The new platform provides patients with hundreds of videos and more than 8,000 leaflets in 20 languages and at a remedial reading level.
Wolters Kluwer on Tuesday launched an interoperable patient platform that the software vendor says will provide patients with remote access to easily understood healthcare educational content.
The new platform, EmmiEducate™ provides patients with hundreds of videos and more than 8,000 leaflets in 20 languages and at a remedial reading level, so they can better understand their health issues and act accordingly.
In an email exchange with HealthLeaders, Jason Burum, a general manager at Wolters Kluwer, says EmmiEducate is designed to "improve alignment between patients and their care teams."
Ultimately, Burum says, "EmmiEducate will meet health system requirements for patient education while helping to reduce unwanted clinical variability, improving workflow efficiency and empowering patients."
"Unwarranted variability in care is a huge challenge impacting quality and cost, and an important tool in addressing the issue is the harmonization of the education a patient receives with the tools clinicians use to guide their care decisions every day," he says.
"With educational content tailored to a variety of learning and reading styles, and interoperability across disparate systems and access points, EmmiEducate gives providers the ability to easily support their patients' information needs within their workflow, delivering easy-to-understand educational materials that mirror the guidance provided to patients during the clinical encounter."
Burum says the platform allows providers to give patients access to content in several ways, from electronic medical records, from remote access, and from the bedside. As needs expand, Burum says, the platform will expand to include "smart outreach programs," and engagement tracking.
"With the addition of EmmiEducate to our solution set, we believe patients will become more empowered as partners in their healthcare," he says. "With better educated patients, hospitals could expect to see fewer readmissions, visits to the ED, patients better prepared for procedures and more likely to adhere to care plans."
The platform is billed on a "per bed" basis, with a range of pricing if the customer is new or adding EmmiEducate to existing WKL platforms.
Burum says the platform has several integration options to fit organizational capabilities.
"EmmiEducate integrates directly into the EMR, allowing providers to deliver this content more efficiently and making it easier to recommend, preview, and assign content," he says, adding that the platform has a website that allows patients to get health answers 24/7.
Favorable patient responses and new investments in the technology will propel the growth of telehealth in 2021
After a spike at the onset of the coronavirus pandemic, telehealth use has stabilized at levels 38 times higher than before the pandemic.
This strong continued uptake, along with favorable patient responses, and new investments in the technology will propel the growth of telehealth in 2021, according to a report from McKinsey & Co.
Overall telehealth use for office visits and outpatient care was 78 times higher in April 2020 than in February 2020, representing nearly one-third (32%) of office and outpatient visits for the month.
The surge in telehealth use was prompted by the pandemic, the shutdown in in-person visits, an increased willingness by patients and providers to use telehealth, and the availability of federal reimbursements for telehealth.
Since that high-water mark, "utilization levels have largely stabilized, ranging from 13% to 17% across all specialties," McKinsey wrote. "This utilization reflects more than two-thirds of what we anticipated as visits that could be virtualized."
"It would likely require sustained consumer and clinician adoption and accelerated redesign of care pathways to incorporate virtual modalities," the analysis said.
McKinsey identified other causes for the growth in telehealth, including:
Improving provider and consumer attitudes about telehealth since the pre-pandemic era.
Regulatory changes to expand telehealth, such as the expansion of reimbursements for virtual services by the Centers for Medicare & Medicaid Services. However, McKinsey warned that there is growing uncertainty about the status of those reimbursements when the public health emergency expires.
The skyrocketing growth of venture capital investment in digital health, which in 2020 was three times the level seen in 2017.
The ongoing evolution of telehealth care and business models, expanding from virtual urgent care or primary care to a wider range of services that would include hybrid virtual/in-person visits and longitudinal virtual care.
Researchers estimate that transportation-related carbon emissions for outpatient healthcare were cut nearly in half in 2020 as patients stayed home and flocked to telehealth.
The surge in the use of telehealth in 2020 saw a corresponding and dramatic drop in greenhouse gasses created by patients otherwise traveling to ambulatory care venues, a new study shows.
"The rapid and widespread adoption of telehealth during the COVID-19 pandemic has had significant environmental health benefits, primarily through reduction in transportation-associated emissions," the study authors wrote.
"If the US healthcare system were to maintain or expand upon current levels of telehealth utilization, additional reductions in GHG emissions would potentially be achieved through impacts on practice design. Ambulatory visit carbon intensity would be an effective way to measure these changes," the researchers wrote.
