News & Updates

  • 14 Dec 2020 8:35 AM | AIMHI Admin (Administrator)

    60 Minutes Source | Comments Courtesy of Matt Zavadsky

    Fascinating report on 60 Minutes this evening.  The link below contains the video version – well worth the watch!

    Interesting that the California AG who did the investigation, brought the suit, and negotiated the proposed $575 million settlement, is the Biden Administration’s pick for HHS Secretary.

    ----------------------

    How a hospital system grew to gain market power and drove up California health care costs

    Sutter Health is in the midst of a lawsuit for business practices that drove up health care prices for Californians.

    The coronavirus pandemic has unleashed more than a flood of disease in this country. It's also expected to accelerate a wave of hospital mergers and acquisitions – with big hospitals buying up smaller ones. This consolidation, economists say, is one of the main reasons the cost of health care in this country is going through the roof.

    There's a lawsuit over this in COVID-ravaged California, with the state attorney general claiming that Sutter Health, a hospital chain based in Sacramento, got so big it had essentially become a monopoly.

    On the eve of the trial, Sutter tentatively agreed to a settlement that's awaiting a judge's approval. But this is, even at this stage, a landmark case because it pulled back the curtain on what has rarely been seen or so thoroughly documented before: how and why hospital prices have been skyrocketing.

    Sutter is a sprawling health care system that's the largest and most dominant provider in Northern California.

    Xavier Becerra: They're like the bully on the block. They were able to bully everyone else to conform; it was my way or the highway.

    The state's attorney general, Xavier Becerra, filed a civil lawsuit against Sutter in 2018. We interviewed him before the pandemic and before he was nominated for secretary of Health and Human Services.

    Xavier Becerra: They were gobbling up hospitals. They were gobbling up physicians through these physician practices. They were just munching away, getting bigger and bigger.

    Till they amassed a conglomerate of 24 hospitals, 12,000 physicians, and a string of cancer, cardiac and other health care centers.

    Xavier Becerra: Sutter got big enough that it could use its market power to dominate, to dictate. It was abusing of its power.

    The suit accuses Sutter of embarking on "…an intentional, and successful, strategy…" of cornering much of the market in Northern California, and then jacking up prices -- for example, on the price of delivering a baby.

    CONTINUE READING►

  • 9 Dec 2020 9:13 AM | AIMHI Admin (Administrator)

    MedArrive Press Release in Fierce Healthcare| Comments courtesy of Matt Zavadsky

    Heads up EMS’rs....  Another VC funded company leveraging the trusted EMS provider community to provide patient-centered care, that adds value to the payers...

    Two versions of the announcement are below.

    We are in hyperturbulent times in our communities and healthcare systems.  Hometown EMS agencies should leverage their community trust and ‘Swiss army knife’ approach to healthcare, including the important 9-1-1 component of our service delivery, to demonstrate new value to our payers!

    Many agencies have been very successful doing this, especially during the pandemic.  Some of us have even applied for, and already received approval, to be ‘Type 73’ providers for CMS, making us eligible for reimbursement from Medicare, Medicaid and others for things like vaccine administration and monoclonal antibody infusions...

    This is OUR time...  J

    Tip of the hat to Curt Bashford and Rob Lawrence for helping assure this information was distributed.

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    MedArrive launches to bring more humanity to healthcare

    With $4.5 million in funding from Kleiner Perkins and Define Ventures, and backed by Redesign Health, MedArrive is poised to bridge the virtual care gap and make affordable at-home care the new norm.

    December 03, 2020

     

    https://www.globenewswire.com/news-release/2020/12/03/2139204/0/en/MedArrive-launches-to-bring-more-humanity-to-healthcare.html

     

    SAN FRANCISCO, Dec. 03, 2020 (GLOBE NEWSWIRE) -- Today MedArrive launched a new care management platform that enables healthcare providers and payors to extend services into the home, scaling access to high quality healthcare and meaningfully reducing costs for providers and their patients. MedArrive – co-founded by Dan Trigub and Inna Plumb – bridges the virtual care gap by integrating physician-led telemedicine with hands-on care from a network of trusted EMS professionals, improving patient outcomes while empowering an underutilized segment of healthcare workers.

