Vaccine Doses to Be Tossed; Trauma Fees for Minor Injuries; Pandemic Olympics

Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.

Millions of COVID Vaccine Doses May Be Tossed

As millions of Americans continue to refuse to get vaccinated against COVID-19, millions of vaccine doses are sitting on shelves about to expire, STAT News reported.

Both the federal government and states are sitting on supply gluts that may soon have to be tossed, just as the Delta variant is sweeping through several regions of the country and afflicting the unvaccinated almost exclusively.

STAT calculated that states alone are sitting on 26.2 million unused doses of mRNA vaccines.

Experts cited potential solutions including the federal government intervening to help states ship unused doses to needier countries and extending vaccines’ expiration dates when possible. Federal officials have thus far declined to authorize states to ship their surplus doses to other countries, and STAT noted expiration dates can only be pushed out so much.

But unless many people change their minds and decide to get vaccinated and/or show up to get their second mRNA shot, many of these doses will never be used.

Many Pfizer doses are set to expire in August, for example. “Given waning domestic vaccine demand, those doses are unlikely to be fully used before they must be tossed,” STAT wrote.

Excessive Trauma Fees for Minor Injuries

Hospital trauma centers have been increasingly assembling teams to respond to emergencies, charging thousands of dollars to insurers and patients with minimal oversight, Kaiser Heath News found.

What was a relatively minimal practice as recently as 2008 has exploded into a massive revenue-generator for many hospitals, including many in Florida, “where the number of trauma centers has exploded,” KHN reported. Hospitals there charged these fees more than 13,000 times in 2019 despite patients going home the same day. That figure was double the number of similar cases in 2014.

Nationally, hundreds of hospitals have pursued trauma center designations in recent years. The number of Level I and Level II trauma centers grew from 305 in 2008 to 567 last year.

Yet many of the patients handled by these trauma teams hardly need the attention. Some are released from the hospital almost immediately after being checked in — if they are admitted at all. “Tens of thousands of times a year, hospitals charge enormously expensive trauma alert fees (up to $50,000) for injuries so minor the patient is never admitted,” KHN reported.

Proponents note that these teams are sometimes essential and they need to assemble them just to be safe.

Trauma centers regularly review and revise rules, said Martin Schreiber, MD, trauma chief at Oregon Health & Science University and board chair at the Trauma Center Association of America. “It is not my impression that trauma centers are using activations to make money,” he said. “Activating patients unnecessarily is not considered acceptable in the trauma community.”

But critics say trauma teams are not needed nearly as often as they are called to action. The result: insurers and patents are charged exaggerated bills and medical personnel must often drop what they are doing to sprint to help victims who don’t need assistance.

“Some hospitals are using it as a revenue generator,” said Tami Rockholt, RN, a medical claims consultant. “It’s being taken advantage of.”

Hospitals began billing trauma team fees to insurers when Medicare authorized them in 2008, for incidents where hospitals are notified of severe injuries before patients arrive.

Rather than having paramedics issue alerts, trauma surgeons said hospitals often call trauma activations based on field information.

The Games Must Go On

The “pandemic Olympics” are underway, with some events already starting this week and the official opening ceremonies scheduled for Friday. Despite rising COVID numbers in host city Tokyo and concerns among athletes and healthcare professionals, organizers and other insiders told the Washington Post that the Games will almost certainly go on over the next couple of weeks.

“While critics have grown louder just days before the Opening Ceremonies, forces more powerful than skepticism — ranging from the financial to the legal to the political — continue to propel the Games inexorably forward,” the newspaper noted.

Tokyo reported 1,387 new COVID cases Tuesday, about 60% over the previous week. The first athletes staying in the Olympic Village tested positive Monday, while at least 71 Olympic athletes, officials, and others affiliated with the Games have already tested positive in July.

But Japan’s pandemic figures still pale in comparison with other countries that are holding live sporting events, such as the U.S. and European nations. Officials are testing athletes daily.

So the Games will likely be completed 1 year after they were originally scheduled. (The 2020 Games were suspended a year because of the pandemic.)

“An Olympics cancellation would have to be justified on the world stage,” Michael Cucek, an expert on Japanese politics at Temple University Japan, told the Post. “The infection and death rates in Japan do not meet international definitions of a crisis.”

Other major international sporting events have already been successfully run earlier this summer, including the European and South American soccer championships.

  • Ryan Basen reports for MedPage’s enterprise & investigative team. He has worked as a journalist for more than a decade, earning national and state honors for his investigative work. He often writes about issues concerning the practice and business of medicine. Follow








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