The test has been promoted by the Trump administration as a key factor in controlling the epidemic in the U.S. and is used for the daily testing that is going on at the White House.
(Image credit: Carlos Osorio/AP)
NPR's Rachel Martin speaks with Republican Sen. Mike Braun of Indiana who was among a panel of senators that questioned the nation's top public health officials at a Senate hearing on Tuesday.
It’s no surprise why auto insurers like State Farm and Geico are sending rebates to customers this spring and summer. No one’s driving, so accident claims are way down and insurers are paying out very little. No one expects drivers to make up for lost time by crashing their cars more often once they return to the roads. That means a dollar saved now on claims is a dollar saved forever. Insurance companies and state insurance commissioners realize this, too and that’s why the rebates are coming.
But you might be surprised that health insurers, starting with UnitedHealth are beginning to do the same thing. United is offering a 5 to 20 percent credit on June billing statements, which is the same order of magnitude as the auto insurers.
So the questions are:
And the answers?
Insurers are spending a lot on some COVID-19 patients. Big bills are rolling in for hospitalized patients, especially those that land in the ICU and are on ventilators for weeks. But even though a lot of people are sick, it’s only the hospitalized patients that incur expenses. With no costly outpatient or drug treatments, overall COVID-19 costs are not so high. Also, many of these patients are older (Medicare) or poorer (Medicaid), not in United’s commercial markets, where the rebates are focused.
Other than COVID-19, the medical system is eerily quiet. Essentially the only other bills are for telemedicine, some cancer treatments, and medications for chronic illness.
We do hear about a coming ‘second wave’ of non-COVID-19 patients later this year as hospitals reschedule elective surgeries, people who have been avoiding the emergency room come back in worse shape, and chronic care patients incur more intensive treatments after declining.
These assumptions are driven by a combination of what seems like common sense, clinician desires to help patients, and wishful thinking by hospital financial chiefs.
But UnitedHealth knows something that others don’t: utilization and costs are not going to rise as fast as people assume. So insurers are getting out ahead of it before regulators, the ACA medical loss ratio requirements, and public opinion force their hand.
I wrote a letter to the Boston Globe a week ago critiquing the conventional wisdom. Looks like they aren’t publishing the letter, so I’m posting it here.
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After the surge: Hospitals prep to bring back regular patients while virus cases linger (Front page, May 3) describes how hospitals are gearing up to work through the backlog of canceled appointments and procedures. Hospitals assume that there will be tremendous, pent up demand for their services. They are looking forward to getting back to normal with cases that pay the bills. They will be in for a rude surprise, however, because many people will continue to stay away. Instead patients will use telemedicine, pursue less aggressive treatments, or just wait for time to heal what ails them. For years, healthcare experts and insurers have known that hospital care is over-utilized and sometimes dangerous. Now COVID-19 has done what co-pays, deductibles and hospital safety reports never could –keep patients away. It’s no surprise that elective procedures and routine visits have plummeted. After all, hospitals canceled them. Surprisingly, the use of emergency rooms in Boston for strokes, heart attacks and appendicitis has also dropped by half during the emergency. Many emergency patients will return, but those with common issues like back pain and rashes will think twice or three times before coming in. Patients who are due for colonoscopies or mammograms will put them off even longer than usual. |
By healthcare business consultant David E. Williams, president of Health Business Group.
The post Why is UnitedHealth rebating insurance premiums? appeared first on Health Business Group.
In the latest episode of #CareTalk, CareCentrix CEO John Driscoll and I talk about whether it’s right to make meat plants reopen. We also ponder whether public health after #COVID19 will look like security after 9/11. As if that wasn’t enough for one episode, we tacked on a debate on why emergency room use has plummeted and whether telehealth is here to stay.
If you like what you see, remember to subscribe.
The post Should meat plants reopen? #CareTalk tackles this meaty topic appeared first on Health Business Group.
Trade groups expect the British government to roll out new coronavirus travel restrictions on Sunday, including a quarantine for out-of-country arrivals. And they're already pushing back publicly.
(Image credit: Ben Stansall/AFP via Getty Images)
A hearty and comforting soup with a definite kick, this Ginger Turmeric Squash Soup will is guaranteed to make you feel warm inside, whether you decide to eat it hot, or cold!
Yeah, I know, I’ve been loving on squash a lot lately, and you’re probably thinking: “Geez lady, enough with the squash already!”
