Orthopaedic Surgeon Benjamin Schwartz, MD

Home Care

Medicare Advantage Lacking In Home Care

A study in JAMA Health Forum stirred the pot ahead of a busy HIMSS week by suggesting that Medicare Advantage patients are getting skimped on home care.

Researchers conducted a cross-sectional study of 178k traditional Medicare and 107k Medicare Advantage patients, analyzing those who had care between 2019 and 2022.

Compared to their Medicare counterparts, MA patients:

• Saw shorter home health lengths of stay (-1.62 days)
• Saw fewer nursing, therapy, and aide visits (social work was the only exception)
• Had 3% lower odds of improving mobility
• Had 4% lower odds of improving self-care metrics
• Were 5% more likely to be discharged to the community

While home health isn’t a massive focus for most MA plans, it’s an important resource for keeping patients out of nursing facilities or other long-term care.

• MA beneficiaries are also more likely to live alone and without a large support network, so the fact that they’re getting discharged to the community more frequently – combined with less mobility improvement – isn’t a great recipe for success.

The study doesn’t dive into the cause behind the discrepancies, but whether the differences are due to the administrative burden or cost-limiting incentives of MA plans, the negative implications for patients are clear. Less functional independence, and more caregiver burden.

The Takeaway

With over half of Medicare beneficiaries now enrolled in MA plans, there’s a growing concern over how the plans are operated, and whether the fences they set up around coverage are limiting access to treatment. All-in-all, this study seems to validate that concern, and reinforces the need for keeping a close eye on outcomes as MA enrollment continues its upward trajectory.

Visit Nabla at HIMSS to See Ambient AI in Action

HIMSS24 is almost here, and it’s the perfect place to learn more about how ambient AI can assist your clinicians. If you’ll be in Orlando next week, make sure to swing by Nabla at Booth #1185 to see Nabla Copilot in action and discover how ambient AI can be seamlessly integrated into your team’s workflows. Definitely a demo you don’t want to miss.

Bridge Remote Care Gaps With RPM + PERS

Head over to our Q&A with Clear Arch Health CEO Robert Flippo to see how combining remote patient monitoring and PERS into a turnkey solution that’s easy to implement for both patients and providers can help more people remain independent as they age in place.

Selecting Your Drug Database and CDS Solution

Do your providers need easy access to real-time drug knowledge and clinical decision support? Explore Synapse Medicine’s complete guide to drug database advantages, use cases, challenges, and factors to consider when selecting the right solution for your organization.

The Wire

• Emory Brings Epic to Mac: Emory Healthcare is now the first US system to bring Epic to Apple’s Mac platform on a large-scale deployment. MacBook Air laptops will apparently be rolled out to a large number of Emory clinicians throughout the year, a decision that was reached following an in-depth analysis that revealed MacBook Airs will eliminate $300 in costs annually due to higher software licensing and support upkeep on PCs. Not to bury the lead, but the partnership also includes the first-ever Mac-native launch of the Epic Hyperspace app.

• Headspace Enters The Metaverse: Mental health app pioneer Headspace is tuning into the Metaverse with the launch of Headspace XR, a meditation app for Meta’s Quest virtual reality headset. Headspace XR, which was funded in part by Meta, guides users through meditation and exercises like a Tai Chi-inspired movement game to promote mental wellbeing. VR mental health treatments have already been cleared by the FDA, but Headspace doesn’t plan on using the modality for its therapy or psychiatry offerings…at least not yet. 

• Top 10 Health System Fast Facts: Definitive Healthcare data shows that the largest 10 health systems collectively account for over 185k beds, or roughly 20% of all acute care hospital beds in the US. The biggest of the big include HCA (41,694), The VA (25,260), UHS (21,201), and CommonSpirit (19,405). The report is worth taking a look at for some fast facts on staffed beds, hospitals, facilities, discharges, and even net patient revenue.

• WebMD Acquires Healthwise: WebMD Health is acquiring the operating assets of Healthwise, which develops patient-engagement tech that can be embedded into content-as-a-service platforms through portals, websites, or at the point of care. The acquisition includes Healthwise’s content, solutions, and client relationships, which WebMD will incorporate into its Ignite platform to reportedly allow it to support a group of 650+ healthcare orgs that includes more than half of all US hospitals.

