In certain areas across the country, people are going back to work, families are eating in restaurants and healthcare offices are reopening. For those who work in the latter, that means the pressure is on to fill appointments and get patients back in to see providers.

Many people have been hesitant about visiting the doctor’s office, which is yet another hurdle hospitals and health systems need to overcome. 

, emergency room visits dropped by over 40 percent in April. A study in the journal 

It is important to get patients back in the door to keep them healthy and avoid disruptions in care, especially for those with chronic conditions. On the business front, it is also important to drive revenue and manage the demand—especially with projections that hospital losses 

 $323 billion in 2020 and many office practices may not survive.

Ensuring a smooth ‘Go-Live’ process in the COVID-19 era

To successfully reengage patients, it is critical to provide crystal clear communications along every step. This includes everything from addressing where patients should park to how to check-in upon arrival and how to check-out after seeing their healthcare provider. Providing detailed information, in advance, about small details can have a big impact on how people feel about coming in for an appointment.

Here are 5 ways provider organizations can re-engage patients and book appointments.

Make sure patients know you will keep them safe

People will have anxiety and a lot of questions about what to expect for in-person appointments. You can help ease this stress by sharing clear, consistent messages about safety protocols your organization has implemented. This includes details such as when patient areas are cleaned and disinfected, whether the hospital has separate areas for treating patients with and without COVID-19, 

if all staff and patients are required to wear masks

, and so on. Even if it seems obvious, build trust by outlining exactly what you are doing.

, and direct mail are all effective channels to incorporate into multi-channel communication campaigns to get these messages across to patients. These three channels, in particular, can easily disseminate important communications to large populations of patients and prospects. Traditional methods like direct mail are attention-grabbing this day and age, and even more so now as people continue to spend most of their time at home. A multi-channel approach is exponentially more effective (upwards of 300 percent) than single or dual-channel campaigns, according to Gartner.

Utilize data to predict preventive care needs

Preventive care has dipped significantly during the coronavirus pandemic, as many people delayed or skipped routine medical appointments. It led to reductions in screenings for cancer and other high-cost conditions. People who need these services need to be seen quickly to catch signs of disease early, but identifying who these patients are is challenging, especially given now outdated clinical and claims data due to COVID-19 stay-at-home measures.

Provider organizations can mitigate this by analyzing all types of data, including current and historical clinical and claims records. The totality of data can help provide a clear, timely picture of who needs to be seen when, and for what risks. Behavioral models can help predict some of this, such as the likelihood of a patient to use virtual care or self-report conditions related to the service line.

Encourage ambulatory care and telehealth visits

Even though you know you have established protocols in place to keep people safe, some will still want to avoid traditional hospital/clinical settings to protect themselves and loved ones. To keep them safe and maintain revenue in-network, recommend that people use telehealth services or book appointments at your ambulatory care centers, as appropriate for a particular patient’s condition and situation.

 have exploded in popularity and usage. Make sure your patients know which of these (and other) services you offer virtually and clearly communicate the different options they have to book online appointments. Email and text messaging are a great way to drive knowledge, engagement and usage in these tools you are supporting.

Class action lawsuits can result from a protected health information data breach

Personal outreach always stands out, especially in times of crisis. Get your providers involved—that’s who patients often want to hear from! Direct mail and text messages directly from that doctor that you then blast out are great ways to have doctors personally invite patients back to the practice and encourage them to rebook appointments that may have been delayed. As a key component in these messages, also outline some of the safety protocols put in place, as mentioned earlier.

On the provider side, use this time to check in with top-referring doctors with a phone call or email. You could also send lunch or host a virtual Continuing Medical Education (CME) session to keep your practice top of mind among industry colleagues.

COVID-19 will have lasting changes to the way people receive care, as well as a long-term impact on total wellbeing. It is now a necessity to support physical, financial, emotional, and social health outside of the clinic. Health systems will find that patients will remain loyal to providers that find ways to connect with them and offer support at home, in between appointments, to help ensure their wellbeing. An online Health Risk Assessment (HRA) can be a helpful tool to provide this support. HRAs can help educate people about their health risks, promote community health and identify additional patient needs.

