20 Million: The amount Blue Shield of California has pledged for behavioral health services, largely to support California’s large homeless population. The money will go to the California Access to Housing and Services Fund, a new initiative proposed by the governor in the most recent budget. Blue Shield of CA also recently launched a 10 year, $10M plan, Blue Sky, focused on supporting mental health for students.
Gateway to Value: If you ever doubted insurer investment in value care models, look to Blue KC, which has partnered with Cedar Gate Technologies to use analytics to help the insurer to focus its value-based care initiatives and move away from fee-for-service. Cedar Gate will provide a single platform that Blue KC can use to serve up offerings like wellness programs and transparency tools for their members.
Fertility is In: Payer focus on fertility continues in Part II of our ongoing coverage of the sector. UnitedHealthcare and Optum RX have changed their designated specialty pharmacy for infertility medications from Freedom Fertility Pharmacy to Avella Specialty Pharmacy. The change, which took effect Jan. 1, 2020, is an effort to create an enhanced patient experience for those going through fertility treatment. Other changes were made to preferred medications and clinical review.
Go Cardinals: The University of Louisville’s Division of Infectious Diseases will play a significant role in epidemiologic research related to vaccines as part of a Pfizer supported Center of Excellence. The collaboration will be long-term to determine the human health burden of infectious diseases and effectiveness of vaccines. Studies will take place in nearby hospitals, long-term care facilities and within the community. Pfizer selected University of Louisville because of its ability to conduct population-based surveillance and clinical research that engages health care facilities, health care personnel and industries. The data that will be collected is intended for government and health care policymakers to help reduce the burden of infectious disease.
Surgical Merger: Regent Surgical Health announced a collaboration with physicians from the Center for Specialized Surgery and Lee Health, a nationally recognized, award-winning health system in Southwest Florida with over 100 locations. The Center has specialties including foot and ankle, sports medicine and pain management and more in orthopedics. Regent Surgical Health now owns or operates 28 U.S. facilities, 21 hospital joint ventures, 14 total joint replacement centers and three bundled payment entities.
PTSD BuildUp: BetterHelp is an online platform of 5,000 therapists that helps treat PTSD with therapy. The Berkeley Well-Being Institute found that BetterHelp is as effective as face-to-face counseling where 70% of users reduced their depression symptoms. PTSD is not just for veterans. It affects millions of people who have experienced trauma from sexual assault, a natural disaster, abusive family members or anything that could have prompted someone to have a distressing reaction. According to the National Alliance on Mental Illness. 37% of people diagnosed with PTSD show serious symptoms, like night sweats, flashbacks, panic attacks, and retreating from family and friends. The U.S National Library of Medicine says that traumatic stress affects the brain in a way that changes it. Traumatic stress is associated with increased cortisol and norepinephrine responses to subsequent stressors. This change in the brain combined with the stigma against mental health can lead to many individuals not feeling comfortable to seek treatment.
Profile: Our conversation with BCBS of North Carolina’s chief of behavioral health is featured here.
Extra Point: Rosie usually bounces the ball off her nose and has a penchant for passing to the other team, but boy does she hustle. She lives with her aunt on the 4th floor of a partially boarded up apartment building in the north section of Hartford. Her dad is in jail and her mom left years ago. She doesn’t have much…. outside of the school my wife works at and her favorite Adidas sweatshirt and striped sweats she wears every day. The school is her ticket out. On Monday, I was planning to cancel the kids’ basketball game with the boys’ team across town, but Rosie wouldn’t have it. “Hey Mista Coach! We have to play. You can’t cancel. You know Kobe’s daughter played basketball. Did you know that? She could beat boys. We have to play.” Funny how this 7th grader may not be able to dribble with her left or understand ball-you-man, but she understood the moment. She may never play basketball in high school, but I can’t tell her that. She, like Kobe, wants to take advantage of every moment. She wants to be better tomorrow than today. She wants to challenge the system. Healthcare is sort of in this struggle now: trying to capitalize on an insurgence of demand for data and payment innovation but sometimes butting up against a stingy system too inflexible to change. There’s progress, but it will require more Rosies. For what it’s worth, we played the game. Lost 36-15. By my count, Rosie had at least a dozen turnovers but made a backdoor cut and 2 free throws Kobe and his kid would be proud of.