Jan 13, 2023 | Managed Care Friday
1,000: The approximate number of deaths prevented by a naloxone vending machine, according to a recent study published by the University of Cincinnati and Caracole. The vending machines are placed outside a targeted naloxone distribution and syringe service program. Anyone can access the program’s counselors as well as two injectable doses and two nasal spray doses of naloxone, a sharps disposal kit, kits for safe injections, smoking, and sex, as well as a pregnancy test, PPE and a box of bandages every seven days. 637 individuals registered for the program in the first year, 12% of them...
Jan 6, 2023 | Managed Care Friday
20: Percent reduction in telehealth commercial reimbursement rates for medical visits, not behavioral, starting this spring for a few New England area insurers. The trend is accelerating in pockets of the US as we predicted with some insurers lowering rates 20-30%, one as much as 50%, but none changing the policy for behavioral sessions. One New Hampshire plan will keep telehealth rates for “medical sessions” at the same level as in-person. Empire Strikes Back: Just like Vader’s effort to retaliate against the resistance, nonprofit health plans SCAN Group and CareOregon are merging to create...
Dec 23, 2022 | Managed Care Friday
Extra Point: The late Jerry Stiller invited everyone to air their grievances on this day, using a symbolic pole in lieu of a Christmas tree. “You gather your family around, and you tell them all the ways they have disappointed you over the past year,” Stiller’s Frank Costanza said in the classic Seinfeld. In my home, that’s really more of a Thanksgiving tradition, although sometimes if I’m lucky, the grievances come in the afternoon after school when I forget to pick up Sophie or when I’m cooking dinner, and despite all the effort, it tastes a little bit like garbage. My wife, God love her,...
Dec 16, 2022 | Managed Care Friday
48: The percent increase in the number of in-network behavioral health providers among commercial health plans over the past 3 years, according to a recent AHIP survey. Against All Odds: Even Phil Collins could not have predicted this, beginning January 2023 Excellus BCBS will cover gambling disorder treatment services for managed Medicaid members. New PBM: The Mark Cuban Cost Plus Drug Company is partnering with EmansaRx Plus, a PBM created by the Purchaser Business Group on Health, which represents almost 40 large non-hospital self-insured employers. EmansaRx Plus will start with generic...
Dec 9, 2022 | Managed Care Friday
51: Percent of 6,382 18–22-year-old males in our poll who say they will likely sign up for one of those virtual primary care health insurance plans when they get a job after college and a not so surprising 28% say they may not get any insurance, one junior music theater design major saying he thinks he can just use urgent care if needed. Scrubs TV character John Dorian sort of captures the mindset of today's college age males. "It's funny," Dr. Dorian said, "I guess sometimes when you do nothing at all, things just have a way of fixing themselves.” No Longer Taboo: Starting January 1, 2023,...
Dec 2, 2022 | Managed Care Friday
27: The number of urgent care centers Providence health system closed in Southern California this month, citing staffing challenges, inflation and increased competition. The health system’s virtual services will still be available to patients, as well as their in-person primary care services. As payers and providers continue to push virtual first options, we wonder if we’ll see more of these closures in other markets. Stuck In Bed: Hospitals are struggling to discharge patients because of healthcare staffing shortages downstream, leaving many patients stuck in a bed they don’t truly need....
