Client News Coverage

The explosive popularity of telehealth to ensure ongoing access to care as COVID-19 ravages the nation brings with it an equally rapid rise in patient self-scheduling—an upward trajectory accelerated by the need for streamlined methods of scheduling vaccinations.

Born of necessity, self-scheduling has nonetheless added to the already dismal state of patient matching. Desperate for appointments, many patients inadvertently create multiple medical record numbers as they work through the schedule system, wreaking havoc on health care organizations’ electronic master patient index (EMPI) and EHR systems, as well as the ongoing quest for a 1% or lower duplication rate.

When I founded hc1 a decade ago, I believed that every patient should be treated as a unique individual. We built the hc1 Platform because we saw that if every individual’s laboratory data–which drives 70% of the diagnostic and therapeutic decisions–could be organized intelligently, we could unlock an unprecedented level of clinical decision support to personalize and improve care for all patients.

We knew that the platform would effectively lay the foundation for targeted pharmacogenomics and precision prescribing techniques. What we did not know at the time was that the decision to place our stake in the promise of lab insights would ultimately help drive an improved public health response to an unprecedented crisis: the COVID-19 pandemic.

Electronic Health Reporter»

Overreliance on geographic or population averages to quantify and measure social determinants of health (SDOH) can send healthcare organizations down a costly and inefficient path when it comes to designing interventions to improve outcomes and reduce costs. Because these averages tend to mask the discrete patient experiences, their use can result in programs that fail to fully address the barriers representing the greatest potential for improving health outcomes — and healthcare organizations’ returns on investment.

The Wall Street Journal recently published an article posing that the pandemic is reshaping how Americans care for senior family members, and that more families will opt to keep loved ones at home, rather than relying on senior care facilities. While the pandemic has and will certainly continue to reshape the senior care industry, what might the industry look like in the coming years and after the pandemic?

To find out, we asked senior care industry professionals for their thoughts, insights, and predictions. We’re pleased to share them with you now.

iAdvance Senior Care»

There will be little nostalgia associated with placing 2020 in rearview mirror for most health care stakeholders. Especially on the financial front, the year has left provider organizations with unprecedented challenges that will likely follow them well into 2021.

One report released in September 2020 suggested that for-profit hospitals will continue to see a financial decline for another 12—18 months. In tandem with those challenges, health care organizations face mounting compliance concerns related not only new COVID-19 guidance and telehealth, but also the introduction of new Evaluation and Management (E&M) codes. Add an uptick in audit activity to the mix, and it stands to reason that revenue integrity must become a top priority.

There are various considerations in reopening offices and bringing employees back to work safely, especially now that COVID-19 infections are once more soaring in various areas. If your office is open, then COVID-19 contact tracing solutions are necessary tools in preventing further transmission because they let office managers identify who may be infected or contagious and react appropriately.

“Conscious entrepreneurship” is at the heart of being an entrepreneur. As entrepreneurs, we must be conscious of the world around us and the impact of our actions. For example, at Carrot Health, we are acutely aware there is power — and potential consequences — in using data modeling. For example, Optum (UnitedHealth Group) used models based on historical medical spend to identify future risk. The models were biased against populations with limited access to a doctor (i.e., lower spend), such as BIPOC communities. As an unintended consequence, the models tended to recommend more services to white members than BIPOC members. Failing to understand the bias in your data can result in critical mistakes and, in this case, perpetuate systemic racism.

The Centers for Medicare and Medicaid Services (CMS) in recent months predicted both lower premiums and richer benefits for Medicare Advantage (MA) plans in 2021. Specifically, CMS anticipated a decrease in average premiums of more than 34% from 2017 levels while plan choice, benefits, and enrollment increased—making the average monthly premium the lowest in 14 years.

But while CMS accurately depicted the indisputable trend of moving toward lower costs and higher value in MA offerings, it did not tell the whole story. To do that, we consolidated and reported on all Medicare Advantage and Prescription Drug Plan (PDP) benefit data nationwide released by CMS. This provides a much clearer picture on how these trends impact individual members vs. across member populations.

