Hospital care is leaving the hospital

The ideas and innovators shaping health care

May 13, 2024 View in browser   By Daniel Payne, Carmen Paun, Ruth Reader and Erin Schumaker INNOVATORS Hospital executives say they can provide quality care at your house. | Getty Images Hospitals have a new message for patients: Stay home. Empowered by Washington and armed with Covid-inspired health innovations, health executives seek to increasingly move care outside of the hospital — despite the seeming risk to their bottom line, Daniel reports. Hospital leaders are building their telehealth offerings and hospital-at-home programs. They’re also creating new lines of business and selling proprietary artificial intelligence tools they’ve developed. Their aim: To make their systems more efficient and solidify their finances. “It's a real game changer for us … [and] one of the silver linings to the pandemic,” John Couris, president and CEO of the Florida Health Sciences Center in Tampa, said of Congress’ support for remote care. "We're all trying to diversify our revenue streams.” And Washington? Congress is urging the leaders on, with legislation in the works that would help hospitals expand their at-home offerings and allow Medicare to continue paying for telehealth, which lawmakers temporarily permitted when Covid struck. House legislation that would extend loosened pandemic rules for telehealth and hospital care at home won unanimous approval in the Ways and Means Committee last week. In the Senate, Marco Rubio (R-Fla.) and Tom Carper (D-Del.) introduced a bill that would extend the rules permitting government reimbursement of care at home. A Carper aide told POLITICO that he plans to soon introduce another measure that would make hospital-at-home offerings permanent. Lawmakers hope remote care will help solve the country’s existential health care problems by broadening access to treatment while preserving the financial viability of providers and the government insurers, Medicare and Medicaid, they rely on. Even so: While both hospitals and Washington like the idea of care at home, they may not agree on what the new services are worth. Hospitals want to charge the high rates inpatients and their insurers pay, even if care has moved to the home or an outside clinic where it’s less expensive. Lawmakers are considering imposing site-neutral policies, which would cut into the higher prices hospitals charge compared with similar services at other health facilities.   THE GOLD STANDARD OF HEALTHCARE POLICY REPORTING & INTELLIGENCE: POLITICO has more than 500 journalists delivering unrivaled reporting and illuminating the policy and regulatory landscape for those who need to know what’s next. Throughout the election and the legislative and regulatory pushes that will follow, POLITICO Pro is indispensable to those who need to make informed decisions fast. The Pro platform dives deeper into critical and quickly evolving sectors and industries, like healthcare, equipping policymakers and those who shape legislation and regulation with essential news and intelligence from the world’s best politics and policy journalists. Our newsroom is deeper, more experienced and better sourced than any other. Our healthcare reporting team—including Alice Miranda Ollstein, Megan Messerly and Robert King—is embedded with the market-moving legislative committees and agencies in Washington and across states, delivering unparalleled coverage of health policy and the healthcare industry. We bring subscribers inside the conversations that determine policy outcomes and the future of industries, providing insight that cannot be found anywhere else. Get the premier news and policy intelligence service, SUBSCRIBE TO POLITICO PRO TODAY.     WELCOME TO FUTURE PULSE Bristol, Maine | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Do a new doctor's board scores affect their patients' survival rate? A new study found that they do. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Ruth Reader at rreader@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp.   WORLD VIEW There's interest in pyschedelics at the European Medicines Agency. | Shawn Zeller/POLITICO The EU is a step behind the U.S. in examining psychedelics’ potential in medicine, our European colleagues report. Its drug regulators aren’t considering any applications, and Dr. Steffen Thirstrup, chief medical officer at the European Medicines Agency, says that’s a pity. “Psychedelics deserve a second chance,” Thirstrup said. “We’ve seen an enormous growth in mental disorders, exacerbated by the Covid-19 pandemic. And looking back at the past decade, we haven’t seen any new therapeutic advancements for mental disorders.” What’s the holdup? The clinical trials he’s seen aren’t convincing, Thirstrup said. “These trials are rather small from a regulator standpoint, and they are of relatively short duration,” he said. Because of those limitations, some questions are still unanswered, including how long the effect of psychedelic therapy will last and whether retreatment is needed. Placebo-controlled, double-blind trials are also challenging when psychedelics are involved since it’s usually obvious when someone takes a mind-altering drug. And if the U.S. moves first? Thirstrup said the EU would consider looking at the clinical data under FDA review but wouldn’t simply “take the potential U.S. approval and just rubber stamp that in Europe.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     FORWARD THINKING Climate change could affect where malaria hits the hardest. | Getty Images Climate change could reduce the number of Africans at risk of malaria, according to a new study that examined how water supplies could affect the breeding grounds of the mosquitoes that carry the disease. That might sound like good news since Africa accounts for the vast majority of the world’s malaria cases and deaths — but it might foreshadow other threats, one of the study authors told Carmen. How’s that? In the study published in Science, researchers in the U.K. and Namibia created models to predict how climate change will affect where malaria is transmitted in Africa. The models considered surface water and rainfall coupled with low or high levels of the greenhouse gas emissions that warm the Earth. Unlike previous studies that considered mostly rainfall, the new research predicts that some areas of Africa — starting in the west and moving east to South Sudan — will become too hot and dry for malaria-carrying mosquitoes to breed. Malaria causes flu-like symptoms and kills more than half a million people a year worldwide. But Mark Smith, associate professor in water research at the University of Leeds in the U.K. and part of the team leading the study, told Carmen that a dwindling water supply would have worse effects than a good supply would. While a dwindling water supply would be helpful to reduce malaria, it won't decrease dengue, another mosquito-borne disease. In fact, it would increase it, since dengue is caused by a virus that can withstand higher temperatures. The models also predicted potential changes in the malaria season across different parts of the continent: a decrease in Botswana, for instance, while some parts of South Africa would see an increase. Why it matters: Smith hopes the study can help forecast future threats and pinpoint where scarce public health resources are most needed. What’s next? He plans to develop more detailed geographic models identifying bodies of water in every African country and the potential effects of climate change on malaria risk near those locations.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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