Innovation Insights - June 10th, 2024 Edition

Welcome to this week's healthcare innovation newsletter, where we delve into the latest significant developments and trends in the industry. In this edition, we cover three key topics: the CMS's announcement of a $500 million funding opportunity aimed at increasing ACA outreach and enrollment efforts, the projected 15% decline in inpatient bariatric surgeries over the next decade, and the growing crisis of healthcare provider and clinician burnout. Additionally, we highlight the urgent fight against fentanyl overdose and share exciting upcoming events and initiatives in the healthcare sector.

Advocacy Corner – Fighting Fentanyl

In the time it took you to read this newsletter 1 person died from an overdose with an 72% likelihood it was from Fentanyl.

I had the opportunity to attend Country Music Awards Festival (CMA Fest) this past weekend. Jelly Roll is an artist I really enjoy. He shared his latest song and briefly his testimony to congress on the fight against Fentanyl in the USA. I thought his testimony was well done.

See Jelly Roll’s testimony here: https://www.youtube.com/watch?v=rDSekKuG44E

Reminder: Two major nursing initiatives to be aware of and consider supporting.

1. Support the Center for Nursing Reimbursement - https://commissionfornursereimbursement.com/ nurses are baked into the room and bed charge. This is ancient thinking and needs to change. This commission is working to change this! Show Rebecca Love RN, MSN, FIEL and team some support!
2. Support Nursing Receiving #STEM Designation - through Nursing Is STEM - https://www.nursingisstem.org/ By designating nursing formally as a STEM profession we gain a lot including the ability to get to our next generation much earlier and share all that nursing has to offer!

Upcoming Event To Check Out!

LinkedIn Live: https://www.dhirubhai.net/posts/caryntomer_this-is-going-to-be-such-a-fun-conversation-activity-7202388758883700736-ox55 ?Join Kathy McGrew CNIO Microsoft, Becky Fox, CCIO Intermountain Healthcare and myself, Brian Norris for a fireside chat on nursing innovation, generative AI’s impact and where nursing (and all clinical) innovation is headed. You won’t want to miss this! Use the link above to register for the June 14th session! The session is sponsored by MedeAnalytics .

#1 - CMS Announces $500 Million Funding Opportunity to Increase ACA Outreach and Enrollment Efforts

The Centers for Medicare & Medicaid Services (CMS) has announced a significant funding opportunity, with $500 million in grants available over the next five years. These grants aim to enhance outreach, education, and enrollment efforts for health coverage through the Federally Facilitated Marketplace (FFM) on HealthCare.gov . This marks the largest funding allocation for Navigator grants to date, emphasizing the importance of reaching underserved and diverse communities.

Key Points:

1. New Navigator NOFO Features: Increased focus on smaller, community-based organizations to enhance local outreach. Multi-year grant funding for extended project stability. Simplified application process to encourage broader participation.
2. Eligibility and Application: Eligible applicants include a wide range of organizations, from non-profits and trade associations to chambers of commerce and tribal organizations. Total funding of $500 million over five years, with $100 million available in the first year.
3. Support and Deadlines: CMS will provide technical assistance through two sessions on June 13 and July 2, 2024. Applications must be submitted by July 8, 2024, through Grants.gov .

For more information, including how to apply and technical assistance session details, visit CMS Navigator Grants and the Grants.gov listing .

#2 - Inpatient Bariatric Surgeries to Decline 15% in 10 Years: Vizient Report

https://www.beckershospitalreview.com/quality/inpatient-bariatric-surgeries-to-decline-15-in-10-years-vizient.html?origin=PayerE&utm_source=PayerE&utm_medium=email&utm_content=newsletter&oly_enc_id=1904I7399467I5F

According to a June 10 report by Vizient, the rate of inpatient bariatric surgeries is expected to decrease by 15% by 2034. This trend is driven by two main factors: the increasing availability of weight loss pharmaceuticals and a projected rise in outpatient surgical volumes by 13%. Inpatient bariatric surgeries, which are typically reserved for higher acuity cases, are seeing a decline as patients opt for nonsurgical options like GLP-1 weight loss drugs (e.g., Wegovy and Zepbound).

In early 2024, bariatric surgeons reported fewer referrals and a "temporary lull" in operations. At Pittsburgh-based UPMC, there has been a significant rise in demand for nonsurgical obesity treatments, especially with the new class of medications.

A key concern for patients is the long-term efficacy of these treatments. Gastric sleeve operations result in a 30% weight loss before stabilizing at 20%-25% after 5-10 years, while gastric bypass surgeries lead to up to 38% initial weight loss, steadying at 30%. There is less long-term data on GLP-1s, but a four-year study published in Nature Medicine found that the average Wegovy user lost 10% of their body weight.

Financially, bariatric surgeries cost between $15,000 and $23,000 upfront, whereas GLP-1 injections cost about $1,000 per month.

Key Takeaways:

1.???? Projected Decline in Inpatient Surgeries: Inpatient bariatric surgeries are expected to drop by 15% by 2034, driven by the rise in weight loss pharmaceuticals and outpatient surgical volumes.

2.???? Shift to Nonsurgical Treatments: The popularity of GLP-1 weight loss drugs is leading patients to choose nonsurgical options, reducing the number of inpatient bariatric surgeries.

3.???? Cost and Long-Term Efficacy Considerations: While bariatric surgeries have significant upfront costs and known long-term outcomes, GLP-1 injections are expensive monthly and lack extensive long-term data on efficacy.

