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  • 14 Feb 2024 11:56 AM | Addie Thompson (Administrator)

    Neel Ghoshal was 13 years old when his life changed. 

    Born in 1978 to Sam and Pritha Ghoshal, who immigrated from India eight years prior in pursuit of the American dream, Neel grew up in the Northeast.

    There were moments of struggle but life was good in the New York City area, where his father worked at the World Trade Center. 

    In November 1991, Ghoshal’s mother went back to India to visit her father. She never made it home. 

    His mother had been managing a kidney issue, Ghoshal said, but a disconnect between doctors and a lack of access to health care led to a misdiagnosis. For reasons unbeknownst to him, the family and doctors in India did not contact medical professionals back in the United States. She died a few weeks later in 1992. 

    Ghoshal recalls feeling angry at the systems that were designed to protect people like his mother. 

    “There was no reason she had to pass,” he said. “She did because of this lack of access.” 

    Though he has worked in multiple industries during his professional career, Ghoshal’s desire to help fill the gaps in the health care system has always stuck with him. That, plus a family connection to the hospitality industry, is driving his new business venture, Healthpitality

    The memory of his mother is directly tied to the “why” behind Healthpitality, Ghoshal said. Many U.S. citizens, including the majority of hospitality workers, struggle to access affordable health care. For those who do have traditional health care, long wait times and pricey copays can make it hard to see a primary care physician regularly. 

    Set to launch in January, Healthpitality is being marketed as a membership-based alternative to traditional health insurance. It will rely heavily on telehealth services to treat the many hospitality employees — more than 50 percent nationally — who do not receive health insurance from the restaurant or hotel that employs them. At Healthpitality, Ghoshal wants to create an environment where members of the hospitality industry “are partners in their care and are treated with the same VIP treatment that they provide for their guests night after night.” 

    Hospitality industry workers can become Healthpitality members individually, but Ghoshal envisions restaurants making this membership an employee benefit. The monthly subscription will cost employers $38 to $55 dollars per month per employee, plus a $250 onboarding fee, and includes unlimited telehealth visits. 

    Restaurants will be billed monthly per employee, meaning restaurants will not be left with footing the bill of someone who leaves the staff, Ghoshal said. On the flip side, workers will not be dropped when they switch jobs. 

    Subscriptions for individual employees purchasing their own Healthpitality package are $65 per month. Hospitality workers who want to sign up individually will be asked to provide proof of employment, such as a recent paycheck. 

    ‘Telehealth first’ 

    Ghoshal, who moved to Charleston in 2018, describes Healthpitality as a “virtual-first” health care provider. His experience with telehealth includes working as a consultant for Doxy.me, a telemedicine business that got its start as a tool for health care providers to bring prenatal care to women who normally would have to travel long distances for well-checks and weigh-ins. 

    Though he understands the benefits of telehealth, Ghoshal also recognizes that it cannot cover every health care need. It simply is not possible to do every type of visit remotely, meaning Healthpitality members will still have to schedule appointments for imaging tests, blood work and other visits that require in-person interaction. 

    In-person visits, recommended by the doctors and nurse practitioners employed by Healthpitality, will incur an out-of-pocket expense for either the restaurant or the employee. 

    “Our providers are adept at leveraging telehealth’s best practices to serve our members. However, when necessary, they are also skilled at identifying situations where in-person care is essential, and will accordingly refer members to external providers,” Ghoshal said.

    Telemedicine has been more widely adopted since the pandemic, said Medical University of South Carolina Director of Primary Care Telemedicine Dr. Marty Player. It has been especially effective in treating mental health disorders, Player said. 

    Telemedicine’s limitations include the inability to conduct testing and exams that must be done in person. South Carolina law also prohibits doctors from prescribing certain “controlled” medications without establishing care with a patient in person. 

    Early research prior to the pandemic suggested that telemedicine provided more access to people who already had access to health care, Player said. Developments in the field suggest that, moving forward, telemedicine could increase access for more vulnerable populations, he said. 

    “Access to primary care is still limited in this country in general,” Player said. “I think there’s a benefit to having the telehealth option.” 

    Healthpitality currently has six employees and plans to have three doctors and six to nine nurse practitioners by its January launch in South Carolina and Florida. The primary focus at the onset will be on acute care. As Healthpitality sees a growth in demand, the plan is to broaden services to encompass primary care and preventive medicine, said Ghoshal, whose brother is a certified master chef, a designation given by the American Culinary Federation. 

    The eventual goal is to create a “comprehensive health and wellness ecosystem” where members can manage most of their health needs. They will do so by working with Healthpitality’s concierge team, who will be trained to understand the realities of working in the restaurant industry. 

    “Their deep understanding of the unique challenges faced by those in hospitality ensures that every interaction is not only helpful, but also empathetic and tailored,” Ghoshal said. 

    Ambitious future goals include the creation of “healthpitals,” units that would bring health care services directly to members for seasonal needs like flu shots and physical exams. The overarching goal, Ghoshal said, is to make health care accessible and convenient for all Healthpitality members. 