In this new COVID world, we need to help patients feel comfortable coming back in and it starts with the right communications to the right people. As the American Hospital Association stated in its Stop Medical Distancing campaign: “Don’t die of doubt. When an emergency strikes, hospitals are still the safest place – even during a pandemic.” Conditions still need to be managed, vaccines administered and care delivered – let’s get patients back in the door safely, and soon.

Jaci Haack is the VP of Client Strategy at

Articles

It is critical to provide crystal clear communications along every step, including where they should park and how to check-in upon arrival. 

5 ways to reengage patients in the COVID19 era

Telemedicine has proven to be a double-edged sword, says Wayne Jonas, MD. Until we learn how to take advantage of the benefits, and manage the challenges, telemedicine will be anxiety-provoking.

Videos

Until we learn how to take advantage of the benefits, and manage the challenges of telemedicine, it will be anxiety-provoking.

Telemedicine may pose new threats for physician burnout

The COVID-19 pandemic hit U.S. healthcare like a bolt of lightning. Hospitals and healthcare organizations had to react very quickly, not an easy thing to do when you’re dealing with a highly contagious novel virus spreading quickly through communities and wreaking havoc on our medical system. Physicians, nurses, and others on the front lines of clinical care were helping thousands of seriously ill patients while lacking basic PPE—and trying to keep themselves from falling ill. No doubt, these clinicians are heroes who answered the call of COVID-19.

Behind the scenes, this pandemic forced healthcare providers to rethink their models of care delivery. Many organizations needed to quickly make the pivot to telemedicine. Additionally, some cities and states were being hit much harder by COVID-19 than others. Physicians and nurses were game to help but had to make sure they were properly credentialed in order to do so. Physicians and nurses can’t legally work if they aren’t licensed in a particular state. In normal times, this process is timely, extensive, and complicated—during a global pandemic, it can seem downright impossible.

Prepare for patients who refuse to wear a mask in your practice


The good news? It wasn’t impossible, and here is where (one of the many) unsung heroes of COVID-19 came into play—the provider credentialers who sprang into action and worked tirelessly in the back office or even remotely to support front-line clinical staff so that they could work. If a physician in California needed credentials quickly to provide telemedicine to a patient in Texas, credentialers made it happen. If a nurse licensed in a state where COVID-19 infections were lower wanted to support care teams in hard-hit New York City, credentialers worked to fast-track those credentials.

March to May 2020 was the highest three-month stretch of state license application volume our clients have ever experienced with California and Florida taking the lead.

Recently, we pulled some data on the number of credentials requested and issued during COVID-19, and the surge we have seen was massive, showing the weight of the task that credentialers were asked to perform. Some data points worth highlighting:

While every client saw big changes, comparing the first quarter 2020 with the second, two of our clients saw an over 500 percent increase in telemedicine credentials, and two more saw increases over 100 percent.

March to May 2020 was the highest three-month stretch of state license application volume our clients have ever experienced with California and Florida taking the lead; both states were hit hard by COVID-19.

Among our clients, internal medicine, emergency medicine, and family medicine specialties saw the highest increases in credential applications.

Comparing state license applications in 2020 versus 2019, we’ve seen a 260 percent increase (369 in 2019 versus 1,328 in 2020 so far).

To those front-line credentialers, we salute you

Physicians and nurses were direly needed during the earliest months of COVID-19. Many were falling ill themselves and unable to work. As of July, 

 have been infected, and more than 500 have died. Those who stepped in were working extraordinarily long hours. Some providers even came out of retirement to help. To all those who worked behind the scenes to make sure these physicians and nurses were able to continue working, wherever and whenever they were needed, thank you.

The pros and cons of private practice versus hospital employment

Thank you for taking on the tireless task of credentialing staff across state lines, for working through the complicated intricacies of credentialing for telemedicine, and for working to fast-track the physicians and nurses coming out of retirement.

As we have learned, COVID-19 waits for no one; it’s fast-moving, and unfortunately, it’s not going anywhere anytime soon. Thankfully, we have those in healthcare who are fast-moving too and have the right tools to make miracles happen when needed. To those front-line credentialers, we salute you.

