Nursing homes find that hospice care is turning into a bonanza as it’s being used for many more patients than were traditionally seen as hospice patients. And taxpayers are getting big new Medicare bills to pay for it, as Richard Salit reports in The Providence Journal.
As summarized by Becker’s Hospital Review, here are “four strategies from PwC that incorporate six consumer-oriented principles patients are looking for: convenience; transparency; affordability; reliability; seamlessness; and quality.”
1. Accelerate the migration to digital.
2. Partner with a sidestepper. “Many consumers today find the claims process confusing, as well as costly, PwC points out. Therefore, PwC encourages healthcare providers and insurers to consider partnering with nontraditional companies offering services that sidestep claims.”
3. Embrace simplicity. “Given that many consumers don’t understand their insurance benefits and are confused by their medical bills, online payment sites, mobile apps and aggregated billing can all help bring about a simplified consumer experience, according to PwC.”
4. Multiply payment options. “Providing multiple payment options and helping consumers plan for costs can reduce bad debt and days in accounts receivable.”
She calls it the “attempt by someone trained in principles of bioethics and in facilitating discussion—I argue they also need techniques of mediation—to help patients, families, and staff agree upon a care plan when there’s disagreement and conflict.”
“So why the rush to conclude that the guidelines were part of an industry plot? Have stories about industry greed so permeated our collective consciousness that we have forgotten that industry and physicians often share a mission — to fight disease?”
The public is becoming increasingly and frustrated by the gigantic and arbitrary drug-price surges, which threaten to destroy efforts to bring overall U.S. healthcare costs — far and away the world’s highest — under long-term control.
As the AHA’s site notes “Critics say most of the price increases appear to be arbitrary and some have happened virtually overnight, even for medications that have been available for some time. They’re demanding more transparency from the drug industry.”
A New York Times editorial speculated that disclosures on investment and profit “might shame [drug] companies into restraining their price increases and provide state officials with information to determine what action to take.”
Governing magazine noted:
“In state’s fight for price transparency, drugmakers are winning.”
Long Beach, Calif.-based managed-care insurer Molina Health is booming, both in revenue and net income, and the main reason is the Affordable Care Act’s expansion of Medicaid.
“We believe that government-sponsored initiatives, including the Affordable Care Act, will continue to provide us with significant opportunities for membership growth in our existing markets and in new programs in the future,” Molina said Thursday in a filing with the Securities and Exchange Commission.
Molina almost exclusively focuses on Medicaid. It sells health plans in 11 states. Six —California, Illinois, Michigan, New Mexico, Ohio and Washington—have expanded Medicaid under the ACA to low-income people making below 138 percent of the federal poverty line.
Molina’s managed-care skills are particularly important with its large Medicaid population since states want that population to be in rigorous managed-care systems. It’s tougher to do that with the Medicare population because the elderly have much more political clout than do the poor.
Jamahal C. Boyd Sr., director of multicultural competence and inclusion at Cincinnati-based Mercy Health, cautions providers to stay in their “respective lanes” to maintain efficiency and effectiveness in population-health efforts.
” In an attempt to innovate, some providers and systems are trying to respond to the diverse needs of their patient population that extend far beyond what takes place in the exam room.
“Not that this isn’t a good idea or approach, but when what providers are planning to do falls outside of the scope of what they do best, or outside of their experience and/or expertise, it becomes challenging. Oftentimes, this can cause providers to over-promise and under-deliver, which can lead to patient dissatisfaction, loss of credibility or consumer confusion.”
“If a provider or system is an expert at providing the best healthcare or specialty care for its patient population, then that is its lane. But providers can also innovate and effectively meet the peripheral needs of a patient by establishing effective partnerships and leveraging current relationships with those who have expertise in specialized services or service areas in the communities they serve.”
The Boston Globe says the the startup is working with Alegeus Technologies, “which sells software for managing individual healthcare plans such as health-savings and flexible-spending accounts. Alegeus claims some 400 clients that process more than $7.5 billion in annual payments.”
“Many consumers lack the fluency to sufficiently scrutinize healthcare expenses and advocate on their own behalf,” said John Park, chief strategy officer at Alegeus. “Advocacy services, such as those that CoPatient provides, give consumers tools to play a more active role in their healthcare – breaking the cycle of passive ‘auto-payment’ of healthcare expenses.”
Another why the age of extreme healthcare inflation may really be over, despite the flood of sick Baby Boomers.