• WVU Medicine Adds Hyro: WVU Medicine is deploying Hyro’s suite of AI assistants across its websites and call centers over the next three years, with the goal of streamlining patient and employee interactions while boosting operational efficiency. The integration will include Hyro’s Al Voice and Web Assistants (information requests, scheduling, refills), Call Center Automation (smart routing, call-to-text, live agent handoff), Employee Assistance (HR inquiries, IT and admin support), and a whole bunch of analytics layered on top to help with leadership decision making.

• Nuance Expands Alliance with Providence: Nuance Communications expanded its alliance with Providence to investigate ways to accelerate AI innovation and deployment at scale. Providence has already deployed Nuance’s PowerScribe, Dragon Ambient eXperience, and Dragon One Medical solutions; the new relationship will focus on improving efficiency with Microsoft Cloud for Healthcare, accelerate Providence’s development of in-house AI applications, and expand deployment of solutions like Nuance DAX Copilot for automation of clinical documentation. 

• Plastics in Our Plaque: A landmark NEJM study revealed that many patients with carotid artery disease might have microplastics and nanoplastics embedded in their carotid plaque, and those patients have a massive 4.5x greater risk of cardiac events within three years. An alarming share of the 257 participants had polyethylene (58.4%) or polyvinyl chloride (12.1%) in their plaque, and 20% of those patients experienced heart attack, stroke, or death (vs 7.5% in those without plastics). Cardiac Wire’s deep dive has all the details.

• Evernorth Behavioral Health Group: Cigna’s investor day got its shareholders up to speed on its momentum within pharmacy benefits management and employer health plans, but also included the launch of its new Evernorth Behavioral Health Group. The outpatient behavioral health provider group will launch into select markets where it can guarantee patient-provider matching within 72 days, before expanding nationwide next year. Cigna noted that it’s only focused on employing providers within high growth segments like virtual care, behavioral health, and the home.

• UnitedHealth Cyberattack Update: UnitedHealth Group provided an update on its steps to counter the cyberattack on its Change Healthcare unit, which has halted medical claims processing across much of the US. The company said that electronic prescribing was fully functional on March 8, with revenue cycle functionality expected by March 15 and medical claims connectivity restored March 18. UnitedHealth added that there is no evidence that any other of its systems – such as its enterprise imaging division – have been affected.

• CHS Gets Meds From Cuban: Tennessee-based Community Health Systems is the first provider org to team up with Mark Cuban Cost Plus Drug Company to acquire medications in order to help tackle rising costs and potential shortages. The partnership will start with essential meds like epinephrine and norepinephrine, and just so happens to coincide with MCCPDC opening its own Dallas facility to bring manufacturing in-house. 

• OpenNotes Labs Launch: OpenNotes is wading into the AI waters with the launch of OpenNotes Labs, a new initiative aiming to explore how AI can improve the patient experience through enhancing areas such as provider communication and clinical documentation. While OpenNotes initially made its mark on the industry by drumming up greater transparency in medical records, it hopes that OpenNotes Labs will add to its legacy by steering away from bias in upcoming innovations in clinical documentation, medical records, and patient engagement.

Unlock Revenue Potential in Payor Enrollment

Tune into Medallion’s Webinar on March 21 to delve into the intricacies of managing providers’ CAQH profiles during payor enrollment and learn the best practices to prevent any lapses. They’ll be walking through the end-to-end process, as well as the solutions that can help elevate your credentialing workflow.

The Best Partner for Sustainable Staffing

Delivering the best care requires a partner who understands the current staffing challenges. See how connectRN empowers its partners to deliver sustainable staffing through tools and resources designed to enable the best care possible.

Better Diabetes Management With Glooko

Glooko’s diabetes management platform transforms the way patients connect with their providers, driving better engagement, adherence, and ultimately outcomes. Take a look at Glooko’s latest clinical studies to see how their platform is driving sustained improvements for people with diabetes.