Tag: COVID-19
A hundred years ago, the Spanish flu pandemic led to a revolution in public health. Healthcare systems were overhauled, national health surveys were launched, and cross-border cooperation laid the groundwork for what later became the World Health Organization. Now, with everything from grocery shopping to the global economy upended as a result of COVID-19, thoughts inevitably turn to the legacy of the current pandemic. As healthcare providers struggle to reorganize services, staffing and revenue cycles, change is being forced at a blistering pace. Adjusting is tough, but it’s also accelerating technology trends that healthcare has been slow to leverage until now. Could the coronavirus pandemic bring the future of healthcare to us sooner than expected, just like what happened in the years following 1918? What more can providers do to prepare for challenges in the new normal? Here to stay: telehealth and virtual care Necessity drives innovation – and one key example now is the telehealth explosion. Only a few months ago, remote healthcare was a business choice, selected for being more cost-effective and more convenient for patients, and for reducing the service-load on busy physicians, compared to traditional face-to-face care. Today, it’s an operational essential in preventing the spread of the coronavirus, giving patients a safe way to speak to their doctor without leaving their homes. Relaxed regulations, clearer payment rules and a hundreds of millions of federal cash injection are giving the roll-out a helping hand. Not only is this promoting better patient care and mitigating some of the revenue loss from reduced patient visits, it’s giving providers an unexpected opportunity to conduct a large-scale experiment in the use of telemedicine that would otherwise have been impossible. And it’s working. Patients, physicians and providers are getting used to the benefits of virtual care. Telehealth and self-service patient engagement will likely become the norm once the pandemic settles. Future-proofing healthcare services for a post-pandemic world Even though COVID-19 is far from over, now is the time to plan ahead for managing the pandemic fallout and to protect against future risks. As leading trends forecaster Mary Meeker suggests in her coronavirus trends report, what we really need to prepare for the aftershocks of COVID-19 is better integration of healthcare and technology. We already have the tools at our fingertips – and telehealth is just the start. Where are the gaps? Improving contact tracing and syndromic surveillance The medical community highlights contact tracing as essential for getting a handle on the spread of the coronavirus and potential future outbreaks. Unfortunately, we don’t yet have a system of universal patient identification, which could aid disease tracking by monitoring patient interactions with different touchpoints across multiple health services and generally aiding more accurate patient records. Still, many providers are turning to universal identity managers to track healthcare interactions and share accurate patient information safely and securely within their own networks. Prioritizing data protection and security With the surge in remote care and mobile health, keeping patient data safe through robust identity protection and matching is even more important. A tool such as Precise ID can give providers reassurance that only patients engage with their information – whether on their phones or visiting a provider’s health portal – without creating long wait times or adding complexity to the sign-up process. Strengthening the revenue cycle Estimates suggest health systems could lose an average of $2,800 per COVID-19 case, with many losing up to $10,000, if payers do not raise reimbursement premiums. Ceasing revenue-generating services to accommodate COVID-19 cases only compounds the financial strain on the healthcare system. With revenue cycles at breaking point, there is no room for inaccurate coding or claim denials. To help hospitals and healthcare organizations stay on top of rapidly changing payer policies, Experian Health is offering free access to COVID-19 and telehealth payer policy alerts, so providers can avoid delayed payments and costly claim denials. While the 1918 pandemic led to a complete revolution in our understanding of public health, the legacy of this virus may be more of an evolution – accelerating technological progress already moving forward. The organizations that adapt the quickest to the new normal will be most likely to survive. Find out more about the free resources and support available through Experian Health’s COVID-19 Resource Center to help your organization tackled the most pressing COVID-19 concerns.
