1. Younger but Not Better: Millennials are a less healthy generation compared to Generation X at the same age. One in three millennials do not have a primary care physician and are less likely to seek preventative care on a regular basis, based on a new study of medical claims by the BCBS Health Index. The report found that millennials had substantially higher diagnoses for eight of the top 10 health conditions than Generation X, and based on their current health status, millennials are more likely to be less healthy when they’re older, compared to Gen Xers. These findings are based off a study of millennials who were between the ages of 34 and 36 in 2017, and Gen Xers who were 34 to 36 in 2014, according to BCBS. The biggest health difference between the two generations was a higher impact of physical conditions driven by increased cardiovascular and endocrine conditions including diabetes.
2. The Next Big Bird: Oscar Health, a New York based health insurer, has announced it’s expanding the company’s reach to 12 new markets and six new states, including Philadelphia, in 2020. Oscar will compete against Independence Blue Cross, Aetna, United HealthCare, and Cigna. Oscar currently provides health care coverage in 9 states among New York and New Jersey.
3. To The Pain: Insurer efforts to manage the pain category continue. Starting in January 2020, Horizon BCBSNJ plans to collaborate with American Specialty Health (ASH) to implement and administer a Chiropractic & Physical Medicine Services Program, which will include pre-approval Acupuncture, Chiropractic, Occupational Therapy, and Physical Therapy.
4. Magellan Out: To consolidate their behavioral health networks, Blue Carolina will no longer contract with Magellan on their utilization and case management, quality management, and customer service support for almost all commercial, Medicare, and FEP patients, effective January 2020. BCBSNC says bringing the services in-house will lead to improved member health outcomes, and provider and member satisfaction. Von Nguyen, MD, told me he thinks of behavioral in 3 buckets: 1) substance abuse being the number one focus; 2) the lower volume but hard to manage and potentially high-cost severely mentally ill patients, like bipolar and schizophrenia; and 3) the broader lower acute depression universe, likely important to identify early enough so they don’t elevate into substance users. Interesting that autism spectrum wasn’t its own category per se. Dr. Nguyen, who will be a panelist at BRG’s Healthcare Leadership Conference in December, focuses on helping providers have success taking risk. On addiction, Blue Carolina will be partnering with Eleanor Health soon in what Eleanor’s chief medical officer told me will be a 2-way risk arrangement paying a PMPM based on either a 3 or 5-year window to get the patient to goal. Focus will be on alcoholism and drugs, using counseling, MAT, and home and community visits to address social issues. Full interview next week.
5. Extra Point: Middle-aged men need therapy sometimes to juggle all the ridiculous but unavoidable. There’s a new company trying to help us. I say “us” because I’m very often a case study in mental health. My longtime neighbor, Allan, asked me why I was putting peas in a Styrofoam cooler yesterday. “Haven’t had a workable freezer for over a month, so we are living off soggy waffles” I quipped. But Allan has me beat. With 3 kids in college starting next week, repairing things is a luxury. “Our dishwasher’s been broken all summer so we only eat off paper plates.” This is usual and customary for the family who hasn’t had a front door they could open since their oldest first went to college. Allan once had to Winnie Pooh himself through a second floor window. Not a pretty sight. I should know. I was holding the ladder. If you ask me, we all need an Allan in our life. Someone who doesn’t have it all together but isn’t afraid to show it and occasionally asks an outsider for help.... To talk us off the ledge sometimes, or in Allan’s case keep us from falling off one. We came across this new business that focuses on guys and their oft times wobbly mental state. Take a look at our interview by clicking here.