Mar 27, 2020

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3 min

Our perspective on Covid-19: Removing administrative barriers to improve care delivery is as critical as ever

By

Seth Cohen, Midori Uehara

We have all seen the numbers. Over 550,000 cases worldwide as of March 27. Over 25,000 deaths worldwide and 8,200 deaths in Italy alone (Source: Washington Post).  We watch the numbers rise and we feel the ever-increasing weight of this public health crisis. But sometimes, numbers can be numbing. Behind every statistic is a human life, a family, a community. We know this all too well at OODA Health. A member of our community was diagnosed with Covid-19, and has been hospitalized for the past two weeks. Fortunately, recovery is in sight, but the journey has been terrifying and challenging. Our co-founder, Giovanni Colella, M.D., was raised in Milan and speaks daily to friends and family affected by the circumstances in Italy. Our key partners, like CommonSpirit and Blue Shield of California, are on the front lines working around the clock to deploy mission-critical support to patients in need.   

This is a sobering moment; and for us, it is a deeply personal one. During this unprecedented time, we are grateful for and humbled by the mobilization of providers and payers across the country to fight Coronavirus (Covid-19).  We see you serving at the front line for testing and treatment, even coming out of retirement to do so; we see you moving mountains to free up capacity in your hospitals; we see you making rapid-fire policy decisions to ensure access to care; we see you working around the clock to secure PPE; we see you ramping up telehealth and remote work on a dime. We see you and we are thankful.

Inspired by those around us, the OODA community is fired up to do our part in the fight against Covid-19. A key company value is to “prioritize people.” People are the reason we (virtually) come to work every day to build our solutions and the reason we came together to pursue our mission over two years ago. 

Our mission—to remove every administrative barrier to proper treatment for patients and the clinicians who care for them—is as timely as ever. We urgently need a human-centered healthcare system free of administrative waste. Just this week, we heard from our partners about prior authorization delays that have unnecessarily extended patients’ hospital stays, occupying crucial beds. We heard about dire cash shortages leaving hospitals to choose between making payroll and buying PPE. We heard about newly unemployed patients struggling to pay premiums to maintain coverage. At OODA, we are laser-focused on removing barriers such as these so that our healthcare payers and providers can focus fully on access to and provision of life-saving healthcare.

On the patient side, we have deployed solutions to ensure that out-of-pocket costs are not a barrier to Covid-19 testing and treatment.  Specifically:

  • Helping patients pay for their care is at the core of what OODAPay, our patient billing solution, does. We are accelerating the rollout of OODAPay in order to ensure all patients have access to affordable and convenient care when they are most vulnerable.
  • In particular, we are ensuring patients understand that some health plans (like our partner, Blue Shield of California) have waived cost-sharing for all Covid-19 testing or that their hospital, like our partner CommonSpirit, may have suspended billing related to the testing and treatment of Covid-19.
  • We are helping payers restructure their approach to premium payments to ensure continuity of coverage, introducing payment plans and extended grace periods for small groups and individuals. 
  • Anticipating increased enrollment in Exchange plans as a result of rising unemployment, we are working with payers to design services for individual plans that will streamline billing and enable access to financial services to manage out-of-pocket expenses.

In addition, we know that many of our provider partners are preparing for months of financial strain and uncertainty. Hospitals are anticipating lower reimbursements, driven by a shift in patient mix to Medicare and cancelations of elective care. They may also face lower patient recovery rates due to the economic downturn, as patients migrate into higher cost-share plans and de-prioritize paying their medical bills. At a time when every available hospital resource is needed to respond to Covid-19, OODA is helping in a couple of key ways:

  • In addition to helping patients, OODAPay is designed to help providers strengthen their financial position. By guaranteeing payment for the patient portion of the bill and handling all operations of the billing, we relieve our provider partners of the need not just to do patient billing, but also to think about it.
  • Our clinical data-sharing infrastructure streamlines complex claim processing and prior authorizations. This enables clinicians to reduce administrative tasks and get back to patient care, and eliminates care delays that take up important time (at best) and a hospital bed (at worst).

These are just a few ways we are responding today. As a nimble young company sitting at the crossroads of payers and providers, we are ready to respond to the needs of our system in this turbulent time. We will learn more tomorrow and the next day and the next, and we will adapt to what we learn. To every organization and individual mobilizing across the healthcare ecosystem, we stand together with you, ready to fight, ready to support, ready to help.

Learn about how you can partner with OODA Health to improve your members’ experience and your revenue management.