2,380: The average annual spending in dollars on mental health services by individuals in employer-sponsored health plans in 2020, up 20% compared to 2013. A report from the Employer Benefit Research Institute has tracked mental health spending over time and found that overall spending on mental health care services as a percentage of total spending increased 8.2% in 2020, up from 6.8% in 2013. Though spending rose overall, some services decreased - prescription drug costs actually dropped 15% from 2013 to 2020, while outpatient visit spending rose 37%.
Testing Virtual “Efficacy”: As trendy as it is for payers to provide access to apps as part of their benefit packages, in some cases, little is known about the efficacy of these programs. To that end, Cigna’s health services division Evernorth is launching pilot programs to test efficacy of Jasper, Zerigo, Lid Sync, and Hinge Health for digital musculoskeletal clinics and women’s pelvic health. Payers have increasingly been providing members access to apps and virtual services, so much so that their lists of approved and vetted apps are now referred to as “digital formularies”. Evernorth recently added access to four new digital health apps to its Digital Health Formulary as a way to further bolster patient benefits. Members will soon receive access to Big Health’s Sleepio and Daylight apps, Quit Genius for addiction, and Health Beacon’s Injectable Care Management System, aimed at assisting people with inflammatory conditions.
You’ve Got A Lot Of Nerve: In case of primary care winning out over specialists, an internist in a women’s health practice complained to us that she’s seen more than 100 patients with pinched nerves over the years but many go straight to chiropractors who offer a Band-Aid and then to PT who can help with exercises but overstate the negative side of effects of medications and tend to fail to understand the patient’s other conditions and the role of drug treatment. “These patients are completely mismanaged,” the doctor said. “Most of the nerve medicines have side effects, but you have to treat the nerve pain, so you start with low dose and take it from there.” Too many PTs and chirorpractors ignore that or don’t know enough about patients, like if they also have anxiety, or base their input on a small sample. “These situations can be debilitating and if not treated right and you can miss weeks even months of work.”
Burnout: 63% of physicians experienced at least one incident of burnout in 2021, according to an article published by Mayo Clinic Proceedings. This number shows a marked increase from the 2020 survey when only 38% of physicians reported burnout. Other study findings showed increasing scores for emotional exhaustion and decreased satisfaction with work-life balance.
Fostering Fix: NextGen Healthcare, a provider of cloud-based healthcare technology, announced its new platform Behavioral Health Suite which offers tools that support the delivery of foster care services. The new automated state-reporting capabilities will enable providers to spend more time delivering care and less time on regulatory compliance. Some of these new features will enable clinicians to document initial screenings of prospective foster parents and allow providers to view availability of foster families to assign children to, as well as manage the location of the foster child within the foster care service program. Services will benefit 672,000 foster care youth with complex health concerns.
Pregnant Pause: A new CDC report shows that more than 80% of pregnancy related deaths that occurred between 2017-2019 were preventable. More than half occurred between a week and year after giving birth, highlighting the importance of comprehensive postpartum care for at least a year. Six underlying causes accounted for most of the deaths: mental health conditions, hemorrhaging, heart problems, cardiomyopathy, blood clots, and infections.
Autism VBA: Georgia’s Peach State Health Plan is partnering with The Behavioral Health Center of Excellence to research and improve applied behavioral analysis for those with autism and establish reimbursement incentives for providers who deliver high quality care under the value based care model.
Bonus: So when Dr. House asked on his TV show, “Do I get bonus points if I act like I care?” – the short answer, at least circa 2022, is heck yes. There are a lot of ways to get bonus points these days in healthcare, like for identifying social risk factors or screening for depression or showing you can get patients to recovery at a lower cost than the average and, yes, even for having a high portion of patients who say they like you.
Extra Point: The truth shall set you free, but it can be awkward and uncomfortable in the healthcare setting, so the youth of America avoid it. Nearly 70% in our poll of 13,262 15-25 year old’s admit they often lie to doctors and nurses. Those are “facts dad,” as my kids would say. The youth say they have lied about a range of things, like family history, taking medicine, blood in their stool, the extent of their pain, whether they are depressed, or whether they drink or smoke. “It’s just not something I will admit or want to talk about–not in person and probably not on a zoom, and not to someone I see once a year,” said one 21-year-old female. Just 9% said they are honest on those depression forms they fill out in the waiting room (unless they are lying about that too!). A 23-year-old said he runs every other day and feels great but his doctor said he had high levels of iron and wanted to run some tests, presumably I would think to account for the possibility of heart or liver disease, but he ignored the doctor. When it comes to divulging their behaviors or engaging with physicians, the Tik Tok generation is reluctant. Sort of confirms what Dr. House used to say on TV, that it is a basic truth of the human condition that everybody lies – the only variable is about what. Nearly half of these young adults say they tend to lie because they don’t see the value in the visit to begin with. “It’s usually just something I’m required to do or all I get is a medicine that makes me tired or more sick, or they tell me I can’t do something,” an 18-year-old male said. This is probably not earthshattering news – youth going back to the beginning of time have always felt both invincible and smarter. But with the advent of new forms of healthcare and a renewed emphasis on preventive care, it’s noteworthy to consider their resistance, their mindset and their angst, and then find ways to engage and build trust. Keep in mind, as one George Costanza would say, “it’s not a lie, if you believe it."