5: The number of chronic conditions that cost employers $2.5B over 2 years, according to a new study published by UnitedHealthcare’s Center for Advanced Analytics, using claims issued by the Health Action Council’s 57 employer members. Asthma, diabetes, hypertension, mental health/substance abuse, and back disorders were the top offenders and the study found that more than 60% of workers experience at least 1 of these conditions. This probably comes as no surprise to most employers, who are increasingly turning to new programs and strategies, including digital health options, to help manage their employees’ conditions, in hopefully a cheaper and more effective way.
Landslide: No not Fleetwood’s classic but the latest move by United Healthcare’s Optum, which has allegedly acquired in-home medical group, Landmark Health. Details of this alleged acquisition remain largely unknown but speak to the broader trend of payers increasingly moving toward being providers. Humana is the clearest example of this, having acquired Kindred at Home and Curo Health Services in recent years.
Top 20: 3 of the Top 20 managed care priorities for 2021 are newly ranked according to this year’s index of priorities. The 16th edition of the Healthcare Payer Index includes a new #1 ranked priority and six services that left the Top 20. Stay tuned for the release and a call in March.
Oncology Rx: Fidelis Care, Centene’s New York Medicaid plan, implemented an oncology prior authorization requirement. All oncology related chemotherapy medications require pre-approval from New Century Health before being dispensed at a pharmacy or administered in a physician’s office or outpatient setting.
Side Of Mayo: Google is opening a new office near the Mayo Clinic in Minnesota in order to accelerate their long-term relationship. The companies began working together in 2019 with the goal of using the Mayo Clinic’s patient data to develop new artificial intel and machine learning tools. Areas of focus include testing AI in radiotherapy for oncology and providing more efficient care. Google is also part of the new diabetes virtual model Onduo in partnership with drug maker Sanofi.
Don’t Back Out: Like an Izzy Mendulbaum moment when the iconic Seinfeld character told Jerry “it’s go time”, only to fall over in writhing back pain, healthcare stakeholders in Michigan are going all in like Izzy to address low back costs. The Michigan Back Collaborative will be led by PCPs and chiropractors, with support from Michigan Blue, its goals to improve service patterns, outcomes, and patient adherence and satisfaction with the plan. The collaborative will have two levels of participation for clinicians—evidence-based training and a more robust level focused on collecting patient-reported outcomes.
New World: Humana is now working with IBM Watson Health to improve member engagement by using artificial intelligence. The program will use an AI-enabled virtual assistant to provide accurate and real-time information about benefits, co-pays and providers to agents, employers and plan members.
Extra Point: A doctor at Beth Israel Deaconess Hospital in Massachusetts has created a “Vaccinated Volunteers” program, through which vaccinated hospital workers in any role can volunteer to spend time with patients during their free time. The pandemic has restricted the number of visitors that most hospitals allow and many patients have remained alone and isolated throughout their stays. My grandmother June was a volunteer nurse even after retiring from a 30 year career at Baystate Hospital in Springfield Massachusetts. I remember June telling me about nursing and social work when she first started in the ER during the depression. “I was just 22 and FDR hadn’t quite yet been elected. It was a hard time. We had very little…and we were the lucky ones. And most days the ER was crowded with desperation.” June, like today’s nurses and social workers young in age and young at heart, was as much companion as caregiver. When I went off to college in 1990 she got the cancer but on Saturdays she and I used to split some anisette cookies around the kitchen table I used during my early days as a poor reporter. I used to stack nickels and dimes on that table thinking about what grandma and her family must have experienced in 1932. The stories they would share. June told me to just listen to people, particularly those who seem lost, and to give them a chance because “everyone has a story” she’d say. And volunteer your time to help them tell it.