#any lag I would imagine was due to COVID

[gel-s-d]

I’m kinda confused by the “gen alpha can’t read!” “It’s because they stopped teaching phonics!” People because like. As far as I can see. They stopped teaching phonics in most classrooms in the 30’s. So, like, most people today didn’t grow up with phonics as the way they were taught to read either.

I always assumed the reason we don’t use phonics very much in class is because English is a very phonically inconsistent language. Like -ough, I before e except after c (and except this gigantic list of exceptions). English is a bit of a Frankenstein language, it never seemed like phonics were all that useful when 70% of the language is from different language roots and therefor will have different phonics rules

[bovitzperspectives]

Productivity loss... or opportunity?

Pre-COVID, the concept of working from home always seemed like a luxury to me. I imagined that remote work would allow me to have a more flexible schedule and a more comfortable work environment—even without the yoga studio, game room, bean bag chairs, and other amenities that so many offices have these days. But when we were thrown into a global pandemic and remote work became the new norm, I began to see that working from home may not be the luxury I thought. Over time, my motivation began to stifle, and my productivity declined. And I was sure I wasn’t the only one.

I wanted to learn how other people were staying on top of their game while working from home, so I took to the internet and started reading up on work life, remote work, and office culture during the Coronavirus era. I came across the concept of “productivity tax,” or the drop in productivity resulting from long-term remote work. While this concept seemed to validate what I was experiencing, the article chalked up this decline in motivation to remote environments significantly lagging behind professional offices on critical factors like technological capabilities. When I took this lens to my own work life, I saw that I already had all of the technology that I needed. This wasn’t the solution I was hoping to find; I kept digging.

As I read more, I learned that the productivity loss I had been experiencing largely comes down to a much more fundamental aspect of the human experience: we are creatures of habit. We rely on structure; we work best when we have a routine to follow. I—along with lots of other folks around the world—was simply more distracted at home because I had lost my daily routine.

Research into how to stay successful in this new work-from-home era points to routines and goal-setting as meaningful ways to curtail productivity loss. When I took this lens to my own work life, I saw that these were exactly what I was missing. And in my case, getting them back really only required small but intentional changes—getting out of bed at the same time each day, only working from my desk, eating meals at normal times, setting timeframes for specific tasks, etc. These little pieces of structure not only provide comfort in my daily schedule and give me things to work towards, but they also allow me to enjoy some of that luxury that I always imagined remote work would have. We may be creatures of habit, but if we’re mindful, we’re also pretty good at finding opportunity in change.  

As a people-first company, my experience has prompted us to be more intentional about how we can best support all of our employees during this challenging time. As the first step, I’ll be leading a roundtable discussion with a few colleagues to hear their stories and brainstorm practical solutions to try out. But my experience has also gotten us thinking beyond ourselves and about workers, parents, educators, caregivers, and other providers across the world who are also experiencing productivity loss due to any number of reasons—insufficient technology, loss of routine, loss of goals, increased stress, health concerns, etc. There’s no shortage of new problems for innovators and brand marketers to work on.

So, what do companies need to know about people to address these fast-growing unmet needs in the workforce?  How can brands meaningfully connect with people to demonstrate their empathy with workers’ new challenges in the face of the pandemic?  To help address these questions, we’re embarking on some new consumer research about “The New World of Work” with our friends at the USC Annenberg Communication School’s Center for the Digital Future.  Just like the research I found helped me address my productivity loss, we’re excited for this research to help brands and innovators develop new solutions for workers around the world. Again, if we’re mindful, we as humans are pretty good at finding opportunity in change.

 - Kevin

[ericvick]

Boston extra jobs, averted layoffs in confront of the pandemic

Again in June, when the Town of Boston was wrestling with its fiscal 2021 budget under the financial pressure of the coronavirus pandemic, Mayor Walsh declared that municipal layoffs were being off the desk.

Now, 6 months later, Walsh has evidently stayed correct to his word.

Irrespective of building around $65 million in cuts to its unique finances proposal, the metropolis has neither laid off nor furloughed any personnel given that the crisis started, according to funds director Justin Sterritt.

In reality, the city’s complete headcount is predicted to improve from about 17,700 staff members last January 2020 to approximately 18,030 workers in January 2021.

Early in the pandemic, staff cuts and furloughs strike other cities and towns in virtually every location of the condition as community officers tried to stability their budgets beneath Covid constraints.

“We’ve been definitely steadfast in our motivation to restrict layoffs and restrict any assistance reductions,” Sterritt explained. “And frankly, I imagine we’re possibly a single of the couple metropolitan areas or number of key cities in the place which is been able to do that.”

The $3.61 billion budget approved by the Metropolis Council signifies about a 3.4 % improve around paying out in fiscal year 2020, according to officers.

To trim shelling out, Boston instituted a six-thirty day period hiring freeze for non-important positions, which Sterritt mentioned will be prolonged by means of the end of this fiscal yr on June 30, 2021. Officers also minimal time beyond regulation in particular departments, minimize shelling out on travel and equipment buys, and delayed the city’s bond sale to the tumble, he claimed.

The $404.2 million police spending budget is down about 2.4 p.c compared to fiscal 2020, partly thanks to the reallocation by the mayor of $12 million in time beyond regulation money to other departments to address what he known as the community health and fitness difficulty of racism.

The metropolis has included positions in some places, Sterritt pointed out, like nurses, social workers and custodians in the university technique, as properly as some positions relevant to setting, general public wellness, and financial development.

On the community health aspect, Sterritt mentioned, the metropolis built a “considerable investment” in neighborhood trauma teams – groups of social staff and clinicians that answer to trauma incidents. Some lengthy-expression positions had been also made in the Community Wellness Commission making use of portion of the reallocated law enforcement time beyond regulation funds.

In whole, about 330 comprehensive-time equivalent positions were being added in this year’s finances, in accordance to the town, which include 279 in the faculty system, 4 in the Community Well being Commission, and 47 in other city departments.

Jim Durkin, legislative director for the American Federation of State, County and Municipal Staff Council 93, which represents government employees throughout New England, explained town staff have been pleased with the stage of guidance Walsh’s administration has provided them for the duration of the crisis.

He claimed Walsh has revealed “great respect and appreciation” for community sector staff. “Because they are required on the position, our customers have not experienced the luxury of sheltering securely in the confines of their home, but the Walsh administration has worked with us to make sure they are as safe as achievable,” Durkin mentioned. “We’re by no means going to be capable to get rid of danger, but by operating with the mayor and his group, we have been in a position to minimize the chance of exposure.”

Pam Kocher, president of the Boston Municipal Study Bureau, claimed the metropolis has benefited from many several years of revenue development partly spurred by new development, which aided the town keep away from personnel cuts that have impacted some other important metropolitan spots. Boston ended fiscal 2020 with a $15.3 million spending plan surplus, marking the city’s 35th 12 months of manufacturing a surplus.

“So coming into this hard circumstance for town governing administration, for the neighborhood, for companies in the town, Boston arrived into it positioned very strongly financially,” Kocher reported. “So that has undoubtedly designed a real distinction for the town.”

Even though the city was equipped to harmony its price range with no chopping employees, it has not been immune to the consequences of a pandemic-era overall economy. Due to the fact the state has permitted firms to delay payments of area taxes these types of as the rooms and meals tax and hotel tax until April 2021, officers are working with constrained data close to local revenues, Sterritt mentioned.

And with the condition going through yet another surge in scenarios that has prompted Gov. Baker to roll back again some reopening pointers, he explained income from organizations like motels and places to eat will most likely carry on to be influenced. The city’s fiscal 2021 spending plan anticipates that excise collections will drop by approximately $38 million, or approximately 19 percent, in accordance to the Analysis Bureau.

“It’s definitely an place of problem, an spot that we’re a minor considerably less informed on than we ordinarily would since the state has delayed all those excise taxes,” Sterritt stated. “But we’re absolutely checking that as a possible area of hazard.”

Nonetheless, more than 70 p.c of the metropolis funds will come immediately from property taxes, a revenue supply that has influenced a bit far more optimism among officials through this interval. Kocher described that due to the fact there is a lag in between evaluation and payment of property tax charges, any decrease in that spot would not arise quickly. But it ordinarily can take an prolonged economic downturn to appreciably effects property tax earnings, she said.

