15: Even though Andy Warhol thought all people would be famous for this many minutes and Swifties know all too well about teenage angst in Taylor’s song about this age, it’s healthcare that has a claim to this number. In 2022, more providers report as much as 15% reimbursement increases to reflect inflation and pay for performance and several health systems are opening 15+ outpatient centers, like Michigan’s Henry Ford Health System, which hopes to open 15 urgent care centers this year with GoHealth to “patch holes in care across the region” and limit ED visits, which averaged more than 129 per day in 2021 across all Henry Ford hospitals.
Palliative Partner: SCAN Health Plan has acquired a palliative care, chronic disease management, care transition management and personal health assessment business for older adults. SCAN’s Medicare Advantage members will now have access to these services from Residentialist Group.
Social Risk: CareFirst BCBS is partnering with healthcare analytics company Socially Determined to offer insights into tracking social determinants of health and help the insurer support individuals with elevated health and socioeconomic risks. Our research study on social risk factors of health, first published spring 2021, featured an interview with Socially Determined co-founder and CEO, Dr. Trenor Williams. Read the report here.
Reversal Of Fortune: Virta Health of Arizona is offering a first-of-its-kind diabetes management program designed to help reverse type 2 diabetes without surgery. The Virta coach program offers tips to optimize food choices and uses daily support health coaches. After two years of the pilot program, 74% of patients are still participating, meaning that it is more sustainable than other diet and lifestyle programs. Clinical trial results also show an average daily insulin dosage reduced by 81%, and 67% of all prescriptions were eliminated.
Retail 2023: CVS Health announced the launch of their new virtual care solution, CVS Health Virtual Primary Care, which will allow consumers to choose their care when and where they want - in a retail setting, at-home health services, or virtually. This offering is being sold to Aetna, fully-insured, self-insured plan sponsors and CVS Caremark clients and will be eligible for Aetna members starting January 1, 2023.
Maternal Instincts: Health plans are increasing focus on maternal health outcomes through various initiatives, most recent of which is Anthem who is providing $14.5m in grants to community organizations. Four California based organizations will receive $1.9m each over the next three years for programs aimed at reducing preterm birth rate, maternal morbidity and mortality and primary cesarean rates.
Nudge This: Playwright Tom Stoddard said words are sacred, that if you get the right ones in the right order you can nudge the world a little bit and the BCBS plan in Massachusetts hopes to do this with a new “Nudge Unit,” an interesting name for a new resource using behavioral science to influence patients. Since its launch, the unit has identified a number of ways to improve member behavior, like when it took Stoddard’s cue and revised a letter to members that is sent with at-home colorectal cancer screening kits. The change produced a 3% increase in test uptake and 500 additional screenings collected. The unit also notifies clinicians if they are outliers in their rates of prescribing certain medications or ordering certain tests. BCBS MA is one of the first health plans to start this unit, but we expect other health plans to launch their own Nudge Unit in the future.
Which 5 Specialists Expect To Be Pushed Into Value? Earlier this week we released a brief highlighting the results of our survey of 278 physicians from 10 specialties. The results tell an interesting story about challenges facing physicians, their expectations, the interesting juxtaposition between compensation trends and reimbursement trends, and the future of physician pay. Find out which 5 of the highest paid specialties expect to be impacted by value-based contracting here.
C3PO For The Older Folks: The New York State Office For Aging (NYSOFA) is aligning with tech startup Intuition Robotics to provide a companion robot, ElliQ, to isolated seniors to provide medication reminders, wellness suggestions and friendly conversations. The program uses AI technology for this care companion for more than 800 older adults with a goal to increase independence, combat loneliness and increase social activity. Unlike other consumer personal assistants, ElliQ is designed to initiate conversations with its users and suggest activities such as physical exercises, trivia games, or sleep relaxation.
Extra Point: This taller man with a mustache wearing a yellow short-sleeve button down and a sea blue baseball cap left the line at the general store yesterday for why I did not know at the moment. The line stretched like a rotary phone cord around the store’s narrow aisles and for the four of us closest to the counter we were near the finish after 20 some minutes. The man - second in line - set down his fresh bread, dish soap, razor and what looked like calamine lotion. I remember because these seemed like an odd but perhaps perfectly normal set of things to get at a store like this. He rushed quickly to the creaky wooden door looking part Burt Reynolds, part Nathan Lane in the way he moved. He softly pulled the brown bag away from an older lady who was losing hold of the bag and beginning to fall, then held the door with his left hand and her hand with his right and made his way outside. Nothing really changed inside the store and when the man returned about 3 minutes later he calmly scooped up his bread and dish soap, his razor and lotion, stopped and stared for what seemed like a minute then made his way to the very back of that long line. “Sir, sir – is that all?” the lady Billie behind the counter said to me. I hadn’t realized I had moved up to the front, so I nodded in the way you do when your mind is somewhere else and then placed my items down and after a long pause said, “actually, um, Billie, can you add to the bill the 4 items for that man over there?” In a sort of abrupt way Billie called for the man to come up, waving him over the way Bob Barker used to on that ‘80s game show. He reluctantly did so and took out his wallet but Billie, God Bless her, said “This short guy with the Italian hat is taking care of your stuff.” On the way outside I introduced myself and asked him his name. “Fran, well Francis, but I go by Fran.” “Nice to meet you – that lady you helped back there, was that your…mom, a friend?” “Oh no,” he chuckled, “definitely not my mom. She’d never have let me take the bag….I don’t know who that was.” Funny how sometimes humanity just shows up from time to time, just need to look up I suppose. Best $13 I’ve spent this week.