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Investing in Non-Traditional Access to Care

May 25, 2021
2:26 pm

Even before COVID-19, our healthcare system was evolving to expand remote and in-home care.  The pandemic has underscored the importance of providing quality care to people where they are.

Leading by example, Mayo Clinic, a Healthcare Leadership Council member, and Kaiser Permanente have partnered to invest in Medically Home Group, a technology-enabled services company which offers a virtual and physical care delivery model including a 24/7 medical command center staffed by an array of clinicians and an integrated care team in the community who deliver care to patients at their bedside. Using this platform, providers can address clinical conditions of greater acuity without the patient needing to enter the hospital. Results have shown that patients who still need to be hospitalized using the integrated Medically Home model have a lower need for recurring hospitalization at 30 and 90 days following a care episode.

Gianrico Farrugia, M.D., president and CEO of Mayo Clinic stated, “Our partnership with Kaiser Permanente and Medically Home will create the next generation of patient-centric, compassionate health care that seamlessly integrates advanced technology with clinical expertise. By bringing best-in-class clinicians and services to patients in their homes, we’ll be able to provide more people with individualized care that’s tailored to meet their specific needs.”

This model increases health system capacity and resiliency and helps close gaps in care for vulnerable populations. Medically Home estimates that 30% of hospitalized patients can benefit from this model. Both Mayo Clinic and Kaiser Permanente have launched programs to ensure complex, comprehensive care is available outside hospital walls, engaging patients in their homes and integrating information such as social determinants of health into their care plans. This is the way of the future, and Mayo Clinic and Kaiser Permanente are demonstrating how healthcare institutions can effectively expand their reach beyond traditional settings.

Improving Patient Care by Applying Lessons Learned from a Pandemic

May 19, 2021
4:57 pm

The COVID-19 pandemic and its social distancing requirements have necessitated changes in the delivery of healthcare over the past 14 months.  As we begin to transition back to normalcy, policymakers and health system leaders are assessing the lessons learned during this period to determine what kind of short-term changes should become permanent healthcare reforms.

At a Senate Finance Committee hearing this week dedicated to this topic, executives from two Healthcare Leadership Council member companies discussed steps that need to be taken to enable individuals to continue receiving quality care in their own homes.

Linda DeCherrie, M.D., clinical director of Mount Sinai at Home, a program developed by New York’s Mount Sinai health system, discussed the benefits found through an innovative care delivery model that provides treatment to patients in home settings.  According to Dr. DeCherrie, the Hospital at Home model reduced the average hospital stay from 5.5 days to 3.2 days while also cutting the percentage of patients who require readmissions nearly in half.

Dr. DeCherrie said the Centers for Medicare and Medicaid Services approved waivers to allow healthcare providers to offer these services to Medicare beneficiaries, but that some health systems are reluctant to establish Hospital at Home programs unless they are assured those waivers will be made permanent or at least extended.

Similar regulatory action is needed to strengthen telehealth access, according to Narayana Murali, M.D., executive vice president of care delivery and chief strategy officer for Marshfield Clinic Health System in Wisconsin.  She told senators that telehealth has increased access to care for vulnerable communities. Marshfield, she said, performed 240,000 telehealth encounters in 2020 compared to 12,500 in 2019.

Dr. Murali said, though, that access to telehealth services remains limited by existing regulatory barriers determining where telehealth can be offered.  She also said telehealth won’t reach its full potential until greater investments are made in broadband access.

I want to give credit to the Senate Finance Committee for scheduling this hearing.  We can’t undo the tragic devastation created by COVID-19, but we can utilize the lessons learned from the pandemic to provide better healthcare to the American people.

 

 

Waiving Patent Protections for Vaccines is a Damaging and Short-Sighted Move

May 06, 2021
3:42 pm

Biopharmaceutical companies are receiving justified praise for the rapid speed with which they produced effective vaccines against COVID-19, offering hope for a return to normalcy from a pandemic that has cost lives and damaged economies.  The success of vaccine production underscores the critical importance of investments in research and development and the value those investments can bring in the future.  Pfizer scientists, for example, are already exploring how the mRNA technology used to create a COVID-19 vaccine can be utilized to develop advanced treatments for cancer, HIV, and other diseases.

Thus, it’s mystifying that there is a push to discourage this kind of investment by shredding the intellectual property protections held by the vaccine makers.

