All through the COVID-19 pandemic, InnovaCare Well being, which operates Medicare Benefit and Medicaid plans in Puerto Rico—in addition to in Florida—has been working intently with suppliers and authorities leaders to deal with the virus’ unfold, together with doing residence supply of every part from medicines to meals for its members within the territory. CEO Dr. Richard Shinto spoke with Fashionable Healthcare Managing Editor Matthew Weinstock. The next is an edited transcript.
MH: What’s the state of play in Puerto Rico proper now?
Shinto: I believe the federal government did an excellent job through the first few months of the pandemic. They closed down the island. No ships had been allowed to come back in. Tourism was stopped. The rationale they did that was they don’t have a deep sufficient healthcare system to have ventilators and all the required means to guard all of the residents of the island.
So the governor mandated across-the-board curfews and shut every part down. They did an excellent job of actually suppressing the an infection.
Our numbers are very low. I believe perhaps we broke near 400 deaths whole. There’s perhaps 24,000 constructive circumstances proper now. The final numbers I noticed, (there have been) about 400 individuals within the hospital. Actually, that’s extra of a (latest) surge. It was even decrease than that, however when every part began to open up, particularly bars, unexpectedly there was one other surge.
At the moment, the stay-at-home coverage is a curfew from 10 at evening till 5 within the morning. No alcohol (bought) after 7 p.m. On Sundays, all people has to remain indoors except it’s only for grocery procuring or going to the pharmacy. Once more, the federal government is placing a variety of stress on all people and the distinction between Puerto Rico and a variety of different locations (within the U.S.), they really do implement it and so they really do tremendous you. The fines will be as much as $500 if you happen to’re not sporting a masks and also you wander across the streets in Puerto Rico.
MH: Are you able to discuss your expertise working with the federal government in Puerto Rico versus in Florida?
Shinto: One of many issues Puerto Rico has achieved an excellent job of is creating alignment. There’s alignment between the well being plans, the suppliers, the hospitals and the federal government. So once we go to D.C. or we converse on behalf of the island, it’s normally one voice.
MH: Working with suppliers, you superior funds to docs and hospitals within the early phases of the pandemic. That’s persevering with, proper?
Shinto: Sure. So far we’ve paid out someplace over $160 million of advance funds to suppliers, each hospitals and physicians. A lot of our specialists are on fee-for-service, so we did fast calculations on what our common pay to them was. From that, we had been capable of advance pay them.
It’s fascinating about disasters and the variety of them that hit the island. We discovered this after Hurricane Maria—the physicians wanted the revenue and so they’re not going to have the ability to submit encounter information.
On the pandemic, we advance paid the docs earlier than we shut down the workplaces. We knew they wanted revenue so they may proceed to handle the beneficiaries and members.
MH: Are you able to speak concerning the work you’re doing with at-home supply of medicines and over-the-counter provides?
Shinto: As you apply within the States, you concentrate on mail order and you concentrate on chain pharmacies. That doesn’t actually work right here. So over time, we received into residence supply. We do residence supply for nearly every part—your pharmacy, all of your over-the-counter (provides). Even previous to the pandemic, we had been already beginning residence supply of meals.
Puerto Rico is a superb testing floor. When individuals began to get all their drugs, all their (private protecting tools)—in the event that they needed masks or they wanted antiseptics for his or her palms—they only (place an order) on the web site and it will get delivered inside 48 hours. Then we began delivering meals after which individuals didn’t need it pre-cooked. They needed to make their very own. Then we began providing groceries, so you’ll be able to go onto our websites and get no matter you want.
We’ve constructed it into our profit design in order that members can get an iPhone, as a result of then the app is already loaded—permitting them to order all their over-the-counter (provides) or if it’s linked into the pharmacy, they will get residence supply there as properly. We imagine the way forward for healthcare must be in that house of supply.
MH: What challenges have you ever had, if any, increase a provide chain?
Shinto: One factor we discovered after (pure) disasters is you’ve received to be forward of the availability chain. I keep in mind all of the water we had ordered after (Hurricane Maria) and the mills, however FEMA got here in and took management and it bothered us that we had an important provide chain. We had pre-ordered rather a lot, however then the (U.S.) authorities comes and takes over.
When COVID got here, we once more preplanned and we went to the availability chain. We had been capable of transfer three,500 workers out of the workplaces, into their properties, in lower than every week. We had a variety of provides like computer systems and modems for individuals who wanted it. We did an important job on pre-ordering PPE and COVID testing. However once more, the (U.S.) authorities got here in and confiscated every part. Then, we needed to wrestle to get the masks, or we needed to go to China. In order that created some issues. Even right now, due to the restricted quantity of reagent on the island, the Puerto Rican authorities has taken management of testing.
MH: So PPE was taken from the island and introduced again to the mainland?
Shinto: It wasn’t allowed to ship to the island. Even the COVID testing, which we had pre-bought. Being a doctor and fascinated with wanting forward … we would have liked to have, masks, robes and gloves. We went after these after which the testing and we had been capable of purchase a variety of testing, however then they might get stopped on the ports. The federal government would take over within the States after which redirect it someplace else.