Tom Sullivan and Gabriel Perna | March 31, 2020
Amid the COVID-19 pandemic, health care provider, payer and life sciences CEOs’ time is more constrained than ever. With so much noise it can be hard to find the more insightful and actionable articles that tend to get lost in the fray.
As a service to readers, Health Evolution will hand-pick and curate the most-appropriate articles from around the web to share here — and we’ll update this page as frequently as is appropriate.
May 26, 2020 4 pm
9 ways COVID-19 has changed health care forever. STAT surveyed a number of policy experts who determined what the health system will look like for decades post COVID-19. Among the predictions – the rapid acceleration of telemedicine, the decline in nursing homes coupled with a rise in home health aides, an inflection point in racial disparities, another reckoning on drug pricing and more. STAT interviewed former CMS Administrator Don Berwick, EmblemHealth CEO Karen Ignani, Rep. Donna Shalala, Democratic congresswoman from Florida and former Clinton administration health secretary and others.
Quote: “The pandemic could help bring about an end to the American tradition of tying health insurance to employment status. It could prompt a reckoning about why Black people and other historically marginalized populations have long suffered so disproportionately — not just from Covid-19, but from nearly every common health condition.”
May 26, 2020 12:30 pm
Why COVID-19 is more common in adults than kids. New research published in JAMA from Mount Sinai discovers why children are more immune to COVID-19 than adults. The researchers say that he virus that causes COVID-19 uses a receptor known as ACE2, found on the surface of certain cells in the human body, to enter its victims. According to research, children have lower levels of ACE2 gene expression than adults.
Quote: “The coronavirus uses ACE2 to enter the human body, where it spreads. ACE2 is known to be present in our airway, kidneys, heart, and gut. In our study, we took this knowledge a step further, finding that there are low levels of ACE2 expression in the nasal passages of younger children, and this ACE2 level increases with age into adulthood. This might explain why children have been largely spared in the pandemic,” says Supinda Bunyavanich, MD, Professor of Genetics and Genomic Sciences and Pediatrics, Icahn School of Medicine at Mount Sinai.
May 19, 2020 10:30 am
For-profit hospitals benefit in CARES funding. Kaiser Family Foundation looked at how money is distributed from the CARES Act to hospitals. Specifically, researchers examined the implications of the decision to allocate funding based on total net patient revenue, which is total patient revenue minus contractual allowances and discounts. According to their findings, by distributing $50 billion of the CARES Act based on patient insurance revenue, hospitals with the highest share of private insurance will receive the most money.
Medical malpractice laws shift during COVID-19. Kaiser Health News reports that governors in Connecticut, Maryland, Illinois and several other states have ordered that most providers be shielded from civil as well as some criminal lawsuits over medical treatment during the COVID-19 pandemic. A group of 36 physician and hospital associations, including the American Hospital Association and American Medical Association, have appealed to congressional leaders for federal legislation.
Social distancing measures worked. Researchers at the University of Kentucky studied the impact of national and local shelter-in-place measures on the growth rate of confirmed COVID-19 cases across US counties between March 1, 2020 and April 27, 2020. The researchers say that without these shelter in place orders cases would have been 10 times higher without shelter in place (10,224,598) and 35 times higher (35,257,098) without any social distancing restrictions.
May 11, 2020 1:33 pm
Researchers create AI-enabled COVID-19 diagnostic tool. Researchers at King’s College London, Massachusetts General Hospital and health science company ZOE have developed an artificial intelligence diagnostic that can predict whether someone is likely to have COVID-19 based on their symptoms. The AI model uses data from the COVID Symptom Study app, from ZOE, to predict COVID-19 infection, by comparing people’s symptoms and the results of traditional COVID tests.
Takeaway: The researchers analyzed data from just under 2.5 million people in the UK and US who had been regularly logging their health status in the app, around a third of whom had logged symptoms associated with COVID-19. Of these, 18,374 reported having had a test for coronavirus, with 7,178 people testing positive. Researchers found loss of taste and smell (anosmia) was one major factor in diagnosis, with two thirds of users testing positive for coronavirus infection reporting this symptom compared with just over a fifth of the participants who tested negative.
