Category: Uncategorized

COVID-19 Makes the Case for a National Health Care System

Apr 13, 2020

By MIKE MAGEE, MD

Governors like Andrew Cuomo of New York have discovered the price for inefficiency and conflicts of interest in the face of the COVID-19 epidemic. As he said last week, “No one hospital has the resources to handle this. There has to be a totally different operating paradigm where all those different hospitals operate as one system.”

Our system is marked by extreme variability: a nation of health care haves and have-nots. Yet even when we Americans acknowledge the absurdity of our convoluted system of third-party payers and the pretzel positions our politicians weave in and out of as they try to justify it, reform it, then un-reform it, many still find solace in telling themselves, “Well, we still have the best health care in the world.”

This crisis in a matter of weeks has revealed the limitations of a conflicted network built on short-term profiteering and entrepreneurial adventurism. Here are a few early learnings:

The COVID Pandemic: WHO Dunnit?

Apr 11, 2020• 5

By ANISH KOKA, MD

COVID is here. A little strand of RNA that used to live in bats has a new host. And that strand is clearly not the flu. New York is overrun, with more than half of the nation’s new cases per day, and refrigerated 18-wheelers parked outside hospitals serve as makeshift morgues. Detroit, New Orleans, Miami, and Philadelphia await an inevitable surge of their own with bated breath. America’s health care workers are scrambling to hold the line against a deluge of sick patients arriving hourly at a rate that’s hard to fathom.

I pause here to attest to the heroic response of the medical community and the countless more working to support them. At the time of this writing, despite 368,000 confirmed cases in the United States, 11,000 deaths have been reported. A horrid number, but still a far cry from Italy with 130,000 cases, and 16,523 deaths, and Spain with 14,000 deaths amidst 140,000 cases. Italy and Spain may be a few weeks ahead of the United States, but at the moment, Italy and Spain have case fatality rates (12.5%, 10%) that are multiples of the United States (2.5%). If this rate does stand, it will be a testament to the tenacity of medical workers toiling under extenuating circumstances.

With the scale of the tragedy now obvious, the take from some very smart people is that the people who should have been paying attention were asleep at the wheel. The easy target is the bombastic New York real estate developer and current President of the United States who repeatedly assured raucous campaign crowds and the nation that the virus was under control before it wasn’t.

The charge is made that the President ignored warnings and painted a rosy picture of an unfolding crisis in a short-sighted attempt to preserve the economy and a beloved stock market. He may be guilty of the latter charge, but the real question relates to ignored warnings. Where were the warnings? Who was sounding the alarm that was ultimately ignored?

Health in 2 Point 00, Episode 116 | Telehealth $$, Layoffs and Rock Health’s Q1 fundraising report

Apr 10, 2020

Today on Health in 2 Point 00, Jess and I run through a lot of telehealth investments including Doctor Anywhere raising $27 million, 98point6 raising $43 million, Tyto Care raising $50 million, SilverCloud Health raising $16 million, SteadyMD raising $6 million, and Aktiia raising $6 million. In addition, there’s a company called Air Doctor which matches people when they’re traveling to doctors on the ground which raised $7.8 million despite the inauspicious timing. On the flip side, there have been a slew of layoffs in the space, and Jess and I give our $.02 on Rock Health’s Q1 fundraising report which was just released. Don’t miss our tag-team interview of Livongo’s Glen Tullman, and check out these episodes in podcast form on Spotify and iTunes. —Matthew Holt

The Tipping Point for Telehealth

Apr 10, 2020• 1

By ALEXA B. KIMBALL MD, MPH

The tipping point for telehealth just happened. Many ways of doing business will change forever after the experience of the COVID-19 pandemic, and health care, too, will never be the same.

Between the release from some HIPAA requirements announced by President Trump this month, shifts in payor policies, and mandated insurance coverage of telehealth visits, innovation and adoption are taking off like wildfire. As patients and outpatient-based physicians hunker down at home, they are rapidly experimenting, and improving the way care is being delivered remotely.

Our institution, which had no prior program, faced with an imminent shut down of elective activity, developed an enterprise-wide telehealth program in days, rendering hundreds of visits as soon as we launched it. This activity is being replicated all around the country.

The THCB Gang Episode 4

Apr 9, 2020

Episode 4 of “The THCB Gang” was live-streamed Thursday April 9. You can see it below and it’s also preserved as a weekly podcast available on our iTunes & Spotify channels. Every Thursday at 1pm PT-4pm ET, 4-6 semi-regular guests drawn from THCB authors and other assorted old friends of mine will shoot the shit about health care business, politics, practice, and tech. It tries to be fun but serious and informative!

This week, joining me were Jane Sarasohn Kahn (@healthythinker), Anish Koka (@anish_koka), Saurabh Jha (@roguerad), Elizabeth Clayborne (@DrElizPC), and Ian Morrison (@seccurve). A fun and very informative discussion about where the COVID-19 crisis is right now and what it’s going to mean both now and in the near future — Matthew Holt

Health Plans Need to Go Farther To Get Us Through the COVID-19 Crisis. Employers Can Encourage Their Cooperation.

Apr 9, 2020• 1

By JEFFREY HOGAN and BRIAN KLEPPER

Among its less appreciated but more worrisome impacts, COVID-19 threatens to destabilize America’s health care provider infrastructure. Patients have largely been relegated to sheltering at home and, to avoid infection, are avoiding in-person clinical visits. The revenues associated with traditional physician office visits have been curtailed. Telehealth capabilities are gradually coming online, but are often still immature. The concern is that many practices will be financially unable to keep the doors open, compromising access and healthy physician-patient relationships.