, a company based in San Francisco, is leading the way to digitizing credentialing for healthcare organizations, making the process quicker, safer, more efficient, and accurate.

Rapid credentializations have allowed healthcare professionals to practice across multiple states during the pandemic.

Backstage Support Heroes: Gratitude for those working magic behind the scenes

 is an antitrust attorney who has represented physician practices in antitrust matters across the country. As a litigator for more than 30 years, he has spent a considerable portion of his practice working on a broad range of complex litigation matters including 

, trade secrets, consumer fraud, and civil RICO.

Over the last 20 years, hospitals have entered many markets previously serviced exclusively by private practice physician groups, either by hiring individual physicians or acquiring entire physician practices. These developments have changed many healthcare markets—oftentimes to the detriment of physicians. For independent physician groups, this means three things:

Hospitals are now their major competitors

Referrals may dry up as hospitals that employ large numbers of primary care physicians steer referrals in-house

Access to hospitals and other key facilities essential to running their practice may be cut off as retaliation for competing effectively

But this does not mean hospitals and physicians are locked in mortal combat from which only one will emerge. In many instances, it can be beneficial for independent physician groups and hospitals to work together; however there are a number of key considerations to creating a successful–and legal–partnership.

Unless a hospital has its sights set on monopolizing physician markets, it may not make economic sense for it to enter a variety of medical specialty markets—or even to expand its position in specialties where it has only limited offerings. Expansion requires a hospital to directly employ physicians, which increases costs, and the hospital may not be able to realize sufficient integrative efficiencies to offset these costs. Further, recruiting and hiring physicians takes time, and motivating and retaining employed physicians presents its own difficulties. Hospitals can hire physicians from existing practices, but this can trigger lawsuits, create ill will, and result in higher salaries than recruiting physicians from outside the community. At the same time, recruiting physicians from outside the community can be riskier than hiring known and established local physicians.

Physicians with established practices typically have longstanding relationships with their patients and the community, and they have established referral networks and skills that a hospital may have significant difficulty replicating. This is exactly what the hospital hopes to build.

Overall, hospitals and physicians have qualities the other wants, which is the bedrock of any potential joint venture or collaboration. Federal and state antitrust laws, however, limit the types of arrangements hospitals and physicians can draft. The antitrust laws, for example, make agreements between competitors that unreasonably harm competition and consumers unlawful. While agreements between firms that do not compete against one another can raise antitrust issues, these types of agreements are subject to significantly less scrutiny than agreements between preexisting competitors. This means that the best time for a physician practice to enter into a joint venture with a hospital is 

 the hospital enters the physician’s area of specialty.

Even if the hospital and private practice can come to terms on a joint venture, they need to do so in a way that does not prompt government intervention. Agreements between existing competitors are subject to certain limitations. For example, agreements to fix prices, allocate markets and customers, or to boycott rivals can violate the antitrust laws.

There are, however, a broad range of collaborative endeavors competing hospitals and physicians can embark on together. Joint ventures in which hospitals and physicians share risk can create significant efficiencies, benefit consumers, bring new services into a community, and prevent redundant and wasteful capital expenditures. Further, certain joint ventures may bring a new medical service into the community, which benefits consumers.

It is important to keep in mind that even a joint venture with a legitimate objective can raise antitrust issues. The Antitrust Division of the Department of Justice and the Federal Trade Commission will look for two key concerns:

Will the joint venture have market power–or too high of a market share–when the hospital and physician group pool resources?

Are there anticompetitive agreements contained within the joint venture’s framework that are unconnected to any legitimate joint venture function?

A significant market power problem can make a joint venture untenable under antitrust laws, but this might be easily remedied by structuring the agreement differently. An ancillary anticompetitive provision in a joint venture agreement might have an alternative that does not raise antitrust problems. Spotting these problems early in the process is important. Taking steps to avoid anticompetitive outcomes goes a long way with the government enforcement agencies.

, trade secrets, consumer fraud, and civil RICO. More at 

You don’t have to be locked in combat with a hospital; in many instances, it can be beneficial for independent physician groups and hospitals to work together.

Negotiating with a major competing hospital 

Personal Protective Equipment (PPE) comes in a wide variety of options depending on what you need protection from. For physicians, this most commonly refers to masks, eye protection, gloves, and clothing protection.