Quote: “Our results suggest that loss of taste or smell is a key early warning sign of COVID-19 infection and should be included in routine screening for the disease. We strongly urge governments and health authorities everywhere to make this information more widely known, and advise anyone experiencing sudden loss of smell or taste to assume that they are infected and follow local self-isolation guidelines,” Professor Tim Spector from King’s College London said in a statement.
Health benefits changing thanks to COVID-19. A new survey from Willis Towers Watson of 816 employers reveals that many of them are changing health benefits to expand access for its employees during COVID-19. More than three in four employers are offering or expanding access to virtual mental health services.
Takeaway: While some employers are enacting furloughs, pay cuts and reductions in 401(k) matching contributions to reduce costs, many are preserving wellbeing plans at a time when employees are facing significant challenges. Others are actually expanding these programs. Nearly 50 percent are enhancing health care benefits, 45 percent are broadening wellbeing programs, and 33 percent plan to make changes to paid time off (PTO) or vacation programs.
Quote: “Although most employers anticipate a significant negative impact from COVID-19, many are taking steps to protect the health and wellbeing of their employees,” Regina Ihrke, senior director and wellbeing leader, North America, Willis Towers Watson, said in a statement. “Employers are doing what they can to support their workers through this difficult time. The pandemic has led to high levels of employee anxiety and stress, so employers are making it easier for employees to get help across all aspects of the wellbeing spectrum.”
May 5, 2020 3:30 pm est
Data Interoperability and Exchange to Support COVID-19 Containment. The Duke-Margolis Center for Health Policy convened a multi-stakeholder working group to identify feasible, short-term steps to improve interoperability and exchange of key data for COVID-19 containment. Their findings were outlined in a paper authored by Farzad Mostashari, MD, CEO of Aledade and Mark McClellan, MD, Director, Duke-Margolis Center for Health Policy & Robert J. Margolis, M.D., Professor of Business, Medicine and Policy; Duke University. The working group called on government and private stakeholders to focus on a 30-to-60-day plan and to use existing systems, rather than building new ones.
Takeaways: Mostashari and McClellan say three immediate, feasible steps will enable public health programs to work more effectively with health care providers, clinical laboratories, and other critical partners in COVID-19 containment efforts. The three steps include:
May 1, 2020 3:51 pm
CMS offers COVID-19 flexibility for ACOs, workforce. With ACOs set to face tremendous financial struggles thanks to the COVID-19 pandemic, CMS threw a lifeboat to them this week. The agency said its making to the financial methodology to account for COVID-19 costs so that the 517 ACOs in the Medicare Shared Savings program will be treated equitably regardless of the extent to which their patient populations are affected by the pandemic. They’re also forgoing the application cycle for 2021 and giving ACOs whose participation is set to end this year the option to extend for another year.
“We’re appreciative of the thoughtful ways CMS will modify the Shared Savings Program during the public health emergency, especially by removing spending associated with COVID-19 patients from performance calculations,” said Clif Gaus, Sc.D., President and CEO of the National Association of ACOs in a statement.
CMS also introduced flexibility around workforce availability, allowing nurse practitioners, clinical nurse specialists, and physician assistants to provide home health services. It will also not penalize teaching hospitals that shift their residents to other hospitals to meet COVID-related needs. It also allowed physical therapists, occupational therapists, and speech language pathologists to provide telehealth services on top of doctors, nurse practitioners and physician assistants.
April 29, 2020 1:29 pm
Nearly 20% of employees are exposed to infections on the job. A University of Washington research team used federal employment data to determine that 14.4 million workers face exposure to infection once a week and 26.7 million at least once a month in the workplace. This equates to 10 percent of the workforce are exposed to disease or infection happens at least weekly and 18.4% exposed at least monthly. Health care was naturally at the top of the pack, in terms of exposure risk.