The remainder of the city’s earnings comes from state support, which is envisioned to remain amount this 12 months at $464.2 million, and community receipts this sort of as interest on investments, fines and fees, licenses and permits and departmental earnings, which are projected to decline by about 1.2 %. Full revenue is believed at $3.6 billion for fiscal calendar year 2021.

Likely forward, Kocher explained, Boston is even now experiencing unforeseen fees because of to the pandemic, and it will be significant for the town to make the most of its federal CARES Act funding and FEMA reimbursements to support minimize the financial impression of the disaster on citizens. The volume of funding the town is receiving from external sources these kinds of as grants has elevated by approximately 20 % from fiscal yr 2020 to fiscal year 2021, according to the Analysis Bureau.

Sterritt explained the city’s initial concern will be holding expert services intact. “We’ve kind of produced a priority of simple city products and services,” he stated, “and which is why we’ve type of concentrated our organizing attempts about the last 7 years to place us in a posture to be prosperous when periods are not as great.”

Meg McIntyre wrote this report for the Condition House News Provider.

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[dailynewswebsite]

Nonprofits are struggling to do more with less money, but donors and volunteers can help: 5 questions answered

A volunteer arms out meals bins in Los Angeles earlier than Thanksgiving. Rodin Eckenroth/Getty Photographs

Traditionally, nonprofits have gotten almost a 3rd of their charitable donations simply in the course of the month of December. Lately, this flurry of giving has begun on #GivingTuesday, an internet marketing campaign that takes place on the primary Tuesday after Thanksgiving. We requested Erica Mills Barnhart, a College of Washington nonprofits scholar, to clarify how nonprofits are holding up amid the COVID-19 pandemic and the financial misery it has triggered, in addition to why everybody with cash to spare ought to think about giving a few of it away now.

1. How are nonprofits faring?

Many are in hassle.

In response to a research on how the pandemic is affecting nonprofits in Washington state, my colleagues and I discovered that demand for companies is 10.2% greater, whereas funding has sunk by 29.5%.

As well as, nonprofits mentioned they’re dropping out on as a lot as half of their normal volunteering hours. This decline in hands-on help is including to the pressure on nonprofit staffs trying to do extra with much less.

The scenario in Washington state mirrors what is occurring nationally.

Simulation fashions developed by Candid, a nonprofit data service, estimate that 8%-25% of U.S. nonprofits could possibly be compelled to shut within the subsequent yr or two.

2. Are some nonprofits harder-hit than others?

Sure. As an illustration, we discovered that Washington state well being and human service organizations are seeing a 29% improve within the want for his or her assist – excess of common. Though their funding forecasts aren’t as bleak as these for different kinds of nonprofits, funding isn’t maintaining with the calls for these teams face for his or her companies.

Organizations serving Black, Indigenous and different folks of shade are particularly struggling, as COVID-19 has taken a disproportionate toll on these communities, making their wants better. Nevertheless, funding for organizations led by, and serving, folks of shade lags behind that for white-led organizations. This disparity is exacerbating the funding hole for these hit hardest by the pandemic.

Arts teams have additionally been significantly hard-hit. ArtsFund, a nonprofit that provides grants to arts teams, discovered that in Seattle and the remainder of the Central Puget Sound area, 73% of museums, theaters and different arts nonprofits had fired or furloughed a few of their workers.

Though transitioning to on-line programming has some advantages, equivalent to with the ability to attain a broader viewers, the report concludes that the “way forward for reside theater and reside music is in danger.”

3. What’s at stake?

From hospitals and colleges to civic leagues and cultural facilities, nonprofits assist maintain Individuals wholesome, engaged, knowledgeable and educated. Not solely do nonprofits serve and help communities of all types, they’re additionally an financial engine.

In response to Johns Hopkins College researchers, these organizations are the nation’s third-largest supply of employment, after retail and manufacturing. They accounted, earlier than the pandemic, for about 1/10th of all private-sector jobs. And the nonprofit sector grew 18.6% within the decade earlier than 2017 – outpacing for-profit employment, which grew by solely 6.2%, based on that report.

Due to this fact, any stagnation or job losses within the nonprofit sector will ripple all through the financial system.

Lives are additionally at stake. Many hospitals and well being care facilities are nonprofits and a few of them are unable to fulfill all their sufferers’ wants. On the present tempo of the coronavirus pandemic’s unfold, even the medical doctors at one of many nation’s best-prepared hospitals don’t imagine they’ll be capable to meet the demand for care.

The nonprofit Feeding America discovered that some 50.Four million Individuals are actually food-insecure, which means that they lack constant entry to sufficient meals for an lively, wholesome life. That was up sharply from about 35 million Individuals being food-insecure in some unspecified time in the future in a given yr earlier than the COVID-19 pandemic. The variety of youngsters who skilled meals insecurity in 2020 grew from 11.2 million to an estimated 17 million – almost 1 in Four American children.

4. Can the federal government assist?

Completely. Fifty-six p.c of the nonprofits that took half in our research obtained Coronavirus Support, Aid and Financial Safety (CARES) Act Paycheck Safety Program loans to help their staff. Whereas almost 30% mentioned they’d some hassle making use of, 95% of those who did apply obtained loans. This means that the federal government’s March 2020 reduction package deal helped nonprofits.

The Home of Representatives has handed a measure that may ship extra financial reduction. Up to now, the Senate has did not observe up. Extra or complementary help on the state and native stage would additionally assist.

5. What can everybody else do?

The reply is easy. Help nonprofits as a lot as doable.

Luckily, Stylish, a fundraising data web site, discovered that 39% of Individuals say they undoubtedly or in all probability will give extra in 2020 than they did in 2019.

Particular person donations are critically vital to nonprofits, as they assist pay for issues that different revenue sources could not cowl, equivalent to hire, tools and salaries. Many – if not most – Individuals can make the most of a US$300 charitable deduction Congress included within the CARES Act. This one-year-only alternative is accessible to taxpayers who don’t itemize their returns for cash given on to tax-exempt nonprofits. The CARES Act additionally included a provision designed to encourage the richest Individuals to present away extra wealth in 2020.

Individuals with none cash to spare can nonetheless help nonprofits by encouraging elected officers to incorporate nonprofits in financial reduction efforts and by volunteering, even when they do it just about.

Companies may help nonprofits by charitable donations. Company philanthropy can probably enhance an organization’s popularity amongst shoppers who, more and more, select what to purchase based mostly on how they really feel about corporations.

[Deep knowledge, daily. Sign up for The Conversation’s newsletter.]

Foundations, entities that give away cash to help charitable causes, may step up. Many already are taking motion to deal with the COVID-19 disaster, which is heartening.

However nonprofits will little doubt maintain struggling to make do in 2021. This is the reason I imagine it’s critically vital that everybody who can afford to donate to nonprofits – together with people, foundations and companies – does so. This inflow of cash would go a great distance.

Erica Mills Barnhart doesn’t work for, seek the advice of, personal shares in or obtain funding from any firm or group that may profit from this text, and has disclosed no related affiliations past their tutorial appointment.

from Growth News https://growthnews.in/nonprofits-are-struggling-to-do-more-with-less-money-but-donors-and-volunteers-can-help-5-questions-answered/ via https://growthnews.in

[dipulb3]

US coronavirus: Experts predict more deaths in September | Foxton News

New Post has been published on https://appradab.com/us-coronavirus-experts-predict-more-deaths-in-september-foxton-news/

US coronavirus: Experts predict more deaths in September | Foxton News

An influential mannequin cited by the White Home issued the dire prediction, saying the US loss of life toll may attain 169,890 by October 1, with a doable vary of about 133,000 to 290,000 deaths.

Day by day deaths are anticipated to lower by way of June and July, then stay comparatively secure by way of August earlier than rising sharply in September, the mannequin forecasts.

“If the US is unable to test the expansion in September, we could possibly be going through worsening tendencies in October, November and the next months if the pandemic, as we count on, follows pneumonia seasonality,” mentioned Dr. Christopher Murray, director of the Institute for Well being Metrics and Analysis on the College of Washington College of Medication.

“Seasonality will probably be a really large driver of the second wave, we imagine,” Murray mentioned at a briefing Thursday.

Shares plunge

Fears of a resurgence of the pandemic — which already has induced hovering unemployment as components of the financial system shut down — appeared to assist rattle Wall Road on Thursday, sending indexes to their lowest ranges since March 16.

