Category: Healthcare Cost

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Healthcare Cost Healthcare Disparities Innovation Technology

The Transformative Power of Telehealth: A New Era in Modern Healthcare

By Dipti Shah

Introduction:

Telehealth has rapidly evolved from a supplementary healthcare service into a vital component of the modern healthcare system. Spurred by the COVID-19 pandemic, its adoption has skyrocketed, offering a glimpse into a future where healthcare is more accessible, efficient, and patient-centered. This article explores the profound impact of telehealth on expanding access to care, improving cost-effectiveness, and the challenges that remain for its widespread implementation.

Expanding Access to Care:

Telehealth’s most significant advantage lies in its ability to extend healthcare access to populations previously underserved. For rural communities, where access to specialized care is often limited, telehealth has marked improvements in health outcomes. A 2021 study published in The Journal of Rural Health found that telehealth reduced the need for travel to urban centers for specialist consultations by approximately 30%, bridging the gap in healthcare access for rural populations. Additionally, telehealth has been particularly beneficial for individuals with mobility challenges and chronic conditions.

For example, a study by Doraiswamy et al. (2022) highlighted a 30% increase in healthcare utilization among patients with mobility impairments, leading to better management of chronic conditions such as diabetes and COPD. Furthermore, telehealth’s convenience has significantly increased patient adherence to treatment plans. During the COVID-19 pandemic, the American Medical Association reported a 35% increase in telehealth visits for chronic disease management, underscoring its role in enhancing long-term health management and improving overall patient outcomes. These examples demonstrate how telehealth effectively bridges access gaps, supports diverse patient needs, and fosters improved health outcomes across various populations.

Cost-Effectiveness and Efficiency:

Telehealth is not only improving access but also contributing to cost savings within the healthcare system. By reducing the need for in-person visits, telehealth decreases transportation costs, time off work, and other associated expenses. Additionally, telehealth can help to alleviate the burden on emergency services by offering an alternative for non-emergency consultations, leading to a more efficient allocation of healthcare resources.

A 2022 study published in Health Affairs estimated that telehealth could save the U.S. healthcare system over $10 billion annually. These savings are primarily attributed to the reduction in unnecessary hospital visits and the optimization of care delivery processes. As healthcare costs continue to rise, telehealth presents a viable solution for enhancing efficiency while maintaining high-quality care.

Challenges and Considerations:

Despite its many benefits, telehealth faces challenges that must be addressed to ensure equitable access. The digital divide, characterized by disparities in access to technology and reliable internet, poses a significant barrier to widespread telehealth adoption. Low-income households, elderly populations, and those in remote areas are particularly vulnerable to this divide, limiting their ability to benefit from telehealth services.

Regulatory and reimbursement challenges also hinder the full integration of telehealth into the healthcare system. While the pandemic prompted temporary regulatory relaxations, permanent solutions are needed to sustain telehealth’s growth. Policymakers are currently working to streamline these regulations and improve reimbursement policies, but continued efforts are essential for long-term success.

Conclusion:

Telehealth represents a transformative shift in healthcare, with the potential to make care more accessible, cost-effective, and patient-centered. As the evidence in favor of telehealth continues to grow, it is imperative that healthcare systems and policymakers work together to address the challenges and fully integrate telehealth into the continuum of care. By doing so, we can ensure that the progress made during the pandemic is not just temporary but forms the foundation of a more resilient and equitable healthcare system.

Bio:

Dipti Shah holds a master’s in physical therapy and has over 10 years of experience in the field. She is passionate about integrating innovative healthcare solutions, such as telehealth, to improve patient outcomes and accessibility. Dipti’s insights are informed by her extensive clinical experience and commitment to advancing modern healthcare practices.

