Experts say hospitals must plan for providing care after an attack

Cybersecurity and patient safety

Experts offer advice for hospitals on protecting systems and patients

Tips and tough love

Criminals know smaller systems are vulnerable to cyberattacks

Targeting small hospitals

Don Williamson, president and CEO of the Alabama Hospital Association

Hospitals in Alabama suffered heavy losses in 2022, and they see a grim outlook for 2023.

Alabama hospital officials say they need the state to distribute COVID-19 recovery funds to hospitals, or some facilities may not make it until the end of the year. The Alabama Hospital Association held a news conference Thursday to draw attention to the gravity of the threat.

“Alabama hospitals face an existential crisis in terms of survival,” said Donald Williamson, president and CEO of the Alabama Hospital Association.

The state has money from the American Rescue Plan Act, and Williamson said hospitals need to get some of that aid simply so they can make payroll.

“2023 looks as dire as 2022,” Williamson said. “We frankly will have hospitals not survive 2023 without some help.”

Hospitals across the country have struggled badly last year. 

In fact, hospitals suffered their worst financial year of the pandemic in 2022

, according to a report by Kaufman Hall, a healthcare consulting firm. Hospitals wrestled with higher expenses, reduced volume, and the COVID-19 relief aid that kept hospitals afloat earlier in the pandemic has largely dried up, and 

there aren’t great prospects for more relief in Washington

However, hospitals in Alabama have fared worse than the rest of the nation, according to a Kaufman Hall report focused on the state’s hospitals. Unlike some other states, Alabama didn’t accept federal funding to expand Medicaid.

“Alabama faced even more severe declines than the nation as a whole,” said Erik Swanson, senior vice president of Kaufman Hall.

Swanson outlined a trove of disheartening data on Alabama’s troubled hospitals. 

In 2022, expenses rose $2.6 billion above pre-pandemic levels, significantly surpassing revenues. Half of Alabama’s hospitals finished with negative operating margins in 2022, Swanson said. Surgeries and emergency department visits continue to lag compared to 2019, the last year before the arrival of COVID-19.

Even though hospitals aren't seeing as many patients, Alabama hospitals are still seeing greater cost pressures in caring for them.

“Hospitals are seeing fewer patients, but they are sicker and staying longer,” Swanson said. 

Those patients are requiring more costly medications, he added. Plus, due to staffing shortages at other post-acute care facilities, hospitals are continuing to care for some patients that are ready to be discharged to nursing homes or rehabilitation centers.

Over the past three years, Alabama’s hospitals lost a combined $1.5 billion, even including federal stimulus funds, Swanson said.

“Hospitals faced a profound financial toll in 2022 with no relief in sight,”  Swanson said.

Adding to the issues, Alabama’s reimbursement rate from Medicare is the lowest in America, according to the Kaufman Hall report. Alabama hospitals also receive lower reimbursement rates from commercial insurers, the report stated.

Over half of Alabama’s spike in expenses come from labor costs, which are nearly $1.4 billion higher than pre-pandemic levels. Most of that spike - $1 billion - went to increases in employed staff, which is important to understand, Swanson said. Hospitals are paying more to recruit and keep staff.

Alabama hospitals also spent much more on contract labor, an additional $324 million compared to 2019, representing a 447% increase over pre-pandemic levels, according to the Kaufman Hall report.

Hospitals are also paying more for drugs and other supplies. Swanson said

“We don’t expect many of these challenges to abate in 2023,” he said.

“Across the state of Alabama, the situation is quite dire."

Williamson, the head of the state’s hospital group, said hospitals across the state are facing a perilous situation. He pointed out that some rural hospitals are facing a serious risk of closure, but he said the challenges aren’t confined to Alabama’s smaller communities.

“This isn’t a rural issue, or an urban issue,” Williamson said. “This is a statewide healthcare issue.”

Williamson acknowledged that without the federal COVID-19 relief funds that were distributed earlier in the pandemic, Alabama would probably have fewer hospitals today.