     

    Backed by Redesign Health, MedArrive is also announcing a $4.5 million seed round, co-led by Kleiner Perkins and Define Ventures. In connection with the investment, Annie Case, Principal at Kleiner Perkins, and Lynne Chou O'Keefe, Founder and Managing Partner at Define Ventures, will both join the MedArrive Board of Directors.

     

    “Now more than ever, as we continue battling a global pandemic, patients deserve healthcare that is accessible, affordable, and safe,” said Dan Trigub, co-founder and CEO of MedArrive. “The current pandemic has placed additional stress on our already flawed health system – patients are avoiding clinics, delaying preventative and critical care, and facing financial strain. By working alongside communities of EMS professionals, providers, and payors to bring high quality care into the home at a fraction of the cost of alternatives, MedArrive’s integrated solution is putting patients back at the center of care.”

     

    MedArrive taps into a capable workforce of EMS professionals (e.g., EMTs and paramedics) so they can leverage the full scope of their training, earn supplemental income and diversify their day-to-day responsibilities. At the same time, patients using MedArrive are able to access trusted medical expertise from the safety of their homes and within their existing health systems, ultimately resulting in better patient outcomes, a better utilized healthcare workforce, and significant cost savings for patients and providers alike.

     

    “Telehealth has enabled patients across the country to access important care from the safety of their homes throughout the pandemic. But many care needs require in-person visits and diagnostics, and often benefit from deeper insight into a patient’s experience at home,” said Pat Songer, COO of Cascade Medical Hospital, Executive Director of the National EMS Management Association, and Advisor to MedArrive. “EMTs and paramedics are highly-trained medical professionals and trusted members of their communities. What MedArrive is doing is enabling this workforce to utilize the full scope of their training and provide care in the home that cannot be done as effectively in a clinic setting, such as medication reconciliation, discharge instruction adherence, fall risk assessment, and collection of key SDoH and environmental data. This translates to better care experiences for patients and lower costs.”

     

    MedArrive launches with $4.5 million in funding from Kleiner Perkins and Define Ventures. This injection of capital will enable MedArrive to continue building their innovative platform, growing their team of industry experts, and driving the expansion of key healthcare provider partnerships across the country. With an initial focus on the Florida market, the team expects to expand quickly and effectively over the coming months.

     

    "Telemedicine is the clearest example of the pandemic remaking business as usual, but telemedicine alone is not the answer," says Annie Case, Principal at Kleiner Perkins. "We need platforms like MedArrive that can enrich and expand the use cases of telemedicine through onsite visits, and we believe MedArrive's partnership-driven approach will help them emerge as a leader in the space. We're looking forward to working with the incredible team at MedArrive as they scale their innovative model and reinvent at-home care."

     

    "Before the COVID-19 pandemic, the healthcare system was focused on the continuity of care from hospital to home,” says Lynne Chou O'Keefe, Founder and Managing Partner at Define Ventures. “With this trend and the urgency of COVID, we believe MedArrive is an important scalable solution that will help redefine how healthcare is delivered to patients at the home."

     

    Today, MedArrive partners can tap into a dense network of more than 20k trusted EMTs and paramedics ready to be deployed across the country, with equal representation in rural and urban markets. This will be particularly critical for our partners looking to distribute flu vaccines and, when available, a COVID-19 vaccine without overwhelming health systems. Additional services include chronic condition management, transitional care, readmission prevention, urgent care, palliative care and more. MedArrive provides the most extensive coverage for providers and payors looking to expand their impact and scale care into the home to meet the diverse needs of their patients.