The Biden Administration has done a superb job in COVID-19 vaccine distribution and administration, but it has taken a misstep on the intellectual property issue.  Yesterday, the U.S. Trade Representative said that the United States would now support a move in the World Trade Organization to waive patent protections for vaccine products.  India and South Africa had initiated this action, ostensibly to open the door for poorer countries to create their own generic version of vaccines.

Seeking this waiver is a move based on a false premise that vaccines are not making their way around the world.  In fact, vaccine manufacturers have pledged to supply over 12 billion doses by the end of this year and working with the World Health Organization to supply doses to 90 developing countries at a discounted price. Eliminating patent protections will do less for global vaccine production and dissemination than what is already occurring.  Any country seeking to make its own version would have to acquire vaccine components and the knowledge on how to manufacture the products and then generate large-scale manufacturing capabilities.  This would take significant time.

The long-term harm here is to future research and development.  Intellectual property protections are vital to the development of new treatments, cures and vaccines.  Without those protections, there is no incentive to invest in the research cycle that can require years and billions of dollars just to get one new product through the development pipeline.  The WTO move achieves limited short-term gain while risking damage that could leave the world more vulnerable to the next public health crisis.

Merck for Mothers Continues to Advance Maternal Health Equity

April 30, 2021
4:25 am

In a nation where Black women are disproportionately impacted by maternal mortality; Merck for Mothers has committed to understanding women’s experiences in order to improve the quality of maternity care. In its Evidence for Impact 2020 Research Compendium, it was found that: 1) racism and discrimination influence perceptions of respect and overall quality of care; 2) fragmented health care systems make it difficult to build patient-provider trust; and 3) patient-centered approaches need to be more sensitive to patient needs to ensure dignity and respect.

The Safer Childbirth Cities Initiative, founded in 2018, seeks to be a catalyst for the focused, locally-tailored engagement needed to bring community resources together to strengthen health systems for all to help women have healthy pregnancies, safe childbirths and life-long well-being. The program has expanded rapidly, and Merck recently announced that the newest grant is the 20th community-led project to be funded. The money is going to the Austin Community Foundation as a fiscal sponsor for the Black Mamas Community Collective, which supports a project to directly tackle racial inequities in maternal health outcomes and increase access to quality care for Black mothers and their families in Austin, TX.

Kenneth C. Frazier, chairman and chief executive officer of Merck and a member of the Healthcare Leadership Council, stated in the press release, “Elevating Black and other historically marginalized voices, community leadership and local health solutions is a fundamental part of helping to reverse the health inequity that has persisted across the U.S. and globally.”

The Healthcare Leadership Council continues to work with its members on the systemic problem of health disparities and proudly promotes the efforts of each member organization to drive change and improve health experiences and outcomes.

 

Time to Discuss a “Health Equity Moonshot”

March 31, 2021
5:41 pm

This month, the Senate Health, Education, Labor and Pensions (HELP) Committee held a hearing on the health inequities witnessed during the COVID-19 pandemic.  The topics discussed in that hearing warrant our sustained attention.

I’m particularly focused on the testimony of Eugene Woods, the president and CEO of Atrium Health (a Healthcare Leadership Council member), a North Carolina-based health system. Out of the tragedies we have witnessed during COVID-19, which have disproportionately affected racial and ethnic populations as well as areas with high rates of poverty and comparably limited healthcare access, Mr. Woods sees an opportunity to do something significant and transformative.

As he put it, “The COVID-19 pandemic has come at a great cost to the world. We should view this reality as an investment that allows us to emerge stronger.  Through unity and collaboration, government and industry are capable of great things. This has been, and still is, a core tenet of American exceptionalism.”

In his testimony, Mr. Woods offered the notion of a private-public collaboration not unlike the efforts that put astronauts on the moon or the Cancer Moonshot Initiative of a few years ago.  In fact, he referred to it as a “health equity moonshot” and suggested four priorities to address the equity gaps that have existed for too long but were made glaringly obvious during the pandemic.  They are:

  • Extending health coverage access beyond the current Public Health Emergency by utilizing innovative private models and government-based structures.
  • Creating worldwide standards for data collection and full data interoperability to enable real-time analytics.
  • Making broadband available to every rural and urban community in the country.
  • Using technology to support sustained well-being, particularly in underserved communities.

If we truly believe in the goal of accessible, high-quality healthcare for every American, then this is an idea that should receive extensive attention and discussion.  To quote Mr. Woods again, “While COVID-19 and the public health emergency we have faced may fade over time, the health inequities the pandemic uncovered will persist if we don’t take this moment to come together around an ambitious goal.”