38: The percentage of Americans who delayed healthcare treatment due to costs in 2022, a 12% increase compared to 2020 and 2021, according to a recent survey by Gallop. More than a quarter of those said the care they skipped was for “very” or “somewhat” serious conditions. Lower-income people, younger adults and women were more likely to delay care. In our own poll, nearly 75% of college age to 28-year-old males tend to skip care, not due to cost but due to fear.
Fertile Ground: About one-third of infertility cases are caused by male reproductive issues, according to a study by the NIH. Employers and fertility benefit managers are responding by expanding their offerings to cover male infertility issues and telehealth companies addressing male reproductive health are gaining increased focus. Posterity Health, a digital male fertility platform, recently announced an oversubscribed funding round of $7.5M. The platform offers technology-enabled male fertility services, including at-home diagnostics, virtual visits and in-person consults. Online pharmacy Ro recently acquired Dadi, a sperm collection and testing startup for $100M.
Kidney Care: If you are living in Idaho and have risk factors for CKD you may just find a kidney damage test kit beside your Amazon package next time you check the front porch. Blue Cross of Idaho members will now have access to at-home kidney damage test kits through a partnership with Healthy.io. Tests include an albumin-to-creatinine ratio urinalysis and results can be shared directly with members’ PCP through their smartphone. A recent study found that 38% of rural Idahoans are between 25 and 100 miles from their PCP, so these test kits aim to reduce barriers to getting tested for kidney damage in hopes of managing it before it reaches CKD.
Dollar Deserts: Dollar General is getting into the primary care business, piloting mobile clinics at three stores in Tennessee. The clinics are being launched through a partnership with DocGo, and represent an expansion of the chain’s DG Wellbeing Initiative, which originally focused on including a wider assortment of medical treatments and supplies in stores. Dollar General execs noted that 65% of its ~19,000 stores are located in healthcare and pharmacy deserts. The clinics will accept Medicaid, Medicare and some commercial insurance plans and will bill those plans at urgent care center rates.
Unisolate: Social isolation is associated with a 50% increased risk of dementia according to the CDC. To address this, Humana launched a program with Wisdo Health targeting seniors with chronic health concerns who may be dealing with loneliness. This one-year pilot program involved 1,400 Medicare Advantage members who were matched with a trained peer using AI analysis and given weekly coaching sessions as well as resources for social determinants of health concerns. The pilot reduced isolation and loneliness and cut down on ER and urgent care visits, along with saving $1,000 a year in medical costs.
Payer Purchase: Elevance, formerly known as Anthem, is buying BCBS Louisiana, adding 1.9M members to Elevance’s overall membership and expanding its footprint to 15 states. The change may create some challenges for Louisiana’s diagnostic providers and pharmacies given the insurer’s efforts to own these services, but independent physician groups or care management models able to scale could benefit.
Extra Point: So, what would you pay for an extra month of quality survival? For an extra week. Without side effects and falls and terrible pain. What’s the threshold? If it’s $50,000 for 2 months, what would you be willing to pay to get it to 3? And how do consumers differ in their answer from doctors, health insurers and policymakers? Does our threshold change for children or our parents, and does it change based on our life experience or socioeconomic situation, or chronic condition? Part of me likes to think it doesn’t, it wouldn’t, that we’re all on the same page regardless of our role in the decision or how much we have available or make or where we live or the credentials after our name. Part of me wonders if cost and price were not an issue — if we took that variable out of the equation— that we’d all just do what’s best in what is an impossible, imperfect and often times painful question. The thing is it’s a question asked of insurers and doctors and of sons and daughters and wives and husbands everywhere every day, perhaps not always in these direct terms, but it’s asked. What incremental gain in months of quality survival would get your attention to keep paying? Is there a cost of therapy threshold at which point you say no, not because you don’t care, but because it stops the pain? And maybe it’s not so much in dollars but in the cost of the crisis, the toll. I wonder what the answers would tell us about our priorities, our behavior in crisis, and our humanity. In the decade since I first asked this question it seems to me that the country has gotten more comfortable talking about dying and what end-of-life care means. Palliative care was once a two-person job at the community hospital where I worked part-time in 1998. Now it’s done outside the four hospital walls and by dozens of nurses and caregivers. I’m looking to ask the questions again and study what’s changed in our views 10 years later, though if I’m being honest, I’m not sure I nor the rest of us are exactly ready for the answers. Like so many of us, as I go through this in my own family, I admit the hardest thing is just juggling emotions with everyday life. But you just keep swimming. And as Cat Stevens once said, I’m thinking about the good things to come.