We spend lot of time talking about fraud, waste, and abuse – three of our industry’s most serious ills. Acknowledging these systemic problems creates a platform for discussion and legislative reform which, in turn, results in better care for patients. But in our haste to highlight where the system is falling short, we sometimes fail to mention how our industry is moving in the right direction. To know where you’re going, you must remember where you’ve been.
Let's examine some of our industry’s latest and greatest triumphs.
1. Tackling the opioid epidemic.
In 2017, the national opioid crisis was declared a public health emergency. By then, it was no longer a warning – it was a statement of fact. The misuse of opioids and other prescription drugs is undeniably one of the greatest health care epidemics of our time. In the many months since this declaration, the crisis has continued to play out in new and increasingly tragic ways. But there is much to be said for giving the enemy a name. We now have proof that drug companies fueled the epidemic with predatory marketing practices, and many states, including Tennessee and Mississippi, have passed laws meant to fight the epidemic. The federal government's comprehensive, bipartisan bill, also known as the SUPPORT Act, addressed the crisis by increasing the public's access to long-term treatment programs and making it harder to ship deadly synthetic drugs, such as fentanyl, into the United States. But of course, there is more work yet to be done.
2. Embracing tech companies.
Companies like Google, Apple, and Amazon are known for entering and disrupting stagnant industries, but their new interest in healthcare innovation could be a boon for everyone. In 2018, Google developed a machine to analyze and collect medical data for big hospitals. Amazon partnered with Berkshire Hathaway and J.P. Morgan to lead employee health initiatives, in addition to starting their own employee health clinic in Seattle. Amazon also made its first foray into pharmacy by acquiring PillPack, a company that packages, organizes, and delivers prescriptions to patients. And recently, Amazon filed a patent for its voice assistant, Alexa, aimed at detecting whether a user has a cough or cold.
3. Making patients the priority.
Patient-first approaches to care delivery are gradually becoming the norm. Researchers and providers have found that by focusing on patient satisfaction, and responding to areas of dissatisfaction, they can not only increase compliance with future treatments and payments, but also improve patient outcomes. Similarly, the topic of patient engagement is garnering more and more attention, especially with the early success of telehealth services and electronic visit verification (EVV) systems. The proliferation of online appointment scheduling systems and post-care satisfaction surveys are signs of progress, too.
4. Cracking down on fraud.
In June of 2018, the Office of the Inspector General coordinated "largest health care fraud takedown in history” with the help of federal and state law enforcement partners. More than 600 defendants in 58 federal districts were held accountable for schemes that resulted in approximately $2 billion in losses to Medicare and Medicaid. Since the last takedown, OIG has also issued exclusion notices to 587 doctors, nurses, and other providers regarding opioid diversion and abuse, according to a news statement. The takedown sent a strong message to the accused and to potential copycats on behalf of taxpayers and the patients affected by these crimes. And thankfully, for every $1 spent on health care-related fraud and abuse investigations over the last 3 years, more than $4 has been recovered.
Interested in learning more about how Healthstar is working to reduce fraud, waste, and abuse in home healthcare? Let's talk.