12: The number of Pennsylvania healthcare organizations that are incorporating tech into member care. UPMC Health Plan has a virtual concierge service that integrates into Alexa and Google Home machines. Members can use the service to ask about coverage, care options and other topics. Geisinger is using biometric technology to check patients in. They have checked in 5,600 patients so far.
Nail Biter: Google is planning to release a new tool later this year that will use AI to help identify skin, hair and nail issues. The AI-based tool is not meant to replace a physician’s opinion but to inform users and help them decide when a physician visit is needed. To use the tool, patients will upload three photos of the affected area, then answer questions about their skin type and symptoms. The AI model will analyze that information and will provide a list of possible matching conditions out of a pool of 288 conditions, Google said.
Baby Script: A virtual care platform for managing obstetrics now allows patients to share weight and blood pressure data and use other remote monitoring tools before and after a pregnancy. The tool is from Cerner, which has partnered with Banner Health on the launch. Obstetricians and family practitioners system-wide at Banner have access. Next, clinical teams will be able to order tools for patients related to chronic conditions and behavioral health through their Cerner EHRs.
House or Home: University Hospital, the academic medical center in NJ, is venturing into affordable housing through a partnership with the state and housing developers. Hospital Partnership Subsidy Program will provide 78 rental apartments to lower-income people and some units will be considered supportive housing, which includes access to medical services. These units will be on top of a ground floor outpatient clinic run by UH. This is another example of fast-moving social determinants of health space. Our healthcare researcher Samantha Guarneri led a study on stakeholder initiatives featured here.
LGBTQ Addition: The newly formed telehealth giant created by the merger of Doctor on Demand and Grand Rounds has already acquired another player in the space, Included Health, a care navigation platform for the LGBTQ community. Research has shown that LGBTQ individuals often struggle with access to necessary medical care and virtual health companies like Included Health are trying to alleviate some of these challenges. A recent piece from our behavioral health reporter Erin O’Donnell addressed the issue – check out the story here.
Rx Benefit: According to recent studies, Cigna and Highmark observed cost savings and higher member engagement for plans with integrated medical and pharmacy benefits, compared to plans that carve out pharmacy benefits. Highmark’s integrated benefits saved an average of between $150 and $230 per member per year between 2017-2019 and Cigna saved an average of $227 per member per year. Stay tuned for an upcoming Eye on Healthcare that further explores the findings.
UnDisabled: The University of Houston College of Medicine and the Humana’s Integrated Health System Sciences Institute have teamed up with Lone Star Circle of Care, a federally qualified health center, and Lone Star Legal Aid, a free legal aid provider, to host a medical legal partnership at Lone Star Circle of Care’s clinic at UH. This partnership developed because of patients struggling with workplace discrimination, disability issues, and inadequate housing, factors know as health harming legal needs, that can lead to serious illness, along with depression, anxiety, and high-risk behaviors such as substance use disorder. The Humana Institute will assess the outcomes to determine how these patients can be helped.
Cornhusker: BCBS of Nebraska is removing AllianceRx as their preferred pharmacy and moving to Accredo for specialty pharmacy and Express Scripts for home delivery, effective July 1, 2021. This is one of several pharmacy priorities for insurers this year, another is developing outcomes-based contracts to manage growing demand for gene therapy. Researcher Ashley Chilton explored developments in this recent report.
Extra Point: One of my old high school buds is an internist at a growing practice down south and bent my ear this week complaining how he came up just short on getting a bigger bonus from one of his more important payers. “I got 79% of the high risk diabetic patients to lower their A1C to a better level but to get the $50,000 kicker I needed to get to 80% - total bull”. Back in high school, Doctor Laney used to wear an ACDC t-shirt and rocked out to Guns N’ Roses during homeroom in 1987. He would always try to haggle with Mr. Whittier over his algebra grades, but teach never gave in, and it sounds like things haven’t changed for “Laney.” I told him my kid Tommy is facing similar growing pains. “Tom came home ticked off about his 79.6 in math – his teacher gave him a C+, which I sort of love. I mean, if there’s any class that should go with the exact number, it’s got to be math. English lit, sure. Art, of course. But math, and maybe healthcare outcomes payment, maybe not. Rounding up feels nice momentarily, sort of the way you feel after you cheat to beat your kid in monopoly, but I’m not so sure it is helping anyone. Here’s to holding your ground.