The Big Stuff.
This week’s top healthcare news.
Coronavirus
Deaths are trending lower than originally projected. Discussions are taking place about re-opening the economy. New York hospitalizations are down.
Bernie’s Out.
Bernie Sanders dropped out of the presidential race on April 8 and endorsed Biden on the 13th. That leaves us with a Biden (Public Option) vs. Trump (Repeal and Replace) showdown. Catch up on their healthcare policies and all of the previous Democratic candidates’ policies, here.
Interestingly, Biden wants to add some of Bernie’s policies to solidify a more united Democratic front (WSJ paywall). On Thursday, April 9, Biden announced 2 new policies to his platform:
- Lowering Medicare eligibility age to 60 from 65 and
- Forgiving student debt for certain low-income populations.
It’s not quite the same as Medicare for All and fully canceling student debt and everything else Bernie had planned, but the policies are a bit of a nod to that direction.
Everyone needs cash and wants a piece of the CARES act pie.
Government payments to healthcare providers are starting to flow, mainly with hospitals. HHS is using UnitedHealth, AKA health insurance giant Numero Uno, to distribute $30 billion in relief funding to hospitals.
Remember that total emergency funding from the CARES Act totaled $100 billion for all healthcare providers dealing with the ‘Rona.
- The first $30 billion will get distributed based on historical Medicare fee for service billing, NOT based on need as it relates to COVID-19 stricken areas. This decision sparked some controversy.
Also, keep in mind that THIS $30 billion is SEPARATE from the $51 billion that hospitals are receiving in advanced payments from CMS.
Billions flying everywhere. Wild times, fam.
So in summary:
- $30 billion in emergency relief funding for hospitals, AKA grants.
- Then, $51 billion in advanced payments, meaning hospitals will have to pay that money back eventually.
- This $51 billion is NOT part of the $100 billion in relief funding.
Hospitals aren’t the only ones going after that $100 billion.
The American Medical Association and other physician groups want a piece of the $100 billion and voiced their reasons in a letter to the HHS.
- While hospitals expect to receive most of the funding, all providers are eligible to receive CARES Act funding so long as they involved with COVID-19 in some way.
Meanwhile, smaller, rural hospitals are worried about receiving any sort of coronavirus aid funding at all.
Don’t forget about Stimulus Package, Part IV.
Apparently, it’s on the way.
- Expect that package to include more small business funding, more healthcare funding, and more local government funding. If they can agree, that is.
A Surveillance state for COVID-19?
Enter…Digital Contact Tracing.
As if the healthcare world needed another buzzword, officials are mulling over the idea of tracing people’s contact with one another via blue tooth in people’s cellphones in order to combat virus spread.
- While proponents of privacy are sure to riot, a short term national surveillance system may end up being the best way to re-open economic activity.
Apple and Google are on board with the idea and just partnered implement digital contact tracing.
- Their proposed solution is supposed to protect peoples’ privacy while creating an effective COVID-19 digital tracking tool.
Is there an end in sight?
Everyone is getting a bit antsy and wondering when the economy will re-open.
- With the improved condition in New York and the effective social distancing measures, state governors across the nation are discussing when to open things back up, something Trump says he only has the power to do.
- In any scenario, the economy is expected to re-open slowly.
Here’s how healthcare is changing. But will it last?
It’s interesting to see how traditional healthcare competitors and verticals are collaborating and working together to tackle supply chain, outbreak, cash flow, and capacity challenges.
- HCA is working with Google’s cloud business to open up data.
- Same with Amazon – they’re using AWS to track Johns Hopkins COVID-19 data and Definitive Healthcare hospital bed data for use in the New York Times and other research publications.
Collaboration and working together
- Payors: Most health insurance companies are now completely covering patient COVID-19 care expenses. Following in the CMS’ footsteps, payors are giving providers accelerated payments, which works as an ‘advance’ on future reimbursement. In a really, really interesting twist, Surprise billing will be banned for any provider receiving CARES act funding.
- Telemedicine: Huge surge in adoption of telemedicine may make the style of primary care more popular afterwards. Telemedicine services are currently getting reimbursed at the same rates as in-office visits by several payors. That may change post-crisis.
- Blurred state lines: Physicians can now more easily practice across state lines (typically different states require different licenses). Physicians can now also provide care for rural hospital patients across state lines via telehealth or phone. Healthcare ordinarily varies widely from state to state.
- CON laws – which are regulations that prevent healthcare providers from building new facilities or hospital beds without that state’s permission – are getting called into question as bed capacity becomes an increasingly difficult issue during the crisis.
Other Coronavirus Tidbits.
- Social distancing is working and is reducing deaths – by a LOT.
- Thousands of tests are going unused in labs.
- The best hopes for a coronavirus drug.
Quick Hits
Biz Hits
- Envision Healthcare, the recent take-private healthcare staffing giant, is looking for ways to restructure its large debt pile.
- Driverless shuttles transport COVID-19 tests at the Mayo clinic
- Stanford teamed up with Apple to release an app that connects first responders to drive-through COVID-19 tests
- Quorum Health, the now-bankrupt hospital operator, reached a preliminary restructuring deal and will continue operations. But some investors think Quorum is using the ‘Rona as an excuse to fast-track its bankruptcy proceedings.
Other Hits
- How COVID-19 deaths compare to other causes of death. (Stat)
- The Coronavirus Crisis in doctors’ own words. (WSJ)
- CMS boosts Medicare Advantage, Part D rates by 4% next year, increases kidney disease payments
Thought-Provoking Editorials
- A bold response to the COVID-19 pandemic – use medical students (JAMA)
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