The Dow plunged 1,862 points, or 6.9%. The S&P 500 dropped 5.9%, and Nasdaq closed 5.3% decrease.

Regardless of shaky coronavirus tendencies, Treasury Secretary Steven Mnuchin mentioned the federal authorities will not put the complete nation again into lockdown to battle the pandemic.

“We will not shut down the financial system once more,” Mnuchin told CNBC on Thursday. “We have discovered that in case you shut down the financial system, you are going to create extra harm, not simply financial harm. Medical issues and all the pieces else that will get placed on maintain.”

The “greatest and most troublesome alternative” states will face within the fall is managing a possible second shutdown, IHME’s Murray mentioned.

“Due to quarantine fatigue, due to the financial results of quarantine, one other spherical of shutdowns might need even bigger results on companies that could be on the sting of not with the ability to keep solvent.”

FOLLOW LIVE COVID-19 UPDATES

Many states have loosened restrictions that started in March to cease the unfold of the virus. But with no vaccine, extra folks congregating in public locations and recent protests for racial justice in major cities, one well being professional predicted that a further 100,000 folks in the USA will die of coronavirus by September.

That prediction from Dr. Ashish Jha, director of the Harvard International Well being Institute, would put the US loss of life toll effectively previous 200,000, increased than what the College of Washington mannequin forecasts by that point.

“And we can’t be finished,” Jha informed Appradab’s Wolf Blitzer Thursday, with many months of fall and winter forward. “It is actually gorgeous to me that we have now this a lot struggling and loss of life, and we’re simply not doing sufficient about it.”

That projection is conservative, he mentioned Thursday as at the least 20 states had been displaying an upward pattern in common day by day instances — an increase of at the least 10% — over the earlier seven days, based on Appradab’s evaluation of Johns Hopkins University data.

At the very least 22 states’ common day by day instances have dropped greater than 10% over the previous week.

However, if instances proceed to pattern upward in some components of the nation, “then I’m being too optimistic, and (the subsequent 100,000 deaths) will come prior to that,” Jha informed Appradab Thursday morning. “However I am hopeful that we will get our act collectively and at the least put again among the social distancing stuff that we have let go.”

He’s not recommending lockdowns, he mentioned. However getting extra folks to put on masks, even exterior, and rising testing and contact tracing, he mentioned, would assist.

Hospitalizations are up in some states

Since Memorial Day, the variety of coronavirus hospitalizations has gone up in at least a dozen states, based on knowledge Appradab aggregated from the Covid Monitoring Challenge between Could 25 to June 9.

In Arizona, officers are telling hospitals to activate emergency plans.

At its earlier peak, the state’s intensive care unit beds had been 78% in use. As of this week, 79% were occupied. Arizona’s Director of Well being Providers Dr. Cara Christ requested that hospitals “be considered” in elective surgical procedures to make sure mattress capability.

“We all know Covid-19 remains to be in our neighborhood, and we count on to see elevated instances,” the Arizona Division of Well being Providers tweeted.

Mattress capability and medical assets had been among the many prime issues in treating the coronavirus pandemic when the nation first reached a peak. Well being consultants say it’s a matter of when — not if — the nation sees another surge in cases that might overwhelm well being care methods as soon as extra.

Fears of one other spike will not be restricted to any specific area.

States have to be prepared for an uptick in coronavirus instances, although, in areas the place protests have taken place over weeks, warned Dr. Tom Inglesby, the director of the Johns Hopkins Heart for Well being Safety.

“We have to be prepared for the doable rising Covid instances from the peaceable demonstrations which were occurring and we have to do what we will to decrease the dangers of these protests,” Inglesby mentioned throughout a media briefing Thursday on the impression of reopening amid the continuing pandemic.

North Carolina not too long ago broke its record with 780 coronavirus hospitalizations by early Thursday, based on the North Carolina Healthcare Affiliation.

Although there may be loads of hospital capability left, state officers are involved about elevated tendencies in hospitalizations when restrictions first eased, then once more after Memorial Day weekend.

Alabama on Thursday reported its largest variety of instances reported in someday — 849 — for the reason that state started monitoring Covid-19 instances.

The variety of Covid-19 hospitalizations since Memorial Day has gone up in Alaska, Arkansas, Arizona, California, Kentucky, Mississippi, Montana, North Carolina, Oregon, South Carolina, Texas and Utah, based on knowledge aggregated from the Covid Monitoring Challenge.

General, the brand new knowledge mark a rise in a number of states that started prior to now couple weeks. The lag interval between when individuals are uncovered to the virus to the time that they might truly get examined and are available again with a confirmed an infection will be about two to a few weeks.

Some states are additional cautious

Areas that had been thought of early sizzling spots stay cautious.

Whereas New Jersey’s numbers are bettering, it is not but out of the woods, Gov. Phil Murphy mentioned. And Los Angeles is encouraging residents who’ve attended protests over the loss of life of George Floyd to watch for signs, to quarantine or get examined.

“You can have an publicity and it’ll not come by way of a contact tracing system. No person is aware of that you just had been there, no person has your identify,” Los Angeles County Public Well being Director Barbara Ferrer mentioned.

Los Angeles County is seeing a median of 1,300 new coronavirus instances a day because it permits extra companies to reopen, together with gyms and museums.

US human trials start for first antibody cocktail which may deal with and forestall Covid-19

A medication that will deal with and forestall Covid-19 is now being tested in sufferers in a number of websites round the USA, based on an announcement Thursday from Regeneron Prescription drugs Inc.

It’s the first trial of a Covid-19 antibody cocktail in the USA. If profitable, Regeneron hopes it could possibly be out there by the autumn.

The scientific trial began Wednesday.

Antibodies are proteins the physique naturally makes to guard the physique from a menace like Covid-19. To make what’s known as monoclonal antibodies for an antibody cocktail, scientists comb by way of 1000’s of antibodies to determine which of them battle the novel coronavirus most successfully.

On this case, Regeneron’s scientists picked two antibodies, scaled them up and put them into a drugs that it hopes can be utilized to deal with signs and as safety for susceptible communities such because the aged or well being care employees.

Massive-scale vaccine trial to start in July

An antibody therapy just isn’t a vaccine and doesn’t present everlasting safety. However this sort of passive immunization works straight away and will probably be out there earlier than a Covid-19 vaccine.

Moderna confirmed Thursday that it expects to start the ultimate part of its vaccine candidate subsequent month.

The research will embrace 30,000 topics in the USA and will probably be placebo-controlled, the corporate mentioned in a press launch.

Moderna remains to be on observe to deliever about 500 million to 1 billion doses a yr, beginning subsequent yr, the corporate mentioned.

Its main endpoint will probably be prevention of symptomatic Covid-19, with secondary endpoints to incorporate the prevention of extreme Covid-19 that results in hospitalization.

Appradab’s Jason Hanna, Jen Christensen, Matt Egan, Madeline Holcombe, Wes Bruer, Maggie Fox, Theresa Waldrop and Amanda Watts contributed to this report.

[jobsearchtips02]

Coronavirus likely shown up in US in December, prior to WHO was informed

The coronavirus may have reached the US by late December, installing evidence suggests.

Due To The Fact That the United States did not initially test commonly for COVID-19, epidemiologists don’t know how far the virus spread in early 2020.

See Business Expert’s homepage for more stories

On January 19, a 35- year-old man strolled into an immediate care center in Snohomish County, Washington, with a cough and a fever. 4 days earlier, he had actually returned from a journey to Wuhan, China.

A test revealed his diagnosis the next day: The US had its first case of COVID-19

But he was likely not the real first. Ever since, a growing variety of puzzle pieces have exposed a different picture of the start of the nation’s outbreak– one that in retrospect seems so obvious it’s tough to imagine we ever thought otherwise. The coronavirus most likely began spreading out in the US in December, before we even understood it existed.

The Washington state patient was just one of nearly 1 million travelers who flew from mainland China to the United States between November 17, 2019– China’s earliest estimate for the new coronavirus’ development– and February 1,2020 According to information provided to Business Insider by Cirium, a database and analytics business that tracks business air traffic, 3,357 flights occurred during that time. That’s a total of 994,281 seats.

Though a few of those seats were probably empty, any of the travelers could have brought the virus.