     

    About MedArrive

    MedArrive enables healthcare providers to seamlessly extend care services into the home, unlocking access to high quality healthcare for more people at a fraction of the cost. MedArrive’s fully integrated care management platform allows providers and payors to bridge the virtual care gap by marrying physician-led telemedicine with hands-on care from EMS professionals. This unique approach means that patients are able to access trusted medical expertise from the comfort and safety of their homes without any interruption to continuity of care, ultimately resulting in better patient outcomes, a better utilized healthcare workforce, and significant cost savings for patients and providers alike. MedArrive has more than 20k highly-skilled EMS providers in its national network and services span dozens of clinical use cases including chronic condition management, transitional care, readmission prevention, urgent care, vaccinations, palliative care and more. For more information, visit medarrive.com.

     

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    Dan Trigub left Uber Health to start a new healthcare venture. Here is what he's working on

    by Heather Landi

    Dec 3, 2020

     

    https://www.fiercehealthcare.com/tech/dan-trigub-left-uber-health-to-start-a-new-healthcare-venture-here-what-he-s-working

     

    In his two years at Uber Health, Dan Trigub worked to expand access to medical transportation, and, now, he's focused on building a unique approach to home health.

     

    Trigub and co-founder Inna Plumb have launched MedArrive as a new care management platform that enables healthcare providers and payers to extend services into the home.

     

    The startup bridges the virtual care gap by integrating physician-led telemedicine with hands-on care from a network of trusted EMS professionals, improving patient outcomes while empowering an underutilized segment of healthcare workers, according to the company.

     

    Backed by Redesign Health, MedArrive banked a $4.5 million seed round co-led by Kleiner Perkins and Define Ventures. In connection with the investment, Annie Case, principal at Kleiner Perkins, and Lynne Chou O'Keefe, founder and managing partner at Define Ventures, will both join the MedArrive board of directors.

     

    Based in New York City, Redesign Health is a venture studio and holding company incubating tech-enabled healthcare businesses.

     

    The injection of capital will enable MedArrive to continue building its platform, grow its team of industry experts and drive the expansion of key healthcare provider partnerships across the country. With an initial focus on the Florida market, the team expects to expand quickly and effectively over the coming months.

     

    The COVID-19 pandemic has placed additional stress on the health system, with patients avoiding clinics, delaying preventive and critical care and facing financial strain.

     

    "By working alongside communities of EMS professionals, providers, and payors to bring high-quality care into the home at a fraction of the cost of alternatives, MedArrive’s integrated solution is putting patients back at the center of care," said Trigub, CEO of MedArrive.

     

    “Now more than ever, as we continue battling a global pandemic, patients deserve healthcare that is accessible, affordable and safe,” he said.

     

    Clinical care is moving more into the home, and telemedicine is growing with the tailwinds of the COVID-19 pandemic, but it can’t solve every health problem, Trigub told Fierce Healthcare.

     

    "Our mission statement is to improve people’s lives to bring more humanity to healthcare, the physical touch and the contact, and telemedicine strips out the human side of care. By building this platform and infrastructure, we're connecting three stakeholders, patients, health plans and health systems and we're leveraging the most under-utilized workforce in healthcare, EMTs and paramedics," he said.

     

    MedArrive taps into a capable workforce of EMS professionals so they can leverage the full scope of their training, earn supplemental income and diversify their day-to-day responsibilities. At the same time, patients using MedArrive are able to access trusted medical expertise from the safety of their homes and within their existing health systems, ultimately resulting in better patient outcomes, a better-utilized healthcare workforce and significant cost savings for patients and providers alike, according to the company.

    Trigub, who left Lyft to become the head of Uber Health, announced in September that he was leaving the ride-share giant.

     

    "Uber, at the end of the day, is not a healthcare-first organization. It's a massive company with amazing scale and reach. But there are lots of competing priorities. I wanted to give my full attention to a pure healthcare business, and it's a tremendous opportunity outside of a large tech environment that can have a lot of red tape and internal politics," he said.