The study –- published in the August issue of The Journal of Climate Change and Health -- estimates that greenhouse gas emissions had been steadily rising from an estimated 18,473 tons of carbon emissions in 2015 to 19,569 tons in 2019, before falling off a cliff in 2020, dropping to 10,537 tons during the pandemic.
Another metric, the carbon-intensity of outpatient visits, was cut in half over the five years examined, a decreased from 8 kg CO2-eq per visit in 2015 to 4 kg CO2-eq in 2020. While the carbon-intensity was falling from 2015 to 2019, it saw its biggest decline in 2020.
"At the same time, telehealth visits had been growing quickly, at 39.3% per year through 2019, and then jumped in 2020 by 108.5%, for an overall increase of 669.6% or 53.2% per year during 2015–2020," the study noted.
The retrospective review relied on outpatient data from more than 600,000 patients at an unnamed health system in the Pacific Northwest. The researchers calculated average distance traveled to the care venue – 17.4 miles -- and calculated the transportation-related GHG emissions generated by an estimated 194 million automobile miles, 2.1 million bus miles, and 2.1 million bicycle miles traveled by patients for in-person visits in 2015–2020.
From 2015 to 2020, the health system saw 15.6 million total outpatient visits increased at 3.2% annually, to 2.7 million. Telehealth visits increased by an average of 53.2% annually while in-person visits saw modest gains of 1.5% annually until 2020, when they declined 46.2%.
"In-person outpatient visits had been increasing at 1.5% per year through 2019, only to decline by 46.2% in 2020 during the COVID-19 pandemic, yielding an overall decline during the study period of 43.0% (8.1% per year)," the study said.
The study authors said their results "likely underestimates emissions reductions."
"We did not account for decreased commuting by healthcare providers conducting telehealth visits from home," they wrote. "Furthermore, the environmental benefit of telehealth may not be limited to reductions in transportation-associated emissions if increased virtual care permits healthcare systems to care for more patients without increasing outpatient clinic space."
In the first six months of 2021, total revenue was the second highest in recent years at $17.2 billion with 27 transactions.
Health systems continue to see solid revenues even as they shift from acquiring smaller, independent hospitals and instead form regional partnerships, a new analysis from Kaufman Hall shows.
In the first six months of 2021, total revenue was the second highest in recent years at $17.2 billion with 27 transactions. In 2020, revenue for the same span was $17 billion with 43 transactions.
"For health systems, partnerships focused on resource sharing within a defined geography proved valuable during the heights of the COVID-19 pandemic," KH said. "Strong regional market presence allowed health systems to partner with health plans and local employers by offering the necessary scale for population-health-focused initiatives. By partnering with well-established organizations, health systems can preserve and leverage local knowledge within a newly combined organization."
Deal activity for Q2 2021 was below pre-pandemic averages with 14 announced transactions, though this was consistent with Q2, 2020 levels. KH said the fewer deals were offset by a high number of transactions with seller revenues above $500 million, including one "mega-merger" involving Spectrum Health and Beaumont Health, with combined annual revenues of more than $1 billion.
Many of the deals in Q2 2021 were concentrated in the Southeast, with Georgia reporting three deals involving eight hospitals and about $11.5 billion in transaction revenues.
In addition to the Spectrum / Beaumont proposed merger, other significant deals in Q2 included:
Tenet Healthcare's planned sale of five hospitals in south Florida's Miami-Dade and Broward Counties to Steward Healthcare System.
Piedmont Healthcare's planned acquisition of four Georgia hospitals from HCA Healthcare; in a separate announcement, University Healthcare System in Augusta, Ga. Said it would join Piedmont Health.
HCA's planned sale of a fifth north Georgia hospital—Redmond Regional Medical Center in Rome, Ga.—to Florida-based AdventHealth.
Rush Health Systems' plan to merge with Louisiana-based Ochsner Health.
The Medical University of South Carolina's plan to purchase three hospitals in Richland County and adjacent Kershaw County from LifePoint Health.
The executive order targets four areas "where lack of competition in healthcare increases prices and reduces access to quality care" -- hospital and health insurance consolidation, high drug prices, and hearing aids.
President Joseph. R. Biden's sweeping executive order to promote competition across a broad range of industries also puts high drug prices, and consolidations of healthcare providers and payers in the crosshairs.
The executive order, signed by Biden on Friday, establishes a broad, multi-departmental "whole-of-government effort to promote competition in the American economy," and includes 72 initiatives by more than a dozen federal agencies.
For the healthcare sector, the order targets four areas "where lack of competition in healthcare increases prices and reduces access to quality care" -- hospital consolidation, health insurance consolidation, high drug prices, and hearing aids.