    For more information, visit healthpitality.life



  • 14 Feb 2024 11:55 AM | Addie Thompson (Administrator)

    We have another Freedom Agenda healthcare win to report! Healthcare in South Carolina just got a little freer and more accessible for South Carolinians on January 31 with the passage of H. 4159, the Telehealth and Telemedicine Modernization Act!

    The bill was first filed last year and passed by the House in May 2023. At the beginning of the 2024 legislative session, the Senate fast-tracked the bill unanimously with an expansive amendment, and on January 31,  the House concurred with the amendment, officially sending the Telehealth and Telemedicine Modernization Act to the Governor’s desk! We urge Governor McMaster to sign this outstanding legislation as soon as possible.

    Palmetto Promise has supported the expansion of telemedicine for years. In fact, it was item #9 in our 2023 Palmetto Freedom Agenda. Telehealth allows patients to access medical care more efficiently, flexibly, and cost-effectively than going in-person for every appointment, and we fully support the reduction of regulations that allow consumers the ability to choose the best care for them. This is particularly beneficial for rural South Carolinians, where in-person medical providers are fewer and further between.

    Back in 2022, PPI Senior Fellow Dr. Oran Smith testified in support of S. 1179, which allowed social workers, professional counselors, and other mental health professionals to practice via telehealth. The bill was ultimately passed in both chambers and signed into law in May 2022. According to the South Carolina Telehealth Alliance, South Carolina’s telehealth scene has grown rapidly, with over 1.2 million telehealth interactions between patients and medical professionals in the year 2022. A few months ago, we discussed the next steps for telehealth and other essential healthcare reforms in our Beyond Policy podcast here.

    Now this session, we are pleased to see the General Assembly take that next step with the passage of H. 4159!

    Representative Sylleste Davis, chair of the House’s Medical Committee, put it best in her post on X (formerly known as Twitter):

    The repeal of Certificate of Need laws in South Carolina opened the door to greater advancements in healthcare freedom and a medical system that is free of burdensome, costly regulations. Now, that momentum continues with telehealth expansion, another Freedom Agenda win that every South Carolinian should celebrate.


  • 14 Feb 2024 11:48 AM | Addie Thompson (Administrator)

    The COVID-19 pandemic created a sudden need for virtual health care for patients and prompted regulators to drop stricter regulation of what could be provided.

    Now, four years later, giant retailers are offering consumers direct access to services while traditional providers adapt and partner to meet patient needs, particularly for rural patients like many across South Carolina.

    The future of health care for many patients and providers could be a mix of both virtual and face-to-face care, experts said.

    Telemedicine, providing an exam via an interactive video system, has been around for decades, but it was limited by acceptance, traditional regulation and reimbursement to limited uses, such as in a stroke. Hooking up a rural emergency room that lacked specialists to a larger medical center meant patients with a suspected stroke could be evaluated remotely, and after a neurologist read a CT scan of their brains, offered clot-busting drugs that improved outcomes and survival.

    Stroke was one of the first ways the technology showed it was better than the traditional approach, said Brandon Welch, CEO of telemedicine company Doxy.me and author of “Telehealth Success: How to Thrive in the New Age of Remote Care.

    “Telemedicine really proved itself in the stroke use case because it was a very clear path to success,” he said. But outside of that, and some limited use in psychiatry, the industry “was kind of treading water,” Welch said.


    That is until COVID-19 hit in early 2020. Suddenly, hospitals and clinics were limiting who could be seen, while many patients feared leaving the safety of their homes, even when sick. Federal regulators like the Centers for Medicare and Medicaid Services quickly loosened the reins on what care could be provided virtually and also reimbursed, and many others followed suit.

    Those flexibilities were meant to be temporary, and technically still are, with the latest expiration on Dec. 31. But most believe they will be made permanent soon. Congress has been trying in various bills, and the South Carolina Legislature recently passed new regulations codifying remote care standards.

    The changes are here to stay, Welch said.

    “They’ve been threatening to end it for the last four years, and every time the time comes, they extend it for another year or two,” he said. Members of Congress don’t agree on much, but “what they can agree on is telemedicine should be here to stay,” Welch said.

    Big companies already believe that. Amazon purchased virtual-care provider One Medical; Costco members in South Carolina can use its provider, Sesame; and other big retailers have followed suit or soon will.

    That kind of access is what many patients want, said Kaitlyn Torrence, executive director of MUSC Health Solutions. She gets it — she uses One Medical herself at times.

    “I demand access. I want it quickly,” Torrence said. “And yet, I still want that continuum of care when I need to go to a higher level (of treatment).”

    It poses a dilemma for MUSC Health and other providers in South Carolina and across the country: How do you compete with that? Or do you even try?

    It’s something MUSC Health is thinking a lot about, whether to continue building its own or partner with a provider like One Medical to provide care that it can’t, Torrence said. For instance, one of those quick-access providers might be the first to see a patient, but MUSC Health becomes the provider for more acute care or for patient management.

    One Medical is already a provider for 8,500 employers and partners with 18 health systems across the country, the American Hospital Association noted.

