new drugs and therapies, and retrofit their physical plants to care for patients with the virus. These expenditures come as months of essential hospital revenue has eroded due to the combination of reduced demand for emergent and non-emergent care, as well as growing uncompensated care costs attributable to the newly uninsured. Specifically, we ask your Administration to:</p> <ul> <li>Ensure the extension of the public health emergency, currently set to expire on Jan. 20, 2021, to safeguard needed flexibilities, including critical 1135 waivers, through the duration of the public health crisis.</li> <li>Ensure providers can retain Provider Relief Fund dollars by allowing use of any reasonable method for calculating COVID-19-related lost revenue, movement of targeted distributions within a system, and use of funds for increased staffing costs.</li> <li>Protect vital federal funding for public programs, including stopping unlawful payment cuts that do not recognize legitimate differences among provider settings, also described as site-neutral payment policies.</li> <li>Ensure vital Medicaid financing arrangements, such as provider assessments and intergovernmental transfers, remain available to states through official rescission of the Medicaid financial accountability rule.</li> <li>Protect the 340B drug savings program to ensure vulnerable communities have access to more affordable drug therapies by reversing harmful policies and holding drug manufacturers accountable to the rules of the program, especially as it relates to contract pharmacy arrangements.</li> <li>Require that private plans serving the Medicare, Medicaid and Marketplace programs eliminate administrative and financial barriers to coverage for COVID-19 testing and treatment and ensure that providers are adequately compensated for this care.</li> <li>Rescind provider requirements to publicly disclose negotiated rates that do nothing to help patients understand their costs, could result in anticompetitive actions on the part of health plans, and, according to the Federal Trade Commission, could result in high costs for patients.</li> </ul> <h3>Recovery&nbsp;</h3> <p>As the hospital field moves forward both with caring for COVID-19 patients and safely delivering needed health care services to others, we ask for your help in ensuring that the nation can successfully “coexist with COVID-19.” Critical to this is ensuring patients’ access to care, as the COVID-19 pandemic has only further demonstrated the importance of comprehensive health coverage. Additionally, given the&nbsp;economic downturn, it is more crucial than ever to ensure affordable, high-quality coverage options are available regardless of employment status or income level. Moreover, to spur recovery, we will need to quickly and effectively distribute vaccinations to the American public. We urge your Administration to:</p> <ul> <li>Engage in robust outreach and enrollment efforts to capture the millions of individuals who are eligible for, but not enrolled in, some form of subsidized coverage.</li> <li>&nbsp;Open a special enrollment period for the Health Insurance Marketplaces for the duration of the public health emergency.</li> <li>Eliminate rules that expanded access to health sharing ministries and short-term limited duration coverage products (so called “skinny plans”).</li> <li>Encourage states to extend coverage and care to their populations through innovative state waivers (section 1115 and 1332 waivers) with appropriate safeguards against eligibility reductions and cost-sharing increases.</li> <li>Allow states to delay Medicaid eligibility recertification during the public health emergency.</li> <li>&nbsp;Rescind recent rules that weaken maintenance of effort protections for Medicaid enrollees.</li> <li>Implement a communication effort on vaccine safety, particularly among segments of the population who justifiably mistrust such efforts, and ensure tracking to understand better long-term outcomes and effectiveness.</li> </ul> <h3>Rebuilding</h3> <p>America’s health care system will never be the same due to COVID-19. We need to seize this opportunity to help reimagine a new system that better protects patient access to care, advances affordability, improves quality and patient safety, and truly transforms health care financing and delivery. This includes accelerating movement toward alternative payment systems that increase provider financial stability, as well as create new care models and alternative care delivery sites. We need to explore new staffing models and the innovative use of technology, such as telehealth and remote patient monitoring, to augment care and allow it to move outside the hospital into patients’ homes. Additionally, we need to create a new era of health preparedness, which includes bolstering our public health infrastructure, diversifying the health care supply chain, and reassessing the interaction between federal, state and local governments. We look forward to sharing further thoughts with you in the new year on rebuilding and reimagining the health care system to make it stronger and more sustainable.