Hospitals
"Hospital consolidation has left many areas, especially rural communities, without good options for convenient and affordable healthcare service," the administration said. "Thanks to unchecked mergers, the ten largest healthcare systems now control a quarter of the market. Since 2010, 139 rural hospitals have shuttered, including a high of 19 last year, in the middle of a healthcare crisis. Research shows that hospitals in consolidated markets charge far higher prices than hospitals in markets with several competitors."
Claiming that "hospital mergers can be harmful to patients, Biden's order "encourages" the Department of Justice and the Federal Trade Commission to review and revise merger guidelines to ensure that patients aren't harmed.
The order also directs the Department of Health and Human Services to support hospital price transparency rules and to quickly implement federal legislation that address surprise medical bills.
Health Insurance
Biden's order notes that "consolidation in the health insurance industry has meant that many consumers have little choice when it comes to selecting insurers. And even when there is some choice, comparison shopping is hard because plans offered on the exchanges are complicated—with different services covered or different deductibles."
Biden has ordered the Department of Health and Human Services to "standardize plan options in the National Health Insurance Marketplace so people can comparison shop more easily."
Prescription Drugs
The order notes that Americans pay more than 2.5 times as much for the same prescription drugs as peer countries, and sometimes much more.
"Price increases continue to far surpass inflation. As a result, nearly one in four Americans report difficulties paying for medication, and nearly one in three Americans report not taking their medications as prescribed," the order said. "These high prices are in part the result of lack of competition among drug manufacturers. The largest pharmaceutical companies are able to wield their market power to reap average annual profits of 15-20%, as compared to average annual profits of 4-9% for the largest non-drug companies."
The administration accused drug makers of using "pay for delay" ploys -- in which brand-name drug manufacturers pay generic manufacturers to stay out of the market – to stifle competition.
"That has raised drug prices by $3.5 billion per year, and research also shows that “pay for delay” and similar deals between generic and brand name manufacturers reduce innovation—reducing new drug trials and R&D expenditures," the administration said.
Biden has ordered the Food and Drug Administration to work with states and tribes to safely import prescription drugs from Canada, pursuant to the Medicare Modernization Act of 2003.
The order also directs HHS to increase support for generic and biosimilar drugs, and issue a comprehensive plan within 45 days to combat high drug prices and price gouging.
The order also "encourages" the FTC to ban “pay for delay” and similar agreements.
Hearing Aids
The order notes that hearing aids cost $5,000 a pair, on average, and that only 14% of the 48 million Americans with hearing loss use them, often because those costs are not covered by health insurance.
"A major driver of the expense is that consumers must get them from a doctor or a specialist, even though experts agree that medical evaluation is not necessary," the order states. "Rather, this requirement serves only as red tape and a barrier to more companies selling hearing aids. The four largest hearing aid manufacturers now control 84% of the market."
Congress in 2017 passed a bipartisan act to allow hearing aids to be sold over the counter, but the Trump Administration's FDA never issued the necessary rules.
Biden's order directs HHS to consider issuing proposed rules within 120 days for allowing hearing aids to be sold over the counter.
The partners say their collaboration addresses Michigan employers' concerns about rising healthcare costs and barriers to care quality.
Everside Health and Michigan State University Health Care have created a partnership to provide employer-sponsored plans with access to direct and virtual primary care across the state.
Under the model, employers and other plan sponsors pay a fixed cost per employee for nearly 24/7 unlimited access to primary care providers. MSU and Everside say their model is not a replacement for employer-sponsored insurance, but rather a complementary wellness program.
Patients will have low- or no-cost access to physicians and 24/7 virtual care, reducing the need for costly ER use. Everside says that employers using its care model save 20% on average in claims costs each year because the model proactively treats health problems before they become dire and require care at more expensive venues such as urgent care clinics and emergency departments.
This affiliation marks the first time that Denver-based Everside has partnered with a medical school.
Seth Ciabotti, CEO for East Lansing-based MSU Health Care, called the affiliation "another example of working with like-minded organizations to fulfill our mission to improve the health of all communities in Michigan."
"The pandemic highlighted the need for every individual to have a medical home supported by a robust relationship with a primary care team for maintaining health," Ciabotti said. "Telehealth visits proved to be a viable delivery mechanism for increasing access to healthcare in rural and underserved areas in Michigan."
Everside CEO Chris Miller said that, until the affiliation with MSU Health Care, employers in Michigan had few healthcare delivery options. "They had to rely on solutions created by large insurance companies or health systems," he said.
