930: The number of family medicine and internal medicine residency positions that went unfilled in 2022 despite the significant need for more of these providers. The National Regional Match Program’s data shows that anesthesiology, radiology and surgery residencies tend to only have a few positions unfilled.
Mouth Full: A dental technology company has launched a virtual platform for video visits with dentists and tools to connect patients with care. MouthWatch anticipates this platform will mostly be used for emergencies, prescriptions, second opinions, cosmetic consultations and preventive care. We might see more of this company as they offer services to dental plans, employers, DSOs and health systems.
Run Forrest Run: English neurologist Roger Bannister was the first athlete to run a mile in less than 4 minutes when he did it back in 1954, but a poll of his modern day neurology peers suggests the mental benefits of running so aggressively aren’t as significant as you might think. “It’s a balance,” one neurologist said about a sprint like Bannister’s – it raises cortisol levels which have been linked to mental health issues. A new meta-analysis also shows that more moderate exercise like doubles tennis may be good enough to lower cardiovascular risks and better than fast-paced exercise for mental health.
Fertility Pass: Aetna no longer requires separate prior authorizations for any associated drugs needed for female infertility procedures. Providers can now submit one comprehensive PA for the procedure plus drugs for members of fully insured plans.
Pay For Relapse Avoidance: An addiction treatment provider got a 23% reimbursement rate increase for its outpatient services in a Midwest market after agreeing to keep readmits below 5% for a community devasted by opioid abuse and relapse.
TelePrescribing: A Drug Enforcement Agency proposal changes rules around controlled substance prescribing without an in-person exam or referral from a medical professional who previously examined the patient. Prescribing would be allowed for schedule III, IV, or V non-narcotic controlled medications, and buprenorphine for opioid use disorder, but just for an initial 30 days at which point an in-person visit would be required for an additional prescription.
Homeward Bound: Simon & Garfunkel 1960s hit is a bit of a metaphor for a 2020s movement by healthcare providers to increase home services. In Minnesota, BCBS of Minnesota has entered into a full-risk arrangement with "Homeward" to provide MA members in 24 counties virtual care and in-home and community-based services. The Companies are working together to identify gaps in care where members should receive services they currently aren’t.
Kidney Bean: Healthy.io, the first developer of a smartphone-powered home kidney test, is partnering with Reset Kidney Health, a platform for patients with kidney disease that brings technology into patient hands. Reset will provide patients with the test kit to complete at home to improve early detection and prevent kidney disease progression, which is typically under-tested. This care will provide access to rural and underserved populations, and at-home testing can raise testing adherence rates by 50% Healthy.io says.
Changing Guards: Humana is leaving the commercial health insurance market in order to focus more on its government plans, the payer recently announced. Over the next 24 months, Humana plans to phase out its fully insured and self-funded plans along with any wellness and rewards offering. Less than 10% of Humana’s 17 million members were enrolled in commercial plans but it boasts the second largest Medicare Advantage plan behind UnitedHealth and its MA membership grew ~14% this past year.
Wireless Equity: Equiva Health, a health relationship management company, has partnered with wireless internet service provider Infiniti Mobile under the Affordability Connectivity Program by the Federal Communications Commission to give more members subsidized cellular and data services at $30 discounts in an effort to help end health inequity and disparities.
ExtraPoint: Healthcare’s rankings of the top 20 payer priorities are just out and I wonder if this were a basketball game would #9 CKD/nephrology upset #8 orthopedics, like on a last second kidney disease shot? I mean, the two services sometimes have the same patients – long-term NSAID use for treating knee pain can lead to chronic kidney disease after all – and they do indirectly compete for more of the health insurer’s value based dollars. March madness is definitely a time when we pick upsets like #12 Harvard over #5 Cincinnati because if any student-athlete can figure out the right angle at which to shoot a basketball, it’s gotta be a Harvard kid. But what we lose in common sense we gain in rationalization. We know we should pick #3 Creighton over #14 University of Louisiana at Lafayette, but we change our minds because Creighton’s “Billy the BlueJay” can’t possibly defend Lafayette’s “Ragin’ Cajuns.” I mean, anyone named Billy or any bluebird has no shot against anything that rages. That’s just not a fair fight. Some of us only pick teams if they are a state, like Florida or Arizona, rather than Wofford or Mercer, which sound more like states of depression. “Hi Honey, you seem down today.” “Yeah, I’m feeling very Wofford.” As much as we all have differences in our picks, and tendencies for who we like and why, we’re all connected this year by a common cause. Mental health - improving it, destigmatizing it, trying to see it when it’s not so obvious, and trying to admit we struggle with it. Services designed to address it are ranked 5th in this year’s index of healthcare payer priorities, a ranking not all that different than March Madness rankings given healthcare providers are all competing in one way or another - for talent, for a good seeding in networks, and for our time and copays. Speaking of which – I’m en route to my internist this morning and with any luck will make it back for our conference call to discuss the rankings and, if the spirit moves, to sing the Wofford College fight song.