56: For Giants football fans, it’s the number of the best linebacker in history, but for those in healthcare it’s a new indicator that virtual psych apps can work, as a reported 56% of patients stopped using Silvercloud for their anxiety or depression after 8 to 10 weeks, according to John Jesser, general manager for Amwell’s population health.
Homeless Healthcare: CVS Health has invested ~$30 million to build affordable housing in several cities, the latest a 36-unit complex in the Denver area for individuals currently experiencing homelessness or physical, intellectual, and/or developmental disabilities. CVS Health, similar to other payers, has been paying increased attention to social determinants of health.
IVF Boost: Gaia is a new fertility startup that wants to help “de-risk” the IVF process by offering personalized insurance. Several fertility companies in the U.S. offer risk-sharing models but it's rare to see IVF insurance offered as a stand-alone product. In addition to insurance and payment plans, Gaia says it has technology that predicts the number of rounds a couple will likely need in addition to the clinics that can offer the right treatment, based on clinical data sets. The CEO says that Gaia’s model means those who do not have live births will pay lower costs for the treatment and those who do have a child can spread the cost of their total treatment cycles.
Reversing Diabetes: Insurers are deploying two new strategies. (1) Season, a new company that focuses on “food as medicine” is betting on health plans eventually covering food as a standard benefit. Season already works with Geisinger and other health systems and launched a clinical trial of its program with CommonSpirit that aims to study how clinically-driven food as medicine programs can help diabetic quality of life. (2) Aetna and Banner Health’s JV is now offering specialized nutrition plans and virtual care to fully insured and ASO groups from Virta, whose pilot lowered blood sugar levels, weight, and use of anti-diabetic meds.
The Undoing Of OON: Mayo Clinic will stop scheduling appointments for out-of-network Medicare Advantage patients, though they will continue to treat OON patients who show up in the emergency room. The decision was made due to an increase in OON patients, particularly from United members. At least half of the 32,000 OON patients coming to Mayo for treatment are covered by United plans. The health system cited capacity concerns, amid worry they would not be able to appropriately serve in-network patients. The decision is not subject to surprise billing regulations, but the health system could use the refusal of service to OON benefits as leverage for more favorable terms and in-network status with payers.
First Batman’s Robin, Now This: Anthem has partnered with Sidekick, a digital therapeutics startup, to offer an app to help those with cancer, Crohn’s disease, and now a COVID Concierge Care app. Patients can track symptoms and outcomes, send messages to clinical care managers and gain virtual rewards for sticking to their treatment plans. The app will first be rolled out in a pilot program to Medicare Advantage members in Connecticut and New York and will target those with acute symptoms, as well as members with long COVID. An estimated 22.6 million Americans have long COVID symptoms.
Cancer Test In The Kitchen: Home testing company Everly Health is partnering with a home cancer testing company to offer its early-detection home cancer test to members of employer health plans.
Primary Care Future: The erosion of the PCP office visit circa 1980 continues, but consumers in a poll we have started seem to like the old way, saying virtual and retail clinics are “convenient” but there are questions about quality. Walgreens and Village MD are on track to have more than 200 in-store primary care clinics this year, recently opening a new clinic in Jacksonville, FL which brings their current total to more than 80 clinics across 12 states. Long term, the initiative aims to have more than 600 primary care practices in more than 30 US markets by 2025, and 1,000 in 2027. More than half of the clinics will be in underserved areas. Amazon Care hopes to serve 10 million self-insured people by the end of the year with brick-and-mortar health clinics in 20 cities and virtual primary care in 11 new states.
One Million To Treat Asthma: Physician groups can get $1 million or more bonus pay for using analytics from Vital Data Technology, then proving the data is lowering ER rates in asthmatics. Vital Data used to provide data to the ER profiling patients, but there wasn’t much benefit. “I don’t need that,” says Barry Lachman, MD, who’s served as a medical director for 3 decades and said the problem is kids would end up back in the hospital 1 or 2 days later “because there wasn’t any education” and “no one knew the patient was there, except the ER.” The data was getting to the PCP 8 weeks later—which is not too helpful, obviously. The PCP, or pediatrician, needs to be the next resource and quickly. “The key is to make sure we get the information,” says Than Soe, a PA who works with refugee populations in Connecticut who says families take their kids to the ER due to untreated asthma and because “it’s what they know – the hospital is their doctor.” Soe, like so many other clinicians, says the ideal time to intervene is when the kid is in the ER or the practice to “give mom who’s missing work tools like a free incentive spirometer that translate into changing behavior” to head off the next asthma attack.
Extra Point: A year after Eric Zeiberg lost his sister Julie to heart complications after a 30-year struggle with severe autism, the 22-year-old is now hearing of new challenges from relatives in Russia, some who have reached out since yesterday saying they are scared and feel trapped and want to leave but are unable to go outside or go to schools or the doctor. Zeiberg is hopeful communication can remain open and that the innocent people in Ukraine, Russia, and other countries can have a voice. He should know. When Eric was just 13 he created a handwriting-to-speech app to help his sister communicate given her speech disabilities. “She was my inspiration, she couldn’t get words out,” he says. His app, HandySpeech, made it onto Apple’s app store to help people with autism, Lou Gehrig’s Disease, stroke, muscular dystrophy, and post-operation voice difficulties. Eric is a bit of a celebrity in our neighborhood for all of this. I watched him grow up, do good for his sister and others without a voice, and make his folks proud. I suppose the world needs more people like Eric.