References:

  1. The Journal of Rural Health. “Telehealth’s Role in Rural Healthcare Access.” 2021.
  2. American Medical Association. “The Rise of Telehealth During the COVID-19 Pandemic.” 2021.
  3. Health Affairs. “Telehealth and Its Potential for Cost Savings in U.S. Healthcare.” 2022.
  4. American Telemedicine Association. “Policy and Regulatory Considerations for Telehealth.” 2023.
  5. The Nielsen Company. “The Role of Telehealth in the Modern Healthcare Landscape.” 2022.
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Clinical General Healthcare Cost Healthcare Costs Healthcare Disparities Innovation Patient-Centered Care Primary Care Quality Improvement

Let Me Be Brief: Medicaid Expansion

A series of briefs by the Texas Medical Students

By: Ammie Rupani and Alwyn Mathew

In 2019, 18% of Texans had no form of health insurance.1 650,000 Texans have lost their health insurance due to unemployment during the pandemic. The rate of uninsured Texans is staggering and has only been worsened by the pandemic. During this critical time, we must talk about Medicaid Expansion and the potential solutions for millions of people with no health insurance. As a medical student, I have seen patients defer life-saving medications such as insulin in order to afford rent or groceries. Consequently, these choices have brought such people to the Emergency Room in diabetic ketoacidosis, which could have been easily avoided with regular insulin treatments. Stories like this are far too common in Texas, and it is important to recognize such outcomes are easily preventable with improved access to health insurance coverage. How can we as students learn to treat people, when the system we are bound to  practice in is perpetuating their very diseases?

Retrieved from Texas Comptroller

Medicaid is a health insurance program managed through the Federal Centers for Medicare and Medicaid Services (CMS). Medicaid is currently jointly funded by the Federal and State governments with the Federal government matching each dollar the State spends. Texas Medicaid is primarily a fee-for-service model that has poor reimbursement rates and high administrative burden that discourages physicians from accepting Medicaid in their practice. Currently, Texas Medicaid coverage is only offered to children, pregnant women, seniors, and people with severe disabilities, who also fall below a certain income threshold. For example, a single mother making minimum wage at her  full-time job is not eligible for Medicaid because she earns too much. However, she does not qualify for Federal subsidies covering some of the insurance cost because she does not earn enough. The Patient Protection and Affordable Care Act of 2010 would help address this woman’s dilemma since Medicaid Expansion would cover all individuals with incomes up to 138 percent of the Federal Poverty Level, amounting to $16,643 for individuals and $33,948 for a family of four. Medicaid Expansion would provide a health insurance option to an estimated 2.2 million uninsured low-wage Texas adults.2

Although the original arguments against Medicaid Expansion in Texas focused on States’ rights and limiting Federal dependence on funding, the primary opposition to this program was the Federal mandate. In 2012, the US Supreme Court ruled that the Federal government could not mandate the Expansion of Medicaid in any State, leading to Texas and several States opting out of the program. Realizing the benefits and improvement in health outcomes, several States have since adopted the Expansion program offered through CMS, including Arkansas (2014) and Louisiana (2016). Currently, Texas spends nearly $40 billion (State and Federal funds) for the Medicaid program, with a 60-40% distribution between the Federal and State Government respectively.3 Expansion would be fiscally sound for Texas as it will reduce the strain on our State budget and draw in more Federal resources. Looking past the dollar amount, it is crucial that medical students and other healthcare professionals recognize the benefits of improved access and early medical intervention that can be achieved through Medicaid Expansion.3

TMA’s Legislative Recommendations4
  • Develop a meaningful, statewide health care coverage initiative using federal dollars to:
    • Extend meaningful coverage to low-income uninsured working-age adults, and
    • Establish a state-administered reinsurance program to reduce premiums for people enrolled in marketplace
  • Provide 12-months’ comprehensive coverage for women who lose Medicaid 60 days
  • Establish 12-months’ continuous coverage for children enrolled in Medicaid, the same benefit given to children enrolled in the Children’s Health Insurance Program.
  1. Accounts TCof P. Uninsured Texans. Retrieved from- https://comptroller.texas.gov/economy/fiscal-notes/2020/oct/uninsured.php
  2. How Many Uninsured Adults Could Be Reached If All States Expanded Medicaid? – Tables. KFF. https://kff.org/report-section/how-many-uninsured-adults-could-be-reached-if-all-states-expanded-medic aid-tables/. Published June 25, 2020.
  3. Federal and State share of Medicaid Spending, 2019, Kaiser Family Foundation- retrieved from – https://kff.org/medicaid/state-indicator/federalstate-share-of-spending/?dataView=1&currentTimeframe=0 &sortModel=%7B%22colId%22:%22State%22,%22sort%22:%22desc%22%7D
  4. Provide Meaningful Health Care Coverage for Uninsured Texans. Texmed. https://texmed.org/Template.aspx?id=55300.
  5. Status of state medicaid expansion decisions: Interactive Map, 2021. Retrieved from- https://kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
Categories
General Healthcare Cost Humour Lifestyle Opinion Pharmacology Psychiatry Psychology Public Health Reflection

Well, Well, Well: Products and services compete for shelf space in trendy wellness market, but are they worth your money?

