1. 64: That’s the percentage of Americans who reported they would attend an appointment via video telehealth, according to an American Well Telehealth study. The Council of Accountable Physician Practices and the Electronic Data Interchange released new documents designed to help healthcare providers in developing and launching telelhealth and telemedicine services. These documents, called “A Roadmap to Telehealth Adoption: From Vision to Business Model,” contain information designed to help identify resources of federal and state regulations as well as policies, pilot programs and use cases. These documents will be updated twice a year.
2. Social SoundBite: ‘So we have this accountable care budget model for health systems and some large groups here. It’s evolved over the years…And I finally realized we had it all wrong. We had been so focused on individual patients and making sure they got in to see the doctor, and took their meds on time that we missed everything around them….we need to start treating and managing the places these people live as the patients. Their homes, their communities – if unhealthy, if community centers are old, if homes are unsafe or unaffordable, they can set off a spiral of costs for more than just one woman or man, but an entire community, their kids and their neighbors.’ -- Paulette Storm, a case worker for the Mercy health system in Springfield, who has worked for Health New England, an insurer, and is working on a task force to spur payer and health system investment in housing and urban development. The main driver: value based models whereby the system has to stay under budget for a population in their community. How your practices can support these new payer and system-led urban communities may be a key question for you in 2019.
3. Medical Student Steering: BlueCross BlueShield of Alabama is expanding its initiative to improve access to primary care and behavioral health through a $3.6 million scholarship fund to the School of Medicine at the University of Alabama at Birmingham (UAB). Med students qualify if agreeing to practice as a primary care or behavioral health physician in an underserved area.
4. 20-20 Vision: Cited by more than 60% of three-hundred 20-30 year olds in our consumer poll as one of their only true health concerns. ‘I don’t smoke, I run a lot and I work about 25 hours a week outside – I’m not sure I have to worry about the same health risks my parents and grandparents have to….but I do wonder about my eyesight. I mean, all I do is look at a screen…’
5. 2019 Diagnosis: United Healthcare will expand its national network of labs in 2019, adding Quest to its list and cementing its relationships with LabCorp. These partnerships will include a number of value based components such as real-time data sharing.
6. Extra Point: Taking a page from pharma formularies, more than three quarters of health plans in our poll anticipate using some kind of tiered network for specialty physicians and facilities in the future, many already with ‘tiering’ models, and to see consumer reaction, click here). The trend, says network manager Paul Willis, is akin to the oft times harsh realities of youth sports where kids are observed, ranked and grouped by ‘value’ to the program. Unqualified former athletes turned couch potatoes carry clipboard, scoring kids with archaic methods, 1=Good, 2=Average, 3=Poor. ‘It’s not much different if you think about – we will steer schools, colleges, our own families to the kids who are in the A grouping – choose them, because they are the best; watch them, because they are just better,’ Willis says. Heck I told my own dad to skip Tommy’s game and go watch Sophie because, well, the game would be better. Last fall, I watched my own kids be put on the so-called B and C teams – they weren’t as good at soccer, Jackie admittedly runs like he has a piano on his back, and Mukue seems to kick the ball backwards at times, including in a game last year when she rolled one back into her own net. Good kids, but some of their in-game decisions cost the team goals. It’s life and makes for a good laugh at supper but reality is they were on the 2nd tier. Physicians, hospitals and other providers are facing a similar threat – or opportunity – and if you think it’s not coming, you’re already missing the point. It’s here. Question is how these initiatives change our behavior – both as clinicians and practice managers, and as patients. Click here for our short primer on some of the tiered network models—their objectives and scoring methods.