15: A SNF in Connecticut has seen this much of a percentage boost in admissions due to bringing in patients with significant comorbidity who were at home and “went south.” Rather than be admitted to the hospitals without enough beds and staff, SNFs have become an alternative facility to help the sick patients, particularly those with dehydration or concerning vital sign changes requiring medical supervision and acute level care. This SNF could be an outlier, however, as we’ve heard reports of declining SNF volume, by as much as 30-40%. In some ways, the crisis puts a new spotlight on a nursing facility’s future role in healthcare.
Take a Chance on Me: Like ABBA’s hit, a Medicaid plan in the South has been researching a new applied behavioral analysis service that focuses on educating parents of kids on the autism spectrum. The service is the brainchild of Michigan’s Richard Solomon, who practices in Ann Arbor, training parents in what some payers have told me may be a less expensive way to do ABA. But since efficacy is not yet proven universally, there’s some hope that insurers will take a bigger chance.
Benefit Boost: Aetna is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all of its commercial members as a fully-covered benefit.
IBD, Crohn’s, and a New Tone: For those of you working in GI practices, or pursuing them, prevalence of IBD and Crohn’s is a big deal and there are reports here in the US of kids with Crohn’s presenting this week with fever and cough. My cousin Erin, a nurse in Rhode Island, said she had “at least a dozen kids” fitting this profile. “None were hospitalized,” and in several cases, the kids were on Humira plus a tablet chemotherapy called 6MP. She said, “we were briefed to be prepped to deal with IBD patients,” and “to make sure they were taking their therapies.” No wonder the commercial payer world has been increasingly interested in value-based models for GIs to help manage ER and other costs for these chronically ill patients.
Where Are All the Doctors?: Telehealth vendors are scooping them up, like startup 98point6, which expects to triple their number of doctors over the next month and Doctor on Demand said they are “rapidly increasing” their provider base.
Psych 101: The Coalition for Behavioral Health in New York, along with the New York Association of Psychiatric Rehabilitation Services, is launching a new program called ‘Strive for Five’ to encourage New Yorkers to find five people in their life who they will check in with during each of the next 30 days.
Testing Tracker: Oscar Health has built the first testing center locator and made it available to anyone who may be in need of COVID-19 testing, not just for its members. People are asked to first take a 1-minute risk assessment survey, and then the site will recommend mitigation measures. If one of those measures is to get tested for COVID-19, the patient will be directed to a testing center locator. Patients can find the closest center with availability for testing. At the time of its release, the tool mapped out 100 testing sites, but they are adding more sites to the resource daily. The tool also immediately links patients with Oscar Health’s telemedicine platform, ‘Doctor on Call’.
March Sadness Reversal: Taking a page from the Virginia hoop squad that won last year’s basketball tournament, UVA Health has independently developed its own COVID-19 tests thanks to an effort by a team of physicians, laboratorians, and the University of Virginia community. UVA is now one of the few institutions across the country that has developed its own test so that the diagnosis can be more readily made. Instrumental in developing the new UVA test were Dr. Amy Mathers and Laboratory Director Mendy Poulter, according to the University.
Demand for CNAs: If you’re an anesthesia practice or home health company experiencing a downtick in surgical volume or visits, maybe consider starting a certified nurse anesthetist traveling business. There’s a market. Distribution warehouses in Memphis, TN are paying top dollar for CNAs to screen employees outside their facilities. These centers require hundreds and sometimes thousands of workers onsite to operate properly, and a spread among employees could potentially shut down an entire business.
Anxious: 92% of people now say they have anxiety about coronavirus, according to a survey of 12,000 from The Mighty. 20% have gone without medical treatments, 85% of people are more worried this week than they were last week, and about 30% have gone without doctor’s appointments. 42% of people under 25 said their lives were “extremely” impacted by the anxiety surrounding the coronavirus, likely “job related or perhaps socially related,” compared to only 15% of those over 65. But there is hope. A rapid response by psychologists and neurologists nationally, some from academic centers, some working for telehealth companies, and some coming out of retirement, is unfolding. These practitioners are being tapped to help local clinics, hospitals, and schools meet demand. It will be interesting to see if the commercial payers further embrace this wave through contracts. For physician groups who are trying to build a tele service on the fly now, part of the objective will be to have a clinical, evidence-based approach to these encounters as well as an ability to evaluate and address mental health, and get paid for the work.
Extra Point: My folks are having an epic number of senior moments these days, and thank God - they keep me sane to hear them, even as their moments are a sign of the times and a sign they are getting much older. Managing their health is another job for me and my family, and my ‘point’ - featured here this week - is my own way to chronicle their behavior in what is the craziest time in our lives. To preview, my mother-in-law who rarely leaves her couch except for daily Mass and a cinnamon cruller at dunks, now wants to suddenly travel, and my dad is agitated because the elderly hour at the Stop ‘n Shop has turned into an old lady traffic jam in aisle 5. His never-diagnosed ADHD can’t handle the molasses-speed shopping. The more things change...