Truth is, I bought a trio of nice big ones last time I went to the grocery store: one huge spaghetti squash and 2 good-sized butternut. With the current situation, I try not to get out of the house too often, so it’s been almost two weeks since I last went shopping for food. Since squash keeps for so long, they were among the last items to be used up, and when their turn finally came, I decided to go all out and baked all 3 at the same time. So yeah, I’ve got leftover cooked squash galore in the fridge!
What better way to use up squash leftovers than by turning them into soup? It’s super easy and in just minutes, you get to enjoy a delicious, piping hot bowl of soup. But even if you didn’t have cooked squash in the fridge, you could very well make this soup with uncooked, cubed squash. I’ll show you…
Before you get started though, let me just give you a little warning: this soup, it packs some serious heat! Ginger does have a bit of an intense bite to it, and combined with the black pepper and turmeric, trust me, you can totally feel the heat! If you’re not a fan, you might want to use less ginger and maybe consider leaving the ground black pepper out.
You can always add more later, if you wish… it’s easier to add than to remove!
(more…)The post Ginger Turmeric Squash Soup appeared first on The Healthy Foodie.
Quick and easy to make, these Light and Fluffy Vegan Pancakes are the ultimate comforting Sunday breakfast! Guaranteed to please everyone – no one will never know they’re made with whole wheat flour!
I’ll give it to you, pancakes are probably not the best breakfast option one could go for, nutrition-wise… But sometimes, you know, one finds themselves in need of a good old plain, comforting, lazy Sunday morning breakfast. And I don’t think anything fits that description quite better than a stack of warm, fluffy pancakes covered with a generous pour of pure liquid gold, aka, maple syrup!
And sometimes, well, you gotta indulge a little… so when that craving for a comforting breakfast hits me, those delicious light and fluffy vegan pancakes are just the thing! And plus, I have removed some of the guilt and made a bit healthier by adding whole wheat flour to them; but really, they are so totally yummy and fluffy and light and airy and moist, that no one will even notice that at all…
On top of being utterly delicious, this pancake recipe is also super quick and easy to make. I get the feeling you will love it just as much as I do; in fact, it’s probably about to become your new go-to… And you’ll probably want to know it by heart, too!
(more…)The post Light and Fluffy Vegan Pancakes appeared first on The Healthy Foodie.
A creamy, cheesy Vegan Fettuccine Alfredo Sauce that not only is crazy tasty, easy and quick to make, but also happens to be super good for you? Oh yes, it exists! And this? is it!
Fettuccine Alfredo is one of those classic recipes that need no introduction… I mean, who isn’t familiar with this super comforting, creamy, cheesy, garlicky pasta dish, and who hasn’t granted it top spots on their list of favorite foods?
Unfortunately, as delicious as it may be, this cream, butter and cheese laden classic isn’t the best choice one could make, nutrition-wise…
Luckily, this vegan version does much better for your body, without even asking you to compromise on anything at all! It’s crazy rich and creamy, mega cheezy and garlicky, super smooth and silky and every ounce as decadent and comforting as its dairy loaded counterpart.
The real kicker though, is that this healthier version is quicker, and easier to make than the real deal… I’m telling you, there’s nothing not to love about this recipe.
Even non-vegans will be all over it!
(more…)The post Vegan Fettuccine Alfredo appeared first on The Healthy Foodie.
View our map and graphics to see where COVID-19 is hitting hardest in the U.S., which state outbreaks are growing the fastest and which are leveling off.
(Image credit: Connie Hanzhang Jin/NPR)
A few years back I heard that sitting is the new smoking. That concerned me, since I’m the type that tends to stay glued to my seat throughout the workday, especially when working from home. Some colleagues and clients have standing desks –or even treadmill desks!– but they never appealed to me.
The Apple Watch has been helpful in encouraging me to stand up. While I ignore most of its other prompts (like the suggestion to Breathe) I am quite responsive to the notification I get 10 minutes before the top of the hour, imploring me to stand up at least once before the clock strikes.
Recently, FluidStance offered to let me test out its Plane balance board, billed as a product that brings “movement and happiness to your workplace.” Bottom line: I like it and you might, too.
With #COVID19 in the air, I don’t get a lot of excitement. So it’s always a highlight to receive a package on the doorstep. The balance board came in a long, thin box; when I opened it up I was impressed with the cloth backpack. I felt pretty cool carrying it up to my home office past my teenagers!
It took me a couple minutes to figure out which end was up. (I got it wrong at first.) And my initial joy was tempered when I read the label on the board.
