A Trump administration-era Medicare program is under increased scrutiny from progressive Democrats. According to this Politico article, the program is a “direct contracting model” that allows private companies to participate in Medicare. Some Democrats, however, say the program is opening up a lane for Medicare privatization.
“There’s a dynamic with the left that [the Center for Medicare & Medicaid Innovation] [has] to deal with for sure,” said McDermott+Consulting’s Mara McDermott.
COVID-19 has not only accelerated dramatic shifts within the healthcare industry, but it has also become a catalyst for change in workforce strategies. In this special report, McDermott Partner Michael Peregrine offers perspective about key trends and priorities for the human capital committee to consider as it plans for the upcoming year and beyond.
The continuation of the COVID-19 public health emergency (PHE) and consumer demand for digitally delivered healthcare not only necessitated the shift from in-person to virtual care, but also continued to drive interest, adoption, investment and transactions in digital health in 2021. Digital health funding in 2021 far surpassed 2020’s totals, with no signs of slowing down in 2022, and the potential permanence of some regulatory flexibilities beyond the PHE are charting a course for continued digital health growth in 2022 and beyond.
The US healthcare system is entering the third year of a public health emergency due to COVID-19, and the challenges and enduring pressures of the pandemic will require US Congress and the Biden administration to consider new response strategies. But other health policy priorities also will garner attention. As we start a new year and new congressional session, McDermott+Consulting examines the health policy priorities and key initiatives likely to dominate the agenda in 2022.
The uncertainty around the termination of state public health emergencies is leading to the growth of healthcare companies with physical and virtual presences. In this recent Reuters video, McDermott Partner Lisa Mazur explained how these providers are more valuable from a valuation perspective.
“And part of that is because they’re able to enroll in Medicaid and get services covered, and they’re more likely to become a participating provider with a commercial plan,” Mazur noted.
Doctors and lawmakers say reliable broadband internet is lagging for populations that could benefit the most from telehealth services. In this MetroWest Daily News article, McDermott Partner Stephen Bernstein and McDermott+Consulting Vice President Mara McDermott offer insight into the challenges—and opportunities—for virtual care as it gains popularity.
Although digital health solutions have long been a key area of strategic growth for the healthcare industry, the COVID-19 crisis accelerated what it means to deliver safe and effective digitally-based care. As the United States shifts focus from short-term crisis response to longer-term solutions, what does a digitally-driven healthcare industry look like, and how can healthcare entities maintain the highest standards of care and meet patient expectations while constructively disrupting out-of-date practice patterns? During a recent virtual conversation, McDermott Partners Michael W. Ryan and Jennifer S. Geetter addressed these questions and more.
As the healthcare industry evaluates how to pay for artificial intelligence (AI) solutions, industry experts say data and real-world evidence are essential for reaching any payment decisions. In this Forbes article, McDermott Partners Dale C. Van Demark and Jiayan Chen provide insight into some of the regulatory challenges AI presents.
“For AI to be paid for, you need data that shows your product is making a difference,” Chen notes. “To do that, you need massive quantities of data to develop the tool or algorithm, but you also have to show that it works in a real-world setting.”
On September 15, 2021, the Federal Trade Commission (FTC) voted 3–2 along party lines (with Republican commissioners dissenting) to issue a policy statement announcing an expansive interpretation of the FTC’s Health Breach Notification Rule, 16 CFR Part 318 (the Rule). According to the policy statement, the Rule applies to health apps and connected devices that are not subject to the Health Insurance Portability and Accountability Act (HIPAA) but are capable of drawing information from multiple sources—for example, through a combination of consumer inputs and application programming interfaces (APIs).
Telehealth’s state-by-state regulatory patchwork means that healthcare providers must navigate a variety of regulations that govern which types of care can be provided by virtual means, and even what modalities can be used in different care settings. McDermott’s recent 50-state survey explores the standard and requirements that physicians and nurse practitioners must follow when prescribing non-controlled substances or ordering tests via a telemedicine encounter. Key issues addressed in the survey include:
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