📍 today in health, it bite administration to end COVID-19 public health emergency in may. What does that mean for your health system?  My name is bill Russell. I'm a former CIO for a 16 hospital system and create, or this week health, a set of channels dedicated to keeping health it staff current. And engaged. We want to thank our show sponsors. We're investing in developing the next generation of health leaders, short test and artist site two great companies. Check them out at this week. health.com/today. Having a child with cancer is one of the most painful and difficult situations a family can face.

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 All right. We knew this day was coming. And it is upon us. So let's go ahead and see what the Becker's hospital review. This article. I'm going to start with. By the administration to an COVID-19 public health emergency in may, the Biden administration has informed Congress, blah, blah, blah. And in may, May 11th actually signaling and end of the pandemic crisis, era and unwinding.

, federal flexibilities that reshaped the nation's healthcare system, and that's going to be the key for us federal flexibilities. And what does that mean with those going away? At present, the administration's plan is to extend the emergency declaration to May 11th and then, and both emergencies on that date.

The office of management and budget said in a January 30th statement, this wind down would align with the administration's previous commitments to give at least 60 days notice prior to the termination of the PAG. Which is great. , but we knew this day was coming. It's not a huge surprise that it is here.

, over the last few years, the PAG has played a significant role in the influence of national healthcare policy. A reformed tele-health and expanded who can use it fast track approvals of COVID-19 vaccines and treatments and preserved healthcare coverage for millions of Medicaid, beneficiaries nationwide.

HHS has renewed the PHG every 90 days since January of 2020, with the most recent renewal declared on January 11th. So telehealth is one of those things. That's going to be interesting and we'll come back to that. And, , and I think. We'll talk about some of the other things, but for the most part, it's going to be about reimbursements. It's going to be about, it's going to be about the flow funds essentially.

To the health system from the lens of the provider, that's the lens we're looking at right now. All right. It goes on. Those states could not disenroll people from Medicaid during the PAG Congress passed a $1.7 trillion omnibus spending bill. In December that detached the federal policy from Medicaid, redeterminations starting April 1st.

States we'll begin re determining who is and is not eligible for Medicaid. A process that could leave up to 18 million people without health coverage. Over the span of about a year. The spending bill also extends Medicare tele-health flexibilities through 2024. Which previously would have ended 151 days after the PhD expired. Okay.

So this is going, the tele-health reimbursements are going through 2024. I think this is one of the biggest benefits. Or silver line, I should say benefits. Silver linings of the pandemic is we now have a plethora of data on tele-health. What worked, what didn't work. What caused fraud, what didn't cause fraud. So now we're not dealing in the hypothetical anymore. We're dealing in the actual.

We can actually look at data. This is my, my ran for 2023. I believe. , we can actually look at data. Where does telehealth work? Where does it increase access? Where does it reduce costs? Where does it provide a better experience for the clinicians? We have a ton of data. From 2020 to 2024, we expanded telehealth and its use.

, with, with reimbursements. , that essentially gave us a, a runway. To see what could work and what couldn't work now. Here's my guests. The omnibus spending bill goes through 2024 for. , For the tele-health flexibilities, but my guess is that'll be revisited and looked at when we get closer to that 24, 24 timeline, if not shame on us, we should look at it and see, you know, what's working what didn't work, where should we continue funding?

Where should we draw funding? Because it does not have any added value. I think we were lazy when we just look at it as tele-health and say, well, telehealth should be funded. Tele-health it's a huge category. Covering a lot of different technologies, a lot of different, , access methods, processes, telephone.

Video. , doctor to doctor consults, you name it tele-health covers eight, a myriad. I have different approaches to delivering care. And so you can't talk about it with, with one big brush and say tele-health should be extended and funded. You have to actually step back and look at each one of those things.

Break it out and say, where did it help? Where did it not help? Right. Sideway spending bill extends Medicare tele-health flexibilities through 2024, which previously would have ended. We talked about that acute hospital care at home waivers and flexibilities were also extended for two years through 2024. Similar to tele-health. The deadline for hospital at home waivers was tied to the status of the PHC.

When the 250 hospitals have been approved by CMS to participate in the acute hospital care at home program. And I think, I think this is the wave of the future. Actually, I believe this is how CMS plans to continue to drive costs out of the equation. Now, clearly not every home is appropriate for acute hospital care, but.

There for those where it does make sense. It does drive the cost down a little bit, , plus is a significant satisfier. COVID-19 tests and vaccines were covered for most Americans at no cost during the PAG. But the federal federal government has planned to shift much of these costs to the commercial market in 2023. Once the PHG ends, Medicare enrollees will generally face.

Out of pocket costs for at home tests and treatments, but vaccines would largely remain free to those with Medicare Medicaid. And commercial insurance, Medicaid programs will still cover physician ordered tests. But treatments will incur a fee. Commercially insured individuals can receive free treatments until federal supplies.

