A few weeks ago, nearly all 50 states were well on their way to reopening (see Reopening Is Not Recovery). Fast forward to present day and the news is now filled with headlines reporting on the surge of positive COVID-19 cases (see Confirmed Coronavirus Cases Are Rising In 40 Of 50 States)—with many states reverting to previously imposed restrictions (see Face Masks Again Required To Be Worn In Pennsylvania’s Public Spaces, Arizona Becomes Latest State To Roll Back Reopening Plans, and Governor Abbott Announces Temporary Pause Of Additional Reopening Phases). Schools that were going to open on-site are now staying virtual. Bar and restaurants that were recently opened are now closed. The uncertainty of the situation is a killer for business operations and investments.
The outlook for the future of health and human service organizations has not improved. We summarized the early data on provider organization financial sustainability in my article, The Sound Of Closing Doors, in early May. Roll forward two months, and a more recent survey found that nearly 40% of provider organizations of all types are at risk of closing as a result of the pandemic’s financial disruption—including 36% of physician practices and 70% of organizations with less than 10 physicians (see Impact On Acute Care Organizations & Physician Practices).
My advice for any executives is to make sure that your strategy includes plans for scenarios that cover the range of possibilities for your organization. (My ‘go to’ framework on the subject can be found in Strategy Under Uncertainty.) I recommend framing strategy around the most likely, the most challenging, the most optimal, and any other scenario that might significantly affect operations and profitability. The recent advice given by Amanda Mull of The Atlantic captures the dilemma for executive teams (see The Horror Of The Coronavirus Data Lag), “…in order to make everyday decisions and assess their own risk, people have to live simultaneously in the past, present, and future.”
As we navigate the path to recovery, we’ll continue to provide you with the tools and resources necessary to perfect your own balancing act with the latest developments in the pandemic crisis.
Testing & Related Efforts
Health and well-being company Humana Inc. announced a pilot home-testing program that will enable at-home COVID-19 test collection for members, making Humana the first insurer to offer LabCorp’s at-home test-collection kits.
The National Institutes of Health is facilitating a national rapid innovation initiative to speed delivery of accurate, easy-to-use, scalable home or point-of-care tests for COVID-19 before the fall of 2020.
On June 17, 2020, Disability Rights Nebraska and a group of organizations filed a complaint with the U.S. Department of Health and Human Services Office for Civil Rights over access to testing for COVID-19.
One-third of 414 worldwide charities surveyed in early June 2020 say that financial challenges due to the COVID-19 global pandemic will force their organizations to close within the next 12 months.
A vaccine for COVID-19 is likely to be developed by mid-2021. For provider organizations considering adding a vaccination program, this article provides guidance on how to ensure consumer safety while mitigating risk.
The Latest In Federal Guidance
On June 1, 2020, the Centers for Medicare & Medicaid Services (CMS) warned states that failure to complete 100% of their focused infection control nursing home surveys by July 31, 2020 will result in being required to submit a corrective action outlining the strategy for completion of the surveys within 30 days.
On June 3, 2020, CMS announced adjustments to 16 value-based care models to account for the COVID-19 pandemic public health emergency that began in March 2020.
On June 3, 2020, CMS announced risk adjustments to the Medicare accountable care organization (ACO) Track 1+ and the Next Generation ACO models to account for the COVID-19 pandemic.
The document was issued on June 1, 2020, by CMS. The document describes the federal requirements on nursing homes to ensure that they have conducted focused infection control surveys to control the spread of COVID-19.
The document was released on June 3, 2020, by the CMS Innovation Center. It lists adjustments to 16 value-based care models to account for changes in cost or health care utilization or delivery due to the COVID-19 pandemic public health emergency.
Updates On Federal Grants & Funding
On June 9, 2020, the federal Department of Health and Human Services announced a $15 billion Provider Relief Fund allocation for provider organizations that participate in state Medicaid and Children’s Health Insurance Program programs, but that have not received a payment from earlier relief allocations.
