131: Number of hours PA Lauren Valley worked at a busy urgent care clinic this past week in my town, often spending off time sleeping at the clinic, filling in for staff who were quarantined. Lauren is a terrific PA – smart, thoughtful, doesn’t just prescribe antibiotics and tests needlessly, calls the sinus issues the little kids have “boogies” but can adapt to help the older lady find her busstop after her appointment. There are thousands of Lauren Valley’s out there – but right about now, we need thousands more…
DropOut: Cigna dropped Livongo from preferred status in its digital formulary on December 15th. Livongo, the digital health product focused on diabetes merging with Teladoc, will now be listed as an alternative, along with LifeScan, and Omada Health will be preferred. Omada Health offers five personalized programs for treating diabetes, hypertension, and other chronic conditions.
Food For Thought: HealthPartners, a health plan in Minnesota, is offering its Medicare HMO members a new benefit in 2022 called FarmboxRx. Eligible members can receive up to two boxes of fresh fruits and vegetables per month, which are put together by nutritionists and they can be customized for specific health conditions, like diabetes. HealthPartners is also addressing food insecurity through initiatives aimed at children, like fruit and vegetable vouchers, and partnerships with community organizations like SuperShelf and Hunger Solutions. Many health plans expanded their offerings to include meals and healthy groceries in 2021 and we expect to see this continue beyond this year.
Travelling Nurse: UPMC is forming its own in-house travel staffing agency for registered nurses and surgical technologists to take rotating, six-week assignments at its hospitals across three states, depending on where the need is greatest, according to a press release. The health system wants to rely less on outside agency staff to help retain current workers and potentially bring back those who previously left, it said in the release.
TeleConsult, Aisle 11: Supermarket chain Hy-vee is launching a new telehealth service, RedBox Rx, which offers virtual health consultations through a partnership with Reliant Immune Diagnostics’ telehealth platform MDbox. Patients can meet with a provider and receive treatment plans for primary care, dermatology conditions, migraines and mental health conditions. And Atrium Health, a North Carolina based health system, has established a new virtual care clinic at a church's Community Life Center in Shelby, NC. People can make an appointment or just walk into the clinic which has telemedicine equipment set up and hopes to provide more access to patients who may not be equipped to do telehealth visits in their home.
The Thing No One Wants To Talk About: The Flagler Access Center, a new mental health center, will open later this month in Bunnell, Florida, providing much needed behavioral health services. Flagler County has one of the highest suicide rates in the state. In 2020, the number of deaths by suicide was 20.9 deaths per 100,000 residents, up from the 2019 rate of 19.3. The center, a partnership between SMA Healthcare and Flagler Health, will host a program to engage youth with mental health services earlier in their lives called the “Be Resilient and Voice Emotions” (BRAVE) program. The center will also utilize and refer to other social services so residents can continue to receive the care they need in their community.
A Win For Emergency: UHC’s ER coverage policy where insurer would review claims for emergency services and retroactively deny or only partially cover claims deemed non-emergent was set to go into effect on January 1, 2022 but UHC is no longer moving forward with this policy.
Surgery Slide: When George Costanza found out he could get his insurance company to pay for physical therapy he had no idea that that meant a man would be giving him a massage. But PT will need all genders to meet growing demand over the next 5 years, buoyed in part by studies like a recent one in the British Medical Journal which found that 6 of 10 of the most common orthopedic surgeries are not meaningfully more effective when compared to less invasive procedures like exercise and PT. Randomized trials showed only minor advantages over interventions like PT. For carpal tunnel surgeries and TKR, their research showed surgery was often most effective. In a quick poll of medical directors who read our journal, 80% said that the results are directionally accurate with their own internal analysis. “Why do you think we are pushing PT?” one physician said.
Extra Point: There’s about to be a major staffing shortage in my household when both Jackie, 18, and Mukue, 20, go back to college Sunday. Neither of our high schoolers leave their rooms as far as I can tell, so I have had to rely on the older kids quite a bit to lay on the couch and leave dirty dishes on the floor and put empty cereal boxes back into the pantry. They’ve really done a great job with that. “But dad, the dog just cleans my plate so it’s fine.” To be fair, Jackie has gotten better. This week he’s been jamming the Special K boxes on top of the already full garbage. Mukue, too – she used to warm her socks and mittens in the oven but then they caught fire last weekend, so she’s stopped doing that, which is nice. Healthcare is going through its own staffing shortages, depleted by the pandemic and the aging of the population. It’s interesting that in the 15 some years I’ve been involved in helping those with healthcare investment, not once has staffing been a major diligence priority, much less the #1 focus that it will be this year, according to nearly 80% in our annual Healthcare Investment Index. I don’t personally have a solution to recruiting and retaining nurses and doctors, though it probably lies somewhere around fair pay, incentives for doing a good job, and enough time off week to week to beat the kids in pickleball.