In the News: Aug 11–18

Maternal Mortality Data Challenges Women’s Health Focus

A recent Health Affairs article offers a data-driven call to action for more comprehensive women’s health care. High US maternal mortality rates and stories of preventable deaths led to an increase in attention on maternal mortality and stark racial disparities in maternal deaths.

In 2018, Black women were 2.5 times as likely to experience a maternal death compared to White women, a ratio that mirrors data from 1942 and 1987, as well as 1930s Jim Crow America. Recent literature has found maternal deaths are attributed almost evenly during pregnancy, at the time of birth and a week to a year after birth. Additionally, mortality rates increased across almost all racial and ethnic groups from 2010 to 2018 for women aged 25–34; however, during the same time period, the ratio of Black to White female death rates decreased.

With two-thirds of maternal deaths occurring before or after birth, integrated and community-based solutions are essential to expand the focus in women’s health. For more information on notable trends, along with guidance on how to grow and differentiate your women’s health services, please read the new Sg2 report Women’s Health Service Line Outlook 2020.

Home Monitoring Programs Improve Survival Rates

A recent study published by the American Heart Association explored the benefits of Interstage Home Monitoring (IHM) programs for infants with single ventricle heart defects. Use of this program educated families on how to recognize potential complications early enough to improve survival rates prior to consecutive surgeries required for treatment. The National Pediatric Cardiology Quality Improvement Collaborative reported a 40% decrease in infant mortality and a 28% improvement in infant weight gain across cardiac centers implementing IHM programs from 2008 to 2016.

Treatment for hypoplastic left heart syndrome involves multiple surgeries: one at the time of birth, with a second surgery approximately 4–6 months after, followed by a third procedure about a year later. IHM programs are meant to focus on the high-risk time between the first and second of these procedures. During this stage, infants need 24-hour care, which is a heavy burden on families and caregivers. Having an IHM program in place not only improves the overall care coordination and management for outpatient care but also brings ease to families because they know medical staff are available and monitoring for potential complications. As they evolved, IHM programs have begun to incorporate telehealth platforms with real-time video visual assessments of patients from their homes.

Considering current events, providers have begun to explore virtual health modalities to improve care delivery and access to services, with remote patient monitoring (RPM) programs moving to the forefront to meet patient needs. To learn more about the advancements in RPM and their influence on patient outcomes, please read Sg2’s FAQ Considerations for Adoptions of Remote Patient Monitoring.

Restructuring Primary Care Payment to Save Practices

A recent Kaiser Health News article focuses on how the COVID-19 public health crisis has sped up efforts to restructure primary care to put it on more financial footing. Primary care accounts for around half of US doctor visits each year, but when the pandemic hit, many doctors had to close their offices, which led to drops in revenue, as well as layoffs and pay cuts; it’s estimated that primary care practices could see a loss of $15 billion nationwide.

There could be a remedy to help keep primary care practices afloat: move the physician reimbursement model away from fee-for-service, which has been long-advocated for but experienced slow-going efforts. Now that physicians realize how vulnerable they become in a time of crisis under such a reimbursement system, interest in physician payment reform has been renewed. Medicare’s new Primary Care First program provides doctors with a fixed per-patient monthly fee and flat fees for patient visits, with bonuses for hitting quality markers. Some private insurers are also offering financial incentives for practices that agree to move away from fee-for-service.

The COVID-19 pandemic has made it even more clear that doctors don’t get paid when they aren’t able to see patients and bill for care piece by piece—organizations need to disrupt the fee-for-service business model to survive. Last year, CMS announced 5 new payment models that may serve as a catalyst for change in health care by expanding participation, increasing competition and accelerating value-based care transformation. To learn more about how these models offer providers more flexibility to engage with patients and reward prevention, wellness and cost management, read the Sg2 Expert Insight Primary Cares Initiative Drives Transformation: Are You Ready to Lead in Value-Based Care?

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