75: The percent in our Poll of the Week who believe a virtual visit for someone with substance use disorder is less effective than in-person treatment even though there are examples of companies like Eleanor Health able to use telehealth without worrying about whether it’s a billable visit given they are paid differently to manage a patient from addiction through recovery. They use the telehealth encounter as a way to check-in, to do anxiety and craving scales, and stay in front of patients as part of a goal toward recovery. A recent study published in AMA’s journal Psychiatric Times highlighted that addiction treatment via telehealth can increase patient engagement and reduce harmful stigma, but there is still clearly some resistance. One poll respondent agrees, saying “It is convenient, and patients would be more comfortable at home. It would reduce stigma as it is more private.”
Fry It Up: The great late night talk show host Craig Ferguson doesn’t get enough credit from the healthcare world. He was among the first to acknowledge the double victory of the healthcare-for-all-movement. “Now that healthcare is guaranteed, I’m frying everything I eat.” Cardiologists are among those who can thank Ferguson.
At Home In NYC: Anthem is acquiring Integra Managed Care, a long-term care plan in New York that serves 40,000 Medicaid beneficiaries with disabilities by providing services in their homes. The purchase expands Anthem’s Medicaid footprint in the state.
Payment Reduction, Eventually: Aetna is delaying their payment adjustment for multiple endoscopy procedures again. Previously supposed to go into effect September 1 and then December 1, the new policy will now be effective March 1, 2022. Aetna will reduce payment for multiple endoscopy procedures in the same family when billed by the same provider on the same date of service for the same member. Multiple surgery reductions can also apply.
Therapy Going Out To Pasture: An inpatient recovery center in Georgia is giving patients access to, wait for it—therapy cows as part of a broader treatment program to help people with anxiety and panic attacks. Does it work and will insurers cover it? Read our correspondent Samantha Kaishian’s perspective here.
Tech Miss: Insurance startups heavily relying on technology innovations are struggling. Clover Health and Bright Health reported missing their medical loss ratios (MLRs) during the third quarter of 2021, both clocking in at over 100%.
Veteran Support: Humana is adding veterans to its Bold Goal communities, giving them the same kind of population health management other Humana members receive. The insurer plans to work with community-based organizations and medical partners to deliver integrated care to the veteran population, who often have more complex physical and mental healthcare needs like PTSD.
Predictive Health: Northwell Health is forming a JV with an investment group to help fund AI startups targeting challenges in healthcare. Engineers and data scientists working at the JV will collaborate with Northwell Health clinicians to create tools to predict, diagnose, and manage health conditions, starting with chronic diseases and preeclampsia. Similarly, LifePoint Health, the Tennessee-based hospital organization, is working with venture firms to launch a startup incubator for health tech in Nashville. The new venture won’t necessarily focus on AI but will look for any type of innovative startups working to improve healthcare quality, access, and outcomes.
Palliative Launch: Kara Health, a hospice and palliative care provider based in California, is launching a joint venture with Palomar Health System in San Diego in an effort to focus on patients with cancer, heart failure, and other serious or terminal illnesses. The partnership is expected to begin in January 2022 and will include a shared savings arrangement for the palliative care business where each party will benefit if they are able to prevent hospital admissions and readmissions.
Academic Home Care: Bayada is entering into another hospital partnership to provide home health services to the system’s patients. Jefferson Health and Bayada’s new company, preliminarily named Jefferson Health at Home, will focus on seamless transitions and virtual care and will also include an academic affiliation, which should create new training opportunities for Jefferson students, particularly at the Jefferson College of Nursing. Back in June, we reported on Bayada’s similar venture with VCU Health System in Virginia. Wonder where the home health company will look for their next partnership?
Extra Point: I suppose I’ve had my fair share of blessings in my life. When I was my 5, Santa brought me a putt-putt speedway and when I was about 17 Mr. Hughes still let me take his daughter Shelly to prom, even though I ran over his basketball hoop with dad’s Dodge. At 22, I got to introduce Rosa Parks at my college commencement and interview Jack Nicklaus about why he shanked his chip on hole #11. And in the fall of 1996, about a month after the Yankees won the series and around the time the so-called Soup Nazi from Seinfeld fame gave me an extra piece of bread with my potato bisque, I got to sit in the 5th row to see Rent on Broadway. It was life changing - the show came at a time when some of my colleagues and friends were living with HIV and facing a world that didn’t understand them, nor their disease. I was probably one of them. Some of them sadly passed on but now, 25 years later, I remember them for the grace and courage they showed. People can live longer with HIV thanks to treatment and early diagnosis and the impact of shows like Jonathan Larson’s Rent. We took the family to Rent last month and it struck me how the show just doesn’t have the same meaning or impact for our kids. They can’t appreciate those times or the disease. Much like they can’t understand why their Black classmates would ever have to sit anywhere on the bus but right next to them. They do have their own cultural crises to deal with now, their own epidemics, and their own music for their own time. But there is one song from Rent that probably does transcend. 525,600 minutes – it opened the second act with the cast of 15 moving in unison to the front of the stage. How do you measure a year, they sang out. How do you measure this year, or how will you measure the next one? For those of us in healthcare it may still be things like COVID shots and vaccines, but also those moments when real humanity shines through, like the nurse who sits bedside, holding a hand and singing a song. Maybe for our kids, it’s measured in lost masks or hours of homework or Instagram friends…or maybe it’s laughter, love, and those Friday night “let’s have pancakes for dinner” with mom and dad and the dog.