     

    While telehealth has helped to increase access to care, many care needs require in-person visits and diagnostics and often benefit from deeper insight into a patient’s experience at home, said Pat Songer, chief operating officer of Cascade Medical Hospital, executive director of the National EMS Management Association and adviser to MedArrive.

     

    “What MedArrive is doing is enabling this [EMS] workforce to utilize the full scope of their training and provide care in the home that cannot be done as effectively in a clinic setting, such as medication reconciliation, discharge instruction adherence, fall risk assessment, and collection of key SDoH and environmental data. This translates to better care experiences for patients and lower costs," Songer said.

     

    MedArrive partners can tap into a network of more than 20,000 trusted emergency medical technicians and paramedics, with equal representation in rural and urban markets. This will be particularly critical for the company's partners looking to distribute flu vaccines and, when available, a COVID-19 vaccine without overwhelming health systems, according to MedArrive executives.

     

    Additional services include chronic condition management, transitional care, readmission prevention, urgent care and palliative care.

     

    The COVID-19 pandemic has accelerated the shift to providing clinical care in patients' homes, according to Plumb, who has experience in private equity, finance and analytics.

     

    "Care is moving into the home, but how can we do it cost-effectively? By leveraging EMS and existing players in the market to deliver care in a cost-effective way, we can be active in both rural or urban environments," she said.

     

    By leveraging virtual care and in-person care, MedArrive enables providers and payers to see what's going on in a patient's home to address social determinants of health and quality of life issues, Trigub said.

     

    That taps into Trigub's experience at Uber Health, where he led the company to form partnerships with Medicare Advantage plans to open up ride-sharing options. Uber Health also has put a focus on Medicaid as a key market to focus on at-risk populations.

     

    "What we can truly do here at MedArrive is have an outsized impact to help democratize healthcare," he said.


  • 4 Dec 2020 5:25 PM | AIMHI Admin (Administrator)

    Washington Post source | Comments courtesy of Matt Zavadsky

    There has been a plethora of national and local news stories this week about this issue –

    An NBC News report and a recent MSNBC interview with Dr. Ed Racht earlier this week.

    Ambulance agencies large and small, urban and rural, on the brink of collapse!

    --------------------

    Pandemic is pushing America’s 911 system to ‘breaking point,’ ambulance operators say

    Surging demand, financial strain are leaving ambulance corps exhausted and running out of funds

    By William Wan, Dec. 3, 2020

    https://www.washingtonpost.com/health/2020/12/03/911-ambulance-services-breaking-point/

    The coronavirus pandemic has pushed America’s 911 system and emergency responders to a “breaking point,” with ambulance workers and their services financially strained.

    Ambulance providers from New York to Iowa to Georgia say the situation is increasingly dire. Desperate for a financial infusion to keep such operations afloat, the American Ambulance Association recently begged the Department of Health and Human Services for $2.6 billion in emergency funding.

    “The 911 emergency medical system throughout the United States is at a breaking point,” Aarron Reinert, the association’s president, wrote to federal health officials in a Nov. 25 letter obtained by The Washington Post. “Without additional relief, it seems likely to break, even as we enter the third surge.”

    The strain could result in longer wait times and some providers going out of business, ambulance operators said.

    Ambulance providers are struggling to meet surging demand even while grappling with increased costs of personal protective equipment, overtime, staff shortages as workers fall ill and decreases in the type of emergency calls that are reimbursed.

    CONTINUE READING►


  • 3 Dec 2020 5:36 PM | AIMHI Admin (Administrator)

    CMS Source | Comments Courtesy of Matt Zavadsky

    CMS is delaying the data collection and reporting period for ground ambulance organizations selected to participate in year 1 for two years and for one year for ground ambulance organizations selected to participate in year 2.

    With this modification, the data collection period for year 1 and year 2 selected ground ambulance organizations will begin between January 1, 2022 and December 31, 2022.

    Does cause a bit of a challenge, since the data from this process is going to be used to evaluate the Medicare reimbursement rates, so further delays may cause a time compression issue on the back end of this timeframe.

