White House to Target Hospitals for Uneven Covid-19 Data Reporting - WSJ
By: Melanie Evans and Alexandra Berzon (WSJ)
S E E D E D C O N T E N T
The Trump administration is taking aim at hospitals, charging that many have been contributing uneven data about Covid-19 cases in the federal effort to gauge the pandemic.
In a move expected as early as next week, the administration is planning to publicize the names of hospitals with data missing from the federal pandemic reporting system, according to people familiar with the discussions. It’s the latest move by federal officials to target hospitals for gaps in daily tallies of Covid-19 patients, shortages of nurses, the number of available beds and other data.
Making data gaps public will let those who use the data see its holes and put hospitals on alert that they risk losing payment from Medicare and Medicaid, the publicly subsidized health insurance programs, under a rule soon to take effect, the administration told industry officials Tuesday, people familiar with the discussions said.
But a series of changes by the administration to the way hospitals report and the data they are required to submit— including abrupt revisions in July —have plagued the federal effort with delays and confusion, say officials at hospitals and states reporting data on hospitals’ behalf.
The move comes as the Department of Health and Human Services and the White House Coronavirus Task Force have scrambled to create a federal reporting system to monitor the pandemic.
A continuing effort by the industry and the administration to fix gaps in data reporting has found some hospitals failed to report, but also identified federal errors, including technology glitches that wrongly labeled hospitals as nonreporting, according to people familiar with the discussions.
“HHS has worked hand in hand with hospitals and states to improve the data-reporting process and will continue to do so,” an HHS spokeswoman said.
Incomplete data hampers the nation’s ability to direct critical supplies where they are most needed, such as the drug remdesivir, threatening to leave hospitals overwhelmed when the pandemic flares.
To identify hospitals with missing data, the administration is planning to publish a measure of how much information is supplied by each hospital for individual data elements, according to people familiar with the discussions.
The list of requested data as of mid-July includes 32 questions, some which ask for additional details, requiring anywhere from two to 11 answers.
Chip Kahn, chief executive of the Federation of American Hospitals, a trade group for investor-owned hospitals, urged the administration not to make hospitals’ data gaps public. “This is being done to put hospitals in an awkward situation when hospitals are trying to comply,” he said.
Hospitals haven’t been required to report data to federal agencies, but that is expected to change. Last week, the Centers for Medicare and Medicaid Services moved to make it mandatory. Hospitals that fail to report could face losing payment from Medicaid and Medicare, the agency said, under a new rule that surprised the industry.
“Some hospitals are doing a fantastic job, and they report into us daily, and some it’s just not consistent, and some not at all,” said Seema Verma, the CMS administrator. The rule is scheduled to take effect as early as Wednesday.
A sudden switch to reporting, announced in July by the administration, drew criticism and pleas to slow or reverse the decision from public health, state and hospital officials. The mid-July announcement told hospitals to stop sending data to the Centers for Disease Control and Prevention. Hospitals would instead be required to use another option from Pittsburgh-based TeleTracking Technologies Inc., HHS said.
Federal officials also asked for more data, including reporting on new adult Covid-19 patients in nine age categories.
Public reporting of the data slowed after the switch , which HHS said was needed as the agency tested the quality of the new system. White House coronavirus coordinator Deborah Birx said roughly a month later its data-collection system was an interim step. The CDC would soon again take over the work , she said.
Hospital and state officials say the administration has at times been inaccurate and inconsistent in its accounting of which hospitals are properly reporting during the pandemic.
In May and June, HHS pleaded for data from hospitals that had already provided it to them.
“Because you have not been regularly submitting information to HHS, we do not have the information from you that we need to allocate the remdesivir medication,” said an HHS message received by one hospital and reviewed by The Wall Street Journal.
The hospital received a second message the same day: “Because you have been regularly submitting information to HHS, we have already populated the information we need to make allocations from the information provided.”
—Anna Wilde Mathews contributed to this article.
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