{"id":9883,"date":"2020-04-15T08:25:36","date_gmt":"2020-04-15T13:25:36","guid":{"rendered":"https:\/\/www.billingparadise.com\/blog\/?p=9883"},"modified":"2020-08-19T14:53:14","modified_gmt":"2020-08-19T19:53:14","slug":"covid-19-forces-medical-practices-to-modify-operations","status":"publish","type":"post","link":"https:\/\/www.billingparadise.com\/blog\/covid-19-forces-medical-practices-to-modify-operations\/","title":{"rendered":"COVID-19 Forces Medical Practices to Modify Operations"},"content":{"rendered":"

COVID-19 has forced many physician practices to modify their workflows, for instance the staff at Indiana University Health Physicians has started calling patients with scheduled appointments for routine care to postpone their visits by six weeks.<\/p>\n<\/div><\/div><\/div><\/div><\/section>

Over the last 10-days, the IU Health Physicians have taken a number of decisions to alleviate the spread of novel coronavirus, and protect its personnel numbering 200 primary-care and 1,700 specialty physicians that are spread across 150 ambulatory locations in Indiana.<\/p>\n<\/div><\/div>

Brian Kremer, the chief operating officer of IU Health Physicians stated that they are sending out messages to their patients reassuring them they are not closing down operations, this move is only to protect them and their families, besides their workforce from unnecessary exposure.<\/p>\n<\/div><\/div><\/div>

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Just as IU Health Physicians, DuPage too is limiting patient visits, specifically patients who are elderly and have chronic conditions. These patients are more at risk because of their vulnerability to the dangerous coronavirus symptoms.<\/p>\n

The DuPage practices review patient schedules each morning to see if appointments for the day can be rescheduled, and if patients are open to the changed schedule.<\/p>\n<\/div><\/div>

As a means to limit the exposure to the coronavirus in their communities and workforce, the IU Health Physicians is one of many physician practices taking preventive steps. At the same time, patients continue receiving routine care.<\/p>\n<\/div><\/div>[vc_single_image image=”9908″ img_size=”large” alignment=”center”]

As Dr. Mia Taormina puts it “We are not turning anyone away who has a need or desire to be seen at this time”. Taormina works for the Illinois-based DuPage Medical Group as a chairperson in the infectious disease department, the health system is spread across 120 different locations.<\/p>\n

Just as IU Health Physicians, DuPage too is limiting patient visits, specifically patients who are elderly and have chronic conditions. These patients are more at risk because of their vulnerability to the dangerous coronavirus symptoms.<\/p>\n

The DuPage practices review patient schedules each morning to see if appointments for the day can be rescheduled, and if patients are open to the changed schedule.<\/p>\n<\/div><\/div><\/div><\/div><\/section>

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Mollifying Concerns<\/h2><\/div><\/div>[vc_message icon_fontawesome=”fa fa-snowflake-o”]As worried and confused patients continue calling the practices, educating the community has become an additional task that they have to carry out. New Jersey is amongst the many states that have seen[\/vc_message]

New Jersey is amongst the many states that has seen a spike in COVID-19 cases, RWJBarnabas Health Medical Group with 2,000 providers across 300 practice sites is experiencing a spurt in calls from concerned patients that fear that they may be carrying the virus. The questions most of the callers had, according to<\/p>\n

\"\"<\/p>\n

Dr. Andy Anderson, CEO of the medical group “Do I have this or not? And how sick am I going to get from this? The health facility as a result has initiated robocalls, so that patients can be educated on how to protect themselves.<\/p>\n<\/div><\/div>

Social distancing and stay-at-home practices are being recommended to low-risk patients, while high risk patients can access the test for the virus at a few RWJBarnabas sites. One patient has so far tested positive for the coronavirus in a RWJBarnabas clinical setting. In accordance, the health facility has been following regulations notifying
\nthe New Jersey Department of Health and the Centers for Disease Control and Prevention.<\/p>\n<\/div><\/div>

The hospital currently isn’t experiencing any shortages of protective equipment so far, but if a situation so arose, Anderson said that they can redistribute supplies from other sites, the supplies are closely being monitored.<\/p>\n

Besides a short supply of protective supplies like masks and gowns, another worrying factor for practices is the limited coronavirus test kits.<\/p>\n

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Questions from clinicians about how to test for the virus in their communities are being addressed by Aledade, a consultancy that partners across the country on various value-based payment contracts, according to Dr. Farzad Mostashari, who is CEO of the company.<\/p>\n

Communities in rural areas are dependent on practices for healthcare, but lack of personal protective equipment required to do the tests are a major worry, he says.<\/p>\n<\/div><\/div>

The company is working hard on behalf of the practices, and trying to source the masks for them, so that they can continue with their business, according to Mostashari.<\/p>\n

Local health systems for communities are being referred by DuPage Medical Group to high risk patients that come to them for coronavirus testing. Plans are underway by the medical group to test patients at some of its clinics, however, according to Taormina they will be limiting exposure in the drive-through hospitals.<\/p>\n<\/div><\/div><\/div><\/div><\/section>

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Virtual Health Systems<\/h2><\/div><\/div>[vc_empty_space][vc_empty_space]<\/div><\/div><\/section>[vc_message icon_fontawesome=”fa fa-snowflake-o”]As worried and confused patients continue calling the practices, educating the community has become an additional task that they have to carry out.[\/vc_message]

In the process of dealing with testing and supply concerns, physician practices are exploring telehealth as a vital tactic.<\/p>\n

The limited supply of personal protective equipment that healthcare providers across the country are experiencing has motivated IU Health Physicians to adopt a policy of screening through telehealth as often as possible.<\/p>\n