    CMS has issued a revised blanket waiver yesterday: https://www.cms.gov/files/document/summary-covid-19-emergency-declaration-waivers.pdf to delay the Medicare Ground Ambulance Data Collection System. 

    Please see page 31 of the above linked document 


  • 2 Dec 2020 9:08 AM | AIMHI Admin (Administrator)

    Source Slide Deck | Comments Courtesy of Matt Zavadsky

    Nice to see EMS in the Phase 1a sequence recommended by the (Advisory Committee on Immunization Practices) ACIP yesterday afternoon! 

    May help with talking points for state officials who do not seem to think EMS providers should be in Phase 1?!

    You can download the full slide deck here è https://www.cdc.gov/vaccines/acip/meetings/slides-2020-12.html


  • 2 Dec 2020 8:51 AM | AIMHI Admin (Administrator)

    Modern Healthcare Source | Comments courtesy of Matt Zavadsky

    Perhaps a little bit of a mixed-bag for some telehealth services, but overall, seems that the extension of the telehealth services for emergency department visits, and the hint that those provisions may become permanent, may help the role of telemedicine in EMS and patient navigation.

    The final rule also contains coverage for telehealth services provided in a patient’s home.

    The use of video telemedicine for physicians to supervise other healthcare providers – could also be beneficial for an EMS integration strategy.

    ---------------------

    CMS signs off on physician fee schedule changes

    MICHAEL BRADY

    December 01, 2020

    https://www.modernhealthcare.com/physician-compensation/cms-signs-physician-fee-schedule-changes

     

    CMS on Tuesday signed off on Medicare's 2021 physician fee schedule, giving providers just a month to prepare for the changes.

     

    The final rule permanently allows Medicare providers to use telehealth to carry out home visits for so-called evaluation and management services and some visits for people with cognitive impairments. It also temporarily continues telehealth services for emergency department visits and other services with an eye toward making them permanent, according to a CMS fact sheet.

     

    "Telehealth has long been a priority for the Trump Administration, which is why we started paying for short virtual visits in rural areas long before the pandemic struck. But the pandemic accentuated just how transformative it could be," CMS Administrator Seema Verma said in a statement.

     

    According to CMS, more than 24.5 million of Medicare's 63 million beneficiaries and enrollees received a Medicare telemedicine service during the public health emergency. The agency expanded the telehealth services rural enrollees can receive at healthcare facilities. During a call with reporters, Verma reiterated that Congress needs to change federal law to permanently allow non-rural beneficiaries to receive telehealth benefits or for Medicare beneficiaries to receive telehealth services at home. She noted the agency will study the safety, quality and cost of remote patient monitoring and virtual physician supervision.

    Continue Reading>


  • 1 Dec 2020 5:55 PM | AIMHI Admin (Administrator)

    NBC News source article | Comments courtesy of Matt Zavadsky

    At the same this this came out, it was reported that a bipartisan group of Senators are proposing a $900B aid package, wonder if more aid, or Treatment in Place language could be added to the package!?

    ----------------------

    Ambulance companies at 'a breaking point' after receiving little Covid aid

    In a letter obtained exclusively by NBC News, the American Ambulance Association told the Department of Health and Human Services that “the 911 emergency medical system throughout the United States is at a breaking point.”

    Dec. 1, 2020

    By Phil McCausland

    https://www.nbcnews.com/news/us-news/ambulance-companies-breaking-point-after-receiving-little-covid-aid-n1249586

     

    Stefan Hofer's ambulance company, West Traill EMS, in Mayville, North Dakota, has received only one or two calls that weren’t related to Covid-19 over the past two months. But he said the case count has ballooned by 20 to 30 percent because of the pandemic. At the same time, the company's expenses have mounted, its revenue has cratered and its workforce is being decimated by the virus.

     

    The company — which is private and supported by volunteers, a few employees and four trucks — covers more than 1,500 miles of North Dakota prairie and serves about 10,000 people on the far east side of the state.

