May 3, 2019 | Managed Care Friday
1. 25,000: People living with Parkinson’s in Michigan out of the roughly 1 million nationally. BCBS of Michigan is teaming up with the Kirk Gibson Foundation to raise awareness and provide resources. In the meantime, there continues to research on Parkinson’s. A new study released this year says a new device may be helpful in slowing or reversing the progression of the disease. The experimental study investigated whether using a novel delivery system could regenerate dying dopamine brain cells in patients with Parkinson’s and even reverse their condition. It could be ‘the first...
Apr 12, 2019 | Managed Care Friday
1. 16,752. No, this isn’t another Rent song, it’s the average cost believe it or not that a diabetic person will spend on average each year on medical costs, according to a recent study by the ADA. Cigna and Express Scripts introduced a patient assurance program to cap the out of pocket costs at $25 for every 30-day insulin prescription. Cigna says this reduces the out-of-pocket costs for insulin by 40% or more and improves affordability of insulin costs for people with diabetes. The Patient Assurance Program will be available to members in participating non-government funded pharmacy plans...
Mar 29, 2019 | Managed Care Friday
1. 700: Number of direct primary care practices in the US via a new coalition of doctors who provide a kind of low-cost monthly membership to serve people without insurance and those with high deductible plans. The new delivery model has a concierge feel with higher touch care and a new-age pricing model: Memberships are $75 a month for adults, $25 for those under 21, with unlimited telemedicine and office visits and house calls for $25. Labs and meds are charged at wholesale cost plus 10%, according to Jonathan Bushman, who runs Reliant, a practice in Oklahoma that’s part of the emerging...
Mar 22, 2019 | Managed Care Friday
1. 64: Percent of high school seniors in our poll earlier this month who say they are interested in medical school or healthcare jobs, but when ‘breaking out the results’ by gender, the numbers change a lot—girls (73%) and boys (49%). 2. Stroke of Genius: A new remote monitoring program has reduced bad ‘LDL’ cholesterol by 40% in less than 12 weeks, and cut blood pressure values in half according to results we found from Always Health Partners, formally known as Neighborhood Health Plan of Massachusetts. The plan’s remote medical management program is focused on reducing the risk of heart...
Feb 22, 2019 | Managed Care Friday
Extra Point: Unlike my kids whose idea of a crisis is their iphone app froze or the dog licked the waffle, meaning they have to make another one, there are real crisis situations going on and they are sparking a flurry of new healthcare psych-focused models. The latest is a new mental health facility focused on helping Medicaid patients in Tennessee, and it’s already at capacity. The center focuses on both crisis intervention and other psych needs, but its model has led to some questions from those we interviewed about its designation, whether it turns away crisis patients, and more broadly...
Feb 15, 2019 | Managed Care Friday
560,000: The number of referrals United Healthcare made over the last couple years to social services for its Medicare enrollees. United hopes to start creating diagnosis codes for social determinants of health, like housing, food and transportation…actual diagnosis codes (ICD-10 codes) have been rolled out first for helping address social determinants of health in Medicare patients. Medicaid related codes are next. About 1 million Medicare Advantage enrollees identified a social related issue connected to their health, a United spokesman confirmed. The Parkland Center for Innovation in...
