This Week Health

The Public Health Emergency has been extended. Take a deep breath. But what happens when it ends? Today we explore.

Transcript

Today in health, it, what does it look like if the federal health emergency and my name's bill Russell, I'm a former CIO for a 16 hospital system. And creative this week health, a set of channels dedicated to keeping health it staff current and engaged. We want to thank our show sponsors or investing in developing the next generation of health leaders, Gordian dynamics, Quill health towel, site nuance, Caden medical, and Kern health.

Check them out at this week. health.com/today. All right, following up on yesterday's show. , from time to time, it's important to determine what you believe in what is going to happen next. And so we go to an article from yesterday, this from Becker's as well. , COVID-19 public health emergency set to be extended. HHS is set to extend the COVID-19 public health emergency past mid July Bloomberg reported on May 16th.

And it goes on to talk more and more about that. , it doesn't really have anything beyond that. To be honest with you, it just says, Hey, we think it's going to be continued. , there's no indication that it's going to be stopped. So forth and so on. And it got me to thinking, what does this mean for us? And if I were going to create an I believe statement, what would my, I believe statements be.

And so I did a little research on the, on the internet and tried to determine what the implications were. And I found a, an article on the. , Kaiser. , KFF Kaiser family foundation. , website, what happens when COVID-19 emergency declarations and implications, coverage costs and access. So they have a really cool chart in here.

And I'm going to go through it and see if it indicates anything that we should be thinking about. And that's fairly long church. I'm not going to hit the whole thing, but here's what we've got. So, Medicare beneficiaries in traditional Medicare and Medicaid advantage pay no cost sharing for COVID-19 at home testing.

, tests per month testing related services, so forth and so on. And the implications on that are that millions of people have received free COVID-19 testing and that will cease. Once the, , federal health emergency. , comes around and that likely will be the case I think, I mean, it does represent a significant cost and some people are not going to get tested.

, for, , for COVID without this, but again, we focused on the intersection of technology and healthcare. So I'll let you figure that one out. , whether that's a big problem or not. And to be honest with you, it doesn't have to be a federal health emergency. There's a lot of other ways that they could trigger and pay for those costs, especially for the communities that are, ,

Disenfranchised underserved. , you know, not able to pay for these kinds of tests there's programs that could be that testing could be incorporated. Into, , let's go to tele-health that's probably closest to it. So among the major changes to Medicare coverage of telehealth during the PAG Medicare beneficiaries in any geographic area can receive Telehouse services rather than beneficiaries living in rural areas. Only beneficiaries can remain in their homes for telehealth visits, reimbursed by Medicare.

Rather than needing to travel to a healthcare facility. Telehealth visits can be delivered via smartphone in lieu of equipment with both audio and video capability and an expanded list of Medicare coverage services can be provided via telehealth. , This is probably the one that's going to impact us the most. And I've talked about this before. In fact, I've talked about this two years ago.

And then again, last year I talked about this. , at the end of the day. , for this population for the Medicare population. , we experienced a boom in terms of our, , ability to be reimbursed for these types of services. And that's great for us. It gave us a, almost a two and a half, a two year to two and a half year.

Ramp on the services and the ability to stand up a viable tele-health program around it. , but at the end of the day, we always knew this was going to come to an end. And we were going to have to figure out a way to make this either a. , benefit that the, , the patients, the clients, the customers were willing to pay for, whether it be a commercial or Medicare, , or a service that was cost neutral, or that had so many benefits internally to.

Our operation or to the clinicians. That it was going to continue. So it's not like, oh my gosh, this is coming to an end. What are we going to do? This is one of those things that you should have been planning on for, I don't know the better part of two and a half. A to three years. , because it was a foundational item in the federal health emergency. Now, with that being said, I believe that, , CMS is looking at the data and determining in what areas did tele-health actually move the needle forward in terms of access costs.