</p> <h3>Address Ongoing Critical Challenges</h3> <p>The events of 2020 have brought forth a number of vulnerabilities in our health care system, especially those related to health equity, workforce resilience and behavioral health care. Our recommendations in these areas follow.</p> <p><u>Equity:</u> Unequal access to care, disproportionate disease burden and disparities in health outcomes predate the COVID-19 pandemic. However, they have contributed&nbsp;to one of the greatest tragedies this year: the disproportionately high mortality rate from COVID-19 among Black and Latino communities, especially among those serving as essential workers. We urge your Administration to take steps to help make meaningful progress, such as:</p> <ul> <li>Rescind the “public charge” rule that has contributed to disparities in enrollment in health care coverage among Latino and other immigrant communities.</li> <li>Repeal the June 2020 final rule that narrowed the scope of non-discrimination protections under Section 1557 of the Affordable Care Act.</li> <li>Rescind Executive Order 13950, Combating Race and Sex Stereotyping, which has a detrimental effect on diversity and inclusion training in federal agencies, grantees, contractors and beyond.</li> <li>Empower the Secretary of Health and Human Services to lead a department-wide effort addressing health inequities and engage in an inter-departmental effort to address the social and structural determinants of health.</li> </ul> <p><u>Workforce</u>: Recruiting, training and maintaining staff is challenging in the best of times. The surge of COVID-19 cases and the continued need to handle the pandemic has resulted in strain and exhaustion, especially among clinicians. To protect our front-line caregivers, ease workforce shortages and prevent clinician burnout, we urge you to:</p> <ul> <li>Provide support for front-line workers by ensuring child care, housing, PPE and priority access to vaccines.</li> <li>Expanding the physician supervision requirement waiver to include nurse practitioners.</li> <li>Coordinating with the Department of Defense and other relevant agencies to provide direct staffing relief in hard hit communities.</li> <li>Reinstitute critical waiver flexibilities, such as those that halted data collection and in-person routine compliance surveys.</li> <li>Make certain telehealth flexibilities permanent.</li> <li>Support a more diverse and inclusive workforce through clinician education and training efforts and new recruitment initiatives targeted at underrepresented communities.</li> <li>Reduce variability of scope of practice laws to allow caregivers to practice at the top of their license.</li> </ul> <p><u>Behavioral Health:</u> The burden of COVID-19 also will have far-reaching effects on behavioral health. The stress from unemployment, isolation due to quarantine, and grief over loved ones lost to the pandemic are likely to manifest in increases in already high rates of deaths of despair (i.e., suicides and substance use). While hospitals and health systems have been working hard to integrate behavioral health services into physical health care, serious gaps and barriers in insurance coverage and reimbursement have&nbsp;resulted in dire workforce shortages and reduced access to care. It is critical that your Administration address these urgent, nationwide needs by taking steps to:</p> <ul> <li>Enforce the Mental Health Parity and Addiction Equity Act requiring insurers who offer coverage for behavioral health conditions to use comparable standards for those services as for medical/surgical services.</li> <li>Eliminate regulatory barriers to care coordination posed by the restrictions under 42 CFR Part 2, which limit the ability of providers to share important information regarding care and treatment for substance use disorders.</li> <li>Improve the behavioral health workforce by considering additional funding and/or student loan forgiveness to support training for health professionals at all levels to reduce workforce shortages.</li> </ul> <p>On behalf of our members and all of the hospitals and health systems in America, we look forward to working with your Administration to swiftly address the COVID-19 crisis and improve access to high quality care and coverage for all Americans.