Takeaway: While health care occupations represent the bulk of workers exposed to infection and disease, police officers, firefighters, childcare workers, and personal care aides are also at risk, said Marissa Baker, an assistant professor in the UW School of Public Health, lead author of the report.
Advice: “The public health implications from our study are that workplaces need to make sure that they are not only protecting their workers at work, but also coming up with contingency plans to make sure that sick workers are not coming to work, and that can be accomplished through training workers to fill in for each other, providing additional paid sick leave during this time and similar measures.”
Update April 27, 2020 10:38 am ET
CMS suspends advanced payment program. CMS announced on April 26, 2020 that it’s reevaluating the amounts that will be paid under its Accelerated Payment Program and suspending its Advance Payment Program to Part B suppliers effective immediately. CMS says it is suspending the program in light of Congress passing $175 billion in relief funds for providers as part of the CARES Act and the Paycheck Protection Program and Health Care Enhancement Act. Before those two bills were passed, CMS expanded the Advanced Payment program. In the last several weeks, CMS had approved more than 24,000 applications and advanced more than $40 billion to Part B suppliers and more than 21,000 in applications totaling $59.6 billion in payments to Part A providers, which includes hospitals.
Update April 23, 2020 11:34 am ET
Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. Researchers at Northwell Health in New York City have come out with a paper that provides characteristics and early outcomes of patients hospitalized with COVID-19 in the New York City area.
Updated April 22, 2020 at 10:12 am ET
The National Institutes of Health published COVID-19 treatment guidelines that were created by a panel consisting of physicians, statisticians and other experts.
Updated April 20 at 12:16 pm
COVID-19 population data shows race disparity. New data released by the CDC shows that 33% of people who’ve been hospitalized with COVID-19 are African American. Research from Johns Hopkins found similar statistics. Considering only 13% of the U.S. population is African American, why is there such a disproportionate number? NPR reported on this disparity and why it exists.
AHA issues roadmap for return to elective surgeries. The AHA, American College of Surgeons (ACS), American Society of Anesthesiologists (ASA) and Association of periOperative Registered Nurses (AORN) developed a roadmap to guide readiness, prioritization and scheduling for the return of elective surgeries. The groups say facilities should not resume elective procedures until there has been a sustained reduction in the rate of new COVID-19 cases in the area for at least 14 days.
The financial situation for hospitals is dire. Industry groups are calling on the government to provide for funds in the “Provider Relief Fund.” The initial $100 billion won’t be enough to keep many hospitals afloat, says the Federation of American Hospitals in a policy brief. The government has begun the second round of distributing funds from the CARES Act this week.
Social distancing works. It really works. A new study from researchers at Columbia University Mailman School of Public Health finds that almost 185,000 deaths in the Northeast and 33,000 deaths in the Midwest could be averted by reducing person-to-person contact through actions such as travel restrictions, social distancing, and self-isolation for sick individuals.
The researchers created an online tool identifying U.S. counties that are at risk of exceeding their critical care surge capacity limits within six weeks and estimated the lives that could be saved with enhanced social distancing and ramped up medical care.
Rural Hospitals feel the squeeze. Before COVID-19 ever entered the picture, rural hospitals were already in trouble. In 2019, a record-setting 19 rural hospitals closed. It’s not accelerating at an even faster pace and it won’t get any easier thanks to COVID-19, NPR reports. Decatur County General Hospital in Tennessee will shut down indefinitely by April 15, it will be the ninth small-town hospital to close in 2020 alone.
New York is merging all its hospitals to battle the coronavirus. Vox reports on the bold plan that essentially “socializing the entire system,” to fight against the pandemic.
Helping public health officials combat COVID-19, by Google SVP Jen Fitzpatrick and Chief Health Officer Karen DeSalvo, MD.
The Federation of American Hospitals is collecting COVID-19 resources relative to issues and advocacy.
Updated Tuesday, March 31 at 12:28 am EST
The top 3 Coronavirus priorities for the next month, as outlined by former CMS Acting Administrator Andy Slavitt.