WARNING, USE AT YOUR OWN RISK! This product creates an unstable surface. Use of this product may result in injury or death. Use at your own risk.
Injury I can live with. But death? Even if sitting is the new smoking (and that’s actually controversial) death is still the old death!
Although my balance is good, I’ve never had much luck with skateboards, wakeboards, surfboards of anything kind of board. I was particularly good with the pogo stick as a kid, however.
I need not have worried, because the FluidStance board is really easy to balance on. If you do fall off, it’s about 3 inches so no biggie! It does provide a nice stimulus –better than just standing on the floor, and it’s easy to swivel around, too, should the temptation strike you.
I didn’t want to risk messing up my hardwood floor, so I put a mat under my chair. It protects the floor but does make it a little harder to swivel. When I’m not standing (which is still most of the time) I put my feet on it and use it as a footrest.
I’ve always done audio conference calls, but the pandemic seems to be pushing what would have been in-person meetings and even many phone calls into the video realm. Since I’m not even walking from one conference room to another, I’m sitting even more and am making an effort to stand.
The balance board is good to stand on during conference calls, but it presents a couple of challenges. For audio, I’m a bit far from the speaker phone –but I’ve checked with others and my sound seems good. But for video calls my head ends up out of camera range, even if I tilt the monitor up. I could probably do something about that with a webcam or mounting my laptop on a shelf, but I haven’t. These are minor annoyances but it means I don’t use the board as much as I might like to.
I’m not sure whether there are measurable benefits from using the balance board, but in any event I do like it and plan to keep using it. The literature that came with the deck said, “We aim to blur the lines between work and play, making work a more fluid and natural part of our whole lives.” I can feel that.
The FluidStance product is very well built. It’s solid, attractive and durable. Built in California, it’s well positioned to ride the de-globalization that seems likely post-COVID.
I recommend it.
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By healthcare business consultant David E. Williams, president of Health Business Group.
The post Stand up! How I’m incorporating a balance board into my home office routine appeared first on Health Business Group.
When COVID-19 hit, hospitals knew they would see a decline in elective surgeries and routine visits. After all, they canceled them! But the volume of patients visiting the emergency room has also dropped dramatically, and no one can seem to fully explain it. Sure, maybe we could expect fewer car crashes and skiing injuries. But heart attacks and strokes? If anything it seems like those numbers should be going up due to higher stress levels. Yet, the analyses in cardiac care during the pandemic show a sharp decline not only in elective cardiac procedures, but also in cardiac catheterizations for acute heart attacks, specifically, those with ST segment elevations – the most life threatening type.
Conventional wisdom tells us that the drop in ER visits is a bad thing. Patients must be dying at home, outcomes must be worsening, and the patients that do survive will show up as train wrecks once the pandemic subsides. Those assumptions are probably true to a certain extent, but the open question is how true? Acute conditions and complications warrant acute care. But in the routine care of behavioral health and other chronic conditions such as diabetes and hypertension, extensive overuse of the emergency room rather than other ambulatory settings has been a prime area of concern and debate for several years.
We know that ERs are overused in normal times. And we think they’re underused now during the pandemic, but to what extent should be analyzed and debated as we inform the necessary adaptation of our systems of care. We expect to see an incredible amount of variation in ER utilization as the situation unfolds, by specific patient populations, urban vs rural settings, and geography-specific COVID-19 case burden.
We are encouraged that Datavant has convened a wide variety of industry players to construct a COVID-19 Research Database, a set of de-identified data sets made freely available to enable rapid studies at scale. The new initiative fills an important gap between quick observations that are available from small sets of real world data and clinical trials, which are robust but slow.
The ER phenomenon we’re discussing is not completely unprecedented. Researchers (and ER staff) have long observed the ‘big game effect’ – where ER visits decline as people defer them to watch their favorite team. (The Health Business Blog first reported on it in 2005: Red Sox’ success eases health care crisis.) Some, but not all, of those visits are avoided entirely without negative consequences. The COVID-19 pandemic provides an opportunity for a much longer time series. Let’s use it as a chance to study what’s going on so we can apply the lessons learned as we emerge.
What could explain sustained, lower utilization of the ER? There are a few possibilities:
So what should we do with this unexpected information?
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By healthcare business consultant David E. Williams, president of Health Business Group and Surya Singh MD, president of Singh Healthcare Advisors.
The post Where did all the emergencies go? appeared first on Health Business Group.