"Our new partnership with MSU Health Care is designed to change the status quo in employers' favor by bringing together our proven direct primary care model and advanced technology with MSU's strong innovation and research capabilities," Miller said. "The result is expected to be measurable cost savings with improved access to quality care."
In a retrospective cohort study published this week in Annals of Internal Medicine, NIH researchers examined the records on 144,116 hospitalized patients cared for in 558 hospitals to see how COVID-19 surges affected patient outcomes.
The researchers devised a "unique surge index" that measured the strain on hospitals each month from COVID in relation to bed capacity and found that clusters of high–surge index hospitals experienced 2-fold greater mortality than in hospitals not experiencing surges.
The metric showed that nearly 1 in every 4 deaths and almost 6,000 total deaths may have been attributable to hospital strain due to COVID-19.
"These system perturbations have significant consequences for those who provide clinical care," corresponding author Vineet Chopra, MD, a hospitalist at Michigan Medicine, wrote in an accompanying editorial.
"First of all, providers are marshaled to deal with an adversary they know little about. They are then asked to do so in unfamiliar areas of the building, with people they may never have worked with before," he wrote.
"On top of this, new processes for critical clinical decisions, such as when to test for COVID-19, how to treat, when to intubate, or how to manage cardiac arrests, are introduced. As hospitals swell with cases and these rapid changes unfold, what happens to patients needing care for COVID-19?"
The findings come as healthcare providers grapple with the burgeoning global threat of a surging COVID-19 delta variant.
The authors suggest that many COVID-related deaths could be prevented with smart, coordinated regional public health strategies and health system interventions.
Chopra said an emphasis on bolstering staff is also critical because burnout and stress related to the pandemic are prompting many clinicians to leave the field.
"The findings are sobering and provide several lessons," Chopra wrote. "First, we learn that clusters of high–surge index hospitals not only existed but varied across geography and time."
"Second, we witness the effect of therapeutics in the form of decreasing ICU admissions and mechanical ventilation rates."
"Third, we comprehend how detrimental COVID-19 surges were to clinical outcomes: After risk adjustment, patients cared for in the highest surge strata experienced 2-fold greater mortality than in hospitals not experiencing surges."
The healthcare sector has lost 537,000 jobs since the start of the pandemic in February 2020.
The healthcare sector lost 12,000 jobs in June, with hospitals recording a third straight month of job losses, preliminary federal data show.
Hospitals lost 5,500 jobs, and nursing homes lost 9,600 jobs in June. Those losses were slightly offset by 2,900 new jobs in ambulatory services, the Bureau of Labor Statistics reported on Friday.
After seeing modest gains at the start of 2021, hospitals have recorded 10,200 job losses since April.
The healthcare sector has shed 537,000 jobs since the start of the pandemic in February 2020, with hospitals accounting for 102,000 job losses, and nursing homes accounting for 360,000 job losses. Ambulatory services sector has grown 75,400 jobs in that span. There were 15.9 million people attached to the healthcare sector workforce in June, BLS said.
The BLS report accounts for employment in mid-June and can be subject to considerable revision.
The larger economy saw solid job growth in June, with 850,000 new jobs created. Nonfarm payroll employment is up by 15.6 million since April 2020 but down by 6.8 million, or 4.4%, from its pre-pandemic level in February 2020.
"These measures are down considerably from their recent highs in April 2020 but remain well above their levels prior to the coronavirus pandemic, 3.5% and 5.7 million, respectively, in February 2020," BLS said.
Most of those jobs (343,000) were in the leisure and hospitality sector, with restaurant jobs (194,000) accounting for more than half that total. Those totals are down 2.2 million (13%) from February 2020. State and local government hirings rebounded as well, with 155,000 new jobs reported, as school systems across the nation rehire teachers.
The nation's unemployment rate remained largely unchanged at 5.8% in June, as did the number of jobless people, at 9.5 million.
The Requirements Related to Surprise Billing; Part I , set to take effect on January 1, 2022, is the first in a series of rules to protect patients from healthcare-related financial hardships.
The federal government on Thursday unveiled the first in a series of new rules designed to protect patients from financial hardship due to surprise medical bills and balance billing.
"No patient should forgo care for fear of surprise billing," Health and Human Services Secretary Xavier Becerra said in a media release announcing Requirements Related to Surprise Billing; Part I.
"Health insurance should offer patients peace of mind that they won't be saddled with unexpected costs," Becerra said.