</p> <p>Sincerely,</p> <p>/s/</p> <p>Richard J. Pollack<br /> President and Chief Executive Officer</p> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/access-health-coverage" hreflang="en">Access &amp; Health Coverage</a></div> <div><a href="/topics/disparitiesequity-care" hreflang="en">Disparities/Equity of Care</a></div> <div><a href="/topics/health-insurance" hreflang="en">Health Insurance</a></div> <div><a href="/topics/emergency-readiness" hreflang="en">Emergency Readiness</a></div> <div><a href="/topics/access-behavioral-health" hreflang="en">Access to Behavioral Health</a></div> <div><a href="/topics/workforce" hreflang="en">Workforce</a></div> <div><a href="/topics/disparitiesequity-care" hreflang="en">Disparities/Equity of Care</a></div> <div><a href="/topics/advocacy-public-policy" hreflang="en">Advocacy &amp; Public Policy</a></div> <div><a href="/topics/price-transparency" hreflang="en">Price Transparency</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/taxonomy/term/113" hreflang="en">Letter/Comment</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><p>December 11, 2020</p> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <h4 class="page-header">Key Resources</h4> <div class="field_related_files file file--mime-application-pdf file--application-pdf"> <div> <article> <div class="field_media_file"><span class="file file--mime-application-pdf file--application-pdf"><a href="/system/files/media/file/2020/12/aha-outlines-initial-policy-priorities-for-biden-administration-letter-12-11-20.pdf" type="application/pdf" title="Letter: AHA Outlines Initial Policy Priorities for Biden Administration">AHA Outlines Initial Policy Priorities for Biden Administration</a></span> </div> </article> </div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Fri, 11 Dec 2020 20:34:41 +0000 dsamuels_drupal 674601 at https://www.aha.org FDA expands Novavax EUA to include children 12 and older https://www.aha.org/news/headline/2022-08-22-fda-expands-novavax-eua-include-children-12-and-older <span class="title">FDA expands Novavax EUA to include children 12 and older</span> <span class="uid"><span>ctorres_drupal</span></span> <span class="created">Aug 22, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2020-03/doctor-washing-hands.jpg?itok=qvOg7lgQ" width="900" height="400" alt="Doctor washing hands" loading="lazy" /> </div> </article> </div> <div class="body"><p>Novavax today <a href="https://ir.novavax.com/2022-08-19-U-S-FDA-Grants-Emergency-Use-Authorization-for-Novavax-COVID-19-Vaccine,-Adjuvanted-for-Adolescents-Aged-12-Through-17" target="_blank">announced</a>&nbsp;the Food and Drug Administration expanded the emergency use authorization for its Adjuvanted (NVX-CoV2373) COVID-19 vaccine. Under the expanded EUA, the two-dose primary series can be administered for adolescents between the ages of 12 and 17. The vaccine was previously subject to an EUA for adults over the age of 18. FDA’s decision was based on data from Novavax’s ongoing pediatric expansion of its phase 3 clinical trial, which indicated a clinical efficacy of 78.29% in preventing SARS-CoV-2 infections, Novavax said. Novavax notes that its pediatric trial culled data during a period in which the SARS-CoV-2 delta variant was the predominant strain in the U.S.&nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/covid-19-vaccines-and-therapeutics" hreflang="en">COVID-19: Vaccines and Therapeutics</a></div> </div> <div class="field_type">Headline</div> Mon, 22 Aug 2022 19:18:46 +0000 ctorres_drupal 685087 at https://www.aha.org CMS fact sheets summarize status of Medicare COVID-19 waivers https://www.aha.org/news/headline/2022-08-19-cms-fact-sheets-summarize-status-medicare-covid-19-waivers <span class="title">CMS fact sheets summarize status of Medicare COVID-19 waivers</span> <span class="uid"><span>ctorres_drupal</span></span> <span class="created">Aug 19, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2018-03/stock_nurse_happy_patient_ipad_900x400.jpg?itok=a1MF2xlp" width="900" height="400" alt="stock_nurse_happy_patient_ipad_900x400" loading="lazy" /> </div> </article> </div> <div class="body"><p>The Centers for Medicare &amp; Medicaid Services yesterday released <a href="https://www.cms.gov/coronavirus-waivers" target="_blank">fact sheets</a>&nbsp;summarizing the current status of Medicare COVID-19 blanket waivers and flexibilities by provider type, as well as flexibilities applicable to the Medicaid community. The fact sheets include information about which waivers and flexibilities have already been terminated, have been made permanent or will end at the end of the COVID-19 public health emergency. &nbsp;<br /> “Throughout the PHE, CMS has also maintained a list of COVID-19 <a href="https://www.cms.gov/files/document/covid-19-emergency-declaration-waivers.pdf" target="_blank">waivers</a>, but unless otherwise specified in these fact sheets, these waivers will end with the PHE,” CMS officials said in a <a href="https://www.cms.gov/blog/creating-roadmap-end-covid-19-public-health-emergency" target="_blank">blog post</a>&nbsp;today. “With this information in hand, we expect that the health care system can begin taking prudent action to prepare to return to normal operations and to wind down those flexibilities that are no longer critical in nature.”&nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/medicare" class="topic" hreflang="en">Medicare</a></div> <div><a href="/topics/medicaid" hreflang="en">Medicaid</a></div> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> </div> <div class="field_type">Headline</div> Fri, 19 Aug 2022 20:43:31 +0000 ctorres_drupal 685073 at https://www.aha.org Hospital COVID-19 data reporting transitioning to CDC in mid-December https://www.aha.org/news/headline/2022-08-18-hospital-covid-19-data-reporting-transitioning-cdc-mid-december <span class="title">Hospital COVID-19 data reporting transitioning to CDC in mid-December</span> <span class="uid"><span>ctorres_drupal</span></span> <span class="created">Aug 18, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2020-07/aha-nurse-leader-covid-900x400.jpg?itok=Cr7duN_y" width="900" height="400" alt="Nurse Leaders COVID 900x400" loading="lazy" /> </div> </article> </div> <div class="body"><p>In mid-December, hospitals will transition to reporting COVID-19 data via the Centers for Disease Control and Prevention’s National Healthcare Safety Network, which will assume responsibility for collecting the data when the Department of Health and Human Services’ contract with TeleTracking expires Dec. 31. CDC will host a series of training webinars on the transition beginning Aug. 23. For more information and to register for the webinars, visit the CDC webpage on the <a href="https://www.cdc.gov/nhsn/covid19/transition.html" target="_blank">transition</a>, which the agency will continue to update with guidance and information.&nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> </div> <div class="field_type">Headline</div> Thu, 18 Aug 2022 20:28:07 +0000 ctorres_drupal 685057 at https://www.aha.org Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals https://www.aha.org/guidesreports/2022-08-15-pandemic-driven-deferred-care-has-led-increased-patient-acuity-americas <span class="title">Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Aug 15, 2022 - 02:06 PM</span> <div class="body"><div class="container"> <div class="row"> <div class="col-md-8"> <p><img alt="Key takeaways" data-entity-type="file" data-entity-uuid="6870a4ad-76fd-4a2d-84bf-3da20c93c555" height="435" hspace="10px" src="/sites/default/files/inline-images/key-take-aways-pandemic-driven-report.png" vspace="vspace&quot;10px&quot;/" width="238" loading="lazy" class="align-left" />At the outset of the COVID-19 pandemic, communities across America entered mandatory quarantines and temporarily shut down many every day services such as schools, retail stores and libraries. This was done to help control the spread of the virus and protect people and communities. To increase personal and public safety across the country while conserving personal protective equipment (PPE), many hospitals and health systems moved to cancel or delay non-emergency procedures in early 2020. Similarly, many states and the federal government imposed or recommended shutdowns or delays in non-emergency care. At the same time, many Americans avoided or delayed seeking care, including primary care and other specialty care visits.</p> <p>COVID-19 treatment is highly complex and resource-intensive, which has been a driver of overall increases in patient acuity during the pandemic. However, non-COVID-19-care has increasingly contributed to rising patient acuity, as well. The confluence of these factors has contributed to patients experiencing more severe disease, in many cases requiring longer hospitalizations and more intensive treatments.</p> <p>A recent report from <a href="https://www.kaufmanhall.com" target="_blank">Kaufman Hall</a>, with data from <a href="https://nam11.