68: Percent of older adults exactly one year ago who said the quality of care during a telehealth encounter would not be as good as a face-to-face visit, according to a University of Michigan poll on aging, with half saying they did not feel personally connected to the healthcare professional and four in ten reporting difficultly seeing or hearing. The poll asked a national sample of 2,200 adults, ages 50 to 80, about their ‘tele’ experience and, welp, things sure have changed. By May, according to our own poll of 1,362 adult parents aged 35-55, 51% preferred virtual over in-person as compared to urgent care, although when we peeled back the answers, it was clear telehealth had its limitations too. Just 34% liked it for discussing pain symptoms in May, compared to 42% in April. Many said they found the diagnostic capabilities of the NP or physician limited over the virtual platform. 77% of moms said they prefer in-office for themselves, but a slim majority would likely make more use of virtual for their younger kids—better “than toting around my kids.” The question for the payment system is how to adjust to the new telehealth boom, value it, and pay for it, and if recent reports from our interviews with health plans are any indication, how to monitor for abuse too. “We’ve had a decent wave of companies billing so much telehealth it adds up to more than what would be possible in a day—a good amount of abuse of the system,” a source said. These developments don’t mean reimbursement reductions per se but likely mean a re-adjustment on how to ensure appropriate payment.
Eye of the Tiger: Eye care practices around the country are seeing an increase in the number of LASIK procedures over the past few months. Several surgeons in major cities like Los Angeles report a 30% increase, mostly driven by younger adults. Some health analysts think this is because people are spending less money on travel and entertainment, and possibly because people can recover at home while continuing to work.
Injectable Target: Look out for pre-payment reviews and post-payment auditing of medical injectable drug dosage and prescribing, as nearly half of payers in 2021 will use third party help to dig into claims for injectable drugs administered in the office setting. These companies will hone in on how many units are administered for the patient as well as average wholesale price information to ensure that claims are coded appropriately.
Social Seinfeld: The comedian used to say he liked soup so much because he was a lazy eater. Soup kitchens used to be the old model of helping the underserved, a kind of symbol of how those more fortunate could assist the poor, homeless, or hungry. But the science and data around social services, including the benefits of a single bowl of hot soup, are changing behavior. Now, more insurers than we predicted six years ago are hiring social workers and an increasing number are designing social service networks to help improve a person’s physical and mental health. A Michigan insurer will reportedly be the first in the Wolverine state to offer financial incentives to providers who screen patients and submit information on social determinants of health. Beginning in January, providers who are recognized as a Patient-Centered Medical Home can use an approved tool to screen patients and complete the SDOH survey to receive increased reimbursement. Click here for a story on another leading insurer’s policy.
Extra Point: Tommy was pulling in a solid C- in social studies last month, which was both disappointing and perplexing. I mean, some subjects like English can be difficult because of all that tension between the past, present, and future, and all those double-meaning words like ‘lie’ and ‘lead’. But social studies? It’s not about what will be but what already was. Easy peasy. After a few civics lessons over undercooked flapjacks at supper, I got Tommy to understand culture, poverty, checks, balances, and how a bill becomes a law. By last week, he had pulled his grade up to an A, although a not-so-solid 68% on a recent quiz probably will hurt. “I didn’t know the test would be today Dad!” That’s called a pop-quiz kiddo. Get used to it. The A is a popular letter in the history of healthcare. There was the BBA, the MMA, the ACA, the AIDS epidemic, and more recently a wave of conditions like autism and addiction—and now anxiety. The CDC lists about 41 conditions and diseases starting with the letter A, though it understandably doesn’t feature all, including only those that have critical or broad relevance to public health. For instance, I couldn’t find apathy, which I would like to lobby to be added to the list. At a minimum, it seems to be a re-occurring condition in both our boys and as COVID continues on, may become a bigger problem than we want to admit.