The document was released on May 13, 2020, by the Federal Communications Commission. It lists the names of organizations approved for funding through the FCC COVID-19 Telehealth Program.
United States Senate Majority Leader Mitch McConnell announced that LifeSkills Inc. in Bowling Green received $491,818 to expand telehealth services throughout 18 rural counties in Southcentral and Western Kentucky.
The Georgia Department of Human Services (DHS) will work to reduce social isolation for older adults and people with disabilities amplified by the COVID-19 pandemic as a result of a federal CARES Act grant.
The Illinois COVID-19 Response Fund has awarded Chestnut Health Systems $100,000 in its most recent round of funding.
Tracking The Disrupted Landscape
About 68% of provider organizations that serve people with intellectual/developmental disabilities reported that they have closed one or more service lines by government order due to the pandemic, according to 689 organizations that responded to a survey conducted by the American Network of Community Options and Resources.
Hallworth House Rehabilitation and Nursing Center, a nursing home center based in Rhode Island, announced plans to close in late August 2020 as a result of the COVID-19 public health emergency.
University of Washington Medicine announced the permanent closure of its psychiatric facility, with lay-offs of 23 staff members effective in mid-July.
The COVID-19 pandemic could cost private health plans from $30.0 billion up to $547 billion over the next two years, according to an estimate by America’s Health Insurance Plans, a trade association for health plans.
According to the American Health Care Association/National Center for Assisted Living, the pandemic has increased operating costs for most nursing homes at the same time that revenues have dropped.
Clinical Updates In The Field
Obesity may greatly raise odds for a child or adolescent to develop a severe form of COVID-19. Approximately 22% of those children and adolescents who were admitted to the hospital with a severe form of COVID-19 were obese.
During the COVID-19 pandemic emergency, Massachusetts emergency departments and outpatient settings conducted fewer psychiatric assessments per week in late March compared to January and February.
About 39% of 502 Americans surveyed in May 2020 reported using bleach and disinfectants unsafely at home in effort to prevent transmission of COVID-19.
During the week ended April 25, 2020, Medicare received 1.4 million claims for services provided by telehealth.
On June 25, 2020, the Centers for Disease Control and Prevention published updated guidance on underlying medical conditions that put individuals at increased risk for severe illness from COVID-19.
On June 15, 2020, the Centers for Disease Control and Prevention published statistics for COVID-19 case data for the pandemic response.
On June 5, 2020, the Centers for Disease Control and Prevention published results from a panel survey testing knowledge about safe preparation, use, and storage of cleaners and disinfectants to prevent COVID-19.
Among people in the United States diagnosed with COVID-19, the most common underlying health conditions linked to hospitalization and death were cardiovascular disease (32%), diabetes (30%), and chronic lung disease (18%).
Support For Vulnerable Populations
Mental health professionals have a unique, and essential, role in the COVID-19 pandemic. Joseph Goldberg, M.D., clinical professor of psychiatry at the Icahn School of Medicine at Mount Sinai, and Dri Wang, PharmD, BCPP, senior medical science liaison with Otsuka Pharmaceutical Development & Commercialization, discuss the role of clinical professionals beyond the pandemic.
Providing emotional and psychological support to frontline staff is more critical than ever. In this webinar, Alan “Tony” Amberg, MS, MSN, APRN, PMHNP-BC, PsychU’s Nurses Corner Section Advisor, proposes Psychological First Aid to better support nurses and frontline workers during COVID-19.
The Pennsylvania Department of Health and Department Human Services issued updated guidance to ensure a safe return to activities, visitation, and other events for residents in nursing homes, personal care homes, assisted living residences, and private intermediate care facilities.
Rising Above Disabilities, a large camp for adults and children with developmental disabilities in Southern California, is hosting its first-ever fully remote summer program.
The American Red Cross is launching a Virtual Family Assistance Center to support families struggling with loss and grief due to the ongoing coronavirus pandemic.
Optum, a leading health services company, and Wider Circle, a tech-enabled community-based health care services company that drives better health for older adults and other vulnerable communities, have partnered with Helping Hands Community to launch the “Community Food Circle” initiative.