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.syntellis.com%2F&amp;data=05%7C01%7Ccmilligan%40aha.org%7C46ab28639ade40fdebfb08da875dcbd2%7Cb9119340beb74e5e84b23cc18f7b36a6%7C0%7C0%7C637971134184354853%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&amp;sdata=m9uT0sK8gNPP6Ex2%2FlgIZ9OsfDkAHSNrSjj6wh4DtEY%3D&amp;reserved=0" target="_blank">Syntellis Performance Solutions</a>, show significant increases in the average length of stay (ALOS) for hospitalized patients during the pandemic compared to pre-pandemic levels. (See Figure #1) Further, data from <a href="https://www.stratadecision.com/" target="_blank">Strata Decision Technology</a>, a healthcare financial software and analytics firm, show that patients being treated for conditions like cancer and hepatitis, as well as patients undergoing common procedures like appendectomies and mastectomies also experienced significant increases in acuity during the pandemic.1</p> <p>View the detailed report below.</p> </div> <div class="col-md-4"> <p><a href="https://www.aha.org/system/files/media/file/2022/08/pandemic-driven-deferred-care-has-led-to-increased-patient-acuity-in-americas-hospitals.pdf" target="_blank" title="Click here to download the Report: Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals PDF."><img alt="Cover: Report: Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals." data-entity-type="file" data-entity-uuid="" src="https://www.aha.org/sites/default/files/2022-08/cover-pandemic-driven-deferred-care-has-led-to-increased-patient-acuity-in-americas-hospitals.png" style="border: solid black 1px;" /></a></p> </div> </div> </div> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/cost-management" hreflang="en">Cost Management</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/taxonomy/term/127" hreflang="en">Guides/Reports</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><div class="container"> <div class="row"> <div class="col-md-8"> <p><span style="color:#d50032;">Rise in patient acuity has been a driver of increases in labor, drug, and supply costs for hospitals creating unsustainable financial challenges</span></p> </div> <center> <div><a class="btn btn-wide btn-primary" href="https://www.aha.org/system/files/media/file/2022/08/pandemic-driven-deferred-care-has-led-to-increased-patient-acuity-in-americas-hospitals.pdf" target="_blank" title="Click here to download the Report: Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals PDF.">Download the PDF</a></div> </center> </div> </div> </div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <h4 class="page-header">Key Resources</h4> <div class="field_related_files file file--mime-application-pdf file--application-pdf"> <div> <article> <div class="field_media_file"><span class="file file--mime-application-pdf file--application-pdf"><a href="/system/files/media/file/2022/08/pandemic-driven-deferred-care-has-led-to-increased-patient-acuity-in-americas-hospitals.pdf" type="application/pdf" title="Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals">Pandemic-Driven Deferred Care Has Led to Increased Patient Acuity in America’s Hospitals</a></span> </div> </article> </div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Mon, 15 Aug 2022 19:06:53 +0000 dsamuels_drupal 685010 at https://www.aha.org HHS issues guidance on ordering commercial COVID-19 monoclonal antibody https://www.aha.org/news/headline/2022-08-12-hhs-issues-guidance-ordering-commercial-covid-19-monoclonal-antibody <span class="title">HHS issues guidance on ordering commercial COVID-19 monoclonal antibody</span> <span class="uid"><span>ctorres_drupal</span></span> <span class="created">Aug 12, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2020-02/HHS%20Logo.jpg?itok=3-5a7koj" width="900" height="400" alt="HHS Logo web sized 900x400" loading="lazy" /> </div> </article> </div> <div class="body"><p>The Department of Health and Human Services yesterday released <a href="https://aspr.hhs.gov/COVID-19/Therapeutics/updates/Pages/important-update-11August2022.aspx" target="_blank">new guidance</a> on ordering, reporting, payment and cost-sharing for the COVID-19 monoclonal antibody therapy bebtelovimab, a treatment option for outpatients at high risk for hospitalization that begins transitioning from HHS to commercial distribution next week. Anticipating depletion of the federal government’s supply, Eli Lilly and Co. is making bebtelovimab available for purchase through AmerisourceBergen.</p> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> </div> <div class="field_type">Headline</div> Fri, 12 Aug 2022 19:53:52 +0000 ctorres_drupal 684990 at https://www.aha.org CDC updates public health guidance for preventing COVID-19 illness https://www.aha.org/news/headline/2022-08-11-cdc-updates-public-health-guidance-preventing-covid-19-illness <span class="title">CDC updates public health guidance for preventing COVID-19 illness</span> <span class="uid"><span>hnesich_drupal</span></span> <span class="created">Aug 11, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2020-06/aonl-cta-900x400-covid-19.png?itok=2shChPnN" width="900" height="400" alt="aonl-cta-900x400-covid-19.png " loading="lazy" /> </div> </article> </div> <div class="body"><p>The Centers for Disease Control and Prevention today released <a href="https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e1.htm?s_cid=mm7133e1_x">updated guidance</a> to help people protect themselves and others if they are exposed to, sick or test positive for COVID-19.