An early, strong surge of respiratory syncytial virus, or RSV, is keeping Michigan hospitals and physician practices busy with sick patients. This common respiratory virus that infects the nose, throat, lungs, and breathing passages most often impacts young children and older adults.

The Centers for Disease Control & Prevention (CDC) reports that RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia in children under 1 year. RSV is the leading cause of hospitalization for infants, leading to annual 58,000 hospitalizations, and an estimated 100-500 deaths among children younger than age five years. Older adults are also at risk, with over 14,000 dying annually from RSV.

Hospitals across the country are reporting record high case numbers of RSV. Many Michigan hospitals are experiencing near capacity cases and practices are also seeing high numbers of RSV diagnoses. Pfizer is currently working on a RSV vaccine for older adults but experts predict it will be some time before a vaccine is available.

The following resources can be printed and shared with parents and patients:

• RSV in infants & young children fact sheet (CDC)
• Older adults at risk for RSV infographic (CDC)
• RSV fact sheet (NFIS)
• RSV infographic (NFIS)

Hierarchal Condition Category (HCC) coding is very important to ensuring appropriate coding. This risk-adjustment model helps show accurate patient complexity to estimate future healthcare costs. And accurate diagnostic coding can help improve practice revenue.

The Physician Alliance provides a variety of coding tip sheets for members. Examples include:

• Hierarchical Condition Category (HCC) coding and risk coding education tip sheet
• HCC Forever Codes tip sheet (UPDATED!)
• HCC coding example sheet (NEW!)

Members can access these tip sheets via TPA's secure member portal.

As a new year approaches, it's a great time to look at ways to cut costs and improve business efficiencies.

The Physician Alliance's Affiliate Partners program offers access to a wide variety of products and services. These partners help TPA members with cost-effective, innovative solutions to reduce business overhead costs and optimize business performance. Current partners include:

The U.S. Department of Health and Human Services (HHS) estimates that an estimated 2.2 million people are infected with Hepatitis B. And only 30 percent of adults are vaccinated against the virus.

The Physician Alliance’s Affiliate Partner, Atlantic Health Partners (AHP), recently added VBI's new adult Hepatitis B vaccine PreHevbrio to their vaccine purchasing program. PreHevbrio is a three-dose Hepatitis B vaccine approved for adults (18 years and older) for the prevention of the virus. The CPT code for this vaccine is 90759.

AHP has also added the Priorix vaccine (Measles, Mumps, Rubella) to the GlaxoSmithKline (GSK) portfolio. This CPT code is 90707 (same as Merck’s MMR).

For more information on vaccines and pricing, please contact Atlantic Health Partners. The Physician Alliance members receive annual rebates on vaccine purchases through AHP.

Michigan children's hospital says it's 100% full due to RSV surge, ABC News

People With Long Covid Face Barriers to Government Disability Benefits, Kaiser Health News

Mindfulness worked as well for anxiety as drug in study, Associated Press

Pediatric health groups call for national emergency to fight respiratory illnesses, The Hill

Michigan voters approve amendment adding reproductive rights to state constitution, NPR

Why Some States Want to Guarantee Medicaid Coverage From Birth to Age 6, Kaiser Health News

Flu vaccines cut pneumonia, cardiovascular issues in heart failure patients, CIDRAP