One More Look at HealthLeaders' Top 10 Stories of 2022

We're taking one final look at HealthLeaders' most-popular stories with our readers over the past 12 months.

1. New Legislation Would Expand Authority for APRNs Treating Medicare and Medicaid Patients

Newly introduced bipartisan legislation to improve healthcare access for Medicare and Medicaid beneficiaries would expand authority for advanced practice RNs (APRNs) to treat those patients.

The legislation does not provide full practice authority (FPA) in all 50 states—individual states govern those guidelines—but it does reduce a number of federal barriers that impede access to care for millions who receive healthcare through Medicare and Medicaid. Read more here.

2. New York Grants Full Practice Authority to State's Nurse Practitioners

New York is the newest state to grant nurse practitioners (NPs) full practice authority, joining 24 other states and Washington, D.C.

New York Gov. Kathy Hochul signed the state budget into law on Saturday, that includes legislation that eliminates the requirement for NPs to have a written practice agreement with a physician and allows them to provide the full scope of services they are educated and clinically trained to provide. Read more here.

3. Researcher: 'The Levees Have Broken' at Emergency Departments 

Hospital emergency departments have been under severe strain during the coronavirus pandemic, according to a pair of new research articles.

The new studies examine boarding of patients in emergency departments before they are moved to inpatient beds and patients who left without being seen (LWBS), the latter presumably because of ED crowding and long wait times. The Joint Commission has deemed extended boarding of patients in the ED as a patient safety risk, with boarding recommended not to exceed four hours. Relatively high LWBS rates can have significant negative consequences for patients if they are deferring care for acute conditions. Read more here.

4. Longevity in Older Adults Based on Cholesterol, Physical Capabilities

Factors such as  ability to grocery shop, whether and how often they smoked, and the amount of certain cholesterol particles present in their blood can help predict how likely an individual over 70 years old will live two, five, or 10 years into the future, researchers at Duke Health have found.

"This study was designed to determine the proximal causes of longevity—the factors that portend whether someone is likely to live two or more years or 10 more years," researcher Virginia Byers Kraus, MD, PhD, said in a statement. "Properly applied, these measures could help determine the benefits and burdens of screening tests and treatments for older people." Read more here.

5. Temporary Nurse Aides Waiting to See if They Will Lose Their Jobs

A significant number of temporary nurse aides (TNAs) may lose their jobs Friday if the Center for Medicare and Medicaid Services (CMS) doesn’t reissue a blanket waiver.

The American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) have asked the Center for Medicare and Medicaid Services (CMS) to reissue the blanket waiver originally intended to allow  nursing homes to employ temporary nurse aides beginning during the pandemic.

TNAs handle non-clinical tasks, serving as companions for nursing home residents. In June, the section of the 1135 waiver permitting their employment ended, giving them four months to become certified nursing assistants (CNAs), which would allow them to remain at their facilities. Read more here.

6. 'The Good Clinic' Primary Care Group Staffs Solely With NPs

A primary care clinic start-up is differentiating itself by staffing its facilities only with nurse practitioners (NPs).

Minneapolis-based The Good Clinic chain is designed to emphasize patient engagement, continuity of care, and an emphasis on wellness and convenience through a unique nurse practitioner-driven model, says Larry Diamond, CEO of Mitesco Inc., which operates The Good Clinic brand.

More than half of U.S. states—26 states, Washington, D.C., and two U.S. territories—have granted patients full and direct access to care by NPs in adopting Full Practice Authority (FPA), according to the American Association of Nurse Practitioners (AANP). Read more here.

7. UnitedHealth Sued Over Low Reimbursement Rate for Physicians 

UnitedHealth is the target of a lawsuit by Envision Healthcare and several other physician practices, who claim the country's largest health insurer engages in a nationwide practice of low reimbursement rates for providers to force them out of network.

In doing so, UnitedHealth is allegedly driving physicians to its subsidiary, Optum, and paying providers at rates lower than the company offered for in-network.

Once UnitedHealth forces providers out of network, it allegedly pays the provider less than its billed charges and then charges the patient's plan a commission or surcharge for the savings. UnitedHealth, however, has no intention of paying the billed charges for out-of-network services and denies entitlement to payment for those charges. Read more here.

8. No Surprises Act Could Lead to Uptick in Emergency Department Visits

The No Surprises Act may have the unintended effect of causing millions more emergency department (ED) visits, according to a study from the Agency for Healthcare Research and Quality.

Since going into effect on January 1, 2022, the federal ban protects patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities.

The study, published in The American Journal of Medical Care, compares ED visits in 15 states with balance billing bans between 2007 and 2018 to ED visits in 16 states without bans to examine the ripple effects of a significant reduction in out-of-pocket payments under the No Surprises Act. Read more here.

9. Atrium Health Proposes $85M Satellite Hospital in North Carolina 

Atrium Health—a Charlotte, North Carolina-based healthcare network with over 40 hospitals and $2 billion in net operating revenue—wants to turn its Harrisburg, North Carolina-based emergency room into a satellite hospital.

The health system submitted a "certificate of need" proposal to the Cabarrus County authorities for the $85.5 million expansion and is waiting on the state to approve the project.

"In an effort to bring high quality, convenient access to care to the residents of southern Cabarrus County that are already choosing AH Harrisburg for their health care needs, AH Cabarrus proposes to relocate 24 acute care beds and one operating room from its main campus to its existing Harrisburg hospital campus," Atrium said in a press release shared with HealthLeaders. "The proposed project also involves the replacement and relocation of an existing fixed MRI scanner to Atrium Health Harrisburg from Atrium Health MRI at its Concord Mills/Speedway location."

Additional inpatient, imaging, and surgical services will include 20 medical and surgical acute care beds, four ICU beds, a replacement CT scanner, a relocated and repaired MRI machine, fluoroscopy services, and the addition of a C-arm (a large, mobile imaging device) in the operating room.

The decision date for this project is set for the end of January. If approved, Atrium Health expects the satellite hospital to open on January 1, 2026. Read more here.

10. Bill Introduced to Prohibit Medicare Advantage Plans from Using Medicare in Name 

MA plans are under fire once again, this time with the introduction of new legislation that's aiming to take 'Medicare' out of the name.

The Save Medicare Act, sponsored by representatives Mark Pocan (D-Wis.) and Ro Khanna (D-Calif.), arrives just ahead of the open enrolment period, running from October 15 to December 7.

The bill would prohibit private insurers from using 'Medicare' in plan titles or advertising, and levy fines on payers that use the "deceptive practice."

"'Medicare Advantage' is just private insurance that profits by denying coverage and the name is being used to trick seniors into enrolling. That’s not right," Khanna said in a statement. "This bill will prevent these private insurers from labeling themselves as 'Medicare' and allow us to focus on strengthening and expanding real Medicare instead." Read more here.