&nbsp;<br /> &nbsp;<br /> The guidance encourages individuals to understand their risk for significant illness from the virus; take steps to protect themselves and others with vaccines, therapeutics and nonpharmaceutical interventions when needed; receive testing and wear masks when exposed; receive testing if symptomatic; and isolate for at least five days if infected.<br /> &nbsp;<br /> “We’re in a stronger place today as a nation, with more tools — like vaccination, boosters, and treatments — to protect ourselves, and our communities, from severe illness from COVID-19,” <a href="https://www.cdc.gov/media/releases/2022/p0811-covid-guidance.html">said&nbsp;Greta Massetti</a>, a member of the CDC COVID-19 Emergency Response Team who helped author the guidance. “We also have a better understanding of how to protect people from being exposed to the virus, like wearing high-quality masks, testing, and improved ventilation. This guidance acknowledges that the pandemic is not over, but also helps us move to a point where COVID-19 no longer severely disrupts our daily lives.”<br /> &nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" class="topic" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/covid-19-cdc-fda-and-cms-guidance" hreflang="en">COVID-19: CDC, FDA and CMS Guidance</a></div> </div> <div class="field_type">Headline</div> Thu, 11 Aug 2022 21:01:00 +0000 hnesich_drupal 684978 at https://www.aha.org What COVID-19 Continues to Teach Us about Hospital Culture https://www.aha.org/news/healthcareinnovation-thursday-blog/2022-08-11-what-covid-19-continues-teach-us-about-hospital <span class="title">What COVID-19 Continues to Teach Us about Hospital Culture</span> <span class="uid"><span>Matthew Diener</span></span> <span class="created">Aug 11, 2022</span> <div class="field_media_featured_image"><article> <div class="field_media_image"> <img src="/sites/default/files/styles/900x400/public/2022-08/Center-Blog-Dawn-French-900x400.jpg?itok=pgLK0Fb8" width="900" height="400" alt="Dawn French headshot. Senior Vice President, Marketing and Community Outreach, White Plains Hospital." loading="lazy" /> </div> </article> </div> <div class="body"><p><img alt="#healthcareinnovation Thursday" src="/sites/default/files/2019-11/innovation-blog-banner-900.jpg" style="float: right; margin-left: 15px; max-width: 33%; margin-top: 6px" /></p> <p>Situated in the heart of Westchester County and just outside of New York City, White Plains Hospital was among the first hospitals in New York to face the COVID-19 pandemic during the early days of 2020, back when there were many unknowns.</p> <p>I will never forget the first case and how quickly the numbers multiplied — seemingly doubling each day early in the pandemic. The overhead rapid response codes blared at a frequency never heard before, and there was an intensity during those first few weeks that was overwhelming.</p> <blockquote> <h4>As we reflect on what has helped those on the front line persevere, we come away with lessons learned about the importance of a strong culture of teamwork, support and encouragement throughout our organization to achieve the best outcomes.</h4> </blockquote> <p>In time, however, we all have learned to adapt. As treatments continue to be developed and we understand more about the virus, the fear of the unknown diminishes and COVID-19 becomes our new normal. Many times, we think the end of this pandemic is here, and then a new variant appears or a new spike occurs.</p> <p>With each wave comes a new challenge, but our team is prepared and repeatedly steps up to care for our community. Health care workers deservedly have been recognized for their heroic efforts throughout this pandemic, but it’s not over yet.</p> <p>As we reflect on what has helped those on the front line persevere, we come away with lessons learned about the importance of a strong culture of teamwork, support and encouragement throughout our organization to achieve the best outcomes. Here are a few lessons.