#3 - Addressing Healthcare Provider and Clinician Burnout: A Growing Crisis

Healthcare provider burnout is a critical issue with significant repercussions for both healthcare workers and patients. The demanding environments in which healthcare providers work often strain their physical, emotional, and psychological well-being, leading to increased mental health challenges and premature departures from the workforce. This growing problem threatens patient care accessibility and overall healthcare system functionality.

Key Quotes from Healthcare Workers:

Kevin C., Nurse, Florida: “There was a point where I could no longer contain the heartbreak of everyone that had been lost.”

Nisha B., Palliative Social Worker, Pennsylvania: “Something has to change. Something good has to come out of this or it will be for nothing.”

Derick S., Respiratory Therapist, Nevada: “The primary concern for burnout is not being able to emotionally take care of each patient individually or uniquely.”

Causes of Burnout:

Burnout among healthcare workers is driven by various factors, including:

• Excessive Workloads: High patient volumes and long hours lead to fatigue and stress.
• Administrative Burdens: Significant time spent on paperwork and compliance detracts from patient care.
• Limited Control: Lack of autonomy over schedules and work conditions adds to stress.
• Inadequate Support: Insufficient organizational support and resources leave workers feeling isolated and overwhelmed.

Health Worker Burnout Harms Everyone:

More about this topic in the “Addressing Health Worker Burnout” report - https://www.hhs.gov/sites/default/files/health-worker-wellbeing-advisory.pdf

If not addressed, the burnout crisis will:

• Reduce patient care access.
• Increase healthcare costs.
• Hamper preparedness for future public health emergencies.
• Worsen health disparities.

Solutions and Actions:

Everyone has a role to play in preventing health worker burnout. Here are some recommended actions based on various roles:

For Healthcare Organizations:

• Commit to Health and Safety: Build a commitment to the health and safety of workers into the fabric of health organizations.
• Policy Review and Revision: Ensure policies do not deter health workers from seeking appropriate care for their physical health, mental health, and substance use challenges.
• Increase Access to Care: Provide high-quality, confidential mental health and substance use care for all health workers.
• Rebuild Community: Strengthen social connections among health workers to mitigate burnout and feelings of loneliness and isolation.
• Combat Workplace Discrimination: Address bias, racism, and discrimination in the workplace.
• Invest in Prevention: Fund preventive health and social services to address health inequities.

For Governments:

• Invest in Evidence-Based Practices: Support plans and partnerships that ensure the health, safety, and well-being of health workers.
• Address Punitive Policies: Remove policies that deter health workers from seeking mental health and substance use care.
• Reduce Administrative Burdens: Simplify processes that contribute to burnout.
• Recruit and Retain Diverse Workforce: Expand and maintain a diverse healthcare and public health workforce to meet current and future challenges.
• Prepare for Emergencies: Commit to a coordinated approach to prepare health systems and workers for public health emergencies.

For Health Insurers:

• Support Quality Care: Improve care quality by supporting the time health workers spend with patients.
• Reduce Administrative Load: Minimize the burden of prior authorization requests and other documentation requirements.
• Ensure Access to Care: Provide access to quality mental health and substance use care.
• Partner with Providers: Collaborate with healthcare organizations to improve clinical care and preventive services.
• Increase Transparency: Enhance transparency to enable better health decisions by providers.

For Health Tech Companies:

• Design for Health Workers: Create technology that meets the needs of health workers, care teams, and patients.
• Focus on Interoperability: Develop platforms with interoperability from the outset.
• Integrate Data: Strengthen the integration of data across different platforms and health sectors.
• Improve Data Access: Ensure seamless storage and access to health data.

For Educational Institutions:

• Support Learner Well-Being: Prioritize the well-being of health professional learners and faculty.
• Address Hidden Curriculum: Recognize and address the impact of hidden curricula on trainee development and well-being.
• Promote Mental Health Access: Increase access to mental health and substance use care for students and staff.
• Foster Inclusion and Diversity: Support diverse and inclusive environments to promote well-being.
• Strengthen Community Connections: Enhance connections between trainees and the communities they serve to mitigate burnout.

For Families, Friends, and Communities:

• Recognize Signs of Burnout: Learn to identify signs of distress in healthcare workers.
• Support Health Workers: Follow public health guidelines and encourage others to do the same to support health workers.
• Be Kind to Healthcare Providers: Show kindness and understanding towards healthcare workers as patients and community members.

For Health Workers:

• Recognize Burnout: Be aware of signs of burnout in yourself and colleagues.
• Stay Connected: Maintain connections with peers and seek help when needed.
• Prioritize Well-Being: Focus on activities that bring joy and connection.
• Advocate for Change: Use your voice to promote positive changes in your workplace and community.

For Researchers:

• Develop Assessment Tools: Create tools to regularly measure and respond to health worker burnout.
• Study Pandemic Impact: Research the immediate and long-term effects of the pandemic on health worker well-being.
• Investigate Payment Models: Understand how payment models and technology affect worker well-being.
• Enhance Health IT: Improve health information technology to support healthcare delivery more effectively.

By working together, we can help our healthcare workforce heal and thrive, ensuring they can continue to provide the care and support we all rely on. Addressing burnout is not just a healthcare issue; it's a public health imperative that requires collective action and commitment.

Have a wonderful week and thank you for reading.

Brian Norris MBA, RN, FHIMSS