” I believe that’s highly possible,” Dr. Lauren Ancel Meyers, an epidemiologist at the University of Texas at Austin, informed Business Insider. “Well back into December, there was a time period where there was a lot of global travel in and out of Wuhan.”

Certainly, two people who fell ill in Washington state in December later checked positive for COVID-19 antibodies, The Seattle Times reported. (Though it’s possible they had a more common illness at the time, then got an asymptomatic case of coronavirus later on.)

” If it turns out that the virus was currently in numerous cities in the United States by December, that is relatively constant with whatever we now comprehend about how this infection spreads,” Meyers included.

Anthony Fauci, director of National Institutes of Health Transmittable Illness, talks to reporters about the coronavirus at the White Home in Washington, DC, January 31,2020

Leah Millis/Reuters.

That flight data, obviously, doesn’t represent people originating from Europe, though genetic research studies recommend that’s how the pathogen got to the US East Coast. In France, a man come to a health center outside Paris spending blood on December 27, four days before the WHO learned of China’s mystical outbreak. His sample later on tested positive for COVID-19

Offered the extremely globalized nature of our world, any possibility that this was just a “Chinese virus,” as President Donald Trump has actually called it, now seems an absurd idea. That misunderstanding enabled early, undetected spread and added to a sluggish federal reaction that made the American break out into the devastating, uncontrollable monster it has become.

Let’s evaluation the timeline

A firefighter performs disinfection at the Wuhan Tianhe International Airport in Wuhan, China, April 3,2020

Xinhua/Cheng Min via Getty Images.

You most likely keep in mind how this all started: In late December, dozens of serious and inexplicable pneumonia cases started cropping up in Wuhan, the vast capital of China’s Hubei province.

China reported the new condition to the World Health Organization on January 3, after the organization requested info about reports it had seen on an open-source platform, the Associated Press reported.

By then, the infection had likely been infecting humans for at least a month

” As soon as it ended up being clear that there was a large outbreak in Wuhan, we were– and we must have been– conscious that there was an affordable opportunity that the infection had already shown up through global travel, or would soon arrive through international travel in the United States and all over the world,” Meyers stated.

A traveler using a mask waits to check in for a flight at Miami International Airport in Florida, March 21,2020

Carlos Barria/Reuters. The US’s very first coronavirus death, California autopsies have actually revealed, took place weeks earlier than we originally believed In Florida, at least 170 individuals who were later verified to have COVID-19 initially reported their signs from December 31 to February 29, according to the Miami Herald

The early size of the United States break out might never be clear

A staff member obstructs the deem a person is required to an ambulance in a stretcher from a Washington state nursing center, February 29,2020

Elaine Thompson/AP.

Redfield just recently suggested that the CDC’s new report programs why early widespread testing may have been unsuccessful.

” It really would be like trying to find a needle in a haystack,” Redfield stated in a briefing on May 29.

However other specialists say that early testing could have prevented the shutdowns and waves of death that have actually afflicted the nation.

” On the contrary, I think [the CDC study] demonstrates the need for large scale-ups and improvements to public health infectious-disease surveillance,” Michael Mina, an infectious-disease expert at Harvard’s TH Chan School of Public Health, informed NPR

A healthcare employee checks people at a drive-thru COVID-19 testing station run by the state health department, in Denver, Colorado, March 11,2020

Jim Urquhart/Reuters.

In South Korea, for example, rigorous contact tracing, effective public details sharing, and prevalent screening helped the nation contain its outbreak within a couple of weeks. South Korea reported its very first coronavirus case on January 20– the very same day as the United States.

For many weeks, it had the highest testing-per-capita rate of any country on the planet. South Korea never ever went into a complete lockdown, and today its death rate stays low: around 2%.

Taiwan, primed by its experience with SARS in 2003, responded right away upon hearing of China’s outbreak. The state started to keep an eye on incoming travelers from Wuhan for indications of breathing health problem on December 30, after Chinese eye doctor Li Wenliang warned fellow medical professionals about a possible outbreak looking like SARS.

In the following weeks, Taiwan quickly presented screening and public details projects

A student gets his body temperature measured when returning for classes in Seoul, South Korea, on May 27,2020

Lee Sang-ho/Xinhua by means of Getty) (Xinhua/ via Getty Images.

United States testing, meanwhile, lagged behind.

” We lost numerous months’ time where we would have been able to isolate people and avoid the cases from accelerating as we did,” Jennifer Nuzzo, an epidemiologist at the John Hopkins Bloomberg School of Public Health, informed the Washington Post

South Korea had actually reported 11,668 confirmed cases and 273 deaths due to COVID-19 since Friday. The US’s verified case overall is ticking towards 2 million, and more than 109,000 people have actually passed away. To approximate America’s real case count, epidemiologists have actually said, we should multiply the main overalls by 10

‘ It’s practical to understand what the real history of the infection has been’

Employees gather samples from homeless individuals during a coronavirus testing operation, in downtown Miami, Florida, April 16,2020

Marco Bello/Reuters.

A Company Expert survey of more than 1,000 Americans, performed in late April, discovered that 33%of participants thought they may have had the coronavirus. A couple of said they had symptoms as early as December 2019.

Most of those individuals most likely did not have COVID-19– “in the winter season, there are a great deal of various infections that flow in US populations,” Meyers stated– however it’s very possible some did.

Gaining a better understanding of the real start of the United States break out isn’t simply a matter of verifying somebody’s suspicions about their own disease, however, or remedying the historical record.

” If it ends up that it was spreading out more thoroughly prior to we were aware of it, it may lead us to change our quotes for the proportion of cases that are asymptomatic or mild,” Meyers stated. “It may likewise simply sort of give individuals instinct for how long it takes between when an infection is very first presented into a city, and when it begins emerging and truly causing a large number of cases in medical facilities and deaths.”

Comprehending how brand-new viruses spread around the world world– and how quickly they can seep into brand-new populations– could assist researchers and policymakers learn from the errors of 2020 and prepare for the next pandemic

A medical staff member tends to a client suffering from COVID-19 in the extensive care unit at the Circolo healthcare facility in Varese, Italy, April 9,2020

Flavio Lo Scalzo/Reuters.

At this moment in the current crisis, though, American epidemiologists have actually gotten utilized to dealing with restricted data.

” It’s useful to understand what the true history of the infection has been in the United States,” Meyers said. “But I do not think that will always change our fundamental scientific understanding of the virus.”

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[nbcymca]

Week Two

Well here I am, two months after stepping foot back on Canadian soil, picking up where I left off and reflecting on the last of my journey with Y Australia.  

As the second week of my placement came to an end, with each passing day the COVID-19 pandemic was picking up speed. When I left for Australia just a few weeks prior, I did not imagine it would have such an impact on my experience. Within days the crisis went from merely a rearrangement of activities due to a conference cancellation, to waking up to news that the NHL was cancelled, Disneyland was closed for the first time since 9/11, and the Canadian borders were closing.

Thus, I made the difficult (but right) decision to return home. Traveling that day had yet to resemble the Insta photos that I am sure you have all seen – empty planes. Instead, there was a somber feeling of paranoia in the airport. The planes were packed with people who were frustrated with their need to rebook, overpaying, and vacations cut short– it was clear everyone was in the mad dash to make it home. When I hit YVR in Vancouver, we were met with an unfamiliar routine where we could not access the public and a deserted airport. Although, I tend to think that I am mostly rational and level-headed, I admit that it was challenging to not feel a great sense of anxiety and the sense that the world was ending.

Thanks to the support of Y Canada, I was relieved to finally make it home….and I hit the ground running. During my travel, the pandemic continued to ramp up in Canada. By the time I entered my home, I went straight to my office due to quarantine and to support my home Association with communications – the first weeks were a blur of long hours, quarantine, jet lag, anxiety, high emotions, and difficult decision making.

It felt merely impossible that just days before I was waking up in my Melbourne condo, spending my days with new friends, new places, and building beautiful memories, filled with learning…although so truly disappointed that the placement was cut short and that a swift exit didn’t allow for proper goodbyes, I am so grateful for the time that I had. The memories, learnings, and relationships felt deeper than possible within only a few weeks. I keep sharing that I am so grateful I had the time that I did have and that I was not scheduled for any later or the experience would likely have been cancelled all together.

I look forward to bringing my learnings into my Association as our work continues past the pandemic – strategy, governance, child protection, community impact, and so much more.