Not all PPE materials are created equal, however, and the composition will change how you use the equipment to 

. From disposables meant to reduce the spread of germs, to reusable equipment that can be easily washed and sanitized, healthcare professionals use a huge variety of PPE every day.

Let’s start with the biggest PPE topic of discussion during COVD-19: masks. Cloth masks made of cotton or other fabric are the easiest to make and use; however, their loosely-woven material and lack of filters means they are not suitable for physicians providing medical care. They can be worn around 

 to help prevent the wearer from spreading the virus, but that’s all.

 Traps to avoid with physician practice mergers

 are made of plastic fibers like polypropylene. They are loose-fitting and best for physicians treating non-COVID patients. These types of masks help prevent the wearer from spreading large droplets of saliva when they talk or cough, but they don’t protect the wearer from others’ contaminants.

Respiratory masks, like N-95s or FFP2s, are made from a polyester shell and contain a polypropylene filter within that shell. This combination of materials, paired with the tight seal around your mouth and nose, means that these high-grade masks 

 from spreading germs. They’re best for those who are working directly with infected patients.

Eye protection is fairly straightforward when it comes to materials. Most are made of plastic frames with glass or plastic lenses and are designed to function similarly to surgical masks, in that they protect the wearer from others’ contaminants. They can also serve as a reminder not to touch your face or eye area.

Another option is a large face shield, usually made of plastic, that doubles as eye and mouth protection. These shields are worn on your head and come down to act as a barrier between your entire face and potentially infected individuals. Plastic is preferable, as it is easy to clean and less breakable than glass. Pair these with masks for even better protection.

Physicians are very familiar with latex gloves. These gloves are made from rubber latex, a material useful in barrier protection. They are also disposable, which is essential for preventing the spread of infection.

For those with latex allergies, nitrile gloves work well. Nitrile is a hypoallergenic, synthetic compound. These gloves also provide barrier protection and are disposable, exactly like latex. However, nitrile gloves are slightly more resistant to puncture and tearing, so they make an excellent choice for physicians, as they regularly use needles, scalpels, and other sharp instruments.

12 ways medical practice staff can help prevent a patient lawsuit

Clothing protection offers the widest variety in terms of the materials with which it is made. The traditional white lab coat is the most basic and is usually made of cotton, linen, or a polyester blend. There is some debate as to the cleanliness of these lab coats and, thus, their continued usage, but they do help protect physicians’ clothes and exposed skin from germs.

Surgical gowns are also effective PPE. These come in a wide variety of ratings depending on the severity of infection or other contaminants. Non-surgical, disposable gowns are usually made from woven polyester. These are useful for low-risk situations where a reusable option is preferable.

Other surgical gowns are made from a fabric called Spunbond Meltblown Spunbond, or SMS. It’s a lightweight, non-woven fabric made from layers of polypropylene processed in different ways. This material is strong and very effective at filtering out contaminants.

When there is a higher risk of infection, physicians will tape closed the entry points of their gowns, like the areas around the wrists. For the highest risk of contamination, entire suits called coveralls are used. These are made from high-density polyethylene (HDPE). HDPE is very effective at keeping the wearer safe from contamination.

Continuing with the higher-risk scenarios, physicians often wear head coverings. These are made from similar materials, like polypropylene blends, to the other PPE equipment we’ve discussed, and come in the form of caps and hoods. Depending on the severity of infection, these coverings can extend down the neck area and connect to the main body PPE.

Similar to head coverings, if shoe coverings are required, they are typically made from similar polypropylene materials. They are almost always disposable and help prevent grime and infections from contaminating a physicians’ shoes for personal protection. They are also useful in helping prevent infections from outside getting introduced to sterile environments.

Personal protective equipment is vital in preventing the spread of infections and diseases. Most PPE comes in some form of woven plastic material, but there are variations like cotton or another porous fabric. It’s essential to know the level of protection you need and choose the material that will meet that level.

Aaron Smith is an LA-based content strategist and consultant in support of STEM firms and medical practices. He covers industry developments and helps healthcare professionals connect with patients. In his free time, Aaron enjoys swimming, swing dancing, and sci-fi novels.

