The COVID-19 pandemic is the challenge of a lifetime. While most of us play an important role by sheltering at home, it is a far more daunting moment for others. I'm pulling for the health care workers, frontliners, families, and companies most directly impacted. Across Evolent, we are focused on protecting high-risk members and patients, advocating for independent physicians, and supporting our people. Here are some of the ways we're working to make a difference.
Protecting High-Risk Members and Patients
First and foremost, we are focused on protecting the health of the millions of lives cared for by our payer and provider partners. Among our efforts:
- Identification of the most vulnerable members. We rapidly adapted our predictive models to prioritize members who have the highest risk for COVID-19 infection and complications, including those with existing chronic conditions and social barriers such as poverty and housing.
- Outreach and engagement. Our care management teams have been proactively reaching out to these high-risk members to educate them on COVID-19 prevention, symptoms and when and how to contact a primary care provider or get testing. Our care managers are also ensuring these members have at least 30 days' worth of medication, durable medical equipment and access to nonperishable food and water.
- Adapting clinical practice guidelines to reduce transmission. Our specialty care management solution has provided clinical guidance to our partners, suggesting cancer treatment plans that reduce risk of coronavirus exposure by minimizing trips to the treatment center. Their oncology clinical guidelines have been refined to favor longer-acting chemotherapy or oral agents that can be taken at home. A new phone screening tool helps practices to efficiently (and remotely) triage cancer patients and provide the most appropriate intervention and site of care. We're also investigating ways to enable and/or expand our networks to deliver more care at home.
Advocating for Independent Physicians
Independent physicians, including primary care physicians, oncologists, cardiologists, and their staff members are on the front lines of the fight. And they're among the most vulnerable in this crisis—both from the risks to their own health and, like many vital small businesses, from financial damage to their practices. Physician practices are reporting 30% to 75% reductions in fee-for-service visits, as they urge many patients to avoid direct contact. Across the country, plummeting revenue is causing practices to seek extended lines of credit or lay off employees. We can’t afford to lose this vital part of our health care ecosystem. This is an under-reported crisis within a crisis. Here's how Evolent is working to address it:
- Seeking financial relief for independent practices. Evolent has raised concerns in D.C. about the threat the pandemic poses to these practices. Along with several primary care organizations, we asked Congress for financial relief for these practices. We are hopeful that provisions in the new $2 trillion stimulus package, such as expanded small business loans and a $100 billion emergency fund for providers, will help them remain viable. Providers who need immediate cash flow can also seek three months of Medicare payments in advance. We will continue to monitor this issue to ensure providers get sufficient relief as quickly as possible.
- Expanded access to telemedicine. Evolent is facilitating access to HIPAA-compliant telehealth solutions among independent practices for our ACO partners. The need is clear: One-third of surveyed practices indicated in late March that they had not implemented telehealth but wanted to do so.
- Advocating for increased telemedicine reimbursement. While the federal government has expanded coverage for telehealth encounters for the COVID-19 response, for physicians working out of private practices Medicare reimbursement for virtual visits was still 30% less than that of an in-office visit. Evolent, along with 16 other provider organizations, urged CMS to increase this reimbursement during the pandemic to be equal to that of a face-to-face office encounter. That increase was part of a broad set of changes CMS recently announced to manage a surge of COVID-19 cases.
Our offices remain closed to protect the health and safety of our employees. We are providing extra support and resources to the more than 3,000 Evolenteers now working remotely to help them through this challenging time. I am extremely proud of their resilience and dedication to improving our health care system.
The pandemic is testing all of us. Evolent is working hard to do our part to rise to the challenge.
This article was originally published on LinkedIn.
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