Now, let me share about the second week of my placement…although less organized than my first week’s reflection, there were so many highlights.

My week included a large variety of sights and YMCAs from stadiums – to Carleton Baths Aquatics facility AND a lot of work in the Y Aus office that really owned in on my goals for my time there.

I spent one day in National Safeguarding Unit Training with the national office and many other senior YMCA leaders. Although emotionally heavy, this was so impactful from hearing stories of survivors, the work the Y is doing, to profiling sexual offenders.  Rolling out work of this calibre and importance across a vast federation is a huge undertaking – In particular to the workshop, I really enjoyed seeing the strategies involved and aligning this with all the work Associations do.

Similarly, I had the opportunity to work with the national communications team where they shared their processes, strategy, and challenges.

One of my goals (and highlights) was the invitation to participate in the national Employee Value Proposition Committee work- Y Aus collected a team of leaders from the different Associations to create a national employee engagement framework – we worked through the differentiators, timeline, and pieces involved with this project. Working as an employer in the non-profit sector is challenging to ensure that your employees have buy in to your cause, in addition the balancing act of being an employer of choice in offerings for employees while also ensuring financial sustainability, and that funders and other stakeholders are pleased or accepting of the balance your organization.

I spent a day at various sites with YMCA Victoria, or ‘Y Vic.’ Where I truly found my people.

First, I met with Mick, where I learned about the Bridge and Rebuild programs. The Bridge program is a social enterprise in government and private prisons that provides training and support to young people. Rebuild is similar where participants have the opportunity to learn the training and skills and then work in maintenance or construction to actually work and earn money- transitioning them into life outside of prison.

I was gifted this beautiful chopping block shaped like Australia that is my favorite souvenir – and will sit in my office so I can share the story about this great work.

The rest of the day, I met with Ange and her team where I learned about all of their camp and youth development programs, including Future Leaders, UNOY, Youth Parliament, Pride, and digital marketing.

Her department boasts over 200 volunteers, and only a handful of staff that make all their community impact and camps possible. They shred for hours their keys to volunteer engagement around development (from skill development such as Mental Health First Aid, to movie nights, to volunteer awards), an annual youth retreat, flat hierarchies, commitment to experimentation and risk taking. They have created a model for all their programs that build temporary communities for projects and teams quickly for volunteers and staff– which is the secret to camp’s success.  They created a camp community outside of camp. I want to create that model of development for staff and volunteers.

Also I got this sweet Y pride shirt!

Lastly, the craziest thing I did was visit a Y Skate Park (I took a photo for those that know how outside of my character and comfort zone this would be- but have somehow deleted a group of my photos). I learned about the programs offered for schools, lessons, social, coaching, competitive, and for girls in skate to promote opportunities for physical activity, but even more importantly it creates an opportunity for peer support. Youth can partake in skate as an outlet and have positive role models there to provide support in a relaxed and non-threatening environment.

[kristinsimmons]

5 Steps Health Insurance CEOs Must Take to Help with COVID-19

By JEFF LIVINGSTON, MD

Imagine a country where you can not see a doctor. Who will refill your blood pressure prescription, see your sick child, mend your broken arm, deliver your baby, or run the ventilator if you fall victim to Coronavirus? The COVID-19 pandemic created a cash-flow crisis causing mass physician layoffs and closure of medical practices. A world without doctors puts us all at risk. The pandemic is the invisible enemy, and the CEOs of large insurance companies have the tools to help doctors stay in the fight.

Our government, healthcare providers, and individuals are doing our part to flatten the curve of the pandemic. It is time for the insurance industry to take massive action to salvage the US health system.

Practices are closing already. Tenet Health care announced a $250 million dollar reduction effective March 27, 2020. Other large and small health systems are implementing drastic cost-cutting measures. Data reported in USA Today, an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June.  

On a personal note, I have been wearing my glasses for two weeks as I can not get my contacts refilled. My trusted eye doctor has already shut the doors and cannot refill my prescription. 

Which CEO will lead the way?

In times of crisis, leaders lead. They rise to the occasion and accept the challenge. Leaders take bold steps to overcome obstacles. Americans wait to see which large private insurance company CEO will appear on Bloomberg or CNBC announcing proactive, life-saving initiatives to help our country and our healthcare system. 

Our forward-thinking potential champions are UnitedHealth Group CEO David Wichmann, Cigna CEO David Cordani, Humana CEO Bruce Dale Broussard, Anthem CEO Gail K. Boudreaux, and BCBS CEO Scott Serota.

Only one of these leaders gets to be the hero. 

One leader gets a “first-mover” advantage. They set the stage and light the path for other CEOs to follow. Americans will read only one of the names in every news headline, and only one will be the subject of a Harvard Business Review case study. 

Only one leader will be celebrated on Twitter and praised on Facebook. Only one CEO’s face will grace the front page of the Wallstreet Journal. Their company will be rated “BUY! BUY! Buy!” by Jim Cramer on Squawk on the Street. The others will be forgotten, failed leaders who placed profits before patients. Who will be first, and who will follow?

The question is, “which CEO of a large private insurance company is ready to take the bold, strong steps to lead America through this crisis?”

Now is the time for CEO action 

The United States needs immediate coordinated action to prevent a complete collapse of our health system. Private insurance companies must act before the hammer of government intervention wakes them from their slumber. Without prompt and effective solutions, the industry should expect a crushing blow of governmental regulation. Slow movers will not be rewarded.

Failing medical practices have a trickle-down effect. As the pandemic ravages our economy, unemployment rises to all-time highs. Patients lose their health insurance. The drop in monthly premiums leads to plummeting revenue. Combine the incoming barrage of astronomically expensive COVID-19 care claims with the loss of revenue from decreased subscribers, and insurance companies will find themselves in the same cash-flow crisis as doctors. 

The insurance industry cares about the health of the nation, but they also have an economic incentive to keep doctors in business. To keep it simple, when doctors fail, so will the insurance companies.

The negative cascade will continue as the US uninsured population skyrockets. Patients’ only options will be taxpayer-funded Medicaid and public health options.

The domino effect triggered by a sudden shortage of healthcare workers will impact the sustainability of the private health insurance industry. A lack of action triggers an accidental move towards a single-payer system. 

If we go down, so do the insurance companies.

Health insurance industry CEOS control their fate

CEOs face a choice that will determine our country’s path. These two options should haunt their thoughts and keep each CEO awake at night as this pandemic requires big, bold action.

Option number 1: Let medical practices fail and allow the government to solve the problem. 

Option number 2: Offer market-based private industry solutions. Solve the problem, or it will be solved for you. 

Without urgent and decisive action, the collapse of our current system moves the US one step closer to a government takeover of healthcare. The irony is thick. To save the private health industry, health insurance companies must make short term financial sacrifices to prevent a collapse of the system. 

The solution to relieve the cash-flow crisis burden lies squarely on the shoulders of private insurance companies. The industry has taken some positive steps. We must give credit where credit is due. Many companies waived cost-sharing for COVID-19 care. While beneficial, it is a drop in an empty bucket. This step received media praise, but it is not sufficient to solve the crisis. 

Many suggest the burden is on doctors to renegotiate their insurance contracts. It is not practical for every practice in the country to negotiate terms with each third party payer individually. Our practice has contracts with over one hundred third-party payers. Individualized contract negotiations is not a scalable solution.

Others suggest the federal government must offer solutions. The passage of the CARES act was an excellent first step. Other congressional actions will follow. CMS, which governs the federally-funded Medicare program, expanded a widely popular Accelerated Advanced payment system. State governments manage Medicaid rules. We do not have time to wait for all 50 states to agree upon 50 different solutions. 

The only path to keeping medical practices solvent way at the required speed is action by the CEOs of large insurance companies. 

Here are five actionable initiatives a health insurance company can implement immediately to help the US health system navigate through the pandemic.

1. Replicate the Accelerated Advanced payment system

To increase cash flow to providers impacted by the Coronavirus pandemic, CMS allows providers to request up to 100% of the Medicare payment amount for a three-month period. Private third-party payers can replicate this process for all providers throughout the country. This one step triggers a cash infusion allowing doctors to keep the doors open and will enable us to serve those in need. 