Not all PPE materials are created equal and compensation will change how you use this equipment in your workplace.

PPE composition: Variations matter

The pandemic has left some physicians with more time due to fewer patient visits; however, for the physicians in the ‘center of the storm’, mindfulness and mind-body practices are very important for building a resilience to burnout with less time and increased stressors, says Wayne Jonas, MD.

Mindfulness and mind-body practices are very important for building a resilience to burnout. 

How physicians can manage burnout with less time

While face masks are generally acknowledged as a vital safety device by the majority of the medical community, the CDC and OSHA, there is still some resistance to wearing them that can create legal and physical risks for medical practices. Here are some basics physicians should consider.

To avoid potential conflict, patients should be provided advance notice of your policy to avoid surprise and embarrassment, which often leads to resistance, business disruption and negative social media attention. Your mask policy should be clear, included in your intake documents and processes, posted inside and outside your practice, uniformly enforced and legally compliant.

Mask F.A.Q.’s for medical practice owners and managers

There are cases where cloth masks cannot reasonably be worn due to occupational safety issues including contamination from other harmful agents such as chemicals and other agents. Based on my research, those professions are typically industrial in nature and involve specialized processes, safety standards, and equipment that far exceed the burden and value of a cloth mask and is outside the scope of most medical practices.

Others argue a “medical condition” prevents them wearing a mask and therefore you can’t require it and must “accommodate” them and allow them to continue unmasked or face legal action. Based on both the screaming fits and physical altercations documented on social media, not all of these claims appear to be medically valid or made in good faith. While this column centers on asset protection in all its various forms and encourages you to be risk and lawsuit averse, don’t be pressured into exposing your staff and patients by threats of frivolous lawsuits if you are otherwise legally compliant. As always, carefully document everything, especially if patients refuse to comply.

Basically, only an individual with a disability who can show that wearing a mask would significantly interfere with their ability to breathe or some other necessary function could claim that an exemption from a mask requirement would constitute a reasonable accommodation,” Stephen Befort,

a professor at the University of Minnesota Law School

That said, a variety of false ridiculous and arguments are aggressively advanced as to why an individual does not have to wear a mask at your place of business, why you can’t require it, and what imaginary rule of law supports their arguments. I don’t suggest you argue these points, but I do think you and your staff should know the facts to effectively enforce your mask policy. The list below is a combination of actual questions I have received from doctors and business owners and the spurious arguments and false statements presented by those refusing to comply.

Yes, you can require masks to be worn on your property and/or place of business to protect other patients and your staff.

No, there is no First Amendment right to ignore mask rules on your property. Complying with government and industry safety standards neither compels nor prohibits free speech.

 have any bearing on requiring a mask at your place of business. 

Yes, you can legally deny service to anyone who does not comply with your rules.

Yes, you may have to provide “reasonable accommodation” to those actually unable to comply, especially if they pose a “

No, there is no established universal legal standard that applies to all patients, it is a subjective, case-by-case analysis and cannot create an “undue burden” for staff and other patients.

No, there are no legally effective “mask exemption cards” 

Yes, you can require employees to follow your workplace health and safety policies.

Yes, there may be situations where you need to 

 for employees who actually can’t wear one for a valid medical reason.

OSHA has not stated masks are ineffective

 against COVID19 or dangerous to wear while working.

Yes, cloth facemasks do provide “source control” and can be required.

No, cloth facemasks are not formally considered to be “PPE”.

Yes, employers can be held to have a duty to provide actual PPE to staff if work conditions (including an inability to distance) make lesser alternatives like cloth masks ineffective.

cloth face coverings should still implement social distancing

, JD, has practiced law exclusively in the areas of asset protection, risk management and wealth preservation for the last 16 years. He helps protect a national client base with more than $5 billion in personal assets, including several thousand physicians. He is a contributing author to multiple books for physicians and a frequent medical conference speaker and CME presenter. Learn more at

To avoid potential conflict, patients should be provided advance notice of your policy to avoid surprise and embarrassment. 