     

    Private EMS services, both in urban and rural centers across the country, collectively received $350 million in Covid-19 relief funds in April, but those companies said that money ran out within weeks. Months later, the need remains great as they face another coronavirus surge.

     

    Hofer said he doesn’t know how long his company can keep up its current pace — much less how it will manage the increase in cases they expect from the Thanksgiving holiday — if ambulance services like his don’t receive additional federal aid. He said he may lose employees soon. That could mean answering fewer calls, too.

    Continue Reading>


  • 1 Dec 2020 5:23 PM | AIMHI Admin (Administrator)

    Modern Healthcare source article | Comments courtesy of Matt Zavadsky

    This is an area for a logical police/EMS/Community Health Paramedic partnerships...

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    Sending specialists to handle mental health crises, not police officers

    November 28, 2020

    STEVEN ROSS JOHNSON

     

    https://www.modernhealthcare.com/safety-quality/sending-specialists-handle-mental-health-crises-not-police-officers

     

    The recent killing of Walter Wallace Jr. by Philadelphia police underscores long-standing concerns about asking police officers to deal with people experiencing a mental health crisis.

     

    The 27-year-old was reportedly wielding a knife when he was shot and killed by officers Oct. 27. Family members claimed they called for an ambulance to get Wallace help, but instead the police came, according to news reports.

    Wallace’s death came shortly after Philadelphia unveiled a program in early October designed to handle such situations. Behavioral healthcare specialists will work alongside police dispatchers to determine the appropriate response to calls about a person having a mental health emergency.

     

    The program apparently wasn’t fully implemented in time to address Wallace’s situation. A pilot phase began in late September, according to representatives from the Philadelphia Department of Behavioral Health and Intellectual Disability Services. The agency is partnering with the Police Department to embed a behavioral health navigator in the police 911 radio room for the program’s second phase, which will dispatch co-response teams when needed; it isn’t expected to begin until early 2021.

     

    A spokeswoman for the city agency was unable to comment because of an ongoing investigation into the matter. But it’s clear the circumstances of Wallace’s death speak to a broader problem many communities face: the criminal justice system is the de facto primary responder for handling mental health.

     

    “When you rely on law enforcement to respond to a situation, they’re looking at the situation through a safety lens and interpreting behaviors as potential threats, and then they respond accordingly,” said Angela Kimball, national director for advocacy and public policy at the National Alliance on Mental Illness.

     

    To address the issue, a growing number of police departments have formed crisis intervention teams, which are sent instead of regular patrol officers to potentially volatile situations. The number of police departments that have added crisis intervention team programs has soared over the past decade from 400 in 2008 to more than 2,700 by 2019. 

     

    Kimball hopes to see more investment in crisis intervention alternatives as public sentiment on law enforcement’s role in responding to mental health emergencies evolves. “It defies logic why this has not happened” before, Kimball said. “It is far easier to maintain the status quo and complain about it than to change your systems.”

     

    As the COVID-19 pandemic exacerbates anxiety and depression, 911 calls for those experiencing a mental health or a substance use disorder crisis are only expected to rise.

     

    Continue reading>

  • 25 Nov 2020 4:58 PM | AIMHI Admin (Administrator)

    CMS Newsroom Source | Comments Courtesy of Matt Zavadsky

    This is an interesting waiver that directly references Mobile Integrated Healthcare Paramedics as an eligible part of the care team.

    EMS agencies providing MIH services should consult with their local hospitals to see if this is a program the hospital may be applying for.

    Tip of the hat to Chris Crowley from West Health for assuring we were aware of this in the waiver.

    Additional webinars will be forthcoming...

