Month: May 2020

Recon takes an analytical look behind select developments in healthcare

Buying kit for a leadership position in the @Home revolution? Implications of Optum’s acquisition of naviHealth

Tory Wolff May 27, 2020

Summary NaviHealth is a leader in post-acute care management; since it manages but does not provide care, its impact is constrained by quality of available providers By aligning with Optum clinical and technology assets, naviHealth can raise the capabilities of post-acute providers, direct more cases to be discharged directly to the home and speed up the return home for others Given inpatient stays often mark the start of sustained needs for help in the home, a post-acute navigator like naviHealth could be well-positioned to orchestrate longer-term “aging-in-place” support Overview of

Covid’s backhand blow: payer mix degradation and the threat of renewed payer/provider rate brawls

Tory Wolff May 18, 2020

Among Covid’s many repercussions, the recession shock will drive a sustained degradation of provider payer mix. I estimate that each 5% added to unemployment will incrementally reduce hospital[1] operating margin by 1.0-1.5% and hospitals would need to charge 3-4% more on commercial care to maintain margins[2]. Given that hospital costs make up 40-45% of commercial total cost of care and we are facing unemployment scenarios of 15-20% (per Robert Wood Johnson – see table and source notes), we could ultimately expect this hospital rate pressure – if not averted or moderated

Wharton Magazine: How COVID-19 Will Permanently Change Health Care

Miriam Alandydy May 13, 2020

Medicare Advantage’s durable – but underexplained – post-acute care advantage

Tory Wolff May 13, 2020

Health Affairs has put out another study – this one by Skopec and team (subscription access) – comparing post-acute care (PAC) among Medicare Advantage (MA) vs. traditional Medicare (FFS). And, once again (see earlier study here – subscription access), we learn that MA beneficiaries use a lot less PAC than FFS with no major differences in outcomes. The pattern varies by type of PAC: far fewer post-acute MA members spend time in an inpatient rehab facility (IRF) but, when they do, they stay just as long as their FFS counterparts;

Covid and the rest: An opinionated take on NEJM highlights for April 2020

Marc Herant May 10, 2020

Hydroxychloroquine does not seem to help much in Covid-19 (with caveat) There has been significant attention to the use of the antimalarial hydroxychloroquine in Covid-19, but data on impact has been scarce. In the absence of clarity, New York Presbyterian Hospital left the use of this drug to the discretion of individual treating physicians from mid-March to early April. This has led to two cohorts of Covid-19 patients which can be compared in retrospective analysis: patients treated with hydroxychloroquine (N=811) and those who did not receive the drug (N=565). The

Month: May 2020

Recon takes an analytical look behind select developments in healthcare

Buying kit for a leadership position in the @Home revolution? Implications of Optum’s acquisition of naviHealth

Covid’s backhand blow: payer mix degradation and the threat of renewed payer/provider rate brawls

Wharton Magazine: How COVID-19 Will Permanently Change Health Care

Medicare Advantage’s durable – but underexplained – post-acute care advantage

Covid and the rest: An opinionated take on NEJM highlights for April 2020

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