There is no doubt the healthcare industry has taken a financial beating as a result of COVID-19. But there is a glimmer of hope for providers. Several new announcements were recently made attached to the Coronavirus Aid, Relief, and Economic Security (CARES) Act, specifically around reimbursements attached to COVID care for the uninsured. The financial stimulus, intended to stabilize hospital finances as providers face short-term revenue reductions due to the cessation of non-urgent procedures and the increased costs for personal protective equipment, has earmarked a portion of the $100B established for CARES to reimburse healthcare providers at Medicare rates for the treatment of uninsured COVID patients. The guidance does not indicate specifically how much money will be set aside to reimburse these claims. The big question? How long will the funds last and how quickly will providers act? With both unemployment, translating into more uninsured individuals, and COVID cases on the rise, the dollars could be exhausted quickly. A recent study by Kaiser estimates the total payments to hospitals for treating uninsured patients under the Trump administration policy would range from $13.9B to $41.8B. While Medicare payments are about half of what private insurers pay on average for the same diagnoses, estimates surrounding COVID care can be in excess of $50k for those severe cases where struggling patients spend weeks in the intensive care unit on a ventilator. Bottom line, it’s likely the funds will be distributed quickly, especially when factoring in unemployment skyrocketing. As of April 30, more than 30M Americans have filed jobless claims amid the coronavirus outbreak. The all-new portal opened on April 27 for sign-ups, and providers can begin submitting claims electronically on May 6. Healthcare providers who have conducted COVID-19 testing of uninsured individuals or provided treatment to uninsured individuals with a COVID-19 diagnosis on or after February 4, 2020 can request claims reimbursement through the program electronically and will be reimbursed at Medicare rates, subject to available funding. A complete list of FAQs regarding the CARES Act and reimbursements are accessible on the Health Resources & Services Administration website. But what other tips and considerations should providers contemplate as they attempt to get their fair share? Here are three actions to optimize a provider’s chances of claiming reimbursements for the uninsured. Automate the insurance check. Providers must attest that they have checked for healthcare coverage eligibility and confirm the patient is uninsured. If they fail to check, they may be denied. Providers must verify that the patient does not have coverage such as individual, employer-sponsored, Medicare or Medicaid coverage, or any other payer options that will reimburse for the COVID-19 testing and/or care of that patient. There are ways to automate this step, completing a second eligibility check to attest that the patients have no coverage before providers submit claims to the government. Scan for the social security number (SSN), if possible. While there may be instances where COVID patients entered a facility and were quickly admitted with no formal registration process, the CARES Act states an SSN and state of residence, or state identification/driver\'s license is needed to verify patient eligibility. If these pieces of information are not captured, providers need to attest that they have attempted to capture this information before submitting a claim. The patient may be long gone, but there are still ways to attempt to retrieve a patient’s SSN after they have exited the healthcare facility. Providers should know that claims submitted without an SSN and state of residence, or state identification/driver\'s license may take longer to verify for patient eligibility. Again, with the possibility that these funds could quickly be exhausted, it is in the provider’s best interest to submit claims that are as clean and validated as possible. Act fast. Recall the Small Business Administration\'s Paycheck Protection Program (PPP) — a coronavirus relief fund for small businesses that was also established under CARES? The $350B allocated by the bill was quickly depleted in days. While these funds were going to individuals in entirely different industries, there is no concrete projections on how long healthcare providers can expect the $1B fund to cover reimbursements for the uninsured. So, providers need to act now, and fast, by tapping into automation and auditing solutions that will optimize their chances of securing their fair share.
