50%: Increase in families requesting grief support services in 2021 according to Boston Medical Center. Primary care doctors in Boston identify families who could benefit from the Good Grief Program and refer children to the medical center. The program estimates that about 10% of the new families are grieving a loss from COVID-19. Maureen Patterson-Fede, the clinical social worker who oversees the program, expresses worry about the future for these children, “I think we're all holding our breath. We're feeling like we're just seeing the tip of the iceberg about what's going to play out for kids."
Smart Implants: Orthopedic surgeons in New York recently completed the first total knee replacement with Zimmer’s “smart” knee implant. The device, the first “smart” implant cleared by the FDA this summer, has an embedded sensor that monitors a patient’s steps, speed, and range of motion so that the provider can monitor progress real time and objectively, rather than relying on patient reported outcomes. It will be interesting to monitor how these sorts of advances change surgeon behavior, and patient behavior.
Kidney Ties: Starting in 2022, BCBS of Massachusetts Medicare members with chronic kidney disease (CKD) will have access to services from Square Knot Health as a supplemental benefit. This program will pair members with a trained navigator to meet with via video and phone to help educate, assess, and mentor members on treatment options, including transplantation. Along with support and education services, Square Knot Health partners with nephrologists, primary care physicians, and transplant centers to remotely monitor members.
Virtual Design: New virtual benefits continue to proliferate as MCOs look to use virtual platforms for triage, primary care, and “steering” to high quality specialists. Starting in 2022, Hydrogen Health, a joint venture between Anthem, investment firm Blackstone, and K Health, a digital primary care company, will be offering nationwide virtual primary care coverage. The joint venture provides text and video-based digital primary care leveraging K Health’s artificial intelligence capabilities to customize care for enrollees. The service is currently offered to Anthem’s fully insured business and aims to expand their user base to more than 10 million enrollees by the end of 2022. How much these virtual plans are adopted by consumers is still to be determined but likely gives us a window into how young adults are changing their stance on preventive healthcare.
Cancer Link: 12 years after City of Hope moved into the land of 340B saving ~20% on their OP drug spend the national cancer center non-profit in Los Angeles is buying Cancer Treatment Centers of America. The combined company expands City of Hope’s geographic reach to Illinois, Arizona, and Georgia and will allow more people to get access to City of Hope’s diagnostic and treatment setting capabilities. It may also lead to some adjustment in how insurer’s approach network design for oncology. There are also likely gains in drug acquisition and potentially more alignment between oncologists on treatment regimens for patients in later stages of cancer, many who complain when local oncologists won’t implement national center protocols. Dale Adams, City of Hope’s pharmacy director in 2010, told us at the time that the center hoped to shave $8 million off the center’s projected $40 million in outpatient drug spend (they spent ~$70 million in total) by qualifying as a 340B covered entity. At least 30% of the center’s inpatient net revenue at that time came from state and local governments for indigent care. Cancer care has evolved in the last decade – more payer-provider partnerships, more drug treatment pathways to promote certain drugs, and more oncology spend through the 340B program. Unlike other services–like orthopedics, GI or cardiology—where payers can benefit most from trying to shift site of service out of hospitals, oncology is typically different, with so much spend tied to the cost of the drug.
Psych Partner: Quartet has acquired telepsych provider Innovatel in the latest example of tech meets service delivery. The mental health analytics company has brought in the psych provider known for serving community mental health clinics. Quartet has had a string of payer partnerships, most recently with BCBS in Philadelphia, and can now leverage its new crop of providers to link demand with one of its own providers.
Extra Point: However you like to move (racquetball, rollerblade, treadmill, ping pong, parachute, or swimming laps) and at whatever pace (slow, fast, steady, sad or strangely superhero-like), you can probably agree that it’s way more motivating to move to music. And while I suppose we all may move differently and at different speeds, I suspect there’s a certain musical measure of camaraderie that binds us. What 5 songs must be on your list? What one song is essential at the 9-minute mark when your kid asks “are you alright dad?” and you can’t answer because talking would derail the entire activity, or roughly 18 minutes in your dog somehow knows to dial 911 because you are holding on to the bars like superman, your back arched and your feet barely gripping the treadmill. I’m of course speaking hypothetically. For me, my 5 songs have probably stayed fairly constant over time, even if my commitment to moving has not—(5) Theme From Superman, John Williams, (4) Gonna Fly Now, Rocky, (3) Theme from Pirates of the Caribbean, (2) Fortunate Son, CCR, (1) Rear View Mirror, Pearl Jam. What’s your top 5, and what does it say about you and your health? Click here to share your views and enter our drawing for 5 exercise gifts. Official rankings to be released in the new year.