May 27, 2021 | Surprise billing laws: Unintended consequences?
INDUSTRY NEWS
GAO: Don’t get too carried away with telehealth
The Government Accountability Office says the full effect of CMS waivers on telehealth coverage during the pandemic isn't yet known, so agencies should wait until there is more research before expanding telehealth coverage for Medicare and Medicaid programs. The GAO made its case before Congress and in a May 19 report. It has concerns in four areas: spending, program integrity, patient health and safety and equity. (mHealth Intelligence; report).
Testimony: Police, mental health pros must work together
Experts testifying before a recent House hearing called for better coordination between police departments and mental health. Communities are forced to “patch together” responses with insufficient resources, Charles Dike, MD, medical director of the Connecticut Department of Mental Health and Addiction Services, told the panel. "This patchwork typically relies too much on emergency rooms and police departments, and can result in patients languishing in emergency rooms, criminalization of persons with mental health and substance use disorders, and at times, the unnecessary and tragic loss of life." (MedPage Today*)
Surprise billing laws: Unintended consequences?
Laws limiting surprise medical bills may be encouraging health care organizations to raise in-network prices, which could drive up insurance, warn health policy researchers. These laws have protected consumers from bills that can climb into the hundreds of thousands of dollars. But some researchers warn that doctors and other medical providers are leveraging state laws that rely on arbitration to increase in-network fees, thereby raising health care costs for everyone. (AP, via Stateline)
INNOVATION & TRANSFORMATION
Epic, Anthem to integrate payment systems
Epic will integrate its payer platform with Anthem’s operating system to facilitate two-way data exchange with providers. The integration is intended to support clinical decision-making and streamline administrative processes. For example, the integration will allow for clinical document exchange and streamline prior authorization. Providers will be notified of significant patient health events, such as discharge. So far, only a few providers will participate in the Anthem-Epic data-sharing effort, but the number is expected to grow. (MedCity News)
CONSUMERS & PROVIDERS
Maybe it’s SDOH, not comorbidities
Patients with cardiovascular disease who had worse composite scores for six social determinants of health—including education, 30-day food security and health insurance—were less likely to adhere to all the measures recommended to lower their risk of contracting and spreading COVID-19, according to research published in Circulation: Cardiovascular Quality and Outcomes. “SDOH burden is associated with lower COVID-19 risk mitigation practices in the CVD population. Identifying and prioritizing individuals whose medical vulnerability is compounded by social adversity may optimize emerging preventive efforts, including vaccination guidelines,” the researchers conclude. (Circulation: Cardiovascular Quality and Outcomes; Medscape Medical News)
A quarter of Medicare participants used telehealth
More than 25% of Medicare beneficiaries used a telehealth visit between the summer and fall of last year—a substantial increase, according to a Kaiser Family Foundation report based on responses to the Medicare Current Beneficiary Survey (MCBS) Fall 2020 COVID-19 Community Supplement. More than half of beneficiaries who had a visit used only a telephone. On the other hand, 23% say they don’t know if their provider offers telehealth appointments, and this percentage is larger among beneficiaries who live in rural areas (30%). (Healthcare Dive; Kaiser Family Foundation report)
NEW & NOTED
Must love vaccines: The White House has teamed up with dating platforms to promote vaccinations. Users who have been vaccinated will be able to display a vaccination badge on their profiles. In addition, those who have been vaccinated will be able to bring their profiles to the top of the pile and be more visible to other users. (Medscape)
Connecting patients to trials: CVS Health has launched a business to connect people to clinical trials and make the trials more efficient. CVS Health Clinical Trial Service is intended to drive greater access to clinical trials and create a better experience for participants to improve retention rates. (Becker's Hospital Review; announcement)
Most doctors employed: For the first time, fewer than half of U.S. doctors are working a private practice, according to the latest American Medical Association Physician Practice Benchmark Survey. Those private practices that continue to operate tend to be larger. (Healthcare Dive; AMA survey)
MULTI-MEDIA
There is no such thing as a safe level of alcohol consumption, according to an observational study, not yet peer-reviewed, that studied the relationship between the self-reported alcohol intake of some 25,000 people in the UK and their brain scans. Dr. Anjay Gupta discusses the research on alcohol and brain health. (CNN)
MARKETVOICES...QUOTES WORTH READING
"If you break your leg and you have a cast on it, everybody comes running to you to sign your cast, but if you have a mental health problem — which is an injured brain instead of an injured leg — everybody runs the other way."—Steven Casstevens, immediate past president of the International Association of Chiefs of Police, quoted in MedPage Today*