    -------------------------

    CMS Announces Comprehensive Strategy to Enhance Hospital Capacity Amid COVID-19 Surge

    Nov 25, 2020 

     

    https://www.cms.gov/newsroom/press-releases/cms-announces-comprehensive-strategy-enhance-hospital-capacity-amid-covid-19-surge

     

    Today, the Centers for Medicare & Medicaid Services (CMS) outlined unprecedented comprehensive steps to increase the capacity of the American health care system to provide care to patients outside a traditional hospital setting amid a rising number of coronavirus disease 2019 (COVID-19) hospitalizations across the country. These flexibilities include allowances for safe hospital care for eligible patients in their homes and updated staffing flexibility designed to allow ambulatory surgical centers (ASCs) to provide greater inpatient care when needed. Building on CMS’s previous actions to expand the availability of telehealth across the nation, these actions are aimed at allowing health care services to be provided outside a hospital setting while maintaining capacity to continue critical non-COVID-19 care, allowing hospitals to focus on the increased need for care stemming from public health emergency (PHE).

     

    “We’re at a new level of crisis response with COVID-19 and CMS is leveraging the latest innovations and technology to help health care systems that are facing significant challenges to increase their capacity to make sure patients get the care they need,” said CMS Administrator Seema Verma. “With new areas across the country experiencing significant challenges to the capacity of their health care systems, our job is to make sure that CMS regulations are not standing in the way of patient care for COVID-19 and beyond.”

     

    Acute Hospital Care at Home

    In March 2020, CMS announced the Hospitals Without Walls program, which provides broad regulatory flexibility that allowed hospitals to provide services in locations beyond their existing walls. Today, CMS is expanding on this effort by executing an innovative Acute Hospital Care At Home program, providing eligible hospitals with unprecedented regulatory flexibilities to treat eligible patients in their homes. This program was developed to support models of at-home hospital care throughout the country that have seen prior success in several leading hospital institutions and networks, and reported in academic journals, including a major study funded by a Healthcare Innovation Award from the Center for Medicare and Medicaid Innovation (CMMI).

     

    The development of this program was informed by extensive consultation with both academic and private sector industry leaders to ensure appropriate safeguards are in place to protect patients, and at no point will patient safety be compromised. CMS believes that treatment for more than 60 different acute conditions, such as asthma, congestive heart failure, pneumonia and chronic obstructive pulmonary disease (COPD) care, can be treated appropriately and safely in home settings with proper monitoring and treatment protocols.

     

    Participating hospitals will be required to have appropriate screening protocols before care at home begins to assess both medical and non-medical factors, including working utilities, assessment of physical barriers and screenings for domestic violence concerns. Beneficiaries will only be admitted from emergency departments and inpatient hospital beds, and an in-person physician evaluation is required prior to starting care at home. A registered nurse will evaluate each patient once daily either in person or remotely, and two in-person visits will occur daily by either registered nurses or mobile integrated health paramedics, based on the patient’s nursing plan and hospital policies.

     

    CMS anticipates patients may value the ability to spend time with family and caregivers at home without the visitation restrictions that exist in traditional hospital settings. Additionally, patients and their families not diagnosed with COVID-19 may prefer to receive care in their homes if local hospitals are seeing a larger number of patients with COVID-19. It is the patient’s choice to receive these services in the home or the traditional hospital setting and patients who do not wish to receive them in the home will not be required to.

     

    The program clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.

     

    To support these efforts, CMS has launched an online portal https://qualitynet.cms.gov/acute-hospital-care-at-home to streamline the waiver request process and allow hospitals and healthcare systems to submit the necessary information to ensure they meet the program’s criteria to participate. CMS will also closely monitor the program to safeguard beneficiaries by requiring hospitals to report quality and safety data to CMS on a frequency that is based on their prior experience with the Hospital At Home model.

     

    Six health systems with extensive experience providing acute hospital care at home are being approved today for the new waivers and include Brigham and Women’s Hospital (Massachusetts); Huntsman Cancer Institute (Utah); Massachusetts General Hospital (Massachusetts); Mount Sinai Health System (New York City); Presbyterian Healthcare Services (New Mexico); and UnityPoint Health (Iowa). This immediately expands the at-home care options for Medicare beneficiaries in the regions served by these organizations. CMS has been in discussions with other health care systems and expects new applications to be submitted.