The interim final rule will take effect for providers on January 1, 2022, and on or after that date for commercial plans or contract years. It will restrict excessive out-of-pocket costs to consumers from out-of-network billing and balance billing, which is already banned by Medicare and Medicaid. The interim rule extends those protections to people insured through employer-sponsored and commercial health plans.
Bans surprise billing for emergency services, regardless of where they are provided. Those services must be billed on an in-network basis without requirements for prior authorization.
Bans high out-of-network cost-sharing for emergency and non-emergency services. Patient cost-sharing, such as co-insurance or a deductible, cannot be higher than if such services were provided by an in-network doctor, and any coinsurance or deductible must be based on in-network provider rates.
Bans out-of-network charges for ancillary care (such as anesthesiology or an assistant surgeon) at an in-network facility in all circumstances.
Bans other out-of-network charges without advance notice.
Requires providers and hospitals to give patients a plain-language consumer notice explaining that patient consent is required to receive care on an out-of-network basis before that provider can bill at the higher out-of-network rate.
The interim rule was implemented under the bipartisan No Surprises Act, a provision of the Consolidated Appropriations Act, 2021. HHS, the Department of Labor, Treasury, and the Office of Personnel Management cowrote the interim rule.
Surprise billing is rampant, and patient advocates have been howling for years for the federal government to take action. It's one of the few issues in Congress that Democrats and Republicans can agree upon.
Two-thirds of bankruptcies are caused by outstanding medical debt. Research has shown that one-in-six emergency department visits and inpatient hospital stays include care from at least one out-of-network provider.
A 2019 study by the Government Accountability Office found that air ambulance providers charged anywhere from $36,400 to more than $40,000, with 70% of these transports furnished out-of-network and most or all of the cost falling on patients.
Biden administration officials say such egregious practices are why the rules are needed.
"No one should ever be threatened with financial ruin simply for seeking needed medical care," said Secretary of Labor Marty Walsh. "Today's interim final rule is a major step in implementing the bipartisan No Surprises Act that will protect Americans from exorbitant health costs for unknowingly receiving care from out-of-network providers."
Written comments must be received within 60 days after the rule is published in the Federal Register.
Hospitals are voicing their opposition to the use of sequestration cuts and unspent COVID-19 provider relief funds to help pay for the plan.
The nation's biggest hospital associations are raising objections to the newly released $1.2 trillion Bipartisan Infrastructure Framework after learning that it would be partially paid for with continued sequestration cuts and unspent money from the COVID-19 provider relief funds.
In a one-page letter sent Tuesday to Senate Majority Leader Chuck Schumer, D-NY, and Minority Leader Mitch McConnell, R-KY, the American Hospital Association and eight other stakeholder associations said they supported improving "core infrastructure needs" that would allow providers to better serve their communities.
"However, we are opposed to the use of an extension of mandatory sequestration, as well as unspent COVID-19 provider relief funds, as financing sources for any infrastructure package," the letter said.
Sequestration Cuts
As part of the relief package put forward in April 2020, Congress suspended until the end of 2021 Medicare's reviled 2% across-the-board sequestration cuts that were supposed to take effect on April 1, 2020. Now, some lawmakers are looking at the cuts as a potential source of infrastructure funding.
"Congress recognized that hospitals and health systems needed relief from Medicare cuts during the pandemic and we appreciate the recently provided delay through the end of this year in the two percent mandatory reductions," the letter said.
"Unfortunately, the Bipartisan Infrastructure Framework lists a continuation of mandatory sequestration as an offset for the infrastructure agreement. Medicare funds should not be used to pay for roads and bridges. We cannot sustain additional cuts to the Medicare program."
COVID Relief Funds Tapped
The Bipartisan Infrastructure Framework identifies unused COVID relief money as a possible funding source.
But hospitals said syphoning away COVID relief money would harm health systems that "are still recovering from the impact of the pandemic, and unfortunately caseloads have increased in some areas of the country due to new virus variants and a lack of vaccinations."
"As you know, hospitals and health systems and other healthcare providers are awaiting the distribution of additional dollars in Provider Relief Funds as well as the recently allocated $8.5 billion for rural healthcare providers," the letter said.
"We would ask that none of these COVID-19 healthcare relief funds be used for the purpose of funding an infrastructure package, given the ongoing need for healthcare providers to offer assistance to their patients and communities."
The letter was cosigned by the AHA, America's Essential Hospitals, Association of American Medical Colleges, Catholic Health Association of the United States, Children's Hospital Association, Federation of American Hospitals, National Association for Behavioral Healthcare, Premier healthcare alliance, and Vizient, Inc.