WellCare of New Jersey, a subsidiary of Centene Corporation, announced a plan to provide additional mental health resources to New Jersey residents impacted by the COVID-19 pandemic.
During its first two months of operation from March 31 to May 25, 2020, the Nevada COVID-19 Aging Network Rapid Response received 757 requests for food delivery, social support, and telehealth from older adults.
The Pennsylvania Department of Human Services is launching six regional health collaboratives intended to help protect long-term care residents from contracting COVID-19.
On May 5, 2020, the Centers for Disease Control and Prevention published guidance on how to help health care personnel and first responders cope with stress related to the COVID-19 pandemic.
On May 31, 2020, CMS issued a letter directing state Governors to test nursing homes and other communities.
The testimony was given on June 11, 2020, by Peter Reed, Ph.D., MPH, director of the Sanford Center for Aging Professor, Community Health Sciences University of Nevada, Reno, School of Medicine. He discussed the Nevada COVID-19 Aging Network Rapid Response, and how its services deliver social support to reduce social isolation.
The William Penn Foundation announced it had approved more than $2 million worth of new grants to Philadelphia, Pennsylvania-based groups, with much of the grant focused on helping youth and summer programs reopen safely amid the coronavirus pandemic.
Leadership Resources For Crisis Management & Recovery
As a result of the COVID-19 pandemic, provider organizations have been forced to make the pivot to virtual services. In this article, Cheryl Lejbolle, vice president of patient engagement solutions at NextGen Healthcare, outlines the key components needed for success with telehealth, from electronic health record integration to leveraging best practices.
Despite the pandemic, maintaining compliance, along with privacy and security, is among the top priorities of clinicians. Mona Sobhani, Ph.D., director of research and operations at USC Center for Body Computing, provides more insight into the topic of security and privacy with real-world advice to clinical professionals.
Health care has always been a stressful profession. Even before the pandemic, we knew that over half of physicians had at least one sign of burnout, including 59% of emergency physicians, 56% of obstetricians, and 55% of family and internal physicians.
“Hybrid” is a word that is no longer associated with just cars, and plants. The pandemic crisis has changed all of that.
It has been a long three months since the start of the pandemic crisis in the U.S. The health crisis still continues—and the economic crisis is just starting.
There is a lot we don’t know about COVID-19. The death rates, the incidence in the population, and the effect of antibodies are still big questions.
“No one wants to give a significant contribution to an organization that is circling the drain.” This comment was made by a board member of a community foundation in a recent meeting.
While the adage “The best defense is a good offense” is typically associated with military combat and sports (and is often attributed to Michael Jordan), it was first said by George Washington in 1799, “…offensive operations, often times, is the surest, if not the only means of defense.”
This web briefing, led by OPEN MINDS Senior Associate George Braunstein, RN, FACHE, covered a best practice approach to shaping service lines as business units that are responsive to market needs and included discussions on how to find cost-effective implementation approaches and build a new service line portfolio for changing market conditions while restructuring services negotiating with payers.
For even more on post-crisis recovery planning, join us for our upcoming web briefings and technical assistance sessions offered by our senior advisors, as part of The OPEN MINDS Executive Blueprint For Crisis Recovery:
- What Will The Payers Change Post-COVID-19? Let’s Ask Them: An OPEN MINDS Executive Roundtable: July 14 at 4:00 pm EDT featuring Deborah Adler, senior associate at OPEN MINDS; Kathleen Mahieu, director of digital product innovation and strategic partnerships at Aetna Mental Wellbeing; Sean Schreiber, executive vice president of network and community health at Alliance Health; Amy Pearlman, vice president of clinical provider strategy at Beacon Health Options; and Roberta Montemayor, director of telemental health innovation for network strategy at Optum Behavioral Health.
- Preparing For Post-Disruption Resilience & Sustainability – Taking Action For The Long Term – An Overview: July 16 at 1:00 pm EDT featuring Joe Naughton-Travers, Ed.M., senior associate at OPEN MINDS.