Health plans have become health care’s bankers, controlling the funding that fuels larger care processes. Health insurance companies and health plan administrators rely on networks of doctors and hospitals to deliver health care services. They also rely on premium payments from employers to administer and pay for health care. In conventional fee-for-service, pay as you go arrangements, providers are paid after they have delivered care services. The stability of this approach, of course, assumes an unhindered flow of patients receiving care.

When the stability of that flow is disrupted, as it has been with COVID-19, physician practices become vulnerable. Solving that vulnerability would give members access to critical services – primary care, specialty care, urgent care and pharmacy coordination – during this epidemic. Without these resources, members will be forced to turn to overburdened hospitals, where they risk increased COVID-19 exposure.

5 Steps Health Insurance CEOs Must Take to Help with COVID-19

Apr 8, 2020• 2

By JEFF LIVINGSTON, MD

Imagine a country where you can not see a doctor. Who will refill your blood pressure prescription, see your sick child, mend your broken arm, deliver your baby, or run the ventilator if you fall victim to Coronavirus? The COVID-19 pandemic created a cash-flow crisis causing mass physician layoffs and closure of medical practices. A world without doctors puts us all at risk. The pandemic is the invisible enemy, and the CEOs of large insurance companies have the tools to help doctors stay in the fight.

Our government, healthcare providers, and individuals are doing our part to flatten the curve of the pandemic. It is time for the insurance industry to take massive action to salvage the US health system.

Practices are closing already. Tenet Health care announced a $250 million dollar reduction effective March 27, 2020. Other large and small health systems are implementing drastic cost-cutting measures. Data reported in USA Today, an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June.

Glen Tullman, Livongo, Live with Jess & Matthew

Apr 7, 2020

Fresh off of a press junket that included talking to Jim Cramer on CNBC & hanging with Maria Bartiromo on Fox Business News, Livongo Health’s Glen Tullman stopped by THCB to talk about the impact of #covid19 (& more) on health tech. Jessica DaMassa and Matthew Holt tag-team interviewed him on Weds 8th April. (Full transcript is below the video)

Here is the transcript:

Matthew:

Hi, this is Matthew Holt from The Health Care Blog.

Blue Cross NC Chief Medical Officer on “Flipping the Switch” To Telehealth at Parity | WTF Health

Apr 7, 2020

By JESSICA DaMASSA, WTF HEALTH

In the early days of the U.S. COVID-19 outbreak, BlueCross BlueShield of North Carolina (Blue Cross NC) stepped up as one of the first health insurance plans to announce reimbursing telehealth visits “at parity” with face-to-face office visits for all providers and specialists. Chief Medical Officer Rahul Rajkumar talks us through the strategy behind that decision to “flip the switch” for telemedicine — which was made in just one meeting (!) – and what metrics and outcomes the Blue plan will be looking at post-pandemic to decide if the switch remains on.

Conversation Highlights:

Changing reimbursement policies to cover ALL COVID-19 testing and treatment
6:45 min: The role of virtual care during COVID-19 and reimbursement at parity
11:11 min: How will telehealth be evaluated post-epidemic?
13:58 min: Telehealth innovation, B2B use, remote monitoring (looking to providers to lead the way)
17:25 min: What’s going to happen with healthcare costs in 2021?

For more on how health tech companies in digital health, telehealth, remote monitoring, health data, and more are responding to the COVID-19 crisis, check out the other interviews in this special series at www.wtf.health/covid19.

Patients & Vulnerable Populations Pandemically Left in the Dark

Apr 7, 2020

By GRACE CORDOVANO PhD, BCPA

To be honest, the United States blew it on the mask front. From a public health, caregiver and patient safety, as well as community transmission standpoint, we are at least 3 months late to game. Anytime a brand new virus that humanity does not have any immunity to makes an appearance, is highly contagious, starts rapidly infecting people as well as the doctors and nurses caring for them, hospitalizing, and killing them in concerning numbers across the globe, we should enable every proactive safety measure at our disposal.

The first confirmed case of COVID-19 in the US was on January 20, 2020. The general public and the millions of people who are considered at high-risk for complications from COVID-19 were advised that wearing masks in public was unnecessary. Many individuals were shamed and called out for wearing masks in public, being directly blamed for personal protective equipment (PPE) shortages on the front-lines. Meanwhile, hundreds of millions of masks and PPE are exported out of the country by brokers daily. People out in public have been mocked for a spectrum of reasons, being criticized as to why masks were being worn, used to run errands, and for removing them incorrectly. On April 4, 2020, the Centers for Disease Control (CDC) recommended that the general public wear cloth face masks in public where social distancing may be difficult, such as at the grocery store or pharmacy, especially in areas where cases of the infection are high for active transmission.

There has been extensive media coverage of PPE shortages at hospitals on the front-lines of this pandemic. Protecting our doctors, nurses, and all caregivers and first-responders is of utmost priority as we work to fight against COVID-19. As a patient advocate, patient, and carepartner to 2 disabled adults, with multiple family members in the high-risk population, was the call-to-action for the public to wear masks delayed so as to not risk further depleting PPE needed for those directly caring for patients sick with COVID-19?