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This week, Medicare regulators released a 79-page report on the pandemic-era home hospital program, which allows approved health systems to provide inpatient care in people’s homes. More than 300 hospitals signed up for the program, and the goal was to expand capacity at a time when people were worried hospitals would be overwhelmed. But many see the program as an important innovation that could help the health system meet the needs of an aging population.
There’s a lot of information out there, so we asked Lee Fleischer, who was the chief medical officer at the Centers for Medicare and Medicaid Services when the program was created, to help make sense of it all.
Broadly speaking, Fleischer said, the study shows the program is safe to implement and that patients and their families like it. He supports extending the program, but said there need to be guardrails to ensure that patients who are hospitalized at home truly need inpatient care and that the payment model is appropriate. Hospitals choose to participate in the program themselves and have important capabilities. The report notes that they commonly educate hospitals and are also common in urban areas. Patients who used home care, on the other hand, were more likely to be white, more likely to live in urban areas, and less likely to receive low-income subsidies. By definition, payments are the same for home health care and inpatient care, so the report focuses on post-discharge costs as a way to determine the potential economic impact. Overall, those admitted at home had lower costs in the 30 days after discharge compared to the comparison group, but Fleischer said this result may be a result of those who chose to participate in the program or the hospital. It is pointed out that there is.
The report found that while caregivers generally like the program, in some cases it can place additional burden on caregivers. Others suggested taking time off from work or hiring a caregiver. “This may limit who can take advantage of this program, and it will only be available to selected patients,” Fleischer said. “From my perspective, home health care is an alternative to inpatient, hospital-based care for less critically ill patients who still need more than home health care and require hospital-level care.” Fleisher said. “This gives some patients and their families options for how to receive care, just as patients can choose between PCP, urgent care, and telemedicine for non-urgent, immediate care issues. It gives us more options. How best to implement and pay for this program requires further analysis during the extension.”
The report, mandated by Congress, provides some new details but is far behind in informing legislative debate on the program, which expires at the end of the year. The current consensus is that a five-year extension will be passed as part of a larger flexibility extension package.
Nonprofit gets caught up in Epic’s antitrust battle
As Epic, the largest vendor of electronic medical records software, and Particle Health, a small data-sharing startup, prepare to go to war in court, they have dragged a little-known organization into the fight.
CareQuality oversees a framework that allows healthcare organizations to share patient health records with each other. It is a critical infrastructure that connects siled data and is a critical element of care delivery.
Last week, Particle filed a lawsuit against Epic for alleged anti-competitive conduct, and the two companies are disclosing their findings to Care Quality after Epic accused Particle of misusing patient data. I’m asking you to. Particle has been cleared of wrongdoing, but says the punishment was imposed to appease Epic.
As STAT’s Brittany Trang reports, how Carequality handles this situation will have important implications for the future of health data sharing. Click here for details
Scientists creating brain interfaces
Brain-computer interfaces that allow people with paralysis to use technology and communicate more effectively have received considerable attention recently, thanks to Elon Musk’s investment in the field through Neuralink. . Behind the hype and science fiction-like appeal of this technology is a cadre of talented scientists who are driving research forward.
In the latest installment of STAT’s new Who to Know series, Timmy Broderick profiles the top people driving innovation in the BCI space. (A few weeks ago, we profiled 12 people leading the way in psychedelic drug development.)
Among the researchers Timmy focuses on is Sergei Stavisky, who is developing speech decoders (devices that help people who have lost the ability to speak) communicate at the University of California, Davis. Emily Glassik, a professor at Case Western Reserve University, is developing techniques to stimulate the nervous system that can enhance or restore sensations such as temperature, touch, and pain in patients with spinal cord injuries. Read the entire list here
Data points on delays in clinical AI utilization
While many may believe that artificial intelligence tools will have a major impact on clinical care, so far they have not been a huge success, according to an analysis of Trilliant Health’s always interesting Healthcare Trends Report. I am storing it.
Using a very large database of payer claims, researchers from an analytics company look back at the use of AI CPT codes used by physicians to bill for services, and find that use has so far been limited. I understand that. Just over 200,000 patients receive these services. Trilliant’s Sanjula Jain said she doesn’t believe there’s a ton of hypothetical AI usage that isn’t captured by the code. Fee-for-service care incentivizes the creation of codes and billing for services.
“I don’t think it’s because people don’t want to charge or don’t know they can charge, because people are lobbying hard to get these codes,” she said. said. “I think this is really a question of clinical utility and clinical value.”
Jain pointed out that this slow adoption does not apply to AI back-office and management applications, which are gaining attention from investors, entrepreneurs, and importantly, healthcare organizations. This is consistent with other recent findings that we recently reported. (If you think Jain is wrong about the clinical use of AI, please let me know.)
ResMed CEO talks about the impact of wearables and GLP-1 on sleep apnea device sales
Earlier this week, I interviewed Mick Farrell, CEO of ResMed, the largest marketer of continuous positive airway pressure devices to treat sleep apnea. His company has grown to $4.7 billion in sales and has room to grow because only a small percentage of people who could benefit from the device know they have sleep apnea. I think there are enough.
The company offered an upbeat outlook at a glitzy analyst event held at the New York Stock Exchange Building. Farrell cited what he called a “double tsunami” of guiding patients to the device. These include new smartwatch features from Apple and Samsung that alert users to possible sleep apnea, and the rise of GLP-1, a wildly popular obesity drug. . read my story here
what we are reading
This AI startup helps patients fight insurance denials, Forbes Why fruit fly brain maps ‘surprised’ neuroscientists, STAT exclusive: Diabetes startup Omada Health secretly uses S-1 Business Insider filed to go public To support addiction treatment, lawmakers tell DEA to reverse buprenorphine enforcement, STAT
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