The Mayo Clinic in Minnesota has made a decision that could have consequences for insurers offering Medicare Advantage plans. What was that decision, exactly? I’m Jeff Lagasse with Healthcare Finance News, and we’ll tease out the answer to that and more in this week’s Top Stories.
The Mayo Clinic is no longer scheduling appointments for patients in most Medicare Advantage plans, citing a significant increase in patients covered by "non-contract" MA insurers, which officials said threatens to crowd out patients covered by in-network insurers. Non-contract MA plans are those in which insurance companies have not negotiated payment rates for services with Mayo. According to Healthcare Finance News (https://www.healthcarefinancenews.com/news/mayo-clinic-halts-scheduling-out-network-medicare-advantage-patients), some insurers, such as UnitedHealthcare, have been negotiating with the Mayo Clinic to bring them in-network for Medicare Advantage, in some cases asking them to outline their requested terms, but Mayo to date has yet to send out proposals. A Mayo spokesperson said the issue is capacity, not reimbursement. He said Mayo doesn't have the capacity to serve an ever-increasing number of patients, and needs to remain good stewards with its contracted plans.
A hospital in Oklahoma City put its intensive care unit on lockdown earlier this month, following what it called "baseless attacks" online regarding its COVID-19 protocols. HealthcareITNews reports (https://www.healthcareitnews.com/news/baseless-attacks-online-trigger-lockdown-oklahoma-hospital-icu) that Mercy Hospital Oklahoma City’s ICU will be locked down until further notice, with 24/7 security posted at the emergency room entrance and continuously rounding throughout the hospital. The hospital has filed a motion for a temporary restraining order against Daniel Navejas, founder of a group called Ekklesia of Oklahoma, a religious group that complained of the hospital allegedly not increasing the patient's dosage of budesonide, a corticosteroid used for conditions such as asthma or Crohn’s disease. Mercy is pursuing additional legal action.
Finally this week, tech-backed value-based care provider VillageMD announced plans to buy chronic care management company Healthy Interactions. As we see in MobiHealthNews (https://www.mobihealthnews.com/news/villagemd-buys-chronic-care-management-company-health-interactions), Healthy Interactions will bring with it both in-person and virtual care models. Its services include small group sessions and a digital engagement platform aimed at supporting patients before and after a session. The virtual platform allows patients to track their goals and tap into educational resources, and to connect with healthcare educators.
I’m Jeff Lagasse with Healthcare Finance News, and this has been Top Stories.