And quality. And any of those areas where they have found. That it has moved the needle forward on access, cost and quality. They are going to continue to reimburse that now. Any of the areas where it's a nebulous or it has not shown. To provide a benefit. I don't think you're going to see CMS willingly, jump up and throw billions of dollars at a program that doesn't have the results that they're looking for. So,

, I, you know, I think there should be a combination of things here. One is, you know, behavioral health, some of the areas where it's been very successful, it is going to continue and it's going to thrive. , some of the areas where it's been less successful, it's going to be on us to figure out if there is a significant benefit to us as an organization, as a.

, healthcare delivery. , entity. And if there is, then we have to bake that into our models. , at this 0.2 and a half years in, if you haven't stood up, what will be your telehealth platform? For the next, I don't know, five years, maybe even decade, , then shame on you. I mean, there was, there was enough money floating around the telehealth.

, ecosystem to stand up that environment and. I believe this can be one of my, I believe statements that telehealth will be a foundational item in any, , care delivery moving forward. As people like to say, we shouldn't call it digital health. It's just health being delivered digitally and health will continue to be delivered digitally.

In new and ever increasingly creative ways. And so having that foundation for delivering digital health. Is, , is incredibly important. You know, I'm looking at some of the rest of these things. And to be honest with you and not a lot of them intersect with, , technology per se. , there's a challenge with Medicaid. There was a significant increase in Medicaid funding.

As a result of the federal health emergency, there's a concern that Medicaid. , w you know, that it will drop off. , significantly in that millions of people will be uninsured. I don't think that'll happen either. , again, I think that's just creating this. Hey, this is what could happen. And technically, if you just followed the letter of the law and read, Hey, here's what happened and we're taking that away. And all of a sudden it's going to go away.

It technically could happen. It won't happen. , because we're not, we're not meaning vindictive people if people are in need and they need that funding and states need that funding and that kind of stuff, we find ways. , to do that. , let's see anything else. , Certain diagnosis. A lot of it has to do with Medicare and Medicaid, to be honest with you. That's what the federal that's what CMS does. That's what the federal health emergency really covered. The things

, that they could address and they could really take care of. So again, from a health it perspective, I think my, I believe statement is. , around this digital health concept. , digital health is just health delivered through digital means. And that could be through IOT devices could be through the phone, could be through telehealth, could be through a plain old telephone line. You.

, phone call could be text messaging. , there should be a platform. My health system should have a platform for delivering health via digital means. And it is incumbent on me as the health it leader. To think about how to build that out in a way that is reusable. I was talking to somebody yesterday and we were interviewing and they were talking, we have a platform. And when I hear platform as a CIO, I think I'm not going to have to implement 20, 30, 40 systems. I'm going to implement this one system and it's going to be a Swiss army knife. I'm going to be able to do a lot of things.

And so. Pushed the CEO a little bit on it. And I said, all right, if I can do this rule based on EHR data, if I could do this rule based stuff and put stuff into the portal, can I do rule-based stuff and send out text messages? Can I do rule-based stuff and send out emails? I do rule based stuff and send out alerts.

And he said, absolutely. And I'm like, yeah, all right, then that's a platform. That's what we're looking for. And we need digital platforms when he platforms that can grow with us to, , take on new devices as they come down the pike. And, , really be malleable because we don't know what the, we don't know what the use cases are that we're going to need. We don't know what's going to happen in genomics. We don't know what's going to happen.

In AI and machine learning, there's going to be constantly. New use cases, new ways of using the technology and it needs to be malleable. It needs to, to have components that we pulled together and we put them together in different ways to create different things. Think Legos. Right. You dump out that Lego's there all over the ground. And, , you put 50 people in a room and they're going to build different things. Somebody can build an airplane. Somebody's going to build a house.

, and it's going to be based on their experience, their background, their passion. And that's, what's going to happen in digital health. If we give them the right set of Lego blocks, they're going to build amazing solutions and that's what platforms are. And that's what I believe I would be very focused in on right now as a health care and health it leader. All right. That's all for today.

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