Covid-19 Legal Risks: Requiring masks at your practice

Use these guidelines to increase mask-wearing compliance at your practice while also reducing risk and conflict. 

Slideshows

Mask policies that may increase compliance and reduce risk and conflict.

Masks and Your Practice: Policies that work, set expectations, and reduce conflict 

, a leading health information technology and services provider.

At the start of the COVID-19 pandemic, many medical procedures were put on pause in order to prioritize the health and safety of both patients and medical staff. With resources focused on battling COVID-19, 

 resulting in a stark revenue loss for practices and inconvenient delays for patients. 

Understandably, many patients remain apprehensive to reschedule elective surgeries due to potential fear of infection, and data shows that it may take anywhere from 

 for practices to “catch-up” on surgical procedures that were canceled due to COVID.

But as the country is working to reopen and bring back some sort of normalcy, healthcare providers, too, can prepare their offices and practices. To ensure physician and patient safety and quality care when welcoming patients back for elective surgeries and other procedures, consider these tips.

 Prepare for patients who refuse to wear a mask in your practice

Reopening Post COVID-19: Establishing an Internal Governance Committee & Plan

Before bringing patients back in person, practices should 

assemble a cross-functional internal governance committee to guide COVID-19 policies

. The committee’s objective is to keep the practice abreast of any local, state, or regional policies, and help you gradually and safely expand access to care.

From front office administrative employees to surgical staff, this committee should cover all aspects of patient care, such as pre- and post-op procedures, providing a dynamic perspective and informing real-time decisions on practice protocols. With guidance from the committee, practices can more appropriately plan for staff coverage, assess facility capacity, solidify equipment resourcing and establish workflows, ensuring that the practice honors local guidelines while also remaining cognizant and sensitive to the needs of each individual patient.

Once the internal governance committee is established, its first step is to develop a written COVID-19 outline or plan that clearly maps out new policies and guidelines, both for internal (staff) and external (patient) audiences. This outline can also serve as a guide to be used during staff training, incorporating guidance from your local jurisdiction on current COVID-19 infection rates in your community, local testing protocols and sanitization procedures and more. The plan needs to clearly communicate how your practice is testing for COVID-19 -- and re-testing asymptomatic patients or false negatives. You can also calculate PPE, medication and surgical equipment needs with the 

 to ensure your supply chain can support practice needs.

As you map out your practice's reopening plan, it’s important that it continues to prioritize patient care. Proactively address the following questions to alleviate patient fear and confusion.

Using multiple entrances to avoid high-foot traffic entrances?

Designating certain dates and times for infected vs. healthy patients?

Removing waiting room chairs and asking people to wait in their cars?

Requiring the use of cloth or N95 masks inside?

Addressing these questions in advance will not only ease patient apprehension, following these guidelines can also result in a more accurate, streamlined, and—most importantly—a sanitary check-in process. Practices may also find it helpful to space out in-person visits, fill in the gaps with telehealth visits to increase cash flow, and allow time for proper sanitization.

Once the plan is finalized, practices should begin communicating these new policies with patients and rescheduling previously canceled procedures. But, how should you 

? That depends on your practice needs. The internal governance committee should guide the strategic plan for delivery of care and help prioritize the sequence of procedures. For example, a practice may prioritize the highest payout procedures in order to revive cash flow. Additionally, practices can block certain times for procedures to take place, bucketing high-risk patients or infected patients to visit the practice during separate times to ensure sanitation protocols are honored. Overall, it's important for the governance committee to define and establish what's best for your individual practice. 

Traps to avoid with physician practice mergers

Communicating COVID-19 Procedures and Welcoming Patients Back In

As you begin to welcome patients back in, use digital tools such as 

 to inform patients about your new policies. Consider using 

 to answer any last-minute questions and to let patients know what they can expect during their visit, or when their appointment time has arrived.

Lastly, leverage your healthcare technology partners for support. Connect with their customer support teams and keep them abreast of your new procedures. Seek additional ways to improve the new policies or procedures to ensure patient safety and satisfaction during post-COVID visits. As we all are adjusting to new social norms, rely on the capabilities of technology to effectively educate, inform and communicate with staff and patients as elective procedures resume.

 chief product and technology officer at 

As you map out your practice's reopening plan, it’s important that it continues to prioritize patient care.

