59: Percent of 35-45 year olds in our consumer poll who said they will “likely” or “definitely” choose Cologuard’s at home test for colon cancer when the time comes over Colonoscopy, several citing advantages like “not having to do the prep my dad did” or not “having to be sedated” and even financial benefits for those who say they may just pay cash “and I think the at home is a lot cheaper”. If a Cologuard test is positive, the patient will need a Colonoscopy, but only 39% knew this. However, the cost of the Colonoscopy in this situation would be applied to the patient’s deductible if they are using insurance.
Sports Meets Health: Sanford Health is investing $300 million to boost rural healthcare in South Dakota, adding additional sports fields to its complex in Sioux Falls and expanding its youth and adult recreational sports leagues. The investment also allows Sanford to create a virtual hospital and 8 new medical residencies and fellowships that the health system hopes will spur a network of specialists in underserved rural communities.
Y Sports: Last month we reported on the grand opening of BCBS IL’s Little Village Wellness Center, now this month BCBS of NC has established a three-year partnership with YMCA of the Triangle to provide discounted medical memberships to qualifying members with a doctor’s referral. Memberships will include tailored health classes, a personal health coach, and access to YMCA facilities.
Telehealth Permanente: The Northwest seems to be taking the lead on formalizing telehealth payment policies. Regence BCBS says they will continue to reimburse telehealth services at the same rate as in-person visits this year for Idaho, Oregon and Utah-based providers. For Washington state providers, the plan will reimburse in accordance with Senate Bill 5385, Telemedicine Payment Parity. Premera in Washington has standardized teledentistry payment while Kaiser Permanente has gone even further, launching its first virtual-first health plan in Washington in an effort to make telehealth a “foundational modality of care”. A consulting nurse service includes video chats with a patient’s “usual clinicians.” Data will be available through EMRs.
Hear This: Right2You now allows UnitedHealthcare members to customize their hearing aids remotely with a smartphone or tablet paired to the technology. The virtual care option is available both to Medicare Advantage and employer-sponsored members.
Reimbursement Down: If ER patients have a non-emergent diagnosis health plans are continuing to downcode these before paying. Molina is the latest payer to establish a policy that will automatically adjust payment for the professional ER services from a level 4 or 5 to a level 3 when a non-emergent diagnosis is reported.
Medicaid Stronger: Behavioral health company Strongwell is helping Medicaid beneficiaries in programs specifically for pregnancy and postpartum and substance use. Texas health plan Superior is among the partners.
Toothpaste, GoldFish & Therapy: CVS is adding virtual and in-person behavioral healthcare services in select HealthHUB locations. Anyone needing services will be connected with a clinical social worker who will do an assessment and refer to specialists if needed. As of now, HealthHUBs are only available in select locations in Houston, Philadelphia and Tampa but 34 new locations are slated to open in the spring of 2021.
Extra Point: It’s good to see sports continue to make its way into healthcare benefits and services. The news today about Sanford and BCBS follows a 5 year trend of health systems and insurers investing in gym and if you look closely the type of investment is changing. We’ve gone from gym members as a supplemental benefit and grants to programs designed to get kids and seniors moving into more contractual relationships. It’s the new primary care. I’ve taught gym class for about a decade myself in inner-city Hartford and I will say that even at my age a good ole fashion game of kickball is just about the best thing. Unless of course you forget you are teaching and start running so fast around third that your head gets ahead of your legs and you fall shoulder-first into home. There I was under a maple tree Wednesday - nauseous and seeing stars, and I quickly became a pathetic man’s Q&A: “What’s wrong with Coach Cote? Naomi muttered. Mista, you alright? Why is he on all fours crying?” No, kids, Coach Cote is not okay. He’s a dummy. I’m a dummy. But healthcare, well, it’s moving in the right direction.