Downside of Automated Patient Messages; End in Sight for Surprise Billing

March 30, 2021 - The pandemic has taught the healthcare industry a considerable deal about patient engagement, but it has also shown that too much of a good thing can turn patients away. While surprise billing was all the rage prior to the pandemic, interest is renewed with new legislation set to go into effect next year.

Consequences of Too Many Automated Patient Messages

Healthcare organizations that over-leverage their automated patient outreach technologies may run the risk of high attrition, according to new data from the Institute for Health Research at Kaiser Permanente Colorado.

The data published in JAMA Network Open found that patients who got a lot of automated messages from their medical providers were more likely to opt out of receiving future messages. These results could provide insights into how healthcare organizations deploy patient outreach messaging in the future, the IHR researchers said. READ MORE

Taking the Surprise out of Medical Bills

Starting January 1, 2022, healthcare providers will be subject to a new surprise billing law that makes it illegal for providers to bill patients more than in-network cost-sharing for out-of-network services and establishes an arbitration process to resolve unexpected out-of-network charges. Providers and payers will need to consider their operational readiness for the law, consumer outreach efforts, and negotiation strategy. READ MORE

Staying on Top of Antimicrobial Resistance

Nearly one in three antibiotic prescriptions written by doctors’ offices, emergency rooms, and hospital-based clinics are inappropriately prescribed annually. But effective and sustainable antibiotic stewardship programs can reduce this type of misuse by ensuring that antibiotics are needed and used appropriately. Overall, these programs help to slow the emergence of antimicrobial resistance and ensure patients receive the most effective treatment. But experts have found that there are notable challenges with implementing these programs into hospitals, ICUs, and other care settings. READ MORE

How ACO Combat Out-of-Network Utilization

Leaders of accountable care organizations rely on their networks of high-quality, cost-efficient providers to improve patient outcomes, reduce costs of care, and achieve shared savings. But patients don’t always stay within cultivated high-performing networks, creating quality and cost problems for even the best ACOs.

“We're arming our providers and patients with the right services to ensure better health outcomes for not just the short term but really the long term, and that is where the power of that network utilization comes in,” says Tyler Munson, senior vice president of operations at Southwestern Health Resources. READ MORE

Bringing Telehealth to Critical Access Hospitals

The Rural Health Behavioral Access Act was unveiled last week during a press conference that emphasized the level of support behind the bill Among those backing the bill are the Alliance for Connected Care, the Ascension health system, the National Rural Health Association and the National Association for Rural Mental Health. The bill targets connected health programs for the nation’s 1,350 critical access hospitals, which are strictly defined by Congress and limited in how they’re reimbursed by Medicare for telehealth services. READ MORE

Humana, Epic to Address Prior Authorizations

After collaborating for 18 months on streamlining data exchange between health plans, patients, and providers, Humana and Epic are moving into the next phase of their partnership which involves electronic prior authorization and member insights. In this new phase, Humana and Epic plan to leverage automatic prior authorizations. The goal of implementing this approach is to diminish the lag between when a provider prescribes a treatment and receives confirmation from the patient’s payer regarding whether the procedure will be covered. READ MORE

Bringing Equity to Health Data Collection

As communities begin to navigate vaccine rollouts, public health officials and healthcare leaders will have to determine how to manage monitoring systems created in response to the virus, what processes are required in order to immunize populations, and what new norms these technologies have generated. A critical part of these conversations is the impact these technologies could have on patient privacy and health equity.

“Low-income communities and communities of color have been disproportionally impacted during the pandemic. These communities have higher infection rates, while frequently being denied just access to medical care and having to live and work in more dangerous conditions,” says Rebecca Gluskin, PhD, chief statistician and deputy director of Measure of America. READ MORE