</p> <h2>Recognize the Value of the Team</h2> <p>Health care workers are selfless by nature, normalizing things that many people cannot. But they are human too. And what we have seen is that when things are at their worst, it is the bond with colleagues and support from others that help health care professionals get through the tough days. This camaraderie begins by developing a culture of teamwork and trust throughout the organization. Hospital staff will do incredible things if they know that they can count on each other, especially when times are their toughest.</p> <p>There are many ways to accomplish this. We have found success in our recently reengaged Rewards and Recognition Committee, which focuses on the work of teams, units and departments in achieving goals. These groups are recognized in an award ceremony attended by colleagues and senior leaders and celebrated in an email to staff and on social media. This small gesture builds pride with our teams and importantly helps to reinforce the idea that we rely on each other for our success and by working collaboratively we can achieve our goals.</p> <h2>Reinforce the Positive</h2> <p>During the height of the pandemic, the reality was that while many lives were lost, we saved many more. We wanted to emphasize to our staff how many people have returned home to their loved ones due to their efforts. To help people visualize the impact they were making, we adopted the butterfly as a symbol of hope. Each COVID-19 patient who was discharged in 2020 received a paper butterfly with a number. Hundreds of butterflies lined the main hallway that staff walk through each day, serving as a powerful reminder of their dedication and effort. Staff rallied behind the idea, taking videos of patients holding their butterflies as they left the hospital and taking a moment to celebrate the win.</p> <p>We now have installed a butterfly garden outside the hospital with plants that attract butterflies and a large stone with a plaque dedicated to the efforts of our teams. It acts as a quiet place for our staff to sit and reflect on those lives they have saved as well as those they could not.</p> <p>In addition, to keep morale high — especially during the first year of the pandemic — hospital leadership sent out nearly 100 emails to staff, including a campaign from the CEO called “Everyday Heroes,” recognizing departments across the hospital for their unique contributions to their efforts at saving lives. Each Everyday Heroes story and photo was posted on social media.</p> <h2>Never Underestimate the Power of Community</h2> <p>Throughout the pandemic, the community has been eager to do what they can to support our efforts, especially early on when many were asked to shelter in place. Local celebrities have sent inspirational messages, and a parade of cars came each week for a Thursday night shout-out to cheer on our heroes. Hundreds of children have sent us heartwarming cards and notes that lined another busy hallway for staff to see. A volunteer group even spearheaded an initiative selling 1,300 signs with motivational messages — like “Stay Strong” and “We Love You” — which lined lawns across the county so our employees could see them as they drove to and from work. That groundswell of support reinforced what we had known, but the lesson was amplified during the pandemic: While it is our role to care for our community, they want to care for us as well.</p> <p>Our community organizations are trusted resources throughout Westchester County and valuable partners in helping to communicate, influence and inspire others to act. These partners have been essential in working with us during this time of crisis to bring key constituents together and provide us with critical insights about the needs of our community members. For example, knowing that a certain subset of community members did not have access to transportation to get a COVID-19 vaccine spurred us to create pop-up vaccination sites in areas of need. In addition, learning about vaccination hesitancy from various community groups resulted in a targeted educational effort from our physicians, in partnership with community leaders, to listen to concerns and relay important factual information.</p> <p>As health equity remains a priority, partnering with those trusted community groups is essential to developing impactful programs to identify real needs and continue to optimize the health of our communities.</p> <p><em>Dawn French is senior vice president for marketing and community outreach at White Plains (N.Y.) Hospital. White Plains Hospital is featured in the AHA Living Learning Network’s second pandemic reflection book, <a href="/center/living-learning-network/pandemic-resiliency-and-community">The Pandemic: Responding with Resilience and Service to Community</a>.