61: The percent of college students who will forgo school this year, according to our random poll of 417 incoming freshman and sophomores. Read what they’ll do instead and how it may impact healthcare by clicking here.
David Gets a Win vs. Goliath in New Pay Model: BCBS of Massachusetts is launching a new payment model for small practices that will combine value-based care and support payments. The model is designed for practices with 1K-20K members and will incorporate upside risk. The pilot does not launch until 2021, but immediate support payments will go out to any provider participants starting in 2020, once they sign the value-based care contract. More payers are entering into value-based arrangements with physician groups, like BCBS North Carolina, on which we reported back in June.
Hurricane Health: While it’s unclear if college athletics will be returning in the fall, the University of Miami is moving forward with a program to monitor the health of their student-athletes remotely. The university is the first in the country to partner with Tyto Care, an Israeli telemedicine company that makes the TytoHome telemedicine kit. The kits will allow the university’s healthcare providers to gather biometric info from student-athletes and remotely examine them, including measuring their temperature and blood oxygen levels. Another initiative in Florida will also make use of TytoHome kits. Baptist Health, a non-profit health system, is partnering with homebuilder CC Homes to provide the kits with every new home purchase. They’re aiming to capitalize on the trend toward home-based connected health.
Grassroots Delivery: DoorDash, best known for food delivery, is partnering with Walgreens Boots Alliance to deliver OTC medication and other drugstore products to patients’ homes. More than 2,300 products from Walgreens will be available for delivery through the program. The service will start in Chicago, Atlanta, and Denver, and eventually expand to other locations. DoorDash previously teamed up with CVS Health in June for a similar model.
Substance Use Partnership: Highmark announced that its commercial, ACA, and Medicare Advantage members in Pennsylvania and Delaware will have access, as of April 2020, to a comprehensive, technology-enabled opioid-use disorder program from Bright Heart Health. Members are able to meet, on-demand, with medical staff and counselors through a smartphone, tablet, or computer, and care teams will be composed of a therapist, physician, case manager, and a wellness coach. The goal of the program is to stop abusing opioids without experiencing powerful drug cravings or severe withdrawal symptoms. Highmark will pay providers through its value reimbursement program.
Kidney Care: Humana is partnering with REACH Kidney Care, a non-profit company affiliated with Dialysis Clinic, Inc., to provide kidney disease care coordination services to commercial and MA members in Alabama, North Carolina, South Carolina, and Tennessee. REACH Kidney Care nurses, pharmacists, and dietitians will work alongside the patients’ PCPs and nephrologists and offer patient education and medication assessments. Amal Agarwal, Humana’s VP of Transformative Home Solutions said, “This whole-person approach to treating chronic kidney and end-stage renal disease provides greater choice and flexibility, including for some the option for in-home treatment.”
Community Health System Resurgence: Optum is partnering with Boulder Community Health (BCH) in Colorado, its second partnership with a health system. Optum will help BCH with back-office type functions, developing risk-based contracts, population health, and negotiations with payers, while BCH will continue to make clinical and strategic decisions. Last year, Optum signed a similar deal in California with John Muir Health. As hospitals, particularly small, independent ones, continue to struggle, exacerbated by the pandemic, look out for more of these unusual partnerships.
Extra Point: Angela Wilmont’s mom, Penny, hasn’t been in the hospital at all this year, not once. In 2018, Penny, now 77, was in 13 times due to complications from heart disease, a hip fracture, a dizzy spell from a drug dosing mistake, a fall, skin infection, dehydration, and chest pain. But help from a who’s who of home care has halted the revolving door. There’s Alexandra, her home health aide, Alexa the Amazon system, Johnny the cardiac trainer for seniors, Bill’s senior rides, a new geriatrician, Tamara, an RN who comes in for medication and BP checks once a week, and Liv from the companion company, who helps Penny shower. “I credit every one of them – they have saved mom’s life and mine.” Angela found her own health declining. “I didn’t exercise, my anxiety skyrocketed. I was shaky, depressed, angry, and gained 15 pounds.” She calls her mom’s care team her own “saving grace,” as she now is much healthier. I asked her how she lined them up all up and she said that a nurse from her mom’s Medicare insurer visited the house in February 2019, about three days after her last hospital trip. “She put it all together for us – the insurer pays for it.” What struck me when I dug a bit deeper is that each one of Penny’s clan of caregivers had an agreement with the insurer and, in nearly every case, they all say their service prevents hospitalizations. At least four of the six get a bonus of some kind for proving they do this. No one can argue that they each had a hand in changing Penny and Angela’s life, but who is really keeping Penny at home? One has to wonder how these bonuses will play out over time, if that insurer will look for more evidence from Liv or Johnny and decide to redistribute the dollars, or if they’ll see the total value in ‘family terms’, now that Angela is healthier. Even though Angela has different insurance.