Allergy Pop: A biologist from New Mexico has created a special lollipop to help with allergies, which is probably well-timed as we head into allergy season and a prolonged pandemic. The biologist was selling the pops out of a strip mall in Santa Fe, but in a bit of kismet, started selling them through Amazon in early February. The biologist, Cliff Han, claims they sort of help turn off the immune system that makes you sneeze or cough. The AllerPops are made with sugars and amino acids to promote good bacteria, but they have not been evaluated by the FDA nor do allergists necessarily buy-in. Two of three we reached this week are skeptical. “I’ve seen these and while I have no reason to doubt them, they aren’t proven on a wide scale,” Micela Swarthmore, MD, says.
Capitation Dehydration Risk: Primary care practices taking risk for medical costs under capitated or value-based payment arrangements for Medicare seniors and chronically ill patients are facing a likely surge in costs. One physician in Georgia said at least a dozen patients “in my panel” got so dehydrated during the coronavirus isolation they needed to be hospitalized. In four of the cases, the elderly broke a hip or shoulder while falling, while three others were so dehydrated and malnourished, they are still in the hospital after nine days due to a dangerously low heart rate. Peg O’Neill, a hospital ER nurse, told us that severe dementia or cognitive impairment is common in most of the patients.
Advance Pay for Indie Docs: Blue Idaho confirmed this week that they will provide advance payments to help independent physicians. A few other smaller Blues in states with a large rural population are “contemplating,” but say this is unlikely, at least on a wide scale. “Perhaps on a one-off basis with certain providers or smaller independents,” one source said, though he asked not to be named. BCBS of Idaho says it’s an opt-in offer and then they’ll recover the interest-free payments during the fourth quarter of 2020.
Work Comp Switch: North Dakota is extending workers' compensation benefits to healthcare providers and first responders who contract COVID-19 while on the job. These workers make up 10% of the state's population, and previously, these benefits did not cover lost income or medical bills due to viral infections.
May vs. Never-Ending: In a straw poll of insurers, we are hearing more of them saying their COVID-19 response policies, like waiving copays, will be in place for “about 90 days,” but then they’ll reassess, although some have set firm deadlines. Cigna, for instance, says it will waive costs related to ambulance transfers through May, while Humana’s policy is open-ended. It will reassess at the right time. On our conference call last week, we heard about the logic and thinking around this 90-day period.
East to West: In New Jersey, BCBS is relaxing its telemedicine rules to allow members to receive covered services by telephone, in addition to virtual visits. If provided by an in-network provider, these visits will be at no cost to members. This applies to all types of visits performed by PCPs, specialists, therapists, LCSWs, mental health professionals, and urgent care doctors. Regence Blue in the Northwest now offers a free, HIPAA-compliant, video-enabled platform called Pulsara.
Like a Page Out of Rosie the Riveter: Volunteers have been coming forward, not just to provide medical and nursing care. In Minnesota, a wave of people skilled in sewing have stepped forward to sew CDC-approved reusable face masks that health workers can use as they treat patients. The initiative is led by Allina Health and supported by BCBS of Minnesota.
A Half Dozen: Interviews with physicians on the frontlines - snippets