But he said the number is going to shrink unless Alabama’s elected officials direct some American Rescue Plan aid, which has yet to be allocated, to the state’s hospitals. And he said the money wouldn’t solve all the issues.

“What we desperately need is a significant infusion of ARPA funds to serve as a bridge,” he said.

Williamson said he’s hearing from members that are worried about keeping their facilities open. When asked if some hospitals are looking at cutting some services to reduce expenses in an effort to stay afloat, Williamson said such steps tend to do more harm than good for their bottom line.

“While you can cut expenses, you almost inevitably cut revenue,” Williamson said. “It becomes a zero game. It’s actually worse than a zero sum game.”

Hospitals that curb services or close clinics can end up losing more in revenue than they save in the reduced expenses. “It begins a death spiral for your healthcare facilities,” he said.

If some hospitals in Alabama close their doors, residents will have fewer options for healthcare needs, Williamson said. Such closures would have long-term consequences, he said.

“It’s much harder to restart a hospital that’s closed,” Williamson said.

Articles

Hospitals everywhere are struggling, but Alabama providers are facing a perilous situation. Without help, some of the state’s hospitals will close, the head of the Alabama Hospital Association says.

Alabama hospitals are facing an ‘existential crisis’

More than half of doctors say they’re suffering burnout, but not many are seeking assistance to deal with it, and some won’t even entertain the idea.

 does an annual survey of physicians on burnout and depression, and the latest report illustrates that many physicians are facing struggles with their mental health. In the new survey, released Jan. 27, 53% of doctors said they were experiencing burnout. And nearly a quarter of the physicians surveyed (23%) said they were battling depression.

Perhaps the most disturbing results in a series of troubling findings came when doctors were asked if they were getting professional help to reduce burnout. Only 13% said they were getting assistance from a professional, while almost half (47%), said they weren’t getting help, but they would consider it.

Roughly four out of 10 physicians surveyed (39%) said they weren’t getting help and wouldn’t think about it.

More doctors are suffering burnout, and health systems must do more

Slightly over half of the physician respondents (51%) said they wouldn’t get assistance for burnout or depression because they perceived it as saying something negative about themselves.

A substantial number of doctors (41%) said they aren’t seeking help because they are concerned their medical boards or employers would find out about it. And 42% of the respondents said they feared others would have less regard for their skills as a professional.

Mental health advocates have urged healthcare professionals to get assistance if they are struggling. Advocates are also pushing for reforms to state licensure laws to drop unnecessary questions about mental health.

Nurses say their mental health is suffering. Why aren’t more seeking help?

Healthcare leaders increasingly say they understand the importance of encouraging clinicians to get mental health. Last year, President Biden signed a law, the 

, directing more funds and resources to improve mental health in healthcare. The law is named for a physician who died by suicide early in the COVID-19 pandemic.

Corey Feist, Breen’s brother-in-law and co-founder of the Dr. Lorna Breen Heroes Foundation, told 

 last year that the healthcare industry must promote mental health, and reforms are needed in state and federal laws to ensure clinicians can get help. He also said doctors and nurses need to understand that some states offer strong protections for those seeking assistance.

Physicians and nurses need to see that they must take care of themselves.

“That is something that does not come naturally to the healthcare workforce that is wired to help others first,” Feist said.

Women physicians are more likely to say they are struggling with burnout, but plenty of men are struggling as well, the survey found.

Almost two-thirds of female physicians (63%) said they were suffering burnout, while 46% of men said they were battling burnout. Healthcare leaders concerned about burnout say that women physicians often struggle because they are managing demanding careers while also still taking on the majority of child care and family responsibilities.

As in the past, most doctors cited administrative hassles as the top factor contributing to burnout. A solid majority (61%) pointed to bureaucratic tasks as the biggest reason for burnout, while 38% said it was a lack of respect from coworkers.

