850: Pacific Dental Services, the Irvine, CA based dental service organization, hasn’t just opened its 850th dental practice but it has launched a dental-medical practice with the opening of 3 practices - general dentistry, pediatric dentistry, and medical care - all in one Nevada location.
All Bets Off Kenny Rogers: More payers are covering therapy for gamblers but not in every setting and not as restrictive as you might think. Excellus BCBS allows OP therapy for gamblers without pre-approval. Residential, partial hospitalization and inpatient services are thought to be investigational.
ACT Now For 7%: Molina in Illinois has decided to increase reimbursement rates +7% for assertive community treatment both for individuals or in groups.
Best Buy, Really? The place with all the big TVs has a health strategy if you can believe it, and it’s not too far afield from the biggest trend in healthcare. In 2018, it bought an emergency call service called GreatCall to add to its home-based motion sensor and monitoring technology to help aging seniors. You could see risk-taking super groups promoting such a service and technology, perhaps MA plans too. Perhaps offering discounts on flatscreens or DVDs if they even exist in 5 years. Can’t you just see it – while Best Buy installs the sensor in your mom’s condo, you ask the technician if he has GeekSquad credentials to help reboot your laptop. Now Best Buy is acquiring Current Health, a United Kingdom-based home care platform that focuses on remote patient monitoring, telehealth, and patient engagement.
Yellow Lab: Caution, labs without much scale or utility. HCSC, the parent company of 5 BCBS plans including Illinois and Texas, is launching a new laboratory program for commercial non-HMO members effective January 2022 that we expect may be something similar to what United and Anthem have launched in recent years, including preferred lab providers and possibly a move to better align lab rates across hospital and outpatient locations. Few details have been announced.
It Takes A Village: Walgreens has doubled down on its investment in VillageMD, the home based primary care group. This will allow 600 more Village Medical at Walgreens locations to open by 2025, with a goal of 1000 new spots by 2027, over half in medically underserved communities. Walgreens also recently invested in CareCentrix, a post-acute provider that helps transition patients from the hospital to home, along with Shields Health Solutions, which helps hospitals run their own specialty pharmacies.
Not Your Dad’s Medical School: Mount Sinai’s Icahn School of Medicine is launching the first AI focused department within a medical school in the US. The Department of AI and Human Health will conduct AI research and build an AI framework to deploy throughout Mount Sinai, allowing all physicians at any of their locations access to any new AI-driven tools that are developed.
Price Sharing: Walmart is partnering with Transcarent to offer self-insured employers a new option. The partnership will offer Walmart’s prescription drugs, optical, telehealth, and other healthcare services along with Transcarent’s digital platform which helps patients navigate their health benefits online and find the right sites of care. This new option is the first time Walmart has allowed other employers its prices on drugs and healthcare services, and the option will be open to employers of any size.
Virtual Benefit: United is planning to launch a new virtual primary product by the end of the year, utilizing its Optum physician network. The new product, NavigateNow, will mostly rely on an Optum care team for primary, urgent, and behavioral health services, with UnitedHealthcare's physician network as a backup for any in-person needs. It will initially be available to select employers in nine markets, with plans to expand to at least 25 markets by the end of 2022, along with making it available to employers with self-funded plans.
Did You Know? 50% of all lifetime cases of mental illness begin by age 14 and 75% develop by age 24, according to the National Alliance on Mental Illness.
Sleep It Off: If you like baseball these days, you’re tired. I mean the Dodgers and Braves is a great matchup for the Pennant, but without Vin Scully on the call I’m yawning by the 3rd inning. At least we have daylight savings coming so we can fall back to sleep. Bet you didn’t know that sleep disorders like apnea cost upwards of $165 billion a year according to Harvard Medical School’s Division of Sleep Medicine. AIM Specialty is trying to control these costs for insurers. Take Carolina where you need to get pre-approval under a relatively new program led by Blue Carolina for home and facility-based sleep tests plus ongoing orders like for CPAP.
My Gift Is My Song: So you try to show value, and you take your daughter who’s struggling out to supper and blast Ben Platt’s new album on the way. You sing an uncomfortably ambitious falsetto at the traffic light, with the windows down. Not because it sounds good, but because it makes her laugh. Nurse Brenda Buurstra once sang ‘You Light Up My Life’ to Robert Olsen during the older man’s weeklong stay for breathing issues at Bronson Hospital in Michigan. Despite initial expectations that Robert’s lungs wouldn’t hold up, he was discharged home in a week and hasn’t been admitted back. Brenda sang to patients before things like readmission penalties and social determinants were a thing. “I’ve been singing to patients for 14 years,” she told a CBS TV reporter. “It’s just the first time I got caught.” I showed my daughter Sophie Brenda’s video clip last night and while she didn’t get that part in the school play this week, she is now seeing her own voice in a different light. Sure, maybe she’ll be a Bernadette Peters or star as Belle on Broadway, but if not, something tells me there’s another leading role waiting for her bedside. Her song here.
Extra Point: In about a year I turn 50 and this invariably means a major healthcare milestone to prep for….wait for it….that’s right, the senior circuit, as in the tennis tour or maybe even water polo. With my speed and agility I should dominate the 60 and 70 year-olds. Seniors across the US are moving more than ever as part of an effort by more doctors and insurers to promote walking groups and aerobics circa Richard Simmons jazzercise of the 1980s, but they won’t be able to keep up with me. I suppose the only thing holding me back may be my limited talent. I mean I lost the spin in my topspin forehand by the time I was changing 3 sets of diapers in my 30s. Maybe the sports senior circuit isn’t quite right. Maybe I’ll create a Bohemian healthcare for seniors circuit instead. My friends always say I’m part Bohemian. I could do what any healthcare startup does. First, create a following, maybe take my followers and go to insurers touting how my program keeps people out of hospitals. That will definitely be a differentiator. I could use fancy words like “measures” and “algorithms” and when they ask me about my site of care I bet I’ll catch them off guard when I say somedays it’s frisbee at the park, some days painting in a meadow. Very Bohemian. When they deny me, I’ll threaten to go out of network, or well actually I can’t threaten that without a contract, but I could find a temporary code for this sort of new age healthcare and bill that, but something tells me that will raise all kinds of questions. Perhaps I should just design a capitated arrangement in Florida and offer risk groups the chance to pay me out of their PMPM. I’ll keep an eye on their patients after they leave clinic but not so much with remote monitoring as more of a spiritual, laissez faire oversight. As I think more about it, 50 seems like a lot of work if I’m not careful.