2. Suspend out-of-network penalties.

It is unsafe to enforce network restrictions during the pandemic. Insurance companies must allow physicians and patients to seek care in hospitals and medical sites of service not experiencing capacity limitations. Doctors need the freedom to direct care where it is safe and where there is room. Trust your contracted providers to guide patients to the safest option available in their local community. 

Insurance companies must recognize the immediacy of this decision to reduce the burden on hospital capacity. Every CEO should consider what they would want for their family and loved ones. 

Would they want to be admitted to an in-network facility known to be at capacity or an out-of-network facility with plenty of open rooms?

Failure to remove network restrictions will cost lives and bankrupt any family factoring finances over safety.

3. Expedited health care provider credentialing process. 

Allow immediate authorization of any licensed provider, in good standing with their state’s medical board, to provide all services on your medical plans. The credentialing process takes 90–120 days. The harsh reality is there is no time for bureaucratic red tape as physicians get sick and die. 

CEOs of every insurance plan should announce an expedited credentialing process. Patients and doctors across the country will take note of the first CEO to take this simple step to keep patients alive.

4. Expedited revenue cycle management 

Medical billing systems (revenue cycle management) create a lag in payment for services rendered. Payments are often not received for up to three months. Reduce the need for layers of record requests, denials, and appeals. Continue oversight for fraud, waste, and abuse, but reduce the barriers to payment. Each lag in payment exacerbates the cash flow crunch for medical practices.

5. Telehealth reimbursement parity 

CMS removed restrictions to allow expansion of virtual care through Waiver 1135. Many offices rapidly expanded their services to implement Telehealth. Reimbursement varies for each third-party payer. Each payer has different guidelines and various payment models for audio vs video consults. The Texas Medical Association published a summary of current guidelines that illustrate the chaos of virtual care reimbursements. No practice can possibly implement Telehealth effectively fat scale following this system.

Keep it simple.

Reimburse any form of virtual care on par with previously established CPT codes for in-person visits during the COVID-19 crisis.

Courage is needed now 

We are counting on the health insurance industry to join providers in the fight against COVID-19 as it crushes every practice, hospital, health system in every specialty in our country. Medical practices across the country need help to stay in business. The United States passed 331,151 COVID-19 cases today. When this article is published, that number will be higher.

The death toll will continue to rise. 

America needs every available doctor in the country to fight the challenges of COVID-19. Health insurance companies can provide the lifeline allowing providers to stay in the battle. 

Time is running out. 

Which health insurance CEO will take the bold action needed to save the US health system?

Thank you to Michael Mcewen from Mcewen and Associates for providing background for this article. 

Jeff Livingston, MD is an OBGYN practicing in Texas.

The post 5 Steps Health Insurance CEOs Must Take to Help with COVID-19 appeared first on The Health Care Blog.

5 Steps Health Insurance CEOs Must Take to Help with COVID-19 published first on https://wittooth.tumblr.com/

[lauramalchowblog]

5 Steps Health Insurance CEOs Must Take to Help with COVID-19

By JEFF LIVINGSTON, MD

Imagine a country where you can not see a doctor. Who will refill your blood pressure prescription, see your sick child, mend your broken arm, deliver your baby, or run the ventilator if you fall victim to Coronavirus? The COVID-19 pandemic created a cash-flow crisis causing mass physician layoffs and closure of medical practices. A world without doctors puts us all at risk. The pandemic is the invisible enemy, and the CEOs of large insurance companies have the tools to help doctors stay in the fight.

Our government, healthcare providers, and individuals are doing our part to flatten the curve of the pandemic. It is time for the insurance industry to take massive action to salvage the US health system.

Practices are closing already. Tenet Health care announced a $250 million dollar reduction effective March 27, 2020. Other large and small health systems are implementing drastic cost-cutting measures. Data reported in USA Today, an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June.  

On a personal note, I have been wearing my glasses for two weeks as I can not get my contacts refilled. My trusted eye doctor has already shut the doors and cannot refill my prescription. 

Which CEO will lead the way?

In times of crisis, leaders lead. They rise to the occasion and accept the challenge. Leaders take bold steps to overcome obstacles. Americans wait to see which large private insurance company CEO will appear on Bloomberg or CNBC announcing proactive, life-saving initiatives to help our country and our healthcare system. 

Our forward-thinking potential champions are UnitedHealth Group CEO David Wichmann, Cigna CEO David Cordani, Humana CEO Bruce Dale Broussard, Anthem CEO Gail K. Boudreaux, and BCBS CEO Scott Serota.

Only one of these leaders gets to be the hero. 

One leader gets a “first-mover” advantage. They set the stage and light the path for other CEOs to follow. Americans will read only one of the names in every news headline, and only one will be the subject of a Harvard Business Review case study. 

Only one leader will be celebrated on Twitter and praised on Facebook. Only one CEO’s face will grace the front page of the Wallstreet Journal. Their company will be rated “BUY! BUY! Buy!” by Jim Cramer on Squawk on the Street. The others will be forgotten, failed leaders who placed profits before patients. Who will be first, and who will follow?

The question is, “which CEO of a large private insurance company is ready to take the bold, strong steps to lead America through this crisis?”

Now is the time for CEO action 

The United States needs immediate coordinated action to prevent a complete collapse of our health system. Private insurance companies must act before the hammer of government intervention wakes them from their slumber. Without prompt and effective solutions, the industry should expect a crushing blow of governmental regulation. Slow movers will not be rewarded.

Failing medical practices have a trickle-down effect. As the pandemic ravages our economy, unemployment rises to all-time highs. Patients lose their health insurance. The drop in monthly premiums leads to plummeting revenue. Combine the incoming barrage of astronomically expensive COVID-19 care claims with the loss of revenue from decreased subscribers, and insurance companies will find themselves in the same cash-flow crisis as doctors. 

The insurance industry cares about the health of the nation, but they also have an economic incentive to keep doctors in business. To keep it simple, when doctors fail, so will the insurance companies.

The negative cascade will continue as the US uninsured population skyrockets. Patients’ only options will be taxpayer-funded Medicaid and public health options.

The domino effect triggered by a sudden shortage of healthcare workers will impact the sustainability of the private health insurance industry. A lack of action triggers an accidental move towards a single-payer system. 

If we go down, so do the insurance companies.

Health insurance industry CEOS control their fate

CEOs face a choice that will determine our country’s path. These two options should haunt their thoughts and keep each CEO awake at night as this pandemic requires big, bold action.

Option number 1: Let medical practices fail and allow the government to solve the problem. 

Option number 2: Offer market-based private industry solutions. Solve the problem, or it will be solved for you. 

Without urgent and decisive action, the collapse of our current system moves the US one step closer to a government takeover of healthcare. The irony is thick. To save the private health industry, health insurance companies must make short term financial sacrifices to prevent a collapse of the system. 

The solution to relieve the cash-flow crisis burden lies squarely on the shoulders of private insurance companies. The industry has taken some positive steps. We must give credit where credit is due. Many companies waived cost-sharing for COVID-19 care. While beneficial, it is a drop in an empty bucket. This step received media praise, but it is not sufficient to solve the crisis. 

Many suggest the burden is on doctors to renegotiate their insurance contracts. It is not practical for every practice in the country to negotiate terms with each third party payer individually. Our practice has contracts with over one hundred third-party payers. Individualized contract negotiations is not a scalable solution.

Others suggest the federal government must offer solutions. The passage of the CARES act was an excellent first step. Other congressional actions will follow. CMS, which governs the federally-funded Medicare program, expanded a widely popular Accelerated Advanced payment system. State governments manage Medicaid rules. We do not have time to wait for all 50 states to agree upon 50 different solutions. 

The only path to keeping medical practices solvent way at the required speed is action by the CEOs of large insurance companies. 

Here are five actionable initiatives a health insurance company can implement immediately to help the US health system navigate through the pandemic.

1. Replicate the Accelerated Advanced payment system

To increase cash flow to providers impacted by the Coronavirus pandemic, CMS allows providers to request up to 100% of the Medicare payment amount for a three-month period. Private third-party payers can replicate this process for all providers throughout the country. This one step triggers a cash infusion allowing doctors to keep the doors open and will enable us to serve those in need. 

2. Suspend out-of-network penalties.

It is unsafe to enforce network restrictions during the pandemic. Insurance companies must allow physicians and patients to seek care in hospitals and medical sites of service not experiencing capacity limitations. Doctors need the freedom to direct care where it is safe and where there is room. Trust your contracted providers to guide patients to the safest option available in their local community. 

