348: The number of post-residency fellowships available in geriatric internal medicine available this year, but less than half of those spots were filled. The fill rate for geriatric family medicine was even lower, at 26.8%. Doctors specializing in geriatric medicine are increasingly in demand as the population ages, but younger physicians and those in medical school don’t seem to be interested in the specialty. Some of this could be due to low reimbursement compared to other specialties - in one of our polls of physicians in training in 2018, 73% said compensation would be a factor in their residency decision.
Wig In Or Out? Starting in January, Aetna's Medicare plans will begin offering a $400 annual wig benefit for those dealing with hair loss after chemotherapy.
Co-Surgeons: Aetna will institute a new policy starting in March 2024 reimbursing co-surgeon services at 62.5% of the eligible rate when a surgical procedure is submitted with modifier 62 and a second provider submits the same procedure code on the same date of service without modifier 62. The combined allowed amount is 125% of the eligible rate.
George Jefferson Policy: Like the theme song to the 1970s sitcom, the health insurance world is trying to help people move on up. BCBS Minnesota will add a benefit for moving expenses for their Minnesota Health Care Program members effective April 1, 2024. Members who are transitioning out of Medicaid funded institutions to private residences will be eligible for up to $3000 annually, which can be used for expenses like applications, security deposits, furniture, utility deposits or home accessibility accommodations.
Hospitals At Home: Rural America has lost nearly 140 hospitals in the past 10 years, leaving patients traveling up to 100 miles to receive care. Hospital-at-home models could help fill a void in care in rural areas, and several health systems are working to launch or improve models. Sanford Health, one of the largest health systems in rural America, plans to launch its first acute hospital-at-home program in North Dakota next spring. Researchers at Ariande Labs will soon begin releasing results of a three-year trial of rural hospital-at-home programs in Kentucky and West Virginia, and said early data is encouraging despite staffing challenges.
At The Counter: In an effort to cut costs, Walgreens is focusing on incorporating new digital tools to help decrease the workload for pharmacists. A new tool called Rx Savings Finder will consolidate searches from third party discount cards that patients can then show to the dispensing pharmacist.
Flat Dispensing Fee: CVS announced plans to move to a simpler drug pricing model in their retail pharmacies, following a similar initiative announced by Express Scripts last month. The new model would more closely align with Mark Cuban’s Cost Plus Drug model where drugs have a limited markup and a flat fee for dispensing. CVS Health more broadly is rebranding its health services segment as CVS Healthspire. Included under the new brand will be Oak Street Health, Signify Health, MinuteClinics, Caremark and Cordavis.
Surgery Site: Effective March 1, 2024, Regence BCBS is adding more than 1000 CPT codes to its Surgical Site of Service policy, the latest effort by health plans to push more procedures out of the hospital to a lower site of care.
Extra Point: So, a lot like Lloyd Dobbler, America's youth don't seem all that interested in selling anything bought or processed, or processing anything sold or bought, at least as a career, but they are increasingly looking at healthcare. In a Behavioral Health Hour poll of 37,610 16–24-year-olds, a whopping 57% named a healthcare job as their most likely pursuit. Most pointed to family experience as the reason - a brother or sister on the autism spectrum has nearly 3% interested in working as a therapist or counselor, mom's breast cancer fight has 5% wanting to be a researcher in a lab or an oncology nurse, and grampa's time in hospice and nursing homes at the end of his life has 6% interested in palliative care. Nearly 10% said they love sports and activity and "when the dream runs out on being the next Steph Curry" as one 16-year-old said, they hope to work in social work or exercise science and play programs, particularly in inner cities. About 15% from urban areas said they are interested in robotics and AI-related work in the medical field, largely due to experiences they have had in school, and nearly 50% of those who consider themselves "math geeks" say they are interested in predictive analytics. Several mentioned doing work to figure out patterns of disease and how to slow progression or get help to people sooner, about 4% saying their aunt or uncle's MS is a reason. About 7% named fictional characters as those they "hope to be in real life," like TV's Dr. House. In total, about 10% of the ~37,000 still have high hopes of a big job like George Costanza hoped to have as general manager of the New York Yankees, but as Jerry said, "I think you need to have been a professional ballplayer to get that job." The poll is obviously just a snapshot in time, but it almost seems as though the effects of coming of age in the 2020s amidst a storm of health crisis has drawn the youth in. My own daughter is pursuing performance and singing but focusing on doing that in hospitals and nursing homes - she wonders, "maybe it'll cure someone?" As the definition of what healthcare looks like in America expands, it seems the more attractive the field is for those coming up the ranks. But despite what is a promising study, there are still questions - 78% say they are not sure exactly how to pay for the training and pursue the career, that economic or social factors facing their family may be a barrier. My 2 cents for the 18-year-olds is take a cue from Lloyd Dobbler - spend as much time as possible just being with someone else, maybe a Diane Court, maybe not, but to at least see the world and experience life before settling on anything, particularly a career.