    Read more here.


  • 16 Jan 2024 3:43 PM | Addie Thompson (Administrator)



    Steve Boucher, the Director of Managed Care Services for the SC Alliance of Health Plans, presented to the Genentech Carolinas Field Reimbursement Team on January 9, 2024. The presentation was designed to elevate the group's fundamental knowledge and included an overview of Medicaid and Medicare, the status of the Medicaid members redetermination project, and an overview of emerging projects and trends  within the Medicaid program.

    The presentation provided insights to the Genentech field reimbursement leaders that attended both in-person and virtually that will enable Genentech to continue their mission to "do now what patients need next.


  • 20 Jul 2023 9:20 AM | Addie Thompson (Administrator)

    On Sunday, July 9, SCAHP hosted a reception for SC Legislators in Charleston at the Dewberry, during the 2023 SLC Conference. 

    Below are some photos from the event. 

    Jim Ritchie pictured with Senator Alexander.



  • 6 Jun 2023 11:19 AM | Anonymous

    Jakob Emerson - Friday, May 26th, 2023

    Eight states have at least 1 million residents enrolled in Medicare Advantage plans, according to a health coverage report published by insurance trade group AHIP in April.

    States ranked by total Medicare Advantage members:

    1. California: 3.1 million
    2. Florida: 2.6 million
    3. Texas: 2.2 million
    4. New York: 1.8 million
    5. Pennsylvania: 1.4 million
    6. Michigan: 1.2 million
    7. Ohio: 1.2 million
    8. North Carolina: 1 million
    9. Georgia: 947,000
    10. Illinois: 794,000
    11. Tennessee: 696,000
    12. Arizona: 682,500
    13. New Jersey: 634,000
    14. Washington: 627,000
    15. Wisconsin: 619,100
    16. Missouri: 619,000
    17. Alabama: 595,000
    18. Indiana: 584,000
    19. Minnesota: 551,000
    20. Virginia: 541,000
    21. Colorado: 479,000
    22. Oregon: 474,000
    23. Kentucky: 466,200
    24. Louisiana: 466,000
    25. South Carolina: 465,000
    26. Massachusetts: 406,000
    27. Connecticut: 377,000
    28. Oklahoma: 273,000
    29. Nevada: 271,000
    30. Arkansas: 250,000
    31. Mississippi: 222,000
    32. Maryland: 211,000
    33. New Mexico: 207,000
    34. Utah: 206,000
    35. Iowa: 197,000
    36. West Virginia: 194,000
    37. Maine: 193,000
    38. Idaho: 164,000
    39. Kansas: 163,000
    40. Hawaii: 154,000
    41. Rhode Island: 116,000
    42. Nebraska: 98,000
    43. New Hampshire: 97,000
    44. Montana: 64,000
    45. Delaware: 63,000
    46. Vermont: 44,000
    47. Washington, D.C.: 27,000
    48. South Dakota: 24,000
    49. North Dakota: 14,000
    50. Wyoming: 9,000
    51. Alaska: 2,000
  • 6 Jun 2023 11:18 AM | Anonymous

    What do the early data show?

    As states begin to unwind the COVID emergency continuous enrollment provision and resume Medicaid disenrollments, early data from a handful of states – highlighted on KFF’s regularly-updated Medicaid Enrollment and Unwinding Tracker

    – reveal wide variation in disenrollment rates. While not all states that have resumed disenrollments have publicly posted their numbers, data from 12 states show that over half a million enrollees have already been disenrolled, nearly 250,000 in Florida alone (Figure 1). In nine states that reported both total completed renewals and total disenrollments, the disenrollment rate ranges from 54% in Florida to just 10% Virginia. Among these states, the median disenrollment rate is 34.5%.

    Click here to continue reading.

  • 6 Jun 2023 11:17 AM | Anonymous

    States must take better care not to expel eligible Medicaid enrollees from the program during the re-determinations process, a senior Centers for Medicare and Medicaid Services official said Tuesday.

    Click to continue reading.

  • 6 Jun 2023 11:14 AM | Anonymous

    Scores of Medicaid recipients will begin to lose their insurance next week as states continue to review whether residents still qualify.

    The South Carolina Department of Health and Human Services anticipates close to 250-300,000 members will be dis-enrolled by 2024. That will roll back enrollment numbers from 1.3 million to pre-pandemic levels at just over 1 million.

    KFF, a non-partisan health research organization, estimated close to 214,300 Medicaid losses, including over 86,000 children.

    Click here to continue reading.

  • 10 May 2023 9:42 AM | Anonymous

    Steve Boucher, Director of Managed Care Services for the South Carolina Alliance of Health Plans presented both in-person and virtual overviews of the Medicaid Annual Review process to hundreds of health insurance professionals. These presentations leveraged Steve’s extensive knowledge of the Medicaid Annual Review process as well as his understanding of the health insurance industry and identified him as a key leadership resource in the Medicaid sector.  The presentations provided the health insurance professionals with trusted information that will enable strategic decisions within their organizations.


           

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