</em></p> </div> <div class="field_author"> <span>Dawn French</span> </div> <div class="field_topics"> <div><a href="/topics/aha-center-health-innovation" class="topic" hreflang="en">AHA Center for Health Innovation</a></div> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/covid-19-caring-patients-and-communities" hreflang="en">COVID-19: Caring for Patients and Communities</a></div> <div><a href="/topics/covid-19-organizational-preparedness-and-capacity-planning" hreflang="en">COVID-19: Organizational Preparedness and Capacity Planning</a></div> <div><a href="/topics/health-equity" hreflang="en">Health Equity</a></div> </div> <div class="field_type">#HealthCareInnovation Thursday Blog</div> Thu, 11 Aug 2022 15:59:12 +0000 Matthew Diener 684963 at https://www.aha.org #WeAreHealthcare: Understanding and Reconnecting to Purpose with VCU Health System https://www.aha.org/advancing-health-podcast/2022-08-10-wearehealthcare-understanding-and-reconnecting-purpose-vcu <span class="title">#WeAreHealthcare: Understanding and Reconnecting to Purpose with VCU Health System</span> <span class="uid"><span>dsamuels_drupal</span></span> <span class="created">Aug 10, 2022 - 08:04 AM</span> <div class="body"><p>As we start to emerge from the COVID-19 pandemic, understanding and reconnecting to purpose, rediscovering our why is key to moving forward. The health care workforce is facing unprecedented challenges and opportunities to redefine care delivery and encourage the next generation of leaders to use the lessons of the last two years to change for the better. Dr. Tom Yackel, President of MCV Physicians, the faculty practice plan of VCU Health System, senior associate dean for clinical affairs in the Virginia Commonwealth University School of Medicine, and past chair of the AHA’s Committee on Clinical Leadership sat down with Elisa Arespacochaga, vice president of clinical affairs and workforce at the AHA Annual meeting to share his thoughts as a clinical leader and practicing physician. This podcast was recorded at the AHA Annual Meeting.</p> <hr /> <p><iframe allow="autoplay" frameborder="no" height="166" scrolling="no" src="https://w.soundcloud.com/player/?url=https%3A//api.soundcloud.com/tracks/1320205309&amp;color=%2324507d&amp;auto_play=false&amp;hide_related=false&amp;show_comments=true&amp;show_user=true&amp;show_reposts=false&amp;show_teaser=true" width="100%"></iframe></p> <div style="font-size: 10px; color: #cccccc;line-break: anywhere;word-break: normal;overflow: hidden;white-space: nowrap;text-overflow: ellipsis; font-family: Interstate,Lucida Grande,Lucida Sans Unicode,Lucida Sans,Garuda,Verdana,Tahoma,sans-serif;font-weight: 100;"><a href="https://soundcloud.com/advancinghealth" style="color: #cccccc; text-decoration: none;" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/final_annualmeeting-elisaayackel" style="color: #cccccc; text-decoration: none;" target="_blank" title="#WeAreHealthcare: Understanding and reconnecting to purpose with VCU Health System">#WeAreHealthcare: Understanding and reconnecting to purpose with VCU Health System</a></div> <p>&nbsp;</p> </div> <div class="field_topics"> <div><a href="/topics/leadership" class="topic" hreflang="en">Leadership</a></div> <div><a href="/topics/novel-coronavirus-sars-cov-2covid-19" hreflang="en">Novel Coronavirus (SARS-CoV-2/COVID-19)</a></div> <div><a href="/topics/workforce" hreflang="en">Workforce</a></div> <div><a href="/topics/nurses" hreflang="en">Nurses</a></div> <div><a href="/topics/physician-issues" hreflang="en">Physician Issues</a></div> <div><a href="/topics/care-delivery" hreflang="en">Care Delivery</a></div> </div> <div class="field_type"> <div>Type</div> <div><a href="/type/advancing-health-podcast" hreflang="en">Advancing Health Podcast</a></div> </div> <div class="field_access_level"> <div>Access Level</div> <div><a href="/taxonomy/term/278" hreflang="en">Public</a></div> </div> <div class="field_paragraphs_text_with_heade"> <div> <div class="paragraph paragraph--type--paragraphs-text-with-headers- paragraph--view-mode--default"> </div> </div> </div> <div class="field_lead"><!-- Image Metadata --> <link href="https://www.aha.org/sites/default/files/2022-08/Advancing-Health-Podcast-meta-2022-08-10.png" rel="image_src" /><meta name="twitter:image" content="https://www.aha.org/sites/default/files/2022-08/Advancing-Health-Podcast-meta-2022-08-10.png"><meta property="og:image" content="https://www.aha.org/sites/default/files/2022-08/Advancing-Health-Podcast-meta-2022-08-10.png"><!-- End of Image Metadata --></div> <div class="field_search_promotion"> <div>Search Promotion</div> <div>Not Promoted</div> </div> <div class="field_archived"> <div>Archived</div> <div>Off</div> </div> Wed, 10 Aug 2022 13:04:15 +0000 dsamuels_drupal 684939 at https://www.aha.org