COVID-19 Updates From AArete

COVID-19 undoubtedly brings one of the biggest challenges ever faced to corporations and people across the world. Healthcare organisations are particularly feeling the pressure as hospitals are overwhelmed with patients and frontline workers witness the virus’ impact up close daily. After careful consideration, our team of clinicians, data scientists and public health experts wondered how diving into influenza data from prior flu seasons would help glean insights on the path of COVID-19 and the ramifications on different patient populations. Dive into our insights below and check back on this page regularly for updates.


Preparing for Influx of Claims is Vital as These Surgeries Resume Across the Country

Updated on May 20, 2020

As elective procedures are resuming in many parts of the country, AArete’s experts are anticipating continued difficulties within the US healthcare system as it relates to both capacity planning and billing/payment accuracy. Elective procedures have been delayed for several months due to COVID-19, and hospitals and payers are in the midst of strategic planning to both estimate demand and evaluate (and in most cases increase) capacity. 

Though the volume of elective procedures has been growing over the last five years, the expected spike due to the COVID-19 related backlog may be problematic on multiple fronts. Our experience suggests that sharp increases in claims volume are associated with increased claims denials, which result in delayed reimbursements for hospitals. Denials and coding errors also create administrative burdens for payers, who must align payments with contracts and policies. The relationship between processed and denied claims can be particularly strong for certain procedures (e.g. knee arthroplasties). We advise providers to ensure accurate coding, and we advise payers to properly configure their systems to take on the influx of claims for elective procedures.

Blood Shortages May Lead to Progression of Underlying Diseases and Costly Care if Providers are not Properly Prepared

Updated on May 1, 2020

AArete is using data science and clinical expertise to address the challenges and uncertainties within the US health system as a result of COVID-19. Most recently, we wondered what potential impact blood shortages due to donor cancellations would have.

Patients undergoing urgent and elective procedures may rely on blood transfusions to mitigate the effects of blood loss. According to the American Red Cross, donation centers are running low on blood supplies, prohibiting physicians’ ability to safely complete these procedures. Additionally, many patients with chronic conditions, such as anemia, kidney disease and cancer, may require periodic blood transfusions. Delays in their treatment due to the current pandemic may lead to progression of their underlying diseases to costlier ones, as well as sudden surges in the number of people requiring transfusions. It is vital for healthcare providers and patients to understand the optimal balance between avoiding unnecessary exposure to infection while maintaining required treatment protocols.

AArete is tracking the ability of providers and payers to meet the growing costs and demand for care. For those who are willing and able, we recommend donating blood as a great way to help those in need during this time and alleviate this challenge.

Effective Planning for Reopening American Hospitals Requires Revenue Planning, Accelerated Scheduling and Deployment of Staff / Materials

Updated on April 23, 2020

HHS announced yesterday the distribution formula for a further $40B of the CARES Act grant, officially determining allocations of $70B for providers. Only $10B of this funding will be allocated to COVID hotspots across the nation, which will leave hospitals in these locations requiring further assistance to cover incurred costs and lost revenue due to canceled elective procedures. The need to strategise and plan for reopening continues to grow in order for healthcare providers to maximise on the demand for elective procedures once restrictions are lifted.

AArete’s Elective Procedure Planning analytics tool incorporates revenue planning, accelerated scheduling, deployment of staff and materials, and other factors and guidelines like those listed by CMS in their Reopening America Again guidance to facilitate the most effective planning.

Forecasting Fundamental to Success as Hospitals, Health Systems and Ambulatory Surgery Centers Prepare for Influx of Elective Procedures Following COVID-19 Pandemic

Updated on April 17, 2020

As coronavirus continues to test the capacity of the US healthcare system, AArete’s clinical experts and data scientists are working together to understand how resource constraints may persist even after the pandemic subsides. We expect that providers and payers will face logistical challenges in meeting the demand for elective procedures that have been postponed during the outbreak.

