29: Percent of primary care practices “hiring” mental health staff in 2021 according to our poll of 567 PCPs, pediatricians, internists and specialty doctors who manage conditions in which depression and anxiety are common, like asthma, crohn’s, cancer, pregnancy and rheumatoid arthritis.
Landing Home: Landmark Health, which focuses on in-home medical care to frail populations, formed a value-based care partnership with Southwestern Health Resources, a clinically integrated network. Through this partnership, the pair will offer multidisciplinary medical care at patients’ homes for approximately 10,000 patients who on average, have between 6-8 chronic conditions. High-risk patients will be assigned a physician or nurse practitioner. Depending on patients’ health needs, they may also be assigned a psychiatrist, social worker, pharmacist or dietician. Patient care will not rely on remote patient monitoring, but instead on in-home medical visits.
Medical Nutrition Scope: Horizon BCBS in New Jersey is implementing a new reimbursement policy for Medical Nutrition Therapy. As of April 15, 2021, these nutrition services will only be considered for reimbursement if billed by a registered dietician, nutritional professional, or a hospital that has received assignment from a registered dietician or nutritionist.
Kidney Disease Shift: Monogram Health is now providing kidney disease care coordination services for Humana members in Alabama, Tennessee, Louisiana and Mississippi. The program offers medication, treatment compliance and monitoring of comorbidities to ensure early detection of chronic kidney disease and end stage renal disease. BCBS of Texas is another insurer creating per member per month payment options for care management companies able to do CKD prevention.
Out of State Protection: BCBS of Nebraska is making a change to help patients who go out of state for care. Starting in mid-April, if a preauthorization is required but not obtained for an out-of-state member, providers will be held responsible for the denied charges. Prior to this change, the member was held responsible. This change means that providers cannot hold out-of-state members responsible for charges that are denied when preauthorization is not obtained.
Pilot For COVID: WellCare is piloting a national at-home COVID-19 testing and flu prevention program for Medicare Advantage members who are symptomatic or have been exposed to the virus. All test collection kits are being offered as a one-time benefit to select, eligible MA members. Each kit includes a PCR test, 20 disposable face masks, hand sanitizer, and an oral digital thermometer to help prevent spread and exposure.
Cigna Behavior Change: A mental health outpatient program called Catasys OnTrak was not reimbursed by Cigna in 2020 but will be for Medicare HMO members with a diagnosis of anxiety, depression or substance use disorder this year.
Extra Point: Please pray for my daughter today. The 19-year-old has an open-book, 48-hour-to-complete, all-multiple-choice anatomy exam this afternoon. The physical therapy major needs a good grade to stay above a 3.0 in her sophomore year and on pace in the rigorous 5-year college program. Back in our day we had 30 minutes and unless we were Lenny Duppee and wrote the chemistry answers in blue ink on our left hand, we had to just know it cold. “But I’m really nervous – I never know if it’s a, b, c or d.” Um, that’s sort of the point kiddo. Maybe pray for my son instead? By tomorrow Jack will know if his dream college picked him, a long shot given his grades and SATs are below the typical accepted and he’s competing against kids who got deferred by Harvard. Probably best to pray for people like 77-year-old Charlotte Stamos. Charlotte came to our house 5 times yesterday to ask when her vaccine appointment was. She was a hospital and nursing home social worker for 34 years and told us yesterday that the independent living facility denied her application because she failed her memory and psych evaluation. Charlotte is in many ways the picture of aging in America – a widower battling a lonely home, a bad hip and a brain that can remember the name of her first-grade teacher, but not that she had her vaccine on Wednesday.