Health Impact News
In the closing months of 2012, and here at the beginning of 2013, we are seeing many reports of healthcare workers losing their jobs for refusing to comply with mandatory flu vaccinations. Health Impact News has covered many of these stories:
When a member of the Indiana Coalition for Vaccination Choice  called up and talked to the person leading the Infection Prevention program within the Indiana University Health system to find out why these healthcare workers were losing their jobs, she reported:
She started with why they are mandating the flu vaccine. Her group of facilities has implemented this mandate due to public and infection control outcry to increase the numbers of HCW being vaccinated. No matter what they have tried; education, making it available, NOTHING “moved the dot” on levels of vaccination. HCW just would not get the vaccine in appropriate numbers to reach our objective of 90% or greater.
So why the emphasis on 90% compliance for healthcare facility employees to receive the flu vaccination all of a sudden?
A healthcare worker from Idaho then sent us her story  and stated:
Well, what happened next may surprise you… the lengths that is, that they would go to fire me for any other reason BUT for not agreeing to the vaccine policy. Why you might ask? Because mandatory vaccination is a “hot topic” in the media right now and infringes on our human rights and no company wants that media attention. This being said they are still willing to do this to meet the guidelines set forth to reach 90% vaccination of all health care workers to get their medicare and medicaid reimbursement.
So, we wondered if this reported condition to get Medicare and Medicaid reimbursement was something new, and mandated by the new “Affordable Healthcare Act,” more popularly known as “Obamacare.” Someone from the Colorado Health Care Workers Against Forced Vaccination organization did some research and sent us the following:
Mandatory Flu Vaccine for Healthcare Personnel, The Affordable Healthcare Act, Value Based Purchasing and Reductions to Medicare and Medicaid Reimbursements
The Affordable Healthcare Act, also known as Obamacare, establishes Hospital Value-Based Purchasing. Under the Hospital VBP Program, CMS (Centers for Medicare and Medicaid Services) will reduce payment amounts beginning with discharges occurring in FY 2013. The applicable percent for payment reductions for FY 2013 is 1.0 percent, and it gradually increases each fiscal year to 2.0 percent in FY 2017. These payment reductions fund value-based incentive payments to hospitals that meet or exceed performance standards on the measures selected for the program. (1) (2) (3)
Beginning January 1, 2013 for the 2012-2013 influenza season, hospitals participating in the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Hospital Inpatient Quality Reporting Program will be required to submit summary data on influenza vaccination of healthcare personnel. However, use of this measure for payment determination will not begin until FY 2015. (4)
All the information on the CDC National Healthcare Safety Network (NHSN) Health Care Professional Influenza Vaccination Module is about reporting. The performance measure for influenza vaccination of healthcare personnel will not be used for payment determination until FY 2015. (5)
The rules for determining the payment adjustment under the Hospital Value-Based Purchasing Program are specified in §§ 412.160 through 412.167 published in the Federal Register /Vol. 77, No. 170 / Friday, August 31, 2012 /Rules and Regulations 53675 (1)
Measures will be displayed on the hospital compare web site. The health care personnel measure is not posted at this time. However preventive care measures for pneumonia and influenza vaccines given to patients are posted as new preventive care measures. (6) (7)
|IMM-1a||Timely and effective care||Preventive care measures||Immunization for pneumonia||Patients assessed and given pneumonia vaccination|
|Timely and effective care||Preventive care measures||Immunization for influenza||Patients assessed and given influenza vaccination|
The measures posted on Hospital Compare represent wide agreement from CMS, the hospital industry and public sector stakeholders such as The Joint Commission (TJC), the National Quality Forum (NQF), and the Agency for Healthcare Research and Quality (AHRQ), and hospital industry leaders.
(1) Dept. of Health and Human Services Medicare and Medicaid payment s for 2013, final rule, published Aug. 31, 2012 http://www.gpo.gov/fdsys/pkg/FR-2012-08-31/pdf/2012-19079.pdf#page=418 
(2) Section 3001 of the Affordable Care Act added section 1886(o) to the Social Security Act that establishes the Hospital Value-Based Purchasing (VBP) Program. http://www.ssa.gov/OP_Home/ssact/title18/1886.htm 
(3) Affordable Health Care Act, Section 3001, Page 266, TITLE III—IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE Subtitle A—Transforming the Health Care Delivery System PART 1—LINKING PAYMENT TO QUALITY OUTCOMES UNDER THE MEDICARE PROGRAM http://housedocs.house.gov/energycommerce/ppacacon.pdf 
(4) Safety Share, Aug. 30, 2012, newsletter published by The Premier Safety Institute, Gina Pugliese, R.N., M.S., editor https://www.premierinc.com/quality-safety/tools-services/safety/safety-share/pss_NHSN_08302012.jsp 
(5) CDC National Healthcare Safety Network (NHSN), Health Care Professional Influenza Vaccination Module http://www.cdc.gov/nhsn/hps_Vacc.html 
(6) Measures displayed on Hospital Compare, The Official US Government site for Medicare http://www.medicare.gov/HospitalCompare/Data/AboutData/Measures-Displayed.aspx 
(7) CMS FY 2014-2016 measures for CMS payment determination https://www.premierinc.com/quality-safety/tools-services/safety/topics/guidelines/downloads/CMS_measures_for_paymentFY14FY16_b.pdf 
Some other facts to consider as our nation begins to lose some of our best healthcare workers who refuse to accept forced flu vaccinations:
- The CDC say that flu vaccines are only effective 50% to 70% of the time in healthy adults, when the vaccine strain is well matched to circulating influenza virus. (link ) That means by their own claims, 30% to 50% of all the healthcare workers who do comply to mandatory flu vaccines will get the flu anyway. This fact leads credence to the information above, that these mandatory flu vaccination policies are financially driven, and not patient-safety driven.
- There are also studies that dispute even the 50% to 70% claims of the CDC in preventing influenza. (See: Flu Vaccines Offer No Benefit: Cochrane Review of Evidence  and Scientists Conclude: Flu Shots “Overpromoted and Overhyped.” )
- There is ample evidence that proper hygiene is more effective in preventing the spread of sickness and diseases than vaccines (See: Study Shows Soap May Be More Effective Than Vaccines )
So for those of you in the media covering this story, let’s PLEASE STOP starting with the presupposition that flu vaccines are effective in preventing influenza, and that this issue is only a human rights issue? It is much larger than that….
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