As part of its goal to reduce administrative burdens on physicians, the Centers for Medicare and Medicaid Services (CMS) has introduced a final rule for Evaluation and Management (E&M) coding changes that go into effect in January 2021. Extensive revisions to the guidelines aim to minimize the amount of time physicians spend on documenting visits—prioritizing the documentation of information pertinent to patient care, creating resource-based reimbursement, and achieving less need for audits.

The move reflects a positive step forward in terms of patient care and administrative burden, yet documentation readiness hinges on a clear understanding of how the changes impact current practices. Rather than focusing on a checklist of conditions for reimbursement, documentation must prioritize a holistic view of patient care to align with the framework supporting E&M codes going forward.

Physicians Practise»

The COVID-19 pandemic has impacted global public health response in unprecedented ways, underscoring both shortfalls and the need for innovative solutions. For micro-communities like university and workplace settings, this reality is especially true.

When most college campuses reopened in fall of 2020, administrators spent the semester fluidly adjusting plans as dynamics around the virus changed. Now, as the U.S. turns the corner into 2021 and campus leaders reflect on the effectiveness of strategies, one area that consistently rises to the top of priorities is the need for good data—highly granular insights that inform optimal decision making within the confines of a college campus

California, once a model of COVID-19 mitigation earlier in the pandemic, has seen its cases steadily rise throughout the summer, culminating in an ongoing crisis.

The state is now seeing case positivity rates of nearly 13 percent, with Los Angeles County seeing as many as 1 in 5 people test positive for the novel coronavirus.

Along with this comes reports of hospitals filling to capacity.

The scene is a severe version of a trend playing out across the country, as COVID-19 deaths nationwide have reached more than 367,000.

Walt Meyer is afraid of getting sick when he travels. Too many people aren't taking COVID-19 seriously, he says.

He'd travel again this year if he could be sure that his fellow passengers were virus-free.

"If they could require everyone to arrive an hour early, get tested, then wait for test results before boarding a flight or entering a resort, it would eliminate some of the risks," says Meyer, an author and professional speaker from San Diego.

His fears are justified, say experts. COVID-19 will be the number-one travel concern of 2021, particularly during the first half of the year. But there are other concerns. The question is: What should travelers be afraid of?

Healthcare organizations are facing a perfect storm of financial challenges. US hospitals and health systems entered 2020 with razor-thin operational margins that were exacerbated by substantial and ongoing losses related to COVID-19.

Amid a dramatic drop in healthcare spending during the first quarter of 2020, financial executives found themselves with limited means for countering ongoing pandemic-related impacts, touching everything from supply chain costs to lost billing opportunities and compliance issues. Notably, the industry acknowledges that federal incentives related to the COVID-19 pandemic will not provide enough relief to surmount the far-reaching financial impact.

Research from Arizona and beyond suggests the coronavirus that causes COVID-19 can spread erratically, making some infected people “superspreaders” and others dead ends for transmission. This can create clusters or COVID-19 micro-hotspots – neighborhoods, schools, towns or other small geographic areas where the virus runs rampant – even while communities next door remain relatively unscathed. These concentrated outbreaks aren’t included in the Arizona Department of Health Service’s COVID-19 data dashboard, which breaks down cases by county.

Dr. Peter Plantes, an internal medicine specialist, works with hc1, a health care data analysis company that recently launched a COVID-19 dashboard explaining the dynamics of the pandemic in new detail.

AZ Big Media»

PHOENIX – Research from Arizona and beyond suggests the coronavirus that causes COVID-19 can spread erratically, making some infected people “superspreaders” and others dead ends for transmission.

This can create clusters or “micro-hotspots” – neighborhoods, schools, towns or other small geographic areas where the virus runs rampant – even while communities next door remain relatively unscathed. These concentrated outbreaks aren’t included in the Arizona Department of Health Service’s COVID-19 data dashboard, which breaks down cases by county.

Cronkite News/Arizona PBS»