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Exploring the State of the Union with a lens of Health IT.


 Today looking at the State of the Union address, seeing if there's any implications to health it.

 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.

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  All right, we're gonna take a look at the State of the Union address. There's 10 healthcare takeaways according to Becker's, and we're gonna see if there's any health it implications for those things. Anytime we talk about things like this, political things, , state of the Union addresses comments from a president or a party, those kind of things.

, I'm reminded that I have to preface this by. , I don't find politics to be a good lens to view things through, especially as a healthcare leader. And the reason is I'm not trying to protect somebody else's interests. I'm not trying to, , see things through my party's interests or my beliefs interests.

I'm trying to look at them through healthcare's interests and say, is there any impact to healthcare and healthcare? It. In my system. And so I'm gonna be doing this as if I were a CIO and not a political pundit. So, , that is going to be my objective. We'll see if I can succeed here. So February 7th, Joe Biden expressed optimism while highlighting efforts related to Covid 19 Medicare and Affordable Care Act.

Let me just go to the 10 things. So Covid 19 today, COVID 19. It no longer controls our. , he reported that Covid 19 deaths are down 90% and the administration will sue and end the public health emergency. , we knew this, we already reported on this, that, , public health emergency will come to an end. I think it's in May, , which is in line with what the president said a while back.

With regard to giving healthcare 90 days notice. So we should, , know that we should be planning for that. We should understand what that means in terms of reimbursements, in terms of, , special situations and those kind of things. Keep in mind that some of the stuff that was only enabled through the public health emergency has since been backed up by some additional.

Legislation and, , funding. So, , bring all those things together. Most large health systems have somebody who is keeping an eye on the various, , regulatory, , laws and policies and whatnot. So, , that should be top of mind for us. Number two, prescription drug costs. President Biden said the US pays more for prescription drugs than any other major country on Earth using insulin costs.

To illustrate the point, it's a bad case. I wouldn't use insulin, , I mean, it's the case is accurate. Insulin's not because Civic RX and others are producing, , alternatives that are much lowering. And so the cost he's talking about here essentially are the Civica costs and the other, , players , he goes on out-of-pocket drug costs for seniors.

This is a better example. Out of pocket drug costs for seniors on Medicare have also been capped at $2,000 per year. If drug costs rise faster than inflation, drug companies will have to pay Medicare back. The difference, okay, so. , if I were a, , pharmaceutical company, if I were a, , pharmacy of some kind, if I operated a large pharmacy, I'd worry about this.

But as a cio. I'd be looking for transparency to the clinician, first and foremost to the patient. , also, but to the clinician because when the clinician is.

, prescribing a drug, them knowing the cost and having a conversation with the patient to make sure that it aligns if there's an alternative that is as effective and less cost, that would be a service that we could offer to those patients. Number three, cancer Moonshot. President Biden highlighted the Cancer Moonshot Initiative, , which was reignited last year with the goal of cutting cancer death rates by at least 50% in the next 25 years.

, turn more cancer cancers from death sentences to treatable diseases. Provide more support for patients and their families. He said during the speech. , fantastic. That's great. I'm not sure it impacts us today. But, , if we were an academic medical center and , I'm sure that this means if there's a cancer moonshot out there, means that there are funds available from the federal government for research, and I'm sure your people are all over that.

, number four, affordable Care Act a record. 16 million people are enrolled in ACA plans. President Biden said millions are saving $800 a year on the premiums under the Inflation Reduction Act. Although the benefits expire after 2025. once more. He urged lawmakers to finish the job and expand coverage to those left off Medicaid.

, and this is something we have to keep an eye. , , very closely with the end of the public health emergency, the number of people , dropping either into Medicaid or off of Medicaid. As a result of that, , we have to keep an eye on our payer mix that leads to profitability or loss for a health system.

And we have to understand what the ramifications of all this shakeup is going to be. , and so, Again, I wouldn't rely on the federal government to be doing anything quickly, , given the polarization of the views on this, and so I would say just project out what it's going to look like and be ready to adjust to either more Medicaid patients.

Medicare is pretty constant, right? It's, it's growing at the rate, it's growing. Medicare advantage is growing faster anyway. You have to understand the economics of each one of those. And then commercial payers, you have to understand, , the mix. You have to underst. The implication on your health system and where that's leading.

Hopefully you have a phenomenal CFO who is helping you with that stuff and helping you understand that. If not, the COO and CEO should be all over that. , but as a CIO should understand it. Medicare President Biden said he would not cut any Medicare or Medicaid, our Medicare or social Security benefits, and he would strike down any law that tries to do so.

I don't know what that's about. , there is no law proposing, or there's nobody who would ever touch that third rail of saying cutting Social Security or Medicare. So I'm sure there's some nuance to that. That's, , not something that we would, , have to worry about because it's, it's just a non-starter opioid addiction.

This is huge. President Biden discussed efforts to tackle the opioid and overdose epidemic, including disrupting in the trafficking, distribution, and sale of fentanyl. Customs and Border Protections in the last year has seized 260,000 pounds of illicit drugs, primarily at ports of entry in the US border, including about 15,000 pounds of fentanyl according to the White House.

