May 21, 2020 | Insurance landscape shifting
INDUSTRY NEWS
Atul Gawande is stepping down as CEO of Haven, the health care venture launched by Amazon, JPMorgan Chase & Co., and Berkshire Hathaway and will instead serve as board chair. “This will elevate my focus from daily management to supporting Haven’s strategy, board, and leadership. It will also enable me to devote time to policy and activities addressing the immediate and long-term threats to health and health systems from COVID-19,” he said in a prepared statement. (STAT News; Haven Statement)
Interpreting tests: Art and science
We don’t know how reliable COVID-19 tests are, so clinicians need to apply their judgment and insight, especially when interpreting negative results, Medscape Medical News reports. False negative rates in published studies range from 3% to 66% in different patient cohorts, and early evidence suggests test accuracy varies widely depending on what part of the body is being tested and at what point in the disease course testing occurs, among other factors. (Medscape Medical News)
INNOVATION & TRANSFORMATION
NEJM paper: Include social factors in VBP models
Social, behavioral and environmental factors need to be incorporated into value-based payment models according to a New England Journal of Medicine paper co-authored by William Shrank, MD, CMO of Humana, and Shantanu Agrawal, MD, president and CEO of National Quality Forum. “Growing evidence indicates that socially disadvantaged people have comparatively worse health outcomes suggesting that clinical and social risk are related,” Agrawal said in a prepared statement. “To improve the health outcomes of all people, including the disadvantaged, we must consider this growing body of evidence as part of a comprehensive, 21st century approach to risk adjustment.” (Becker’s Hospital Review; NEJM)
Research: Stay-at-home orders slowed spread
Research suggests that stay-at-home orders have had a significant impact on slowing the spread of COVID-19, Medscape Medical News reports. One study, published in the Journal of the American Medical Association, found a significant difference in growth in the number of COVID-19 cases between border counties in Illinois, which has a stay-at-home order, and Iowa, which doesn’t. The Health Affairs study found that stay-at-home orders and the closure of restaurants/bars/entertainment-related businesses “substantially slowed the spread of COVID-19.” (JAMA; Health Affairs; Medscape Medical News)
CONSUMERS & PROVIDERS
Lingering symptoms affect many patients
The median time from COVID-19 onset to recovery is around two weeks for mild cases, and three to six weeks for those with severe or critical disease. But many people—even those with mild disease—report symptoms lasting far longer than 14 days. These symptoms include fatigue, breathing problems, aches and cardiac issues. “The body received a tremendous insult, and it just takes a while for the body to recoup from that,” Aaron Glatt, MD, chair of the department of medicine at Mount Sinai South Nassau in Oceanside, New York, told MedPage Today. (MedPage Today)
Looking back at PCCI’s success
Parkland Center for Clinical Innovation has helped Dallas become one of the first metropolitan regions to scale a clinical and community partnership using a web-based information exchange. By addressing food insecurity for individuals with hypertension and diabetes, for example, related hospital readmissions have been reduced by 50%. PCCI has introduced two innovations to make this happen, HealthLeaders Media reports. The first is a 300-page playbook for building a connected community. The second is the technology, which enables efficient referrals and communication between participating health systems and community agencies: a soon-to-be patented, secure, web-based information exchange. (HealthLeaders Media)
NEW & NOTED
Obamacare suddenly more attractive: Health insurers fled the Affordable Care Act in the early years of the law, fearing covering too many sick people would eat away at their profits. Now that job-based health coverage is in jeopardy, they’re rethinking that position. For instance, after leaving 34 state exchanges United Healthcare is reentering Maryland’s Obamacare market and planning other expansions. (Politico)
CDC, state numbers contradict: The CDC has begun releasing nationwide numbers on COVID-19 testing, but they don’t match what states themselves are reporting. One reason is that some states report the total number of people tested, while the CDC reports every test. “But our analysis suggests this—or any other methodological factor—does not fully explain the widespread discrepancies,” according to the article’s authors. (The Atlantic)
Insurance landscape shifting: The health insurance landscape is changing dramatically. Citing recent data, HealthLeaders Media pointed to three of the biggest examples: Skyrocketing coverage losses; consumer fears of medical expenses and unemployment; and payers reimbursing a bigger chunk of COVID-19 claims are just three ways that the crisis is changing the health insurance landscape. (HealthLeaders Media)
MULTI-MEDIA
In an interview with NPR's Short Wave podcast, medical historian Dr. Howard Markel, director of the Center for the History of Medicine at the University of Michigan, talks about what the 1918 flu pandemic can teach us in 2020. (NPR)
MARKETVOICES...QUOTES WORTH READING
“We believe that we are at an inflection point, and that providers and community leaders can truly develop new engagement strategies to address a person’s [total] needs. Folks have moved from sort of just nodding their heads and saying, ‘Yes, this is something important’ to [asking], ‘Where and how do we start?’”—Steve Miff, PhD, president and CEO of Parkland Center for Clinical Innovation, quoted by HealthLeaders Media