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From Facility to Home: How Healthcare Could Shift by 2025

McKinsey Insights | February 1, 2022
 
When patients enter a healthcare facility, their primary aims are to become well again and to go home. While increasing disease burden and rising healthcare costs in the United States have already contributed to a boost in Care at Home services, the COVID-19 pandemic has created a catalyst to truly reimagine their future.1
 
Based on a survey of physicians who serve predominantly Medicare fee-for-service (FFS) and Medicare Advantage (MA) patients, we estimate that up to $265 billion worth of care services (representing up to 25 percent of the total cost of care) for Medicare FFS and MA beneficiaries could shift from traditional facilities to the home by 2025 without a reduction in quality or access. 2 That number represents a three- to fourfold increase in the cost of care being delivered at home today for this population, although how the shift will affect reimbursement rates is not yet clear. What’s more, Care at Home could create value for payers, healthcare facilities and physician groups, Care at Home providers, technology companies, and investors. It also could improve patients’ quality of care and experience.
 
That said, several factors could affect adoption of these services. We outline those factors below, along with actions that stakeholders can take to address them. We also discuss why Care at Home services are rising, how Care at Home could create value for stakeholders and lead to higher-quality care for patients, areas where care could shift from traditional facilities to the home, and strategies for successfully adopting Care at Home.

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What Home Health Providers Need to Know About OASIS-E

Home Health Care News 
By Joyce Famakinwa | February 1, 2022
 
With OASIS-E set for Jan. 1 of 2023, home health providers need to begin preparing now, if they haven’t already.
 
After delays related to the public health emergency, OASIS-E is finally being implemented next year in order to line up with the start of the nationwide expansion of the Home Health Value-Based Purchasing (HHVBP) Model.
 
For providers, payment and outcomes are directly impacted by OASIS data collection. It’s important that the data accurately reflects the status of the patient.
 
The OASIS-E update is arguably one of the biggest industry changes in recent years, J’non Griffin, principal of the coding and OASIS department at SimiTree Healthcare Consulting, told Home Health Care News. 
 
“It will have a lot of new aspects, like social determinants of health,” she said. “It will have some increased behavioral assessments … that the skilled nursing facilities (SNFs) are already providing. It will also help facilitate one of the value-based purchasing items, which is the transfer of health information between post-acute providers, among other things.”
 
Expanded questions on pain and infusion are some of the other OASIS-E changes.
 
“Of course, it will be a learning process, especially in the beginning,” Griffin said. “Just doing things like the mental health assessment will take some education on the clinician’s part because usually, they don’t do those.”
 
For now, only a draft version of OASIS-E is available. But providers should expect the finalized version by the end of the first quarter of 2022. 

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OASIS-E All Items Instrument Available

The updated draft OASIS-E All Items Instrument is now available in the Downloads section of the OASIS Data Sets webpage. OASIS-E will be effective January 01, 2023. Please note the instrument is not yet final. Office of Management and Budget (OMB) approval is required and expected later this year. The instrument may be used for training but not as a final data set for data collection until OMB approval.

Direct link to the OASIS-E Outcome Assessment Information Set Version E (OASIS-E) (cms.gov)

 

A second version of omicron is spreading. Here's why scientists are on alert

Just as the omicron surge starts to recede in parts of the U.S., scientists have their eye on another coronavirus variant spreading rapidly in parts of Asia and Europe. It's officially called "omicron BA.2," and this week scientists detected cases of it in several U.S. states, including California, Texas and Washington.

Although BA.2 is currently rare in the U.S., scientists expect it to spread in the country over the next month. There's growing evidence that it's just as contagious as — or possibly a bit more contagious than — the first omicron variant, called "omicron BA.1."

"It could be that BA.2 does have some small advantage," says Emma Hodcroft, an epidemiologist at the University of Bern who has been tracking variants all around the world throughout the pandemic via the Nextstrain project. "BA.2 might well be, like, 1% to 3% more transmissible, or something like that."

So the big question now is, will that small difference be enough for this variant to lengthen the ongoing surge in the U.S., as it has in Denmark?

What is omicron BA.2?

You can think of BA.2 as a sibling of BA.1, Hodcroft says. They share a bunch of mutations — about 30 or so — but they also have a bunch of mutations that are unique.

"They are quite similar, but they're also different," she says. "So very much like siblings, in my opinion. Different but obviously related."

Back in November, when scientists in South Africa and Botswana discovered omicron, they didn't find just one version. They found three, called BA.1, BA.2 and BA.3 by the Phylogenetic Assignment of Named Global Outbreak Lineages at the University of Edinburgh.

The first one, BA.1, took off rapidly and spread around the world, including in the United States. And initially, it looked like BA.2 and BA.3 were weaker and less able to keep up with BA.1.

"We thought, 'OK, BA.2 is just not as fit as its sibling BA.1, and it will kind of peter out,' " Hodcroft says.

But that's not what happened — not at all...

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Moderna Announces First Participant Dosed in Phase 2 Study of Omicron-Specific Booster Candidate

Phase 2 study of Omicron-specific booster candidate mRNA-1273.529) will include two cohorts: one including participants who received the two-dose primary series of mRNA-1273 and another including participants who received the two-dose primary series and a 50 µg booster dose of mRNA-1273

Omicron neutralization six months after the third 50 µg dose of mRNA-1273 declined, but remained detectable in all participants

CAMBRIDGE, MA / ACCESSWIRE / January 26, 2021 / Moderna, Inc. (NASDAQ:MRNA), a biotechnology company pioneering messenger RNA (mRNA) therapeutics and vaccines, today announced that the first participant has been dosed in the Phase 2 study of the Company's Omicron-specific booster candidate (mRNA-1273.529). Additionally, Moderna announced the publication of neutralizing antibody data against the Omicron variant six months following a booster dose in The New England Journal of Medicine. While Omicron neutralization had declined 6.3-fold from peak titers at day 29 post-boost, levels remained detectable in all participants. Neutralizing titers against Omicron declined more rapidly than titers against the ancestral strain of the virus (D614G) which declined 2.3-fold over the same time period.

"We are reassured by the antibody persistence against Omicron at six months after the currently authorized 50 µg booster of mRNA-1273. Nonetheless, given the long-term threat demonstrated by Omicron's immune escape, we are advancing our Omicron-specific variant vaccine booster candidate and we are pleased to begin this part of our Phase 2 study," said Stéphane Bancel, Chief Executive Officer of Moderna. "We are also evaluating whether to include this Omicron-specific candidate in our multivalent booster program. We will continue to share data with public health authorities to help them make evidence-based decisions on the best booster strategies against SARS-CoV-2."...

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