1/ At @AledadeACO we partner w independent practices on the frontlines of this epidemic, caring for over 500,000 seniors most at risk from #COVID19
We asked docs in 100+ primary care practices "what worries you most about COVID-19 today?"
Their answers should worry us
We asked docs in 100+ primary care practices "what worries you most about COVID-19 today?"
Their answers should worry us
2/ Their number one concern right now- THEY CAN'T GET MASKS, GOWNS, EYE SHIELDS TO PROTECT THEMSELVES, THEIR STAFF, THEIR PATIENTS.
The supply chain has completely broken down for them
I've reached out to health plan CEOs, innumerable GPOs, state health officials to no avail
The supply chain has completely broken down for them
I've reached out to health plan CEOs, innumerable GPOs, state health officials to no avail
3/ This is a big effing problem, and no one knows what's going on
Are countries not allowing PPE to be shipped?
Are speculators holding out?
Citizen hoarding?
Manufacturers really unable to keep up with increased demand?
WTF. We can't get hand sanitizer. who's gonna help?
When?
Are countries not allowing PPE to be shipped?
Are speculators holding out?
Citizen hoarding?
Manufacturers really unable to keep up with increased demand?
WTF. We can't get hand sanitizer. who's gonna help?
When?
4/ There are some masks in the strategic national stockpile, but not enough
Hospitals are running short. We need to get at the root of the problem, cause this is going to be a long fight.
We can't win if our front-line staff are getting exposed, quarantined, infected, killed
Hospitals are running short. We need to get at the root of the problem, cause this is going to be a long fight.
We can't win if our front-line staff are getting exposed, quarantined, infected, killed
5/ As befits these amazing doctors I am proud to serve, they are desperately worried about their patients.
They have seen the statistics, and they know too well the anguish of losing a patient they have sometimes known for 30 years.
"it only kills old people" is not acceptable
They have seen the statistics, and they know too well the anguish of losing a patient they have sometimes known for 30 years.
"it only kills old people" is not acceptable
6/ We're telling elderly patients, those w chronic conditions to stay home, don't go to your doctor's office, avoid #COVID19 but these patients need primary care more than anyone
As this stretches out to months (and it will)- what will happen to deaths from chronic conditions?
As this stretches out to months (and it will)- what will happen to deaths from chronic conditions?
7/ We are working really hard to help our practices switch to tele- primary care visits. Tech. Workflow. and a morass of regulations.
It is great that Congress allowed tele-health billing for visits that are normally face-face, but @CMSGov has yet to clarify rules, allow billing
It is great that Congress allowed tele-health billing for visits that are normally face-face, but @CMSGov has yet to clarify rules, allow billing
8/ Does the doctor have to document that they verified the identity of the patient? How?
Does the patient have to waive HIPAA if doc using a consumer platform (like encrypted iPhone Facetime)? Does it have to be written consent? Can copay be waived?
And each state's different
Does the patient have to waive HIPAA if doc using a consumer platform (like encrypted iPhone Facetime)? Does it have to be written consent? Can copay be waived?
And each state's different
9/ We will work our way through this, and this may well be the push that doctors and patients needed to make tele-health go mainstream, but it sure would be nice if every regulatory agency (including @HHSOCR) was on point to solve problems.
10/ Finally, these independent practices are small businesses.
They've resisted selling to hospitals, weathered unjust payor fee schedules & Medicare facility fees that put them at a disadvantage
They've coped with rising costs and fixed reimbursement
But this could be fatal
They've resisted selling to hospitals, weathered unjust payor fee schedules & Medicare facility fees that put them at a disadvantage
They've coped with rising costs and fixed reimbursement
But this could be fatal
11/ We @AledadeACO will do our best to help these 550 frontline practices
Sorting out confusing, evolving guidance on testing
Advocating for better policies (please, dedicated testing sites)
Looking for PPE
Advising on tele-health
We may give some loans
Who cares for the rest?
Sorting out confusing, evolving guidance on testing
Advocating for better policies (please, dedicated testing sites)
Looking for PPE
Advising on tele-health
We may give some loans
Who cares for the rest?
12/ This response broke my heart
"I worry that I can’t reassure and address all of the staffs needs and concerns all by myself and do everything else I am having to do.
Pretty overwhelmed at the moment and stretched super thin! Any support is more than welcome and appreciated"
"I worry that I can’t reassure and address all of the staffs needs and concerns all by myself and do everything else I am having to do.
Pretty overwhelmed at the moment and stretched super thin! Any support is more than welcome and appreciated"