About two out of three physicians in emergency medicine (65%) said they were experiencing burnout, the highest of all specialities, according to the Medscape survey.

After emergency medicine, the specialties with the greatest percentage of doctors experiencing burnout were internal medicine (60%), pediatrics (59%), OB/GYN (58%), and infectious diseases (58%).

These specialties had the lowest percentages of doctors reporting burnout: public health (37%), pathology (39%), cardiology (43%), nephrology (44%), and orthopedics (45%).

Even in these areas, a good number of physicians say they’re struggling.

Samuel T. Edwards, assistant professor of medicine at Oregon Healty & Science University, said in a September forum on physician burnout that healthcare leaders need to place a high priority on mental health and addressing burnout.

“Burnout is an organizational-level phenomenon that requires an organizational-level response,” Edwards said.

Some doctors say they wouldn’t consider getting help and worry about professional ramifications. The latest Medscape survey on burnout and depression sheds light on the mental health challenges in medicine. 


Burnout and doctors: Many suffer, but few are seeking help

Curi and Constellation, two leading providers of medical professional liability insurance,  have agreed to merge and form an organization with more than $2 billion in assets.

The two firms announced that they reached a merger agreement on Feb. 1. Assuming regulators sign off on the transaction, the companies said the merger is expected to be completed in the second half of 2023.

The leaders of the companies pointed to the value of creating an organization with a national scope to serve physicians and healthcare organizations.

“We couldn’t be more excited to announce this merger with Constellation,” Curi CEO Jason Sandner said in a statement. “Trends in the healthcare industry over the last decade call for partners who can deliver services to healthcare providers at a national scale and in a more diversified way. Curi expects to be that partner, and this merger allows us to continue fulfilling our mission for another 50 years and beyond.”

More hospital mergers should be coming in 2023

Ryan Crawford, president and CEO of Constellation, touted the merger as a combination of “two like-minded companies, both with a vision to provide superior products and services to healthcare providers and organizations across the nation.” 

“We’re bringing together a group of people, products, and services that will continue to deliver unwavering care for our collective customers,” Crawford said in a statement.

When the merger is complete, Sandner will remain the CEO of Curi Holdings, Inc. Crawford will serve as CEO of the merged insurance business.

The merged company will generate $400 million in revenue and serve more than 50,000 doctors, along with healthcare providers around the country, the firms said. The companies also touted recent investments in areas such as wealth management and technology platforms.

Both companies will have equal representation in the management of the newly merged organizations, with 10 directors from each company’s board.

Investors expect more mergers in healthcare, life sciences in 2023

Curi, based in Raleigh, N.C., was founded in 1975 and was originally known as Medical Mutual Insurance Company of North Carolina. The firm insured doctors who couldn’t get malpractice coverage from other firms.

Founded more than 40 years ago, Constellation, based in Minnesota, includes Midwest Medical Insurance Co. (MMIC), Arkansas Mutual and Utah Medical Insurance Association (UMIA). Constellation recently completed the acquisition of Michigan Professional Insurance Exchange.

The two companies are leaders in medical liability insurance. They hope to close the deal in the second half of 2023. 

Curi, Constellation agree to merge, form organization with $2B in assets

Health plans and providers are making progress in doing more administrative tasks electronically, but the new CAQH Index indicates there’s still plenty of work remaining.

 measuring progress in automating business functions. The report shows more of those tasks, such as eligibility and benefits verification, are being done electronically.

Still, the healthcare industry could save $25 billion annually by making the full transition to automating business transactions, according to CAQH, a nonprofit group pushing for more efficiency in innovation in the industry.

The CAQH report also showed a sharp increase in spending on business tasks. Measuring nine common administrative functions, the healthcare industry spent $60 billion on those functions in 2022, an increase of $18 billion over the previous year.

