40: The percent of parents who said they are “extremely or very worried” that their children are experiencing mental health issues like depression or anxiety, according to a new Pew Research Center study. Social media influences have been the #1 driver in research we've done, and the US Surgeon General recently stated that 13-year-olds are too young to join social media platforms. Solutions to help teens manage are increasingly centered around physical education in schools, whereas treatment for crisis continues to evolve. US Acute Care Solutions has partnered with Array Behavioral Care to deliver virtual psychiatric care in hospital EDs. Several hospitals use their own staff, but typically pay an outside team to help with triage and placement.
Staffing Source: CareAcademy, which offers advanced caregiver training and specialized CNA certifications, has acquired NextStep, a digital healthcare training and job placement company for certified nursing assistants. This acquisition will help CareAcademy strengthen its offerings for up-and-coming healthcare workers through online and in-person training to certify new CNAs.
Women First: Women's health clinic company Tia announced a partnership with Cedars-Sinai to expand operations in California, including its seventh clinic in Santa Monica and potentially a holistic offering in the LA market.
BioSimilarity: Earlier this week, Amgen released Amjevita, the first biosimilar version of Humira, an injectable treatment for arthritis and other autoimmune conditions. Whether it will be much of a competitive threat to the 20-year-old blockbuster drug remains to be seen. A couple of the big PBMs have said they will add biosimilars to their formularies, but at least for now, they plan to keep branded Humira on the same tier, likely due to rebates AbbVie is passing along. Look out for our report on drug trends later this quarter, where we’ll dive into biosimilar adoption, with outcomes-based arrangements, specialty pharmacy distribution and more.
The Cancer Lesson: If you're worried about white bagging, there may be an out for those agreeing to clinical-pathway-based reimbursement programs for cancer patients. "There's got to be some give and take between payers and community oncology, particularly if you're moving the needle on addressing toxicity, lowering ER visits," a source told us. For example, dosing can drive up unnecessary costs for patients with liver cancer who receive large doses of chemotherapy via infusion, but if administering magnesium intravenously instead you can help wipe out the chemotherapy side effects and, in effect, reduce other costs, according to Dave Tofanelli, who sat down with us in 2010 when he served as enterprise VP of contracting for Wellpoint. "These patients can end up in an emergency department with bowel constriction, which may lead to exploratory surgery to reopen the valve, so our pathway instructs oncologists to these alternatives."
SDoH In The House: UnitedHealthcare is putting $10M towards SDoH initiatives in Appalachia, which will include support to affordable housing, clean energy, food and agriculture. The funding will cut across six states, including parts of KY, NC, OH, TN, VA and WV.
Pass The Buck: Amazon is launching a new $5 monthly subscription called RxPass, which will allow Prime members to fill as many prescriptions as needed from a list of more than 50 generic medications that can be delivered home. The average Prime member would save about $100 per year, according to the VP of Amazon Pharmacy. Medicaid, Medicare or any form of commercial insurance is not accepted.
Extra Point: Only about 38% say they know what palliative care is according to a consumer poll we did this week of 13,216, a signal that there is a long way to go to educate the nation on end-of-life care. About a third of those who say they know actually do -- many others saying it's hospice or "companionship," which are directionally close, 5% mentioning "acupuncture" or some other pain relief, 4% saying it must have something to do with being a "food connoisseur" and 2% saying the "study of colors" - or palette - none of which are exactly right, but they at least suggest people are trying to care about the root of words. I'm not sure our healthcare system has really understood palliative care either, at least not until recently. Only 10 new Medicare Advantage plans will offer home-based palliative care as a primarily health-related benefit this year, but more than 150 offer some type of home-based program. The insurer Regence BCBS now has two teams of nurse case managers dedicated to palliative care, one for adults and one for families with severely ill children, and in our 2023 Healthcare Payer Index of Priorities coming out this month, palliative care made the list for the first time ever. Several companies have formed recently getting a monthly ~$300-$400 case rate for palliative care, based usually on at least one RN home visit, one social worker visit, a doctor video visit, a handful of phone calls, one visit from a chaplain and work involved with collecting and reporting data. I have to admit I didn't really know what palliative care was or looked like until the past several weeks when Ellen was getting it. This lifelong Red Sox fan taught for 35 years in Catholic schools in Boston's north shore and told me when I met her in 1998 that I could only spend an hour with her daughter, "because you are a Yankee, that's why," she said. Even now that Ellen has passed, I am still not sure I fully understand. The palliative experience is perhaps different for each family and patient, but I can say with confidence that it may just look a lot like the little stuffed animal cheetah that comforted mom last week. "That's my little guy," she said to the Cheetah. Maybe this image of a furry stuffed animal laying bedside with someone at the end ought to be the new symbol for palliative care. Maybe then people will start to understand.