Insurance companies must recognize the immediacy of this decision to reduce the burden on hospital capacity. Every CEO should consider what they would want for their family and loved ones. 

Would they want to be admitted to an in-network facility known to be at capacity or an out-of-network facility with plenty of open rooms?

Failure to remove network restrictions will cost lives and bankrupt any family factoring finances over safety.

3. Expedited health care provider credentialing process. 

Allow immediate authorization of any licensed provider, in good standing with their state’s medical board, to provide all services on your medical plans. The credentialing process takes 90–120 days. The harsh reality is there is no time for bureaucratic red tape as physicians get sick and die. 

CEOs of every insurance plan should announce an expedited credentialing process. Patients and doctors across the country will take note of the first CEO to take this simple step to keep patients alive.

4. Expedited revenue cycle management 

Medical billing systems (revenue cycle management) create a lag in payment for services rendered. Payments are often not received for up to three months. Reduce the need for layers of record requests, denials, and appeals. Continue oversight for fraud, waste, and abuse, but reduce the barriers to payment. Each lag in payment exacerbates the cash flow crunch for medical practices.

5. Telehealth reimbursement parity 

CMS removed restrictions to allow expansion of virtual care through Waiver 1135. Many offices rapidly expanded their services to implement Telehealth. Reimbursement varies for each third-party payer. Each payer has different guidelines and various payment models for audio vs video consults. The Texas Medical Association published a summary of current guidelines that illustrate the chaos of virtual care reimbursements. No practice can possibly implement Telehealth effectively fat scale following this system.

Keep it simple.

Reimburse any form of virtual care on par with previously established CPT codes for in-person visits during the COVID-19 crisis.

Courage is needed now 

We are counting on the health insurance industry to join providers in the fight against COVID-19 as it crushes every practice, hospital, health system in every specialty in our country. Medical practices across the country need help to stay in business. The United States passed 331,151 COVID-19 cases today. When this article is published, that number will be higher.

The death toll will continue to rise. 

America needs every available doctor in the country to fight the challenges of COVID-19. Health insurance companies can provide the lifeline allowing providers to stay in the battle. 

Time is running out. 

Which health insurance CEO will take the bold action needed to save the US health system?

Thank you to Michael Mcewen from Mcewen and Associates for providing background for this article. 

Jeff Livingston, MD is an OBGYN practicing in Texas.

The post 5 Steps Health Insurance CEOs Must Take to Help with COVID-19 appeared first on The Health Care Blog.

5 Steps Health Insurance CEOs Must Take to Help with COVID-19 published first on https://venabeahan.tumblr.com

[hviral]

Can China return to normalcy while keeping the coronavirus in check?

Life is almost back to normal in much of China. Shops, restaurants, bars, and offices are open for business. Manufacturing activity is picking up. Traffic once again jams the highways of major cities. Three quarters of China’s workforce was back on the job as of 24 March, according to one company’s estimate. Wuhan, where the COVID-19 pandemic originated, is lagging, as is the rest of Hubei province—but even there, the lockdown is due to lift 8 April.

China has done what few believed was possible: bring a blazing epidemic of a respiratory virus to a virtual standstill. On 18 March, the country reported zero locally transmitted cases of COVID-19 for the first time. Since then, only 6 of such infections have been reported, only one of them in Wuhan. Now, the key question is: Can China keep it that way?

Public health officials worldwide are watching closely. “China is addressing an issue every country and location in the world will eventually face: how to normalize and restore societal activities, while at the same time minimizing disease-related dangers from the outbreak,” says epidemiologist Keiji Fukuda of the University of Hong Kong.

New infections now mostly come from outside: More than 500 cases have been confirmed in incoming air passengers since 18 March. At midnight on Friday, China banned virtually all foreigners from entering the country and required all returning Chinese to be quarantined for 2 weeks, whether coming by air or over land. But there is still danger within the country as well. The smattering of locally transmitted cases show that the virus isn’t entirely gone. And the very low case numbers may be deceptive. In its tally, China’s National Health Commission does not include people who test positive for the virus but have no symptoms, and local authorities are reportedly suppressing information on new infections to meet the target of zero local cases.

Still, “I believe that there are few local cases,” says epidemiologist Ben Cowling of the University of Hong Kong. But with most of the population still susceptible to infection, fresh outbreaks remain a constant danger. “How to balance getting back to work and a normal state versus maintaining the current status [of few new cases] is certainly critical,” says Ding Sheng, director of the Global Health Drug Discovery Institute at Tsinghua University in Beijing.

Officials are relaxing restrictions very slowly and methodically, Ding says. Many restaurants at first reopened with shortened hours and for a limited number of customers; now doors are open to all. Primary and secondary schools in several provinces have reopened, but only in communities free of the disease, and schools must check students’ temperatures and watch for symptoms. Universities, where students from around the country mix, remain closed, with classes given online. Events that draw crowds are still banned or discouraged. Live music venues and gyms in many cities remain closed. There are temperature checks at subway entrances and factory gates.

A number of local governments had allowed cinemas to re-open, but last week the national government decided it was too early and closed all theaters for the time being. And habits developed during the epidemic persist. Face masks are ubiquitous. People keep their distance in public and at work. Millions continue to work from home.

To guard against flare-ups, investigators trace and quarantine close contacts of every newly confirmed case, including those who may be asymptomatic, Wu Zunyou, an epidemiologist at the Chinese Center for Disease Control and Prevention, told the communist party newspaper China Daily earlier this week. In another precaution, everyone visiting fever clinics in Beijing and other major cities is now tested for the virus. And many provinces check the health status of migrant workers and others crossing their borders. “Any new transmission will be identified quickly and controlled swiftly,” Ding says.

China is addressing an issue every country and location in the world will eventually face: how to normalize and restore societal activities, while at the same time minimizing disease-related dangers from the outbreak.

Keiji Fukuda, University of Hong Kong

Friday’s travel ban—which the government implemented even though it strenuously objected when the United States banned visitors from China in January—addresses the other main risk: reintroduction of the virus from the rest of the world. Flights into China have also been severely curtailed. Chinese citizens who arrive undergo strict screening en route and upon arrival and go into quarantine for two weeks.

A European academic who returned to China a week before the ban took effect described the process to Science. His temperature was taken twice during the flight, and he filled out a form detailing his recent whereabouts, the health status of family members and colleagues, and his use of medications. Another temperature check followed at the Beijing airport, after which the scholar—who asked not to be identified—was escorted to his own apartment for a 14-day quarantine. A community official pasted a quarantine notice across the door jamb, which was removed and replaced for grocery deliveries. Authorities ordered him to a “quarantine hotel” three days later, after a fellow passenger on the plane turned positive for COVID-19. The academic remains “very understanding,” and says he was well-treated. (He says he also got a lot of work done on COVID-19-related economic studies.)

China’s strategy “seems to have been effective thus far in preventing a resurgence,” says Benjamin Anderson, an epidemiologist at Duke Kunshan University in China. But with the virus now circulating around the world, “repeated importations to China will inevitably lead to local transmission,” says Cowling. “Authorities will need to get on top of the cases very quickly,” he says, in a game of whack-a-mole. Remaining pockets of local infection could be a problem as well, says Ira Longini, a disease modeler at the University of Florida. “The models say the disease will come back once the restrictions are lifted. I hope that’s not correct, but I can’t imagine why it wouldn’t be,” Longini says.

Much is at stake. Economists predict China’s GDP may shrink 10% in the first quarter of this year, the worst contraction since 1976. With Europe and America wrestling with their own epidemics, demand for China’s manufactured goods has collapsed—aside from masks and medical equipment and supplies. Recurring COVID-19 outbreaks in China would compound the damage.

The Chinese strategy is aimed at buying time until a vaccine or drugs are available, says George Gao, director of the Chinese Center for Disease Control and Prevention. A group led by Chen Wei of the Beijing-based Academy of Military Medical Sciences has already started a phase I-study of a candidate vaccine, according to China Daily. Trials are expected to last at least through the end of this year. Dozens of other vaccine studies are underway around the world.

Ding, who lived in Beijing through the worst of the crisis, believes China can keep its guard up until these efforts bear fruit. While minor flare-ups could happen any time, he says, a large-scale reemergence of COVID-19 “is very unlikely given what we have learned.”