Most states have advised hospitals and health systems to delay or cancel non-urgent procedures, which generally constitute a sizeable proportion of overall medical revenues. Volume of elective procedures tends to stay high over the course of the year, and the disruption caused by COVID-19 is likely to create a significant backlog after guidelines are lifted. We recommend that hospital systems and ambulatory surgical centers in all states prepare for an influx of inpatient and outpatient cases after COVID-19. Facilities should also prepare to take extra precautions to ensure patient safety since the lingering possibility of contracting coronavirus or another disease will govern patients’ levels of comfort with their proceduralists.

Existing scheduling mechanisms may not be sufficient to plan for this upcoming situation, so care centers will need to start forecasting the availability of surgical supplies, protective equipment, operating rooms, post-anesthesia care units, and staff—and make decisions about how to remedy shortages. An inability to accommodate the postponed procedures may mean revenue loss for providers and compromised health outcomes for patients.

Critically Important for Health Systems in Peri-urban and Rural Areas to Take Inventory of Resources as COVID-19 Spreads Beyond Urban Hotspots

Updated on April 10, 2020

AArete’s clinicians, public health experts and data scientists are collaborating to uncover patterns in the US health system to aid providers, payers, individuals and government entities in the management of the COVID19 pandemic. As the disease spreads rapidly across and beyond urban hotspots like New York City, we advise health systems located in peri-urban and rural areas actively assess readiness for the outbreak. An inventory of respiratory therapy resources and patient loads offers critical insights.

Our New York experience suggests upstate counties with more rural communities have higher per capita utilisation of services for asthma, COPD, pneumonia and ventilator support compared to urban areas. COVID-19 cases in these counties are currently among the lowest in New York state. However, these areas may have patients with increased susceptibility to COVID-19 due to respiratory conditions and supportive equipment, or patients who are immunocompromised due to underlying conditions and medications. Anticipating resource constraints and ensuring proper outreach for these patients at greater risk of complications can alleviate stress for health systems, enable more proactive care and manage costs.

Robust Care Coordination Program Necessary to Manage COVID-19 Treatment for Patients With Substance Abuse Disorders and Dependencies

Updated on April 2, 2020

AArete’s team of clinicians, public health experts and data scientists continue to monitor the #COVID19 pandemic and the impact of its progression on the US health system. Last week, we noted that the 2 weeks following diagnosis are a critical period. Today’s post focuses on individuals battling substance use disorders and dependencies.

Our examination of influenza data suggests a higher inpatient admission rate for this population. If they contract COVID-19, robust care coordination programs to ensure substance use conditions remain managed is important to monitor. A COVID-19 diagnosis may result in treatment setbacks of these members’ substance use disorders, leading to hospitalizations. The CARES Act provides $425M for the Substance Abuse and Mental Health organization (SAMHSA) related to suicide prevention programs and other emergency grants for mental health and substance use disorders. Focusing on this high-risk population and following SAMHSA to coordinate efforts is vital. Lastly, encouraging initiatives to support these patients and the behavioral health workforce during this outbreak may need to be prioritised.

Data Analysis Suggests Two Weeks is a Critical Turning Point for Inpatient Admissions and ED Visits

Updated on March 30, 2020

AArete is monitoring the COVID-19 pandemic, paying close attention to the US health system’s readiness and care for patients. Our clinicians, public health experts and data scientists are working together to help organisations focus on providing the best possible care by advising on issues related to health system readiness and potential fallout related to costs.

We recommend paying close attention to the time falling two weeks after diagnosis of COVID-19. Our examination of influenza data suggests that two weeks is a critical turning point with a spike in inpatient admissions and ED visits. Common clinical trends related to acute respiratory failure with hypoxia, pneumonia, and even accidental poisonings may drive inpatient and ED costs post diagnosis. We recommend the US health system prepare for these high inpatient costs after COVID-19 diagnoses, both for COVID-19’s related respiratory conditions and for potential exacerbations of patients’ comorbid conditions.


We will continue to dive deeper into COVID-19 analytics as the pandemic progresses. Check back on this page regularly for new data-driven insights. If your organisation is impacted as a result of COVID-19, we want to hear from you. Email info@aarete.com, navigate to our Get In Touch page, or reach out to one of our leaders to discuss your challenges with our team. For more content, browse our library of COVID-19 articles below.

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