The novel coronavirus pandemic crisis of 2020 has plunged the healthcare system, and frankly the whole economy, into a dark place. It will take time, and likely a lot of time, to overcome what may end up being several months of a national shut down. Eventually people will re-emerge from isolation, business will resume a new normal, and healthcare providers will turn their attention to the revenue generating services that they temporarily halted, as well as the patients who delayed care for a myriad of conditions. The Centers for Medicare and Medicaid Services (CMS) recently published “phase one” re-opening recommendations that recognized in some areas the possibility of non-COVID-19 care is already being considered. There will be an overflow of pent-up demand and provider organizations need to position themselves now to be ready. One consideration, with many health systems now feeling the squeeze and not being able to re-deploy staff to serve in the crisis, is to use some of those resources and prepare for the next phase. Here are few strategies to get ahead of the curve, if you will, as it flattens: Reschedule appointments – Literally hundreds of appointments– for some providers, thousands – that had been cancelled or delayed will require rescheduling. Deploying an omni-channel scheduling platform now can relieve the pressure of that future volume in several ways: Online scheduling can guide patients to the right care with rules automation, allowing patients to accurately self-book and reducing call center volume.Enable patient scheduling via automated outreach messages sent via text message or IVR. (For example, you can target all those who need to reschedule, reaching them via text campaigns and reducing call center workload).Reduce training time with a call center scheduling solution. Agents (such as temps hired to handle the influx of appointments) can be trained in a matter of hours to schedule and book appointments accurately.Harden your telehealth offering – This crisis has shown the necessity for virtual visit technology during a pandemic; however, its value won’t disappear as the crisis fades. Telehealth is destined to become a staple of healthcare delivery. Restrictions have been lifted and the technology has proven practical, convenient and efficient, paving the way for broad acceptance. But what are the digital complements that can be paired with telehealth to harden the solution and make the offering a robust tool into the future? While many providers are now able to offer this type of virtual care, scheduling across a variety of specialties has become a challenge. A tool that guides patients and call center agents to the right provider across all services, including telehealth, is going to be critical in the months ahead to maintaining scheduling efficiency and delivering an optimal patient experience.Establish your digital front door – Patients aren’t going to want only clinical telehealth options; the whole spectrum of patient-provider interaction is shifting. Scheduling, registration, payments - all these are going to see increased demand for digital self-service. This gets patients out of the waiting room and removes the need to swipe or insert a credit card or use a POS kiosk. Patients, who are consumers, want to use their mobile devices and they will form lasting opinions of those services enabling – or restricting – their ability to do that.Collections optimization – Right now the focus is on caring for patients, as it should be; however, in order to continue operating, providers must collect for the services rendered. Putting in systems that automate collections processes and reduce the human resources necessary to bring in revenue will to be key to capitalizing on the rush of non-COVID-19 care that will soon be required. These are just a few of the ways that healthcare providers can deploy digital technology to prepare and turn this looming challenge into opportunity. The reality is that managing patient engagement and collections through this next phase is critical to the U.S. healthcare ecosystem’s recovery. Organizations that emerge stronger will be those that prepare now and are ready when the time comes. Find out more about patient engagement solutions that can help you respond now and prepare for the future.
In the span of a single week in March, more than three million Americans found themselves unemployed as a result of the coronavirus pandemic. With health insurance so often tied to employment, the spike in the number of people now without coverage is going to leave many both clinically and financially vulnerable. Even those who still have insurance may be unsure about what it actually covers – and whether they can afford their co-pays. Despite being busier than ever, hospitals are seeing revenue drop due to the cancellation of many services that generate revenue, in order to accommodate the existing or expected surge in COVID-19 patients. That revenue loss may be even more at risk going forward as patients struggle to pay. With many hospitals already operating at slim margins, the consequences of a rise in uncompensated care could be significant. Finding strategies to quickly and accurately identify coverage for patients amidst the chaos is critical. Providers need a collections process that’s compassionate towards stressed out patients, and efficient for staff to manage mounting caseloads in an increasingly complex collections landscape. How automation can help providers get COVID-19 covered Automating the coverage discovery process can help solve for many of the current challenges. Here are five use cases: Speeding up coverage checks for a changing case mix. With elective procedures cancelled, more hospital admissions are emergencies, where upfront coverage information may be missing. Add in changes to billing codes for added, changed and waived COVID-19 testing fees, and the collections process becomes a lot more time-consuming. Experian Health’s reliable, automated Coverage Discovery tool can help verify a patient’s insurance status quickly, and ensure the right bills are sent to the right place. Minimizing face-to-face contact during admissions. Social distancing means the admissions process is almost unrecognizable. Having software run coverage checks as soon as patients arrive will minimize the need for lengthy in-person conversations and help intake teams process patients much faster. Finding missing coverage, even when the rules are constantly changing. With many patients changing plans or switching to Medicaid or Medicare, it’s not always clear who should pay for what. Checking for government coverage and forgotten commercial insurance can eliminate expensive write-offs down the line, but it does take time. Coverage Discovery can quickly comb through available coverage, to find reimbursement options and give patients peace of mind. Sweeping for coverage information on telehealth services. Video and telephone-based platforms are the go-to solution for routine care right now. But billing teams don’t always know if calls should be charged at the usual in-person rate or not. With automation, payer updates can be checked upfront for any new references to telehealth and virtual care, so providers know what to charge. Making life easier for staff.When so many of the staff who’d normally check payer websites are now sheltering in place, homeschooling their kids or even in quarantine themselves, it’s unrealistic to expect productivity to remain high. Automation can reduce the burden by running high volume coverage checks, so staff can focus their attention where it’s needed most. Automated coverage discovery is no longer a “nice to have” Automation was already an attractive prospect for healthcare executives looking to “do more with less” and optimize their revenue cycle for the new quality agenda. In the current crisis, getting the information needed to secure reimbursements is even more urgent. By working with Experian Health, providers can use proven tools to check for missed coverage and reduce the risk of misclassified accounts. Experian Health’s Coverage Discovery generates millions of dollars of found coverage for hospitals when it’s business as usual. This could be exponentially higher in the coming weeks and months, as hospitals look for smarter ways to secure reimbursements. Find out more about how your organization can find missing coverage and streamline the billing process during the COVID-19 crisis.