     

    To view the Acute Hospital Care At Home initiative and application, please visit: CMS’: https://qualitynet.cms.gov/acute-hospital-care-at-home  

     

    To view comments from health systems participating in the Acute Hospital Care at Home, please visit: https://www.cms.gov/files/document/what-are-they-saying-hospital-capacity.pdf

     

    Link to FAQs:
    https://www.cms.gov/files/document/covid-hospital-without-walls-faqs-ascs.pdf 
    https://www.cms.gov/files/document/covid-acute-hospital-care-home-faqs.pdf

     


  • 23 Nov 2020 3:27 PM | AIMHI Admin (Administrator)

    JEMS Source Article | Comments Courtesy of Matt Zavadsky

    • Very concerning data from this study from JEMS. 

      Something we can use to remind our field providers about the importance of compliance with infection control process, and advocate for additional mental health resources for our personnel.

      Most notable quotes:

    • We know that the pandemic fatality rate for the U.S. population as of October 17 (217,918 deaths) is 66.4 per 100,000 persons. Using the formula from above we see that the relative risk for FDNY EMS is about 36% higher than the national rate.
    • The data that are available indicate that EMS clinicians are at higher overall risk of death, pandemic-related mortality and suicide than other emergency services and health professions.
    • This shows that in FDNY during the first eight months of 2020, the risk of occupational fatality for EMS clinicians was 14 times higher than the risk for firefighters.  
    • The DOL reports that the civilian occupation with the highest fatality rate in the U.S. in 2018 was “Logging” with a rate of 97.6.16 The FDNY EMS clinicians have a rate of occupational fatality that is 2.5 times higher.
    • The EMS suicide risk in the U.S., as measured by the percent of all fatalities, is about twice as high as the national average20 and twice as high as the risk for firefighters.

     

    ---------------------------

    Occupational Fatalities Among EMS Clinicians and Firefighters in the New York City Fire Department; January to August 2020

    By Brian J Maguire, Dr.PH, MSA, EMT-P, Barbara J. O’Neill, PhD, RN, Daniel R. Gerard, MS, RN, NREMT-P, Paul Maniscalco, PhD(c), MPA, MS, EMT/P, LP, Scot Phelps, JD, MPH and Kathleen A. Handal, MD

    11.19.20

    https://www.jems.com/2020/11/19/occupational-fatalities-among-ems-clinicians-and-firefighters/

    On October 6, 2020, the Fire Department of the City of New York (FDNY) conducted a memorial service for department members who had recently died. It was a somber ceremony for the many fallen personnel. The ceremony was very inclusive and noted the passing of emergency responders, FDNY civilians and mechanics as well as a paramedic who had come to NYC on a FEMA deployment to assist during the pandemic.1 The information on the notice also provided an opportunity for a preliminary agency-level epidemiology analyses to develop a better understanding of the risks faced by FDNY personnel in 2020.

     

    New York City is both the most populous and most densely populated major city in the U.S.; over eight million people live in 302 square miles.2 FDNY covers this entire area and employs 11,230 firefighters and 4,408 emergency medical services (EMS) clinicians (including paramedics and emergency medical technicians).3 In 2018, there were 1.8 million “ambulance runs” in NYC; FDNY firefighters responded to 619,378 calls.4 EMS crews in NYC typically respond to about 4,000 emergency calls a day; at times during the pandemic, demand swelled to over 7,000 calls a day.5,6 Of almost 1.5 million people tested in NYC by August 20, 27% had antibodies to the coronavirus.7

     

    Prior research has shown that EMS clinicians face high risks and have occupational fatality rates similar to police and fire and non-fatal injury rates higher than police and fire.8-10 The purpose of this analyses was to both document current fatalities among FDNY personnel and to compare risks between two occupational groups in FDNY.

     

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