April 27, 2021
AHIP Solutions SmartBrief
Top Stories
The Biden administration could relax guidance on outdoor mask use as early as today, and the announcement could include separate recommendations for fully vaccinated and unvaccinated Americans, according to sources with knowledge of the matter. Along with the new mask guidance, the administration is also expected to announce "guidelines for activities fully vaccinated people can resume," a federal official said, along with infection control recommendations for health care settings.
Full Story: CNN (4/26),  KNBC-TV (Los Angeles) (4/26) 
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The number of newly reported COVID-19 cases in the US dropped 16% to 409,000 for the week ending Sunday, marking the largest proportional decline since February, while related fatalities were down 4% to 4,972, the lowest since October, according to an analysis of state and county data. The CDC reported that 29% of the US population had been fully vaccinated while 43% had received one dose as of Sunday.
Full Story: Reuters (4/26) 
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Telehealth Evolution: Episodic to Longitudinal Care
Due to increased use during the pandemic, telehealth has evolved from episodic urgent care uses to a vehicle that supports longitudinal care. But to compete, health plans must prioritize:
1. Easy access
2. Expertise
3. Personalization
4. Speed to insight
5. Trusted results
Learn More
Providers & Suppliers
A survey of 25,000 health care providers showed the family medicine and hematology/oncology specialties have the highest rates of physician burnout, while psychiatry and anesthesiology have the lowest. The authors, whose work was published in the Journal of the American Medical Informatics Association, noted that burnout is associated with poor clinical care, medical mistakes, physician turnover and suicide.
Full Story: Becker's Hospital Review (4/26) 
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Better resumes. Right under your nose.
Find health care's best and brightest with the AHIP Career Center. This powerful recruiting tool offers better targeting than general interest job sites, plus a searchable resume database, tracking tools, and more. Everything you need to collect better resumes faster. Get started today.
Medical Update
A study published in the journal Nature Communications found that people who had greater levels of omega-3 fatty acids -- specifically, eicosapentaenoic acid and docosahexaenoic acid -- had a 13% lower risk for all-cause mortality, as well as a lower risk for death due to cancer, cardiovascular disease and other causes combined, compared with those with lower levels of omega-3 fatty acids.
Full Story: Medical Dialogues (4/24) 
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VeriFide now offers Medicaid screening for primary source verification
How has your Medicaid PSV process been treating you lately? Click here to learn how VeriFide can assist your organization.
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Emerging Trends: Social Determinants of Health
HHS, in partnership with AHIP and other national organizations, kicked off a social media campaign this week to increase enrollment of Black Americans in Affordable Care Act plans. The goal is to raise awareness of coverage options during the HealthCare.gov special enrollment period, which was recently extended to mid-August.
Full Story: Healthcare Finance (4/26) 
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Some COVID-19 vaccine information in the US is in English only, creating a barrier to vaccination for non-English speaking populations. The Trump administration in August removed language-access requirements in the Affordable Care Act, but Justice in Aging and the Center for Medicare Advocacy have sued the government to have those protections restored.
Full Story: Medscape (free registration) (4/23) 
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Racial and ethnic health disparities linked to the COVID-19 pandemic are found in testing, infection rates, hospitalization and death rates, and vaccinations, according to an issue brief from the HHS Office of the Assistant Secretary for Planning and Evaluation. The document said "longstanding systemic inequalities and structural racism" explain the disparities seen during the pandemic.
Full Story: AAFP News (4/22) 
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Webinar: Cleansing Provider Directories.
Supplying accurate provider directories is an expectation members have of their health plan; however, there are unspoken reasons why they remain in flux. We've uncovered a few, and have suggestions on how to tackle the challenges. Join our industry expert as he discuss real-world concerns, and what organizations can do to improve the data quality. Watch now.
Health Insurance Provider Company News
Top 50 U.S. Hospitals Report
Are you targeting current leading hospitals? Stay focused in today's new normal with help from IQVIA. We support commercial managers with targeting data. Let our Top 50 U.S. Hospitals Report guide you with insights on facility type, market size, bed counts, and additional key areas. Get free market insights now.
Solutions Provider News
AI in workforce management
The workforce has become more digital, dispersed, and remote as firms seek to comply with public health edicts and customer needs. Workforce management leaders have been focused on strategic planning to understand the skills they'll need to invest in to perform future work. Read More.
Pharma News
The FDA is holding a three-day meeting this week to review the safety and efficacy of cancer drugs approved through an accelerated pathway to determine whether the drugs have lived up to their makers' promises. The FDA will hear from Bristol Myers Squibb, Merck and Roche, and a panel of experts will advise the agency whether to revoke any indications for Opdivo, Keytruda and Tecentriq, but the drugs are likely to stay on the market regardless.
Full Story: The Associated Press (4/25) 
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Policy Watch
Affordable Care Act navigators will get $80 million in federal funding for the 2022 plan year to help people find and choose health plans on the federal marketplace.
Full Story: FierceHealthcare (4/23) 
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The HHS Office of Inspector General's top priorities this year include identifying potential fraud, waste and abuse in COVID-19 relief and response programs, oversight and enforcement of telehealth rules, modernizing OIG guidance and compliance resources, and making cybersecurity a priority, according to a presentation by HHS Principal Deputy Inspector General Christi Grimm.
Full Story: Becker's Hospital Review (4/23) 
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During AHIP Institute & Expo Online (June 22 through 24), hear from those paving the way for reform. Keynote speakers include Senator Bill Cassidy, Vivian S. Lee (Verily Health Platforms), Jaewon Ryu (Geisinger), and Ramona Sequeira (Takeda) and AHIP's Matt Eyles. See all the keynote sessions and speakers on the agenda. Through May 14, pay $0/save big on your registration. Register today.
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PPO Direct Members offer payers and administrators targeted strategies that can help expand their provider networks while better serving their customers. American Specialty Health (ASH), a member of PPO Direct, is a health and wellness company, providing health plans, employer groups, insurance carriers and trust funds with programs to improve the health of their members or employees.
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Join us on Tuesday, May 11 from 2 to 3 p.m. ET for "Health Care Payment Fraud: Insights, Trends, and Risks" as Change Healthcare leads a discussion with two expert panelists on the vulnerabilities within health care that fraudsters exploit, and shares actions that can be taken to understand, recognize and mitigate payment fraud risks.
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