4: Number of hospitals HCA is selling in Georgia to Piedmont Healthcare, the Atlanta-based clinically integrated network. The sale gives Piedmont 15 hospitals, reducing HCA’s footprint in the state to 5 hospitals. But HCA appears to be increasingly focusing on post-acute and home-based care, having acquired a majority stake in Brookdale Senior Living’s home health, hospice, and outpatient therapy business earlier in the year. Piedmont is also picking up 3 additional hospitals in the Augusta region through another deal, announced soon after the HCA news.
Where’s The Beef: Tyson Foods is opening the first of 7 Bright Blue health centers in Wilkesboro, North Carolina later this month, for employees and their dependents enrolled in a high deductible plan. The health centers will be operated by Marathon Health and will provide primary and preventive care, including behavioral health counseling. Don’t be surprised to see Tyson layer in a nutritional food delivery program that pushes things like grass fed beef.
Portable Contracts: In a poll of 52 health plan network contracting sources from a majority of the top 30 U.S. plans, our research team found that the likelihood of getting the same contract when acquiring a practice in a different city is difficult if the markets are unique but increases if the acquiring practice is in a value-based arrangement. Which specialists have more success transitioning contracts may surprise you. Stay tuned for the full report coming up.
Maternal Instincts: Anthem Nevada is partnering with the Reno Doula Project to launch a maternal health program that will make doula services available to its pregnant Medicaid members at no cost. The program was designed in response to Nevada’s poor health outcomes; the state ranks 46th for women’s and children’s health. Doulas provide education along with physical and emotional support during pregnancy and delivery and have been shown to improve birth outcomes.
Trust Your Heart: I play hoops with a couple cardiologists, both former D1 players who block my jumpers ala Bill Russell, which I’ll admit is reassuring when I start sweating before the first possession, and also good for post-game shop talk. On Sunday on the outdoor slab I found out one of them is interestingly going multi-specialty, his practice adding a nutritionist, an osteoporosis specialist and a behavioral therapist. Talk about all in the family. “You’d be surprised how these can all connect,” he said. My mom should be happy – at 77, her diet plans from her cardiologist and PCP had her eating different yogurts causing confusion and stress, so an integrated group should help limit the amount of times she calls me asking for medical advice. While up to 80% of cardiologists are hospital-owned, two thirds of the roughly 3,000 cardiology practices in the US have fewer than 5 physicians. These small practices, like my hoops squad, have an opportunity to really innovate, like if a patient needs a new PCI (an angioplasty with a stent) it’s important that cardiologists know the date of the earlier procedure, the stent type and size and vessel location, but most practices and hospitals don’t educate patients enough on the importance of knowing this information, or patients ignore doctor’s orders. If you’re looking at cardiology, don’t just consider the fragmentation – consider how to influence the behavior of heart patients, manage care with sub-specialists, and get paid for it.
Gut Check: This new field focuses on the relationship between mental health and diet and how eating certain foods can promote mental health, which I’ll admit seems obvious but historically nutrition has been focused on physical health. “There is a lot of research on the role of gut microbiota in health and disease,” says Paola Sandroni, a neuroscientist at the Mayo Clinic. “We know certain diets like the Mediterranean diet are better to prevent Alzheimer’s.” I am personally still waiting on what glazed donuts prevent. Read the full story here.
Not Your Father’s Health Plan: Harvard Pilgrim Health Care is the latest to create virtual health plans. Its SimplyVirtual and Virtual Choice, both in New Hampshire, offer virtual visits with PCPs and care team support through its existing partner, Doctor On Demand. Both virtual health plans will be available to large employers starting in September.
No More Blues: The Blue Cross and Blue Shield Association dropped a rule that limited the amount of revenue its 35 plans could generate from non-Blues business. Sources say this could lead to longer-term consolidation between the smaller plans and more partnerships and joint ventures among the larger plans.
Mass Time: Catholics are notoriously late for Mass, heck my dad would always say “it only really matters if we make it in time for last 20 minutes of Father’s homily to get credit”. Hospital systems in Massachusetts have been anything but late to healthcare reform. UMass Memorial Health will launch its own non-profit health insurance company, Central Mass Health, later this year. The health plan will provide care through managed care programs, HMOs and alternative healthcare delivery programs.
Home Base: Kaiser’s Built for Zero partnership aimed to end chronic homelessness has expanded to 30 communities and is showing promising results, reducing homelessness in 10 communities since launching in 2019. Use of data tools has helped track patterns of homelessness, which helps hospitals and local social services providers better target resources.
Extra Point: When I was pup reporter I used to write a day in the life column and 25 years ago this week I joined Lynn Vevier on a home visit to widower Elaine Bryne who at 75 had been in and out of the hospital more than a dozen times over a year. Lynn was moonlighting as a case manager for Aetna to play detective on so-called train-wreck cases. Elaine was sweet, offering me chocolate chip cookies and a cup of milk while we sat at her mahogany dining table scattered with index cards, Parade magazines, stacks of coins and an uncovered jar of Skippy. Lynn knew Elaine was taking 4 prescriptions for hypertension and other conditions and said “show me how you take your pills.” So Elaine grabbed the bottles, opened them up, dumped a few into the Skippy, mixed the spoon around and raised it to her mouth. “Hold the phone,” Lynn said peering into the jar. “Elaine dear, your spoon doesn’t have any of the pills, just peanut butter.” “But it’s crunchy so I figured I was getting the medicine,” Elaine said. That was true to a degree, only thing was the Skippy was the “crunchy” brand so some days Elaine was getting too many pills, some days none at all. This was causing all sorts of problems, like hypotensive shock and fainting. Lynn figured out a new way to right the ship combining a make-shift pill box, peanut butter cups and a weekly home aide visit. Over the next year Elaine only needed the hospital once. I didn’t stay in touch with her much after that but I always tell her story. My colleagues have probably heard me tell it dozens of times over the years but like few other tales it captures so much about our behavior and isolation but also how a little conversation over milk and cookies can change a life.