Hospitals are propping up medical schools, at a cost to their bottom lines

(molly ferguson for stat)

Before Banner Health agreed to shore up two financially struggling medical schools, leaders framed such partnerships as a “must” for Arizona. It’s come with a hefty price tag. Financial statements show the Phoenix-based health system has dedicated roughly $2 billion to the medical schools and a faculty medical group it bought as part of the deal, which closed in 2015. Meanwhile, Banner’s operating margin has slipped. Health systems nationwide see a lot of benefit from partnering with medical schools, but that value is harder to capture in numbers. The prestige of an academic affiliation draws patients and the promise of breakthrough cures. The doctors they’re training will one day save lives. But it doesn’t come cheap. None of this bodes well for a country already staring down a physician shortage and seeking faster cures for a litany of diseases. STAT’s Tara Bannow explains in a STAT+ special report.

2 more weeks of mask mandates on public transit

The mask requirement for public transportation will extend two weeks past its April 18 expiration date while the CDC monitors rising Covid-19 cases, the health agency said yesterday. "The CDC Mask Order remains in effect while CDC assesses the potential impact of the rise of cases on severe disease, including hospitalizations and deaths, and healthcare system capacity," CDC said, citing the BA.2 subvariant, which now makes up more than 85% of U.S. cases. The Biden administration had been planning to roll out a more flexible masking strategy this week to replace the nationwide requirement. Separately, WHO and scientists in Botswana and South Africa have detected new subvariants, labeled as BA.4 and BA.5, but they aren’t sure yet if they might be more transmissible or dangerous.

Small employers brace for huge jump in health insurance prices

Many small companies are expected to face double-digit percentage hikes to their health insurance premiums next year — increases that would add to the broader strain on the take-home pay and budgets of millions of American workers, families, and small business owners. Health insurance brokers, consultants, and benefits advisers told STAT that health care premiums for a lot of smaller employers likely will rise by at least 10% to 15% for 2023. The pandemic is contributing to that, creating headaches for insurance actuaries who are trying to estimate how much care people will get while a deadly virus keeps circulating. But Jenny Chumbley Hogue, who runs her own health insurance brokerage in Texas, said double-digit increases are now “what small employers should always expect on an annual basis.” In some cases, the financial pain could be even more severe. STAT’s Bob Herman breaks it down here in STAT+.

Closer look: A nurse-midwife's view of separation for families seeking asylum

Pregnant women sit with their families while waiting to board a U.S. Customs and Border Protection bus to an immigrant processing center after crossing the border from Mexico in April 2021 in La Joya, Texas. (john moore/getty images)

Maria was 37 weeks pregnant when Customs and Border Protection officers separated her from her husband, Alejandro, after they arrived at the U.S.-Mexico border, fleeing violence in Honduras. Angela, a first-time mother in her second trimester, was released from CBP custody but split apart from her husband, Julio. Ana, a first-time mother in her third trimester, fled Honduras with her husband, Nestor, but he was deported. In a STAT First Opinion, Annie Leone, a nurse-midwife at an immigration shelter on the U.S.-Mexico border, relates their stories and the reason behind them. “I care for asylum-seeking women every day who are traumatized from threats of violence in their homelands and their harrowing journeys to the border,” she writes. “This country’s immigration policies compound their trauma by splitting up families. This undue stress augments the risk of harmful outcomes for mothers and babies.”

‘State of the Air’ is not getting better

Remember early reports of cleaner air during pandemic shutdowns? A new State of the Air report from the American Lung Association dashes any hopes for long-lasting improvement in the air we breathe. Instead, the report covering 2018 through 2020 recorded the most days with “very unhealthy” and “hazardous” air in its 23-year history. Tracking soot and smog, the analysis counts 137 million Americans exposed to unhealthy levels of air pollution. People of color are disproportionately exposed to unhealthy air: 61% more likely than white people to live in a county with a failing grade for at least one pollutant and 3.6 times as likely to live in a county with a failing grade for three pollutants. Air quality has gotten better with reduced emissions from vehicles, power plants, and manufacturing, but wildfire smoke and ozone pollution from hotter, drier conditions born of climate change have offset those gains.

Bringing infections home from the hospital and tracing viruses in canine sentinels

Two epidemiology reports from the CDC’s Emerging Infectious Diseases journal caught my eye, neither related to Covid:

Clostridioides difficile infection causes severe diarrhea and is sometimes fatal. Patients are diagnosed mostly during hospital stays, but the growing number of cases outside the hospital sparked an investigation into its spread. Researchers concluded that patients discharged from the hospital without symptoms could be carrying the infection home. Incidence among people exposed to a recently hospitalized family member was 73% greater than in people not exposed, and that went up with length of hospitalization.
Viruses that cause human illness can be tracked through animals. They might not get sick when bitten by an infected mosquito, but their bodies produce detectable antibodies. It turns out that dogs in Mexico are good sentinels for West Nile virus but not as good at flagging the mosquito-borne viruses Zika and dengue.

What to read around the web today

The final pandemic betrayal. The Atlantic
Heal thyself: Most who tear Achilles tendon can skip surgery. Associated Press
A $2.1 million price tag for Bluebird Bio’s gene therapy is cost-effective, analysis finds. STAT+
Who doesn’t text in 2022? Most state Medicaid programs. Kaiser Health News
Justice Department probes Bausch Health over marketing for dermatology drugs. STAT+