Reopening elective surgeries after COVID19

The search for a COVID-19 vaccine will be the topic of a free MJH Life Sciences webinar at 

As the death toll of the COVID-19 coronavirus pandemic rises above 136,000 Americans and more than 4 million Americans have tested positive for the virus, the whole country waits with bated breath for the development of a vaccine which can bring the destruction to an end.

This race for a vaccine will be the topic of the one-hour session featuring experts on viruses and vaccines.

Click here to register for the free event

, professor of medicine, pediatrics, global health, and epidemiology at Emory University, and director of the Emory Vaccine Center; spent 26 years with the U.S. Immunization Program at the Center for Disease Control and Prevention. His research focuses on vaccine effectiveness and uptake.

 is a virologist studying host responses to infection by combining classical virology with a modern systems biology approaches. Her research focuses on identifying host response signatures predictive of infection severity or disease outcome and host pathways to target drug development or repurposing.

 studies the immunogenetics of vaccine response in adults and children. Along with his team within the Vaccine Research Group, his aim is to improve the health of individuals across the world by pursuing challenges posed by infectious diseases and bioterrorism through clinical, laboratory, and epidemiologic vaccine search.

A trio of experts will discuss the prospects of a handful of COVID-19 vaccine candidates which are entering phase 3 trials.

Coronavirus vaccine: MJH to hold free webinar

Vice President of Radiology & Oncology at 

, which specializes in the temporary placement of physicians and advanced practitioners at U.S. healthcare facilities. He is also President of the 

National Association of Locum Tenens Organizations®

 (NALTO®), the only professional association of temporary physician staffing firms committed to a code of ethics and to maintaining the highest industry standards.

When COVID-19 hot spots began popping up in the US, legislators enacted temporary 

 to make it easier for clinicians to practice across state lines and quickly travel to provide care where it is needed most. Although the legislation is helping increase access to care during an unprecedented time, it will soon expire in many places, either on a predetermined date or when the states are no longer under a state of emergency. States of emergency can be extended, but even when they expire, it doesn’t necessarily mean the need to bring in additional clinicians from out of state to care for patients will wane in every single hospital, especially those in rural areas.

The measures enacted in response to COVID-19 are very similar, or a temporary version, of something called the 

Interstate Medical Licensure Compact (IMLC)

, which some states have participated in since 2017. The IMLC is a voluntary agreement between participating states that facilitates the licensing process for physicians practicing outside of their state of residence. Prior to the pandemic, 28 states or territories had already enacted some form of the compact licensure legislation, and there are 24 states and one territory in which a doctor can carry their State of Principle Licensure (SPL), which is required to get a license in another state participating in the compact. The IMLC greatly reduces the time and administrative burden it takes for a physician to be granted rights to practice outside of their home state and therefore increases access to care.

The pandemic has shown many what those practicing in SPLs have understood for quite a while: the adoption of permanent nationwide legislation is necessary to ensure patients across the country have timely access to the lifesaving care they need both today and in the future.

Masks and Your Practice: Policies that work, set expectations, and reduce conflict

Although the physician licensing requirement was implemented with the goal of keeping patients safe and has served its purpose well, the current system can hinder many clinicians as they try to quickly move across state lines when they’re needed elsewhere. This especially encumbers locum tenens clinicians who typically have a wider area of practice than those who are permanently employed by a healthcare organization.

Locum tenens clinicians have traditionally been utilized to fill gaps in coverage at healthcare organizations by entering into short-term agreements facilitated by locum tenens agencies. Over the past few years, the IMLC has greatly benefited locum tenens physicians and their patients who are living in SPLs and other member states, as many locum tenens providers have always traveled across state lines to provide care per their contracts. This practice has only heightened during the pandemic, and locum tenens staffing solutions have been an essential part of the pandemic response. In fact, at the height of the pandemic, 83 percent of the physicians and advanced practitioners sent to New York traveled there from out of state, and 63 percent of those clinicians weren’t actually licensed in New York.