When a friend recently asked me to join them for a class at Inscape, a New York-based meditation studio that New York Magazine described as the “SoulCycle of meditation”, I was skeptical. On the one hand, I usually meditate at home for free, so paying almost $30 for a meditation class seemed a bit silly. On the other hand, my meditation practice had dropped off considerably since the beginning of the year. Maybe an expensive luxury meditation class was just what I needed to get me back into my regular practice. Stepping off bustling 21st Street into the clean modern space, I heard the sounds of, well…nothing. It was incredibly quiet. Before getting to the actual meditation studios, I had to pass through Inscape’s retail space. The minimalistic shelves hold a variety of supplements, tinctures, and powders that include unique ingredients like Reishi medicinal mushrooms and cannabidiol extract. Many contain adaptogens, herbal compounds that purport to increase one’s resistance to stress, though their efficacy has never been quantitatively proven.[1] These products’ promises run the gamut from shiny hair and stress relief to aura cleansing. I may be a super-skeptic, but even I am not immune to the lures of top-notch marketing. With great consideration, I purchased one of the many magical powders for sale labeled as ‘edible intelligence.’

Since wellness has become trendy, a considerable space in the retail market has opened for associated products dedicated to helping people live their best lives. As Amy Larocca pointed out in her June 2017 article The Wellness Epidemic, “[In the wellness world] a loaf of bread may be considered toxic, but a willingness to plunge into the largely unregulated world of vitamins and supplements is a given.” Even a recent episode of Modern Family poked fun at the wellness trend when Haley Dunphy applied for an ultra-competitive job with fictional wellness guru Nicole Rosemary Page. During her interview at Page’s Nerp company headquarters, Page laments, “People say that Nerp is nothing more than a con-job, a cash grab vanity project from a kooky actress. I want to turn Nerp into the next Disney-Facebook-Tesla-Botox. It’s a world changer.” Though Page is a fictional character, I can’t help but wonder whether the character was inspired by the very real Amanda Chantal Bacon, the founder of Moon Juice, which bills itself as an adaptogenic beauty and wellness brand. Bacon’s Moon Dusts retail for $38 a jar and come in varieties such as Spirit, Beauty, and Dream.

The bottom line is that a sense of well-being needn’t come at the price of thirty-plus dollars an ounce. In fairness to those who choose to spend lavishly, I believe that plunking down a chunk of cash might create an intention to use and derive value from a product, thus positively influencing one’s perception of how well the product works. Rest assured, however, that living with intention and gratitude can be just as easily accomplished without spending any money at all. Carving out time in the day to create a small ritual for yourself can be as simple as spending a few minutes in the morning listening to jazz as you drink your first cup of coffee or allowing yourself to become immersed in a good book before drifting off to sleep. These simple acts allow us to bestow kindness upon ourselves that is especially important in our stressful and busy lives as medical students. My suspicion is that by performing such rituals with intention, we derive much of the same benefit whether our mug is filled with the trendy mushroom coffee or just plain old Folgers.

I’m always thinking about ways I can improve my own well-being, but as graduation approaches I also find myself thinking about how these practices might help my patients as well. One of my fundamental goals as a future psychiatrist will be to help my patients see the value in themselves and in their own lives. I predict that for many of my patients, achieving this goal will depend perhaps on medications but also on the deployment of simple wellness tactics such as I described. I’m not going to lie…I’m still intrigued by many of the wellness products that can be found in places like Inscape, Whole Foods, and the Vitamin Shoppe, especially when I think about the potential benefits they might have for my future patients. I figure that if these products do even half of what they promise to, some of them might even be worth the money. So what happened when I added a sachet of intelligence powder to my usual morning smoothies? Pretty much nothing. At one point, I got excited when I began to feel my fingers getting tingly. Then I realized I had been leaning on my ulnar nerve. Not so brainy after all.

[1] Reflection Paper on the Adaptogenic Concept, Committee on Herbal Medicine Products of the European Medicines Agency, May 2008.

 

Photo credit: Open Grid Scheduler / Grid Engine