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Hospitals are holding off as long as possible before halting procedures to make room for fresh waves of Covid-19 patients, a reversal from earlier this year when facilities postponed care, leading to steep financial losses and public-health risks. National hospital chain Tenet Healthcare Corp. pushed ahead with procedures as states permitted, such as knee and hip replacements, colonoscopies, and surgery to implant pacemakers, through recent surges in Alabama, California and elsewhere. In southeast Wisconsin, where already rising Covid-19 hospitalizations jumped 35% in the first two weeks of the month, Advocate Aurora Health continues nonessential surgery across a dozen hospitals. (Evans, 10/26)

In the early months of the pandemic, hospitals nationwide postponed elective procedures to comply with governors' orders and federal guidance. The deferrals were meant to help conserve hospital beds, personal protective equipment and other resources in case of a surge of coronavirus patients. COVID-19 cases spiked in different areas of the country at different times, and so while some hospitals were full of coronavirus patients, others saw few cases. Their revenue dried up as patient visits plummeted. (Livingston, 10/26)

Two sizable not-for-profit health systems, Intermountain Healthcare and Sanford Healthcare, said Monday they plan to merge to form the country's seventh-largest not-for-profit health system by revenue. Salt Lake City-based Intermountain and Sioux Falls, S.D.-based Sanford signed a letter of intent to form a 70-hospital system with about $15 billion in annual revenue. The CEOs of both systems said their boards unanimously approved the move last week, and they expect to close the deal by summer 2021. (Bannow, 10/26)

Quest Diagnostics, a Secaucus, N.J.–based provider of lab testing and diagnostic services, upgraded its revenue outlook after experiencing solid growth in the third quarter, it announced Thursday. As a result, the company plans to return funding it received as part of the federal Cares Act. “Quest had a very strong third quarter, benefiting from continued demand for Covid-19 testing and the rapid recovery of health care utilization,” said Steve Rusckowski, chairman, CEO and president. (Sim, 10/26)

KHN: Telemedicine Or In-Person Visit? Pros And Cons

As COVID-19 took hold in March, U.S. doctors limited in-person appointments — and many patients avoided them — for fear of infection. The result was a huge increase in the volume of remote medical and behavioral health visits. Doctors, hospitals and mental health providers across the country reported a 50- to 175-fold rise in the number of virtual visits, according to a report released in May by the consulting firm McKinsey & Co. (Wolfson, 10/27)

KHN: ‘No Mercy’ Chapter 5: In Rural America, Cancer Care Is Often Far From Home 

Sixty-five-year-old Karen Endicott-Coyan is living with a blood cancer.  Her chemotherapy takes less than 30 minutes. Before the hospital closed, it was just a short drive into the small town of Fort Scott, Kansas, for her to get treatment. But these days getting to chemo means a trek on rural roads and narrow highways, driving help from her sister-in-law and some Ritz crackers tucked into her purse to steady her stomach on the way home. The whole trip should take less than three hours. Endicott-Coyan puts on her makeup, her diamond earrings and powers through. (Tribble, 10/27)

KHN: Savvy Patient Fought For The Price She Was Quoted − And Didn’t Give Up 

When Tiffany Qiu heard how much her surgery was going to cost her, she was sure the hospital’s financial department had made a mistake. Qiu, who already knew from a breast cancer scare earlier that year that her plan required a 30% coinsurance payment on operations, pressed the person on the phone several times to make sure she had heard correctly: Her coinsurance payment would be only 20% if she had the procedure at Palomar Medical Center in Poway, California, about 38 miles south of where Qiu lives. “I was kind of in doubt, so I called them a second time,” said Qiu. “They gave me the exact same amount.” (Almendrala, 10/27)