A confluence of factors led to the increase in spending, April Todd, CAQH’s chief policy and research officer, told 

Much of the increase is driven by more people seeking healthcare services, including 

some who delayed care earlier in the COVID-19 pandemic

, she said. The volume of transactions increased 28% in the medical industry, CAQH reports.

“Part of the increase in spend is just pure volume and pent up demand,” Todd said.

Healthcare organizations also have seen staff shortages, with some key workers leaving.

“We had a lot of people retire,” Todd said. “We had a lot of people just decide they weren't going to go back to work. So that left a lot of openings, particularly in the medical field, where we had providers that were doing some of these transactions, and they're very highly paid administrative staff to be doing these transactions. 

"We also had a lot of new staff that were coming in that didn't know what they were doing," she added. "And so it took them more time and more money to do these jobs.”

Hospitals and health systems have struggled to fill openings and

 organizations are paying more to recruit and retain employees

. “We were in a point in time where the economy was essentially very favorable to employees. So there was a lot of demand for employees and salaries went up.”

The uptick in administrative spending could well be an outlier, due to the demand for services in the pandemic, Todd said. And because of the progress already made in automating more functions, CAQH projects the healthcare industry is saving $187 billion annually.

Hal Wolf of HIMSS talks about hospitals, digital health, and the future of healthcare

The industry has made great strides, particularly over the 10 years CAQH has studied electronic adoption, Todd said.

In 2022, 90% of eligibility and benefit verifications were handled electronically, up from 84% two years ago, according to the CAQH report. 

While she’s glad to see continued progress, Todd said, “We still have a ways to go on eligibility.”

“It's nice to see that keep going up, and it would be great to get towards 100% here,” Todd said. “There are 18 billion of those transactions. It is the largest transaction in the healthcare industry. Eligibility transactions are going every day for numerous things. And so that in and of itself is just a huge spend. And so anything that we can do to make that more automated is going to significantly impact the industry.”

While most eligibility verifications are done electronically, that’s not the case with 

, which is among the most onerous transactions in healthcare.

In the process known as prior authorization, providers must obtain approval from payers for certain treatments, medications or procedures. In 2022, only 28% of prior authorizations were handled fully electronically, which is actually an increase of two percentage points over 2021, CAQH reports.

As recently as 2019, only 13% of prior authorizations were handled electronically. So while providers seethe over the time spent in prior authorization, Todd said she is glad to see more progress in automating those transactions.

“Prior authorization is still a very low adopted transaction,” she said. “It's still below 30%. But we've seen a quadrupling in growth since we've been measuring the index, and particularly in the last couple of years, there has been some nice growth there.”

The prior authorization process is more complicated than other transactions, since it involves clinical and administrative systems, Todd said.

She cited another stumbling block in reforming the system: the lack of any standard for attachments, such as lab results that would show a surgical procedure is warranted. So a health system might submit a request electronically, but the provider might need to fax the lab results. 

“That's why there's so many faxes that are done for prior authorization,” she said.

On the upside, the Centers for Medicare & Medicaid Services recently proposed a standard for attachments, which could lead to a significant increase in automation of prior authorization, Todd said. Health plans and vendors have been reluctant to develop standards for attachments that could run afoul of federal agencies, because they fear they would have to spend millions to comply, Todd said.

“It really does impact investment decisions,” she said. “And so the attachment standard from CMS is a very, very big deal.”

In 2022, 91% of transactions involving the coordination of benefits were handled electronically, up from 87% a year earlier, CAQH reports. And 72% of claim status inquiries were automated in 2022, up from 68% a year earlier. Claim payments dipped slightly, from 76% in 2021 to 75% in 2022.

After lagging behind other medical organizations, dental practices are increasingly managing business functions electronically, which is a welcome development, Todd said. “Automation in that space has been really nice to see as well,” she said.

Given the influx of new employees in healthcare organizations to fill vacancies during the pandemic, leaders should focus on training, Todd suggested.

