News

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»

MINNEAPOLIS – November 23, 2020 – A groundbreaking analysis by Carrot Health of claims data compiled by the Colorado Hospital Association (CHA) determined that a high Carrot Social Risk Grouper® (SRG) score correlates strongly with higher rates of emergency department (ED) super-utilization. The analysis, which combined data from CHA’s On Demand Hospital Information Network (ODHIN) with consumer behavior data from the Carrot MarketView® platform, also found that food insecurity and other underlying social factors were driving ED utilization and readmissions.

Razor-thin operational margins coupled with substantial and ongoing losses related to COVID-19 are culminating in a perfect storm of bottom-line issues for U.S. hospitals and health systems. A study commissioned by the American Hospital Association (AHA) found that the median hospital margin overall was just 3.5% pre-pandemic, and projected margins will stay in the red for at least half of the nation’s hospitals for the remainder of 2020.

Holiday travel is downright dangerous this year. Earlier this week, the CDC warned Americans to stay home this Thanksgiving. All across the country, people are scrapping their itineraries and making a U-turn.

And for good reason. Some holiday travel errors could land you in the hospital — or worse.

New COVID-19 cases shattering records, as my FORBES colleague Suzanne Kelleher recently noted. Many health experts are warning against all nonessential travel. But if you go — and I'm not saying you should — there are other errors you have to avoid. Because some holiday travel mistakes could kill you.

Forbes»

The fundamental problem with healthcare can be summed up in one sentence: We expect healthcare services that cater to our individual needs, yet the health care system operates under a one-size-fits-all, trial-and-error model. It is a model that results in missed diagnoses, protracted illnesses, and even premature death and wastes $765 billion annually.

The financial toll of this outmoded approach pales in comparison to the human toll. More than 128,000 people in the U.S. die each year from taking medications as prescribed—four times the number of people killed by prescription painkillers and heroin combined, as reported by the Centers for Disease Control and Prevention.

As the healthcare delivery system continues on its journey from a fee-for-service to value-based care reimbursement model, the realization of moving from a traditional “sick care” system that has driven the healthcare industry to date to one that provides more affordable, personalized and preventive care, will be critical to achieving success in this movement.

Many industry leaders believe that the tools needed to reimagine and change how to treat illness, and to establish healthy behaviors in patients by focusing on personal details—such as their unique biology, traits, and environmental factors—are already in place, and the next steps needed to shift the paradigm will be around culture, mindset and operational transformation.

The healthcare industry continues to see an uptick in oversight of federal healthcare payments. In late 2019, HHS’s Office of the Inspector General (OIG) reported that Medicare made $54.4 million in improper payments to acute care hospitals due to incorrectly coded claims. It also recommended that CMS direct its contractors to recover the lost money.

Enter 2020 and the introduction of COVID-19 incentive payments, and today’s C-Suite can expect a continuation of this trajectory in terms of increased scrutiny. In fact, the OIG recently announced its audit plans related to hospital payments covering COVID-19 discharges under the Coronavirus Aid, Relief, and Economic Security (CARES) Act.

Healthcare Business Today»

INDIANAPOLIS — (October 29, 2020) — hc1, the leader in critical insight, analytics, and solutions for precision health that power high-value health care, announced today that Stephen K. Klasko, MD, MBA, will be the keynote speaker during its Precision Health Virtual Summit scheduled for Tuesday, Nov. 17 and Wednesday, Nov. 18. This special two-day summit hosted by hc1 in partnership with Becker’s Healthcare will bring together healthcare leaders and experts to focus on the changes our care delivery system needs as it transitions from fee-for-service to value-based care reimbursement models.

The Covid-19 pandemic has affected nearly every aspect of our lives today. Many of us now have new challenges that come with working from home, homeschooling, and sheltering in place. 

As a part of our series about how busy women leaders are addressing these new needs, I had the pleasure of interviewing Liz Goar, CEO of NPC Creative Services.

Thrive Global»

The last few years have ushered in significant progress on the opioid crisis containment front. Acknowledging decades-long misinformation shortfalls, negligence, and improper prescribing patterns, the healthcare industry took important steps on national and state levels to get out in front of devastating statistics.

A March 2020 report suggested the needle was finally pointing in the right direction. The Centers for Disease Control and Prevention (CDC) reported a 13.5% decrease in opioid overdose deaths from 2017 to 2018.

Unfortunately, that report was quickly overshadowed by the global pandemic that brought the nation to its knees. Opioid misuse, like many other critical healthcare priorities, took a back seat to COVID-19. The fallout is notable. A recent analysis points to a spike in opioid overdose cases by 18% since the start of the pandemic.

Health care is realizing the promise of artificial intelligence (AI) across a broad and seemingly endless range of use cases. The opportunities for using advanced technologies to accelerate labor-intensive processes touch everything from research and operations to supply chain and point-of-care decision making.

Data-hungry revenue integrity and billing compliance functions are no exception. AI tools such as machine learning, natural language search, and anomaly detection are fueling new and expanded insights into revenue integrity, billing compliance, and quality assurance to advance process improvement initiatives. And not surprisingly, the value proposition of these tools is growing rapidly amid COVID-19 as health care organizations try to maximize reimbursements against notable challenges such as revenue shortfalls and rapidly changing regulations.

ForTheRecord»

MINNEAPOLIS – September 21, 2020 – In a newly published KLAS® Research Spotlight Report, 100% of Carrot Health customers interviewed said they were satisfied or highly satisfied with the Carrot MarketView® software and analytics platform, and would both recommend and purchase it again. The report, “Carrot Health: Using Analytics to Drive Outcomes in SDOH,” is based on detailed feedback from Carrot Health customers in the payer and health plan space on how well the company’s social determinants of health (SDoH) insights help them drive outcomes – delivering a more targeted level of care to their patient populations.

Wellesley, MA — September 21, 2020 –– Hayes, makers of the industry’s leading integrated compliance and revenue integrity platform for the nation’s premier healthcare organizations, announced today that CTO Ritesh Ramesh won Silver in the 8th Annual CEO World Awards^®, Executive Achievement of the Year for Information Technology Services category. Hayes also took Bronze for Team of the Year in the inaugural COVID-19 Business Response category in recognition of its work tailoring the company’s flagship MDaudit Enterprise platform to help hospitals optimize pandemic-related reimbursements and attain billing compliance.