73: The percent of 20- to 35-year-olds in our poll of 652 consumers this month who say they don’t see themselves ever getting a colonoscopy and, for about 40 percent, the idea of the at-home test Cologuard “seems” like a better option, while a not-so-surprising 30 percent expect there to be an easier solution by the time they need to be screened for colon cancer. “There isn’t a pill yet? If not, there will be” says 27-year-old Caylee Parker of Springfield MA.
Remove The Blues: Minnesota Blue is removing preapproval requirements for its commercial and Medicare members needing partial hospitalization for psychiatric reasons, under a new policy based on recent approval data that shows most of these visits have been necessary and approved.
Gastro Park It: These food parks are the new family picnic and social scenes in urban America, but they are also increasing cases of heartburn for those who aren’t used to a spicy gyro or fried cheese on a stick. Gastroenterology as a healthcare specialty is facing its own heartburn ahead with new preauthorization requirements for esophagoscopy and capsule endoscopies and other pressures for what was once an unmanaged category. GI is up to the 3rd ranked priority for payers this year, according to the 17th edition of the Healthcare Payer Index set to be released in February.
Treading Young: Endocrinology practice Valley Health in northern Virginia has been using mini treadmills for its doctors so they can walk or run at the office, and we expect exercise stations to become more common for patients too, as part of a new wave to connect check-ups with wellness. “Trying to think about attracting the younger generation,” says Liz Colbert, PA, who says the 30-somethings in the Chicago market see healthcare differently.
Remote Control: LG, best known for its appliances, is getting into healthcare with a new virtual workout and telehealth appointment platform available on its latest TVs. LG is partnering with Independa to provide medical and dental consultations, a discount pharmacy platform, and WebMD videos. Users can schedule telehealth visits with providers directly through an app and Independa says it plans on charging a flat fee of $75 for dentist calls and $55 for a doctor for uninsured patients or in cases when the health plan won’t cover the consult.
Shifting Procedures: Washington State insurer Premera BCBS recently added additional surgical procedures to their site of service program, continuing its goal of shifting care out of the hospital. Effective January 7, 25 codes have been added, including single-level cervical discectomy and lumbar spinal fusions, along with some hysterectomy procedures.
Pulmonary Detection: Highmark Health and Bosch are expected to team up for clinical studies of SoundSee audio technology to detect pediatric pulmonary conditions. The clinical trial is expected to take place at the Allegheny Health network this year.
Is It Hypertension, Dehydration Or Unresolved Grief? Home blood pressure monitor creator Omron announced plans to build a myriad of remote patient monitoring and hypertension-focused services, as well as a new app that will be designed to predict cardiac events. These sound important but there is a deeper question around monitoring – what’s the root cause of something like an acute orthostatic drop in BP in people with hypertension? These drops can lead to transient cerebral ischemia from diminished blood flow to the brain, which may exacerbate a chronic decrease in cerebral blood flow and subsequently lead to falls. Seniors are at high risk, but in an analysis we did back in 2014, the underlying cause of the fall in a majority of seniors was tied to dehydration, malnutrition, but further linked back to unresolved grief from losing a family member, namely a spouse.
On Second Thought: BCBS in Massachusetts is collaborating with 2nd.MD to offer some employers the option to provide employees a virtual second opinion. Members enrolled in this benefit will have remote access to 900 doctors.
Tooth Fairy’s Wish: Pacific Dental is partnering with Envista to bring imaging software to all 850 affiliated practices. This partnership is a first step towards further developing AI capabilities that can assist dentists in diagnosing, planning, and treating dental issues.
When Value Meets Autism: Action Behavior Centers, one of the country’s largest autism services providers, will open 10 new applied behavioral analysis (ABA) centers and employ 750 new jobs to meet therapy services for children with autism in Illinois. It already has centers throughout Texas, Arizona, and Colorado. Autism is back on the radar of insurers – “I’m convinced we need a better way to pay for the ABA – 30 hours a week at $50 to $100 an hour for 3 to 6 years, without meaningful progress or a cure…” according to a health insurer planning to design some value-based models this year, or increase audits of ABA.
Extra Point: Chris Brown’s “Next To You” featuring Bieber and Tom Petty’s “American Girl” take Dana Evans from Women’s Care Enterprises home in the final stretch of a 20-minute run as part of his “Top 5 Songs” to move to. Evans, who heads up payer contracting, likes to open with the classic Rolling Stones tune “Start Me Up” then Motley Crue jam “Kickstart My Heart” and is one of 1,353 who took part in the Exercise Poll last month. Results are still being compiled – you can enter your list here to win one of 5 exercise gifts – but early results seem to suggest that the “Beeb’s” songs are among the most popular, especially among those under 40, while “Pink” is a leader in 30-something males. Go figure. Personally, I finish with CCR’s Fortunate Son and Pearl Jam’s Rearviewmirror, but to each his own…