Many locum tenens agencies already have the benefit of housing internal CVO departments full of dedicated specialists who are well equipped to navigate changes in policies and procedures. They partner with practices to take care of the administrative red tape required to get clinicians into their facilities. And during this time of crisis, CVO departments across the country have stepped up to provide pandemic management services, fulfilling the administrative requirements to get the right clinicians in the right places as quickly as the law allows. But more states either entering into the compact post-pandemic or working toward becoming SPLs would help these departments operate more smoothly, efficiently, and get the right people in the right places sooner so healthcare organizations are never having to wait for relief and patients aren’t having to wait for care.

Marketing and promotion strategies for medical practices

This week is National Locum Tenens Week, the time when we honor our locum tenens clinicians, many of whom have crossed state lines to serve on the frontlines during the COVID-19 pandemic. As we move past the point of crisis, it is time to reflect on the incredible selflessness they and other clinicians demonstrate daily and consider how temporary legislative measures have greatly benefited healthcare organizations and their patients. It is my hope that this experience will encourage decision makers living in states that are not currently participating in the IMLC to consider participating in the contract or move to become SPLs if they aren’t already. Our clinicians do so much for our healthcare organizations and our patients; the least we can do is make it easier for them to get to where they need to be.

Matt Erickson is Vice President of Radiology & Oncology at

specializes in the temporary placement of physicians and advanced practitioners at U.S. healthcare facilities. He is also President of the

(NALTO®), the only professional association of temporary physician staffing firms committed to a code of ethics and to maintaining the highest industry standards.

New nationwide legislation is necessary in the wake of the pandemic.

National Locum Tenens Week: How we can continue to facilitate access to care

Client Services and Marketing Specialist at NGA Healthcare

Physicians are at the forefront of healthcare; yet they are often the victims of insurance payer’s efforts to reduce costs. Why don’t payers focus on reducing reimbursements to hospitals that often have rates 3-to-5 times that of Medicare? Why don’t payers support private practice rather than reduce physician reimbursement rates? The unintended consequence is that we are entering an era where physicians are tired, overworked, and leaving private practice to join hospitals and large health systems.

 from NGA Healthcare, a reimbursement and contract negotiation strategy firm, explains that the payer’s strategy is more focused on control and in actuality doesn't focus on saving money. “Because of the medical loss ratio—payers need to spend around eighty percent of their revenue on claims—payers are not incentivized to save money. The more they spend, the more they can contribute to profit and other endeavors.”

What’s more, these payers are entering into ventures that allow them to spend, rather lavishly, on businesses they own.

“They purchase pharmacy benefit managers, surgery centers, hospitals and physician groups,” Arana says, “which allows them to funnel money to where it is essentially returned to them.”

Arana, who has been negotiating payer contracts for over ten years, believes that promoting private practice and competition in the free market is the answer to the healthcare crisis. This includes trust-busting insurance payers and promoting pricing transparency.

“If people understood just how grossly overpaid hospitals are, they would be alarmed,” Arana says. “If we understood that we could obtain the same service in an outpatient surgery center or physician office at a tenth of the cost, people would certainly consider the alternatives.”

Instead, the lack of transparency in healthcare has allowed payers to funnel money where they see fit, including their own ventures. They are aggressively marketing to Medicare beneficiaries to recruit them to their Medicare Advantage networks. Under these networks, payers can contract physicians at rates significantly below Medicare, and keep the cost savings. They use funds from employer groups to enrich their ventures and hospital partners instead.

Negotiate your rates. Hold the payers accountable. Understand how your contracts are limiting your ability to grow and expand.

Our current model puts physicians under thin margins, especially when so many rates remain stagnant. “Sometimes we need to ask payers for larger increases simply because rates haven’t changed in 15 years. In no other industry does that happen.” Explains Arana. “What we are doing is protecting private practice by increasing margins for physician groups and keeping private practice lucrative. The alternative is, you’re going to see a lot more physicians leaving private practice to join hospitals where rates are 300% greater than a physician’s office. That’s a big problem if we are trying to reduce healthcare costs.” Explains Arana

In few other industries does a third party dictate pricing. Physician reimbursement rates have remained the same for decades, yet premiums increase by large double-digit percentage points.

Physicians: Negotiate your rates. Hold the payers accountable.