As part of the continued efforts, the administration plans to provide 123 new large scale scanners. At Land Point, so forth and so on. I'm not sure that impacts our hosp. I mean, it clearly, it impacts our hospitals. These people are showing up in our ERs and whatnot, so I'm not saying that correctly. , but the whole idea of the borders and that kind of stuff, that's, that's outside of our purview per se.

, I think if I were looking at the opioid addiction, , again, we've covered this with Chime and some, , some people who are on the opioid tax task force. There's a bunch of things we can. From a prescribing standpoint, there's a bunch of things we can do from a, , mental health standpoint. And so that's the direction.

If I hear this, the the borders thing, that's a political and they have to deal with that. I can't, I can't do anything about the borders and the amount of fentanyl coming into the country, but I can serve the community that we have in front of us and try to determine what's the best way to make sure that we minimize or, , eliminate.

The deaths from opioid in our community. , clearly a huge issue and something that should be top of mind for any Chief Medical officer and, , population health officer. , number seven, reproductive and L G B T Q care. Make no mistake, president Biden said if Congress passes a national abortion ban, I will veto it.

Yeah, that's rhetoric. That'll never happen. J just think about it, right? You have a split Congress. There's no way that a national abortion band is going to be passed by Congress, let alone get onto the president's desk. So that is completely rhetoric and it's designed to fire up the base. And if I had to think about what the ramifications, there's no ramifications for that statement . However, I would say the message is pretty clear. You have to take care of the people in your community, especially those who are disenfranchised or, , in some way, , marginalized in your communities.

. , nursing homes in October, the Biden administration announced more aggressive measures to increase accountability in nursing homes, including higher safety standards, minimum minimum staffing requirements, and incentivize quality performance through Medicare and Medicaid funding, as well as higher penalties for low performing nursing homes.

Fail to improve by CMS standards. , again, good move. If you're partnered with any nursing homes, if you happen to own any nursing homes, this is going to be a top of mind issue. Something that you have to, , take into account. I'd be looking at certain technologies in the nursing homes that I think would, , provide a higher level of efficiency, better service.

, I think that technology adoption amongst the, the aging population and the senior popul. It's going to be crucial and, , it does offer some efficiencies that we should be, , examining. Number nine, surprise medical bills. , to me this is the bane of our existence. , the no surprise act. A bipartisan law passed in late 2020 during the Trump administration took effect January 1st, 2022.

It protects patients from out of network bills for emergency care and other services. We're already preventing insurance. from spending, sending surprise medical bills, stopping 1 million surprise bills a month. President Biden said, , yeah, absolutely. In fact, if I were a health system today, I would look at this specifically.

I would look at our contribution to this problem of surprise medical bills and seeing what we can do around that. And then number 10, research advancements present by and touted, , research advancements for multiple diseases, Alzheimer's, diabetes, hiv. And a, , phenomenal great work. Appreciate the government funding that kind of.

And, , helping us to move closer to, , really that, that realization of advanced medicine, , genomics and other things to really attack these diseases, , where they start. So again, , you know, I look at these things. I try not to look through a political lens. It's, it's really hard at times because they're such political speeches, but with that being, , COVID 19 Public health Emergency.

Just understanding that prescription drugs, , understanding, again, transparency at the , at the bedside and at the, the point of prescription. And for patients understanding what the cost of drugs are and giving them options. Cancer, moose shot, knowing where the, money's gonna be, and, , making sure that your health system is lined up to get some of that funding, which I'm sure they're all over.

Affordable Care Act. Understanding the. That is happening today, and that will happen after the public health emergency , goes away, is going to be important. , Medicare, nobody's touching Medicare. , but , You know, again, goes back to that paramix understanding, your Medicare, your commercial, your Medicaid, and your uninsured , population, and how to best care for them.

Opioid addiction. Again, I point you to chime in the opioid task force. I've done great work on, , our. Prescribing of opioids and how that, , can be, , monitored and changed within our health system as well as, , some of the other resources they have around, , mental health and other things, , reproductive and lgbtq.

I don't go specifically to those things as they're, I I think it's, again, that's a political topic. We'll let them deal with it on the politics. But, , in terms of caring for the people in your community and especially those that are disenfranchised and require special needs, that is something that we are called to as a health system.

Nursing homes, again, look, look to, , , increase standards, which is absolutely necessary. , look to technology. And how can technology alleviate that surprise medical bills? , again, , look at the way we. Contribute to that problem, make sure our health system isn't contributing to that problem in any way.

We can, , reduce that. I mean, again, healthcare is one of the biggest causes of personal bankruptcies in our country. And that is a stain , on our industry and then research advancements. Absolutely, let's keep moving towards precision medicine and all the omics and, , let's, let's eradicate some of these diseases would be fantastic. So hopefully I did not offend. By trying to go through this, but I think it's important to look at these things and try to determine what the impact it's going to be on our healthcare system.

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