90: Percent of home health agencies reporting that their clients are canceling one or more visits because they are fearful of contracting COVID-19 or potentially bringing the virus into their homes, according to a Home Care Association of America survey. Many are delaying necessary medical care and even avoiding the ER for a day or two after a stroke or heart attack due to virus fear, which could lead to clinical deterioration and complications. One large home health and hospice company that usually provides care to 35,000 patients experienced 8,000 visit cancellations in the span of one week.
Ortho At Home: Anthem launched Ortho@Home on May 14th, a teledentistry and at-home orthodontia program. The service integrates with orthodontic network provider options and includes possible discounts of up to $200 off retail prices. Consumers with orthodontic benefits will have access to at-home clear aligner therapy, remote oversight of care, teeth whitening, and retainers at completion of treatment, with an average cost up to 60% less than traditional orthodontia. A spokesperson for Empire BCBS, an Anthem plan in New York, said the model makes access “more convenient while meeting demand for remote services.” A question to think through is around the longer-term implications on some aspects of clinic-based dentistry.
10,000 Maniacs: Over 10,000 specialists in BCBS of Michigan’s Physician Group Incentive Program started receiving at least one type of value-based payment this spring, in a program that will run through February 2021. Three forms of value-based reimbursement options are available for specialists, one focused on serving specific populations, one designed more around collaborative quality and a third, in pilot form, based on team model. Two more models will be added next year. Regence Blue in the Pacific Northwest, a pioneer of these designs, says at least 40% of its health plan member claims flow through 120 value-based arrangements with provider partners. Dr. Cheryl Pegus, Regence’s president of consumer health solutions and chief medical officer, remarks they are “continuing to prioritize collaborative arrangements with providers who embrace data-driven approaches to improving the quality, safety, and affordability of patient care.”
Part B Shakeup: Doctor on Demand is the first telehealth vendor to expand services to Medicare Part B beneficiaries, which total around 33M. Before the pandemic, telehealth use in Part B was heavily restricted to specific locations and circumstances, curtailing adoption of virtual care. This changed in March, when CMS declared Medicare would reimburse telehealth visits at parity and expanded telehealth availability to beneficiaries. Though it's the first big telemedicine player to move into Part B, it's unlikely to be the last, with provider MDLIVE also expressing interest in the space.
Raising Arizona: Blue Cross Blue Shield of Arizona announced they are acquiring Stealth Health Choice Arizona in an effort to provide health coverage and related services to Arizonans eligible for Medicaid and those who are dual-eligible for Medicare and Medicaid, which will include the Arizona Health Care Cost Containment System (AHCCCS) and the Generations Medicare Health Plan.
Center for COVID-19: Mounting evidence shows that the COVID-19 virus extends beyond respiratory symptoms to include multiple systemic complications that impact the brain, heart, kidneys, and other regions of the body. Mount Sinai Health System is launching a Center for Post COVID Care to offer additional support for patients who have been diagnosed with the disease, as well as to gather data from those patients as they transition from hospital to home. The center will provide comprehensive multispecialty care and systematic evaluation of the long-term impact of COVID-19.
On a Fortnite: Kaiser Permanente is partnering with professional e-sports organization Cloud9 to launch Presence of Mind, an educational initiative for the online gaming community. Content will be on Twitch, a global video gaming platform known for the Fortnite phenomenon. Cloud9 players and staff will get mental health training with the idea of encouraging teens and young adults to prioritize their well-being.
Extra Point: My kids complain a lot about how I go down the ‘when I grew up’ road way too often. It’s just so easy sometimes. Helps me make a point, like my latest rant: When I grew up, we ate supper together on Sundays. At 2 o’clock. Not because we were hungry, or it was raining, but because grandma said so. Afterwards, we played kickball ‘til dark. We didn’t have hover boards or Fortnite or Twittergrams or Snapbook. When we fell on the driveway during a game of ‘Red Rover’, mom didn’t rush us to urgent care. There was no urgent care. She layered on three Band Aides and gave you a slice of warmed up apple pie. We didn’t have depression—at least not in the way it’s understood today. Yes, we were sad when the Yankees and Sox were in a rain delay, but dad cheered us up by putting the Polka on the record player and throwing us on his shoulders. We danced. We had a simple life with at most three principles, and I’m pretty sure two of them had something to do with mashed potatoes. We didn’t text or Jabber or FaceTime, we stood by an answering machine hooked up to the rotary dial, replaying Sam’s message because you couldn’t hear the phone number the first dozen times. ‘Download’ was not a word. To hear Survivor’s You Can’t Hold Back, we had to rewind Side B for six seconds, then flip the cassette at least a half dozen times to get to Side A to just the right time. When we were bored, we picked up a shovel and dug a hole, found some worms and put them under my sister’s pillow. Our friends were mostly the seven people we shared the upstairs bathroom with. The same seven we fought with for the Raisin Bran. We wrestled with grandma, played ‘setback’ with papa, and listened to Joe Castiglione call the game on the AM dial. On a good day, I would hold the bunny ears on the RCA, so we could watch the game on TV. What strikes me about then is how strikingly familiar it is to now. Last weekend, I asked Tommy to lean the phone against the wheelbarrow when we weeded the driveway. We listened to a replay of the inning Fisk hit that homerun. We ate spaghetti around two and then played Twister, until the dog peed on the green circle. What’s past is prologue. I would argue that, for some of us lucky enough to be safe and healthy, we aren’t standing still at all as it may seem. We are going back, and there’s some good to come from that...