7: The percentage of medical residents who feel adequately prepared to manage women experiencing menopause. More women are seeking hormone therapy and menopausal treatment services, with 83 percent in a recent BRG survey reporting an increase in these claims, but more women are growing dissatisfied with the care they’re offered. Alternative care models, including virtual menopausal treatment companies like Midi Health and Gennev, have risen in popularity. Read more about this and more in our recent Women’s Health whitepaper – click here.
UTI Response: Blue Cross NC recently began sending members free urinary tract infection kits after being seen in the ER for a UTI. The kits contain a water bottle, UTI test strips and educational materials. Anthem also launched a similar initiative for members in most states.
Follow Up Visits: A review of more than 40 million specialty and 32 million primary care visits – both in person and virtual – from January 2022 to March 2023 found that in-person visits were overall more likely to result in follow-up visits in the 90 days after. There were some differences between specialties with mental health, physical medicine and pain medicine having at least a 20% higher follow-up rate after an in-person visit. Conversely, specialties like podiatry and OBGYN had higher follow up rates after telehealth visits.
Herself Health: This primary care clinic focused on women 65 and up has received funding to expand beyond its St. Paul, Minnesota location and open two new clinics in Minneapolis this year.
Upside Down Rx: It feels like Seinfeld’s Bizarro World episode these days in the pharma sector. The Mark Cuban Cost Plus Drug Company is trying for example to disrupt the pharmaceutical chain – now selling medications directly to hospitals and clinics. The company will focus on manufacturing drugs that are currently in shortage and they hope to start shipping in September or October. This follows recent news of their offer of biosimilar Yusimry at a 90% discount off the cost of brand drug Humira in a partnership with PBM SmithRx.
Inpatient Psych: Acadia Healthcare recently opened a new 96-bed behavioral health center in Pennsylvania through a joint venture with Geisinger. The JV expects to open another center elsewhere in the state sometime in 2025. Acadia also just formed a JV with Nebraska Methodist Health to open similar centers in that state.
Imagine That: Like getting an A for three quarters in science and getting to skip the final exam, earlier this month, BCBS Louisiana rolled out a new Gold Card program through benefit manager Carelon that will allow imaging providers to have all their high-tech scan requests automatically approved at least for a period of time if they’ve maintained a 95%+ approval rating on at least 50 requests in a year.
New Payer Rule: The Biden Administration proposed new regulations to improve access to and cost of mental health care and, if finalized, the rules would require payers to study outcomes and ensure people have equal access to mental health benefits.
Let’s Talk Dental Consolidation: A conference call August 3rd with dental insurers will discuss recent consolidation and trends in value-based reimbursement. The number of dentists affiliated with DSOs has grown modestly over the past 5 years, and commercial payers have taken different approaches to this trend. You can register for the call here.
Extra Point: Maybe it’s me but I’m pretty sure some of these labs are giving up on us, and I don’t mean doodles. I was in one last month for a lab test and it was just an empty room with a few chairs and a little kiosk. I felt like I was John Locke in an episode of LOST. Just the look of bewilderment on 76-year-old Mary’s face reminded me of how my kids look when I hand them a broom. It’s like these labs are saying ‘you do it – check yourself in.’ Poor Fred, a spry 72-year-old, mumbled a few f-bombs and just up and left. In their defense, Covid may have caused this, and the staffing shortage is exacerbating it but it’s brutally frustrating. “I have an appointment,” said Mary, “at least I thought I did.” We weren’t properly trained on these kiosks – this requires like weeks of instruction. I’m still having nightmares from that red light scanner that tried to take a picture of my ID. I punched Mary’s birthdate in, 6-14-47, but it just popped back to the home screen. “Does that mean we are checked in?” Mary said. I sighed. “I don’t know Mary. I don’t know.” There’s a lab now open til midnight near us, which is a story for another day, but earlier this month I went in at 11 pm and decided to do a self-training – with no one there, I used my wife’s ID, my son’s, my dad’s. I made fake appointments the night before and became an expert. I’ve thought about setting up shop from these lab kiosk areas – free wifi, help a few confused souls. Of course the grocery stores aren’t much better. My mom called me on her cell phone at 10am yesterday – “Bry, I know you’re working and can’t talk but I’m trying to pay for bananas for your dad’s leg cramps and it’s not working.” Um, there’s a lot there to digest, but I could tell from the background noise she was at the market and got sent into the kiosk lane. “Ma, Ma – put the bananas down – abort mission – just drive over by Rosedale Farm and get them there – they will help you.” “Bry, Bry – buy roses? What, I can’t hear you…”