COVID-19 Priorities Checklist for State Leaders. Slavitt is currently Board Chair at United of States of CARE, which issued the 10-page document and described it as a dynamic list of best practices.
National Coronavirus Response: A Road Map to Recovering, published by the American Enterprise Institute and written by former FDA Commissioner Scott Gottlieb, MD, and former CMS Administrator Mark McClellan, MD, former FDA medical device center Deputy Director Lauren Silvis, Johns Hopkins epidemiologist Caitlin Rivers and Johns Hopkins professor and health security expert Crystal Watson.
Updated Monday March 30 at 10:00 am EST
Given the ongoing pandemic— and because the in-person Health Evolution Summit has been postponed — we are hosting a virtual gathering, Pandemic Response: A Public-Private Call to Action. During the webcast, CEOs and other C-level leaders will learn from each other and from federal and state government officials about insights and best practices for preparedness, mitigation, education and communication. Leaders will also discuss lessons learned on the front lines of the battle and share information about the available diagnostics, treatments, cures and forthcoming vaccines.
When: April 2, 2020 beginning at 8 am ET.
CEO Reading List
COVID Community Vulnerability Map. Jvion, a health care analytics company, has released a COVID Community Vulnerability Map. The interactive map identifies populations down to the census block level that are at risk for severe outcomes upon contracting a virus like COVID. It also is overlaid with points of interest, such as hospitals, food sources and transportation, in relation to the at-risk communities.
Perceptions of COVID-19 among the general public. The Annals of Internal Medicine assessed knowledge and perceptions about COVID-19 among a convenience sample of the general public in the United States and United Kingdom.
Singapore modelling study estimates impact of physical distancing on reducing spread of COVID-19. A new study in The Lancet looked at the impact of physical distancing on reducing spread of COVID-19.
The COVID Tracking Project. This is an independent, volunteer-run accounting of every coronavirus test conducted in America. “We attempt to include positive and negative results, pending tests, and total people tested for each state or district currently reporting that data,” the website states.
COVID-19 response reveals why public-private partnership is vital to health care. The newest Leadership Matters column from Health Evolution Founder and Executive Chairman David Brailer, MD,
COVID-19 is sparking a lot more questions than answers right now. Here’s one from Paul Keckley: Coronavirus: A gray rhino that will the re-shape the U.S. health system?
Updated Monday, March 16, 11:00 AM ET.
Virtually Perfect? Telemedicine for Covid-19. Judd Hollander, MD, Associate Dean for Strategic Health Initiatives at Sidney Kimmel Medical College at Thomas Jefferson University andBrendan G. Carr, MD, Associate Dean of Healthcare Delivery Innovation at Thomas Jefferson University write in The New England Journal of Medicine about why telemedicine and AI are ideal for Covid-19 screening.
Coronavirus: Health care accelerates innovation in pandemic response. Health Evolution contacted executives from Providence at the U.S. epicenter of the outbreak in Seattle, as well as Spectrum Health, Ginger and Blue Cross Blue Shield Association to report on how they are handling the outbreak. Amid so much bad coronavirus news, we found innovative spirits pushing ahead even harder than usual.
Combating Coronavirus starts with keeping workers well. By Michelle Williams, Dean of Faculty at Harvard T.H. Chan School of Public Health and Arianna Huffington, founder and CEO of Thrive Global in Fortune.
Why it’s not impossible that COVID-19 kills a million Americans, by former CDC Director Tom Frieden, MD, in an article on Think Global Health.
Taiwan’s impressive efforts to thwart coronavirus.
Based on data in the Journal of the American Medical Association, we created this infographic demonstrating why Taiwan is something of a success story amid the chaos.
Vineet Chopra MD, Associate Professor of Medicine and Chief of the Division of Hospital Medicine at Michigan Medicine, and a team of researchers write in Annals of Internal Medicine about the steps U.S. hospitals should take to prepared for COVID-19.