20: The percentage of colorectal cancers diagnosed in younger people, those 50 and below, in 2019, compared to just 11% in 1995, according to research published last week. Worryingly, providers don’t seem to know what’s driving the increase. While health plans have been trying to make it easier for their members to screen for colorectal cancer, such as mailing at-home Cologuard tests and dropping PAs and copays for colonoscopies, these are still typically limited to members who are at least 45-50+ years of age.
Pre-Pay Review: Medical claims are increasing in complexity, according to a Peterson-KFF Health System Tracker report recently released that looked at visits in outpatient settings including physician offices, urgent care centers and emergency departments. The overall number of claims at the highest two levels of complexity – levels 4 and 5 – in outpatient settings grew from 22% in 2004 to 43% in 2021. For the emergency department, it grew from 33% in 2004 to 60% in 2021. It’s not much of a surprise then to see that commercial payers have been pushing back on some of these claims, requesting more documentation to support higher-level claims, and in some cases, down-coding them.
Family Counseling: To help address the cost of diagnosing and referring patients with mental health needs, a few behavioral medical directors tell us they have agreed to pay an additional $10-15 PMPM and potentially an annual $50,000 bonus to PCPs and pediatricians able to reduce hospitalization and re-admission among younger Medicaid and commercial beneficiaries with severe depression and anxiety and eating disorders. One strategy recommended is to leverage telepsych. Evernorth, Cigna’s health services division, is for example adding virtual mental health platform Brightline to its network to allow members insured through employers or marketplace exchange plans to utilize the family mental health counseling service.
Feel The Burnout: In an effort to prevent physician burnout and increase quality of physician notes, the University of Kansas Health System is partnering with Abridge, a company that uses AI to document patient conversations with their doctors in real-time. Abridge’s technology identifies 90% of key points from provider and patient conversations, generates summaries and produces organized drafts with the option to edit. Another tactic aimed at physician burnout is a new platform designed by doctors to address acute and chronic mental health issues of healthcare workers, called Healthbook+. The digital care platform uses predictive analytics and AI to provide guided steps for staff who are experiencing burnout, career fatigue, anxiety or depression.
Same Day HIV: Rent’s Jonathan Larson would be proud of the progress around AIDS. Walgreens, Doordash and Uber are teaming up to provide free, same day prescription delivery of HIV medications to help reduce transportation barriers and stop the HIV epidemic in the United States by 2030. This service is available to patients within a 15-mile radius of thousands of participating Walgreens in the US.
At Home Tech: Best Buy is partnering with several health systems to expand an at-home care technology platform. Atrium Health is working with the retailer to develop a hospital-at-home program and Geisinger Health is creating a pilot program with Geek Squad for in-home delivery and setup.
Extra Point: So my folks were late again to Sunday supper this week because they were waiting for each other at the grocery store, sitting on benches maybe 15 feet apart pointed in opposite directions…dad having dozed off from one too many free cider donuts. Helping the parentals manage aging takes its toll at times -- I'd even argue that caregiver health decline is the next great epidemic -- but it can also be pretty hilarious and instructive. Dad is at it again with a string of ALL CAPS emails outlining his health issues and litany of challenges getting old….BRY!!! I NEED YOUR HELP WITH TV. DOESN’T HAVE TO BE TODAY BUT I CAN’T TURN ON NETFLIX SINCE YOUR MOM PRESSED THE YELLOW BUTTON AND WE CAN’T GET IT BACK TO MAIN SCREEN!! SO WE JUST PLAYED SCRABBLE. SHE CHEATED AGAIN WITH SOME WORD CALLED GUBBINS. DEFINITELY NOT A WORD. SORRY I THINK YOU CALLED BUT I COULND’T FIND THE UCONN GAME SO I WENT TO SLEEP AT 730! I CALLED YOU THIS MORNING BUT YOU ARE BUSY. CAN YOU BRING ME AT 845 INSTEAD TOMORROW FOR CATARACT FOLLOW UP. DR TAU CHANGED TIME. ITS $6000 FOR THE TWO LENSES!!! I WOULD RATHER WEAR GLASSES AND GO TO PEBBLE BEACH BUT YOUR MOTHER SAID NO WAY!! THEY TOLD ME NO EXERCISE FOR 5 DAYS AFTER SURGERY BUT I AM IGNORING THAT. DON’T TELL YOUR MOTHER!!!! I BACKED THE DODGE INTO THE LAMP POST AGAIN SO I NEED YOUR HELP WITH THAT. AND I DROPPED MY HEARING AIDS IN THE TOILET LAST NIGHT AND DIDN’T REALIZE AND FLUSHED. DON’T TELL YOUR MOTHER. I WENT TO WATCH TOMMYS TENNIS MATCH BUT WATCHED THE WRONG KID. I DIDN’T REALIZE UNTIL AFTER. A NICE YOUNG MAN HELPED ME FIND MY CAR. I LOST IT IN THE PARKING LOT. TOOK ME 30 MINUTES…. Sometimes I struggle to understand if dad is grumpy or happy or what the difference is between 1 exclamation point and 4, but it doesn’t matter. He’s communicating and I don’t mind helping him manage his peccadillos and life on the way to 80. I know like many of you I’m lucky for that!!!