Virtual and remote healthcare platforms really haven’t been a flashpoint of consumer demand. Basic portals have been available for a while, owing to the completion of healthcare’s years-long process of converting to electronic health records and regulatory encouragement. “Availability” was not evidence of use, however, and consumers have typically not rushed to register a portal account. That will change in 2020. Now, as most Americans stay home to limit the spread of coronavirus, we’re seeing consumers and providers show much more interest in patient portals and telehealth programs. Thankfully, it has become easier than ever to deliver virtual healthcare. The President’s national emergency declaration removed many barriers to the adoption of patient portals and telehealth, so more patients can access care remotely. In an editorial for the Kansas City Star, CMS Administrator Seema Varma said that as a result of these measures, “all Americans can receive telehealth services in their homes, through their smartphones, for any medically-appropriate purpose. This increased flexibility will allow the healthcare system to prioritize in-person care for those who need it most and minimize unnecessary use of personal protective equipment.” So, how can providers maximize the use of virtual healthcare channels – especially when health services are under increasing pressure? Raising awareness of the role of patient portals in response to Covid-19 Those who might not have engaged with digital life much in the past are now getting used to ordering food online and speaking to family on video and are likely to be more open to the concept of virtual care. Providers like the idea of telehealth and the efficiencies that come with it but are currently more focused on keeping people away from situations that may lead to infection – like a visit to the doctor’s office. That immediate need and consumers’ expanded interest may be the perfect scenario that creates a tipping point for telehealth – both in the immediate weeks and months ahead, as well as on an ongoing basis. Providers must make sure consumers are aware of digital alternatives, however, and be proactive in demonstrating how the patient portal makes their healthcare journey easier and safer. Consumers have no limits to the information they want about Covid-19. Portals are useful in communicating up-to-the-minute news and providing guidance around symptoms, testing and keeping safe from infection. Beyond the care focus, the portal presents patients with a convenient, private and full service means to handle payments, without any staff engagement required. Portals offer a sense of security, too, and – to protect patients from fraud – providers should take a multi-layered approach to protecting the portal, including two-factor patient identity verification, device recognition and extra checks where a log-in request looks suspicious. Positioning patient portals as the future of healthcare The coronavirus crisis stretches material and people resources to their limits. Using technology to gain efficiencies and reduce some of the workload through automation or patient self-help capabilities are critically important; patient portals are playing an increasing role to help manage the tremendous demands being placed on the healthcare system. But, beyond the immediate coronavirus needs, no one really knows what business-as-usual will look like. The Covid-19 response is challenging many deep-rooted norms around how we deliver healthcare. Managing the administrative aspects of health online will very likely become the default. As providers use patient portals to their fullest potential in the short-term, there is a huge opportunity to demonstrate the true value of virtual care – and transform the healthcare industry for the long-term. Find out more about how to optimize your patient portal to help your patients stay safe as they access care during the coronavirus pandemic.