Reiterating what other providers have also been stating, Kremer,the Chief Operating Officer of IU Health Physicians says “The limitations of personal protective equipment for our staff and patients is by far our biggest concern,” further elaborating, he explains “Much of the driver as to why we rescheduled all elective surgeries and limited our outpatient visits to those who have urgent needs is to preserve the personal protective equipment.”<\/p>\n

More than 100 physicians are being enlisted by IU Health Physicians currently to its telehealth platform, as a measure to minimise in-person visits across its sites.<\/p>\n

\"\"<\/p>\n

As Dr. Greg Kiray, chief health officer of IU Health Physicians noted that despite telehealth capabilities being available for a couple of years, the uptake by physicians was slow. The COVID-19 outbreak has brought to the fore the importance of virtual capabilities.<\/p>\n

As a measure to protect both patients and staff from exposure to the coronavirus, the primary-care provider ChenMed in the past few weeks has shifted care for most of its Medicare Advantage patients from clinic visits to either telehealth or home visits.<\/p>\n

\"\"<\/p>\n

As Dr. Christopher Chen, CEO of the family-owned company explains that they are 90% center-basd patient care, and from hereon will now pivot for 90% virtual appointments. ChenMed operates 59 centers in 39 cities around the country, the CEO declared their patients are from a high-risk population for the coronavirus, and he would want to keep them healthy, happy, and at home.<\/p>\n

In a week Chen says, nearly two-thirds of patients were being served by his centers through virtual care or home care, and in another week the target would hit 90%. Small percentage of patients with urgent medical conditions can visit the clinic, which would remain open for them.<\/p>\n

Patients have been called and notified of the change by ChenMed staff, and their reaction has been extremely positive, says Chen, further emphasising that his senior patients were terrified of visiting the doctor’s office or hospital, risking exposure to COVID-19.<\/p>\n

Earlier, ChenMed would encourage the patients to come to their center more frequently, especially patients whose average age was 72, and suffered from five or more chronic conditions. These patients would come as often as several times a month. At full capacity, each center has 2,000 to 3,000 patients.<\/p>\n

Patients under a fixed per-member, per-month payment from Medicare Advantage plans are served by ChenMed, as the center receives a financial incentive for serving these patients.It plans to continue the trend, with emphasis on patient contacts with limited clinic visits.<\/p>\n

Patients without internet access get the benefit of iPad computers being dropped at their homes by ChenMed’s staff drivers, so that virtual medical visits can be facilitated. Any tests recommended, are administered to the patient at home by the clinical staff using safety protocols, EKGs included.<\/p>\n<\/div><\/div>

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Meeting non-medical needs<\/h2><\/div><\/div>[vc_empty_space][vc_empty_space][vc_message icon_fontawesome=”fa fa-snowflake-o”]The non-medical needs of patients are also met by ChenMed drivers, groceries and supplies are delivered, so that they don’t risk exposure to coronavirus. [\/vc_message]<\/div><\/div><\/section>

Practice partners of Aledade are being assisted to implement telemedicine, currently only a few are pursuing it.<\/p>\n

Medicare reimbursement for telehealth services are going to be on par with regular in-person visits, the CMS has announced recently.<\/p>\n

More clarity has been sought from the CMS on this issue by practices, according to Mostashri.<\/p>\n

A risk scoring tool is being proposed by the consultancy to help practices identify patients that are vulnerable or at most risk of the novel coronavirus symptoms.<\/p>\n

Mostashari explained that people are scared, and seniors are scared, patients feel comfortable when they hear from their primary care practices, however, since it is difficult for every patient to be called, his idea of a risk scoring tool was a result of this.<\/p>\n

The present crisis, according to Chen has effectively positioned his company’s shift to virtual and home-based care for the future. It has facilitated ChenMed to provide the services to a larger segment of the population, also covering rural communities. ,<\/p>\n<\/div><\/div><\/div><\/div><\/section><\/div><\/div><\/section>

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Staffing Worries<\/h2><\/div><\/div>[vc_empty_space][vc_empty_space][vc_message icon_fontawesome=”fa fa-snowflake-o”]It is usual for health facilities to experience staffing concerns in health crises such as COVED-19, but RWJ Barnabas have not been experiencing any staffing shortages yet, but if it does occur, they would plan to consolidate practices.[\/vc_message]<\/div><\/div><\/section><\/div><\/div><\/section>

Next few weeks, according to Anderson, staffing may become an issue, as the virus may dramatically spread. Noting that they do not want to rely on staffing agencies to overcome staff turnover, because the agencies are also under a strain.<\/p>\n

Meanwhile, physicians and other employees of ChenMed, who are age 60 or older, and have serious chronic conditions such as diabetes, have been advised to provide care remotely, according to Chen. Only one employee of ChenMed so far has been tested positive for COVID-19, and since been quarantined. This employee was exposed to a child that had come from Italy, and had been tested positive for COVID-19.<\/p>\n<\/div><\/div><\/div><\/div><\/section>\n","protected":false},"excerpt":{"rendered":"COVID-19 has forced many physician practices to modify their workflows, for instance the staff at Indiana University Health Physicians has started calling patients with scheduled appointments for routine care to postpone their visits by six weeks. Over the last 10-days, the IU Health Physicians have taken a number of decisions to alleviate the spread of [...]","protected":false},"author":2,"featured_media":9886,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[721,716],"tags":[],"class_list":["post-9883","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-collections","category-most-recent"],"modified_by":"Erika Regulsky","_links":{"self":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts\/9883","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/comments?post=9883"}],"version-history":[{"count":0,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/posts\/9883\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/media\/9886"}],"wp:attachment":[{"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/media?parent=9883"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/categories?post=9883"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.billingparadise.com\/blog\/wp-json\/wp\/v2\/tags?post=9883"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}