With reporting by Jon Cohen, Martin Enserink, and Bian Huihui.

The post Can China return to normalcy while keeping the coronavirus in check? appeared first on HviRAL.

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[kristinsimmons]

5 Steps Health Insurance CEOs Must Take to Help with COVID-19

By JEFF LIVINGSTON, MD

Imagine a country where you can not see a doctor. Who will refill your blood pressure prescription, see your sick child, mend your broken arm, deliver your baby, or run the ventilator if you fall victim to Coronavirus? The COVID-19 pandemic created a cash-flow crisis causing mass physician layoffs and closure of medical practices. A world without doctors puts us all at risk. The pandemic is the invisible enemy, and the CEOs of large insurance companies have the tools to help doctors stay in the fight.

Our government, healthcare providers, and individuals are doing our part to flatten the curve of the pandemic. It is time for the insurance industry to take massive action to salvage the US health system.

Practices are closing already. Tenet Health care announced a $250 million dollar reduction effective March 27, 2020. Other large and small health systems are implementing drastic cost-cutting measures. Data reported in USA Today, an estimated 60,000 family practices will close and 800,000 of their employees will lose their jobs by the end of June.  

On a personal note, I have been wearing my glasses for two weeks as I can not get my contacts refilled. My trusted eye doctor has already shut the doors and cannot refill my prescription. 

Which CEO will lead the way?

In times of crisis, leaders lead. They rise to the occasion and accept the challenge. Leaders take bold steps to overcome obstacles. Americans wait to see which large private insurance company CEO will appear on Bloomberg or CNBC announcing proactive, life-saving initiatives to help our country and our healthcare system. 

Our forward-thinking potential champions are UnitedHealth Group CEO David Wichmann, Cigna CEO David Cordani, Humana CEO Bruce Dale Broussard, Anthem CEO Gail K. Boudreaux, and BCBS CEO Scott Serota.

Only one of these leaders gets to be the hero. 

One leader gets a “first-mover” advantage. They set the stage and light the path for other CEOs to follow. Americans will read only one of the names in every news headline, and only one will be the subject of a Harvard Business Review case study. 

Only one leader will be celebrated on Twitter and praised on Facebook. Only one CEO’s face will grace the front page of the Wallstreet Journal. Their company will be rated “BUY! BUY! Buy!” by Jim Cramer on Squawk on the Street. The others will be forgotten, failed leaders who placed profits before patients. Who will be first, and who will follow?

The question is, “which CEO of a large private insurance company is ready to take the bold, strong steps to lead America through this crisis?”

Now is the time for CEO action 

The United States needs immediate coordinated action to prevent a complete collapse of our health system. Private insurance companies must act before the hammer of government intervention wakes them from their slumber. Without prompt and effective solutions, the industry should expect a crushing blow of governmental regulation. Slow movers will not be rewarded.

Failing medical practices have a trickle-down effect. As the pandemic ravages our economy, unemployment rises to all-time highs. Patients lose their health insurance. The drop in monthly premiums leads to plummeting revenue. Combine the incoming barrage of astronomically expensive COVID-19 care claims with the loss of revenue from decreased subscribers, and insurance companies will find themselves in the same cash-flow crisis as doctors. 

The insurance industry cares about the health of the nation, but they also have an economic incentive to keep doctors in business. To keep it simple, when doctors fail, so will the insurance companies.

The negative cascade will continue as the US uninsured population skyrockets. Patients’ only options will be taxpayer-funded Medicaid and public health options.

The domino effect triggered by a sudden shortage of healthcare workers will impact the sustainability of the private health insurance industry. A lack of action triggers an accidental move towards a single-payer system. 

If we go down, so do the insurance companies.

Health insurance industry CEOS control their fate

CEOs face a choice that will determine our country’s path. These two options should haunt their thoughts and keep each CEO awake at night as this pandemic requires big, bold action.

Option number 1: Let medical practices fail and allow the government to solve the problem. 

Option number 2: Offer market-based private industry solutions. Solve the problem, or it will be solved for you. 

Without urgent and decisive action, the collapse of our current system moves the US one step closer to a government takeover of healthcare. The irony is thick. To save the private health industry, health insurance companies must make short term financial sacrifices to prevent a collapse of the system. 

The solution to relieve the cash-flow crisis burden lies squarely on the shoulders of private insurance companies. The industry has taken some positive steps. We must give credit where credit is due. Many companies waived cost-sharing for COVID-19 care. While beneficial, it is a drop in an empty bucket. This step received media praise, but it is not sufficient to solve the crisis. 

Many suggest the burden is on doctors to renegotiate their insurance contracts. It is not practical for every practice in the country to negotiate terms with each third party payer individually. Our practice has contracts with over one hundred third-party payers. Individualized contract negotiations is not a scalable solution.

Others suggest the federal government must offer solutions. The passage of the CARES act was an excellent first step. Other congressional actions will follow. CMS, which governs the federally-funded Medicare program, expanded a widely popular Accelerated Advanced payment system. State governments manage Medicaid rules. We do not have time to wait for all 50 states to agree upon 50 different solutions. 

The only path to keeping medical practices solvent way at the required speed is action by the CEOs of large insurance companies. 

Here are five actionable initiatives a health insurance company can implement immediately to help the US health system navigate through the pandemic.

1. Replicate the Accelerated Advanced payment system

To increase cash flow to providers impacted by the Coronavirus pandemic, CMS allows providers to request up to 100% of the Medicare payment amount for a three-month period. Private third-party payers can replicate this process for all providers throughout the country. This one step triggers a cash infusion allowing doctors to keep the doors open and will enable us to serve those in need. 

2. Suspend out-of-network penalties.

It is unsafe to enforce network restrictions during the pandemic. Insurance companies must allow physicians and patients to seek care in hospitals and medical sites of service not experiencing capacity limitations. Doctors need the freedom to direct care where it is safe and where there is room. Trust your contracted providers to guide patients to the safest option available in their local community. 

Insurance companies must recognize the immediacy of this decision to reduce the burden on hospital capacity. Every CEO should consider what they would want for their family and loved ones. 

Would they want to be admitted to an in-network facility known to be at capacity or an out-of-network facility with plenty of open rooms?

Failure to remove network restrictions will cost lives and bankrupt any family factoring finances over safety.

3. Expedited health care provider credentialing process. 

Allow immediate authorization of any licensed provider, in good standing with their state’s medical board, to provide all services on your medical plans. The credentialing process takes 90–120 days. The harsh reality is there is no time for bureaucratic red tape as physicians get sick and die. 

CEOs of every insurance plan should announce an expedited credentialing process. Patients and doctors across the country will take note of the first CEO to take this simple step to keep patients alive.

4. Expedited revenue cycle management 

Medical billing systems (revenue cycle management) create a lag in payment for services rendered. Payments are often not received for up to three months. Reduce the need for layers of record requests, denials, and appeals. Continue oversight for fraud, waste, and abuse, but reduce the barriers to payment. Each lag in payment exacerbates the cash flow crunch for medical practices.

5. Telehealth reimbursement parity 

CMS removed restrictions to allow expansion of virtual care through Waiver 1135. Many offices rapidly expanded their services to implement Telehealth. Reimbursement varies for each third-party payer. Each payer has different guidelines and various payment models for audio vs video consults. The Texas Medical Association published a summary of current guidelines that illustrate the chaos of virtual care reimbursements. No practice can possibly implement Telehealth effectively fat scale following this system.

Keep it simple.

Reimburse any form of virtual care on par with previously established CPT codes for in-person visits during the COVID-19 crisis.

Courage is needed now 

We are counting on the health insurance industry to join providers in the fight against COVID-19 as it crushes every practice, hospital, health system in every specialty in our country. Medical practices across the country need help to stay in business. The United States passed 331,151 COVID-19 cases today. When this article is published, that number will be higher.

The death toll will continue to rise. 

America needs every available doctor in the country to fight the challenges of COVID-19. Health insurance companies can provide the lifeline allowing providers to stay in the battle. 

Time is running out. 

Which health insurance CEO will take the bold action needed to save the US health system?

Thank you to Michael Mcewen from Mcewen and Associates for providing background for this article. 

Jeff Livingston, MD is an OBGYN practicing in Texas.

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