As COVID-19 cases climb in the U.S., healthcare providers are strategizing on ways to prioritize testing for specific patient populations and determine overall treatment plans. Already, the world has identified that people age 65 and older, and those with underlying medical conditions, are more susceptible to severe symptoms from the coronavirus. Another group who could be at greater risk? Those individuals with barriers to health, like social determinants. Social determinants of health (SDOH) are the non-medical factors of healthcare that account for up to 80 percent of health outcomes. When patients struggle with access to care or access to medication, they’re less likely to follow treatment plans or show up to important follow-up visits. In the case of the coronavirus, some providers are now considering SDOH to flag particular data fields in an attempt to identify patients with access to care challenges, specifically where a remote health service or telehealth option would be especially helpful. Drive-thru coronavirus testing sites are popping up across the country, and healthcare facilities in all states are encouraging individuals to leverage telehealth solutions instead of flooding sites with in-person visits. SDOH screening could assist in proactively identifying individuals who need to be routed to different care channels. Consider the following: Patients screened for testing may live outside of driving distance to a hospital or clinic. Should these individuals be guided to a different testing option or alternative location? Some people screened for a test might live alone, without a vehicle, and are unable or unwilling to walk to a testing location. Those with symptoms are discouraged from using public transit, so is at-home testing a better option?Additionally, those who live alone without a vehicle may need a proactive check-in to ensure they have no untested symptoms. Could that help prevent a 911 call and additional stress on the emergency department? Proactively screening a patient population by “access to care” data could enable a provider to expand its coronavirus care strategy and consider information that might mitigate future surges in coronavirus cases and ED and clinic visits. Giving attention to patients or members with non-clinical needs and pairing them with the right engagement strategy before they require an escalated response can have a positive impact on clinical services. “Integrating SDOH data into clinical systems is something providers are just beginning to do, but the response required by COVID-19 presents an opportunity to accelerate that,” said Karly Rowe, Vice President of Product Development for Experian Health. “Identifying at-risk patients who may need help tapping into personalized screening and treatment options could help providers quickly suggest the ideal course of action for individuals, and at the same time conserve resources and contribute to the safety of staff and the larger community.” It’s early days of COVID-19, but data will certainly be a differentiator in managing the first pandemic in the 21st century. “Speed, efficiency and accuracy are critical in situations like what healthcare professionals are facing today,” said Rowe. “Innovative use of data is a big part of delivering on those.”
COVID-19 is beginning to stress the healthcare system, and typical protocols are being upended. But health systems and medical groups are already rising to the challenge of getting patients tested while, at the same time, prioritizing the protection of their communities and staffs. Below are some solutions being implemented: Online screening Many providers are tapping into online scheduling solutions, responding to the COVID-19 crisis with simple splash pages. Posting questions that screen for symptoms can channel patients seeking testing/treatment for COVID-19 down a specific pathway to get the care they need. Those who need other types of care can still book through the solution, directing them to the right provider and appointment. Screening paths allow access to be prioritized and managed accordingly. Mobile testing Providers are also using mobile test units. These enable providers to administer more tests in a geographically diverse manner, without having to expose their internal clinic and hospital environments to contagion. Patients can simply drive through and receive a test while remaining in their car. Some health systems are combining this with online scheduling, allowing patients to schedule appointment slots for testing. This helps manage the flow of patients, reducing call center volume. Health plans are also modifying Some health plans are taking a similar approach, using mobile testing units and a call center scheduling platform to book testing appointment slots for members. Likewise, they can send a link enabling members to self-schedule for a testing slot via text message or email. This type of proactive member engagement to vulnerable populations is key to reducing the impact on Emergency Departments, while helping diagnose individuals so they can get the care they need. Call center operations Call centers are being overwhelmed with volume – and there is more to come. New methodologies to handle the response are complementing normal operations. Some providers have started to publish a dedicated line for COVID-19 calls that connects to a separate call center pod. Others have quickly added scheduling protocols in the scheduling system to route patients to the right care, or mobile-testing unit, based on responses to the questions agents ask. By automating the Q&A in the platform, patients are guided to the right care, and agents need minimal training to assure accuracy. As the number of COVID-19 cases continues to grow in the U.S., more tactics will be introduced to streamline scheduling, testing and care. Technology will certainly be one key lever for healthcare providers to better serve their communities and keep patients and staff safe.
