2021: Cigna will offer telehealth services to all Medicare Advantage members next year, including virtual visits with behavioral health providers at no cost. They will also offer a $0 premium plan next year.
Biosimilar or Different?: Regence Blue Cross in the northwest is implementing a new step therapy program for medications covered under Medicare Part B in 2021, like biosimilar Zirabev. What’s interesting is that Pfizer launched it earlier this year at a wholesale acquisition cost of around $60 for every 10 mg, which is nearly 25% less than its reference product Avastin, a Pfizer spokesman confirmed. The biosimilar is for colorectal cancer, non-small cell lung cancer, and metastatic cervical cancer, among other conditions. Regence will also promote Pfizer’s Ruxience for Hepatitis B, leukemia, and lymphoma. The kicker? They are allowing a 100-day medication supply for their Medicare Advantage members who previously received a 90-day supply. The 10 extra days are free. These trends of incenting patients to use biosimilars are increasing nationally, and not just to benefit patients but physicians too, as more payers are sticking pre-authorizations on the branded drugs and offering doctors incentives to use the biosimilars.
Blue Devil Dermatology: Scans of photographs of dermatology patients’ skin let clinicians more rapidly slot them into appropriate treatment pathways for faster care under a new algorithm built by a team of Duke sociologists and anthropologists. Duke’s time-saving tools include an algorithm that spots urgent heart problems in patients.
Concierge Is Back: United is launching a new concierge-style health plan that will offer members access to free urgent and primary care services. Through a partnership with Canopy Health, United’s California Doctors Plan, members will also have access to 24/7 telehealth services. The companies estimate that members will save up to 25% compared to other health plan premiums.
Tale of the Tape: Athletic trainers will have the opportunity to participate in Blue Cross Blue Shield of Michigan’s commercial networks starting in 2021, reimbursed at 85% of the fee schedule within the scope of their license, minus any member deductibles and copayments.
Extra Point: Dad would get a kick out of the Tale of the Tape this week. 39 years ago, Phil Collins’s people were on the rotary phone with him to help the Genesis pop legend tape the ankle he rolled in time for his show one cold October night at the Hartford Civic Center Mall. Dad, who was athletic trainer and tennis coach at the University of Hartford for nearly four decades, treated Phil like any student-athlete. My sister came along for backstage ankle taping – Collins offering dad a pair of front row seats to hear him belt out his “Can you feel it in the air tonight” number, his #1 hit back in 1981. I wanted to go desperately, but Dad picked my sister and, while I was bummed at the time (okay, I was mad), I get it now. Flash forward to one year ago this month at Madison Square Garden in New York – Collins, now in his 70s, hobbled on stage with a wobbly cane and a broken foot and admitted to the sold out crowd he probably wasn’t going to be skipping around stage or beating those drums, that his ‘messed up’ foot, bad back, and a number of other health issues would keep him stationary, but, against all odds, he was going to sing a few songs…His teenage son played drums and my bride and I, neither having ever seen Phil in concert, sang “Follow You Follow Me” like we were still 10 years old next to the scratchy record player in our parents’ living rooms. It is remarkable how pain, injury, and surgery don’t have to mean you stop. You just have to adjust. I think back to that night when the phone rang and how my mom dropped the receiver on dad’s foot and nearly choked my sister with the phone coil as she frantically stretched the phone over to dad’s ear…. I think back to how dad showed me the next morning how he taped Phil’s ankle like an artist in his own right, and I wonder if the pop star would remember that moment. If he’d remember dad. The athletic trainer.