Run out. And I'm not sure when that would be. I remember at the beginning they ordered eight ton. So, I don't know. , I don't know what the shelf life is and I don't know what that number is going to be. Commercialization would also leave the over 26 million uninsured individuals in the U S with major disadvantages in accessing free vaccines and treatments, maternity and Pfizer have floated commercial vaccine prices of up to $130 per dose.

Mm. , The PhD is termination will also mean states at which by the way just means those 26 million people will not seek out the vaccine. The PhD is termination will also mean states will no longer be required to report COVID-19 data to the CDC. A senior official with the Biden administration told ABC news that the CDC.

We'll be reaching out over the next few months to urge them to continue sharing. Data voluntarily, so they won't be compelled to, but they can voluntarily. And I'm not sure why they would. I mean, we've set up the mechanisms. It's just, , you know, it's just maintaining those pipes. As long as the CDC doesn't change the backend.

To dramatically. And the pipes were built correctly upfront, and they're not brittle. , there's no reason why we shouldn't continue to share that data. Alright, it goes on news of the declarations tentative and comes as flu COVID-19 and respiratory. , virus, which have strain hospitals for months appear to have peaked in September. President Joe Biden declared the pandemic over. I made a decline in cases.

, in case totals and deaths, it's been a heavy flu season and a significant time for other illnesses, chip Khan, president and CEO of Federation of American hospitals. Told Beckers on January 11th. I do think we're fast approaching a point where there will be heightened. COVID-19 surges, but this will be part of the routine.

It's becoming integrated with hospital activity, especially with the drugs, treatments knowledge at this point. On January 30 30th, the world health organization determined COVID-19 remains. A public health emergency while also acknowledging the pandemic is probably at a transition point. The WHS emergency committee.

Recommended the agency work with stakeholders on a proposal for how to maintain focus on COVID-19 once its emergency declaration. Is terminated. , none of this is a surprise by the way. In 2020, we looked at previous pandemics. And, , countries all around the world, pandemics, obviously around the world.

And most of them had a life span of about three years. They were horrific. But they lasted roughly about three years now. , we didn't know what we didn't know about COVID but essentially just looking historically, we were saying three years, develop antibodies, get through this vaccinations, vaccines and whatnot.

, we felt like this was the timeline. So I say all that, not to get political, but to say. From a technology standpoint, because this podcast is about the intersection of technology and healthcare. We knew this day was coming. Okay, so it should not come as a surprise to us. That things are gonna change around the reimbursements.

And things are gonna change around, , you know, data being shared. Things are gonna change, , you know, around tele-health and its practices and whatnot. I've viewed the three years as a massive paid. , test of tele-health. , it was a pilot of tele-health. If you will. Now we had piloted tele-health across the health systems prior to this.

But it was an opportunity to really scale it. Really scale it up, see how it works. And now I think from a health system perspective, you will keep an eye on how CMS is going to fund this as well as the commercial payers. What are they going to fund? Whether or not you always have to keep an eye on that.

Because you have to deliver surfaces that are going to be funded. But on the flip side, we should have our own data at this point. What did drive access up? What did drive costs down? We should have some of that data. And if we don't have that data, we should, we, we do have that data it's in there somewhere, and we should be extracting that data and trying to determine what delivered value for our community, what delivered value for our physicians, what delivered value for our patients and determine what that value is.

And is that value worth continuing those programs that aren't directly funded.

Because potentially that is the case. That is what we need the data for. And that's what is what we should. Use the data for a, as far as the hospital at home initiatives, that's going to continue to grow. The costs of growing out and maintaining these campuses. These acute care campuses is, , is too high.

It's too high for the cost of healthcare that can be passed along. To the patient. And so we have to continue to seek alternative. Venues of care. That are going to drive down the overall cost of delivering care. To our communities and to our country. Right. The, the amount of healthcare dollars going to GDP is untenable.

Now we can, we can talk about all the reasons and all the inefficiencies that exist that are driving that. And if, , You know, if you want to know more about that,

What I would suggest is you go subscribe to a healthcare Z and get your healthcare. Finance education from Dr. Eric Bricker. He does a phenomenal job. And breaking this down. Where are the inefficiencies? Where are the just flat out? Things that make you scratch your head and go. Why the heck does that exist?

, I know people think it's just an easy fix. Just, just, you know, if we only went to this one thing, all of healthcare in the United States would be good. , and then they compare us to these other countries, which are, you know, a quarter of our size, if not a 10th of our size. And they say, well, if, if it works for them, it'll work for us. Well, that, that may be true. It may. , but there's an awful lot of inefficiencies, middlemen and other.

, just downright odd things within our health system and how things are paid for and whatnot. That really need to be looked at really need to be addressed. And, , Dr. Brooker does a good job of breaking that stuff down. So from a healthcare it perspective. If I were a CIO today, I would have the data.

I would have extracted the data all along the way. And if I haven't. Alrighty. I would be doing it right now. I'd be doing it in partnership with our CMO. And our CMIO and saying, okay. What does this mean? What is not going to get funded moving forward in the future? Do we want to discontinue that work or do we want to continue that work?

And let's base it on the data. Let's look at the data, let's give the data to the executive team so that they can make. Good decisions around that. ,  

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