“We need to really train these new folks that are coming in,” Todd said. “Spend time, help them make sure that they're understanding the transactions, so that we can get the time down on what it takes to do those. There really is a need for that, from what we're hearing. There's a lot of new people in this space right now.”

Organizations should continue to press to improve automation in prior authorization, and other functions with low electronic adoption, Todd said. “That's what we hope people use the index for. It gives them areas to focus on and helps to highlight how much money they can save by doing that,” she said.

Smaller hospitals and health systems should embrace the move toward handling more business functions electronically, perhaps with more urgency than larger organizations, Todd said.

“For smaller systems, having electronic systems might actually be more important,” Todd said.

“They're operating on lower margins, lower revenue, and the more automated that they can make their systems, they're going to get paid more quickly, they're going to get paid more accurately,” she added. “And that that only helps them to be sustainable.”

Providers and health plans are managing more administrative tasks electronically, but there is still room for more progress, according to the new CAQH Index. Spending on business functions rose $18 billion in 2022. 

Healthcare industry could save $25 billion with automation, CAQH says

Hospital websites across the country went down or experienced problems due to cyberattacks in recent days, with a Russian group boasting that it is responsible.

A pro-Russian hacktivist group called “KillNet” has claimed credit for the disruptions, and federal authorities issued a 

 Monday that the group was targeting health systems. The group has attacked hospitals and other organizations in the U.S. and other countries that have supported Ukraine in its war with Russia.

Hospitals in Michigan, North Carolina, Delaware, and Iowa all reported issues with their websites. Typically, the organizations managed to restore the sites within hours and they said there was no impact on patient care.

KillNet specializes in distributed denial-of-service (DDOS) attacks, which involve sending thousands of connection requests to servers, subsequently slowing down or stopping vulnerable systems, federal officials say. The American Hospital Association also issued 

University of Michigan Health experienced problems with its public websites Monday as a result of a cyberattack on a vendor, the 

“University of Michigan Health has been experiencing intermittent problems with its public websites as a result of a cyberattack on a third-party vendor we use to host some of our sites,” spokeswoman Mary Masson, a spokeswoman, told the 

Monday. Within hours, Masson said the issues were intermittent.

ChristianaCare’s main website went down Tuesday night, but it was restored within hours, the 

 said. The system said hospital and health systems remained fully operational and there was no impact to data security.

“On January 31, 2023, ChristianaCare experienced a distributed denial-of-service (DDoS) attack on its main public website, christianacare.org, consistent with other incidents reported this week impacting health care organizations around the world. A DDoS attack is a malicious attempt to disrupt the normal traffic of a website by overwhelming it with a flood of internet traffic."

“Our information technology team worked quickly to resolve the situation, and normal website service was restored within several hours,” the system said.

Atrium Health’s website experienced outages Monday, but the hospital systems and patient portal weren’t affected, 

“There was a temporary disruption to our website,” Atrium Health said in a 

 on Twitter. “Our information technology teams have successfully resolved the situation. It's important to note the disruption affected only our public-facing website. Our hospital systems and patient portal remained fully functional.”

Duke Health experienced “intermittent issues” with its public website Monday, a spokesperson for the North Carolina-based health system confirmed to 

The University of Iowa Health Care said public websites went down Tuesday, but 

 they were restored. These sites were down temporarily: UI Hospitals & Clinics, UI Stead Family Children’s Hospital, and the Carver College of Medicine.

The Health Sector Cybersecurity Coordination Center (HC3), a division within the U.S. Department of Health & Human Services, said KillNet has been active since January 2022 “and is actively targeting the health and public health sector.”

On Jan. 28, KillNet’s alleged attack lists for hospitals and healthcare organizations in several countries was disclosed, HC3 said.

The HC3 advisory to health systems said, “While KillNet’s DDoS attacks usually do not cause major damage, they can cause service outages lasting several hours or even days.”

The group tends to exaggerate its capabilities and HC3 said, “It is worth taking any claims KillNet makes about its attacks or operations with a grain of salt.”

Still, some hospitals endured unwanted headaches this week.

federal authorities said they have disrupted a ransomware gang that has targeted hospitals

 announced Thursday that the FBI managed to break into the networks of Hive, a ransomware group that has threatened health systems, financial companies, and schools around the world. Authorities managed to prevent victims from having to pay $130 million in ransom demands, the justice department said.

more IT professionals say they’re hurting patients

Hundreds of breaches of private health data were reported last year, affecting millions of Americans.

The 11 largest breaches of health data in 2022

A pro-Russian hacktivist group claimed credit. Federal authorities had issued an alert about the group this week.

Hospital websites go down in several states in cyberattacks

City of Hope acquired the Cancer Treatment Centers of America

, the organizations are going to share the same name.

The Cancer Treatment Centers facilities are going to be renamed with the City of Hope brand beginning this month. The Cancer Treatment Centers hospitals in Georgia, Illinois and Arizona will now be known as City of Hope Atlanta, City of Hope Chicago and City of Hope Phoenix.

City of Hope is launching an advertising campaign to tout the name changes. Beyond the names, City of Hope says it is sending a message that the organization has evolved into a truly national system.

Robert Stone, CEO of City of Hope, said the acquisition is enabling the organization to offer more services to more patients.

"This past year, we have made tremendous progress to connect more patients, families and communities to our leading-edge research, treatment and care," Stone said in a statement.

“By transitioning these locations to the City of Hope brand and bringing together 11,000 team members around one shared mission, we underscore our commitment to delivering a consistent patient experience as 'one City of Hope' across our national clinical network,” he added.

City of Hope acquired CTCA in a $390 million deal that was first announced in December 2021 and completed in February 2022.

City of Hope now boasts 11,000 employees, including 650 doctors and more than 1,000 researchers. The merged organization treated 134,000 patients in 2022. City of Hope has brought bone marrow transplants and cell therapy treatments to the hospitals it has acquired.

As part of its efforts to offer more treatment services, City of Hope has brought in some new executives in new roles.

The organization recently named Kevin Manemann as City of Hope’s executive vice president and chief integration officer for the clinical enterprise, a newly created role. He will focus on patient access and system integration at the regional and national levels, City of Hope said.

In addition, City of Hope named Jo Ann Escasa-Haigh the chief business officer. She’ll oversee financial strategy and mergers and acquisitions. In September 2022, Philip Okala joined City of Hope as system president, and he is leading the system’s clinical care and research entities.

It’s been a busy time for City of Hope. In July, the system opened a new cancer center in Orange County, California.

With the acquisition last year, City of Hope shifted Cancer Treatment Centers to a non-profit organization.

After acquiring Cancer Treatment Centers last year, the facilities will now all be under the City of Hope umbrella. CEO Robert Stone says the system is looking to serve patients nationwide as 'one City of Hope.'

City of Hope renames Cancer Treatment Centers of America hospitals

After much uncertainty and speculation, healthcare providers now know the end date for the federal government’s COVID-19 public health emergency.

President Joe Biden said the COVID-19 emergency will expire on May 11. The Biden administration had promised to provide at least 60 days' notice before ending the emergency declaration, and ended up giving healthcare operators more time to prepare.

“The main takeaway is we’re glad that there’s more than 60 days notice, which is something we have asked for,” said Claire Ernst, director of government affairs for the Medical Group Management Association. She said she hopes the White House will continue to work with the MGMA and other healthcare advocates.

House Republicans are telling Biden he shouldn’t wait until the spring and have crafted legislation designed to end the emergency right away. However, the White House said Americans and hospitals need time before pulling the plug on the public health emergency.

“An abrupt end to the emergency declarations would create wide-ranging chaos and uncertainty throughout the health care system — for states, for hospitals and doctors’ offices, and, most importantly, for tens of millions of Americans,” the 

The Biden administration and Congress previously agreed to extend waivers for telehealth programs beyond the public health emergency. Stacey Hughes, executive vice president of government relations and public policy for the American Hospital Association, said hospitals are hoping to see permanent reforms relating to 

She also stressed that hospitals will continue to face enormous challenges, even with the end of the emergency declaration. 

Hospitals endured their worst financial year of the COVID-19 pandemic in 2022

, according to Kaufman Hall, a healthcare consulting firm.

“While the country may be entering a new phase of the fight against COVID-19, hospitals and their caregivers continue to navigate a host of weighty challenges including workforce shortages and financial pressures, cost increases for equipment and drugs, disrupted supply chains and sicker patients,” Hughes said in a statement. “These issues will require continued attention and investment from the federal government.

“The decision to sunset the PHE is a testament to the progress we have made, but that progress should not end with the PHE,” Hughes said. “We should preserve many of the best care innovations that served us well during the pandemic, like expanded use of telehealth and the development of hospital at home programs. We will work with the administration to build on the lessons learned from the COVID-19 pandemic, beginning with our strong urging that many of the COVID-19 PHE flexibilities be made permanent.

During the public health emergency, hospitals have received a higher reimbursement from Medicare for treating COVID-19 patients, 

 reports. Medicare has offered a 20% bump in its payment rate for COVID-19 admissions, but that ends with the expiration of the public health emergency.

Hospitals should brace for difficult 2023, but ‘there’s light at the end of the tunnel’

The White House is resisting calls to immediately end the public health emergency to avoid “confusion and chaos.”

“Due to this uncertainty, tens of millions of Americans could be at risk of abruptly losing their health insurance, and states could be at risk of losing billions of dollars in funding,” the White House said in its policy statement. “Additionally, hospitals and nursing homes that have relied on flexibilities enabled by the emergency declarations will be plunged into chaos without adequate time to retrain staff and establish new billing processes, likely leading to disruptions in care and payment delays, and many facilities around the country will experience revenue losses.”

Hospitals and healthcare providers would be facing more uncertainty, but the White House and lawmakers agreed to extend some flexibilities in the 

The package included a provision to extend telehealth waivers for healthcare providers through 2024. And the spending package also included a two-year extension for hospital-at-home programs through 2024.

“Congress had addressed a lot of the critical Medicare telehealth waivers in the omnibus,” Ernst said. “Because Congress acted last month, most of our concerns with telehealth access were addressed.”

Where telehealth can help patients, and providers, avoid in-person care

Telehealth advocates had warned one waiver that is tied to the public health emergency allows for the remote prescription of some medications for substance use disorder. That waiver is slated to end after the emergency designation is phased out.

Kyle Zebley, the American Telemedicine Association’s senior vice president of public policy, said that needs to be addressed.

“The ATA and ATA Action implore our government leaders to provide a sense of certainty to a huge cohort of individuals requiring access to important medications for substance use disorders and other necessary drugs via telehealth after May 11,” Zebley said in a statement.

“Unfortunately, flexibilities allowing for remote prescribing of controlled substances, as part of the Ryan Haight Act, currently expire with the PHE. Without a plan in place, these vulnerable populations will be left out in the cold, and we are quite sure this is not the intent of our government leaders.”

Scores of healthcare advocates have written to the administration

 asking them to provide a remedy for remote prescriptions. “There is now an extreme sense of urgency with the public health emergency ending in only a few months," Zebley said.

States received additional funding for Medicaid coverage in the pandemic, but that too is changing. The federal omnibus package allowed states to begin making new determinations for Medicaid eligibility beginning in April, so some states are expected to stop coverage for some recipients.

Healthcare analysts have said millions could be losing coverage from Medicaid.

Health systems and hospitals could also see additional headaches if millions lose Medicaid coverage, advocates say.

Providers have time to prepare, but they hope the White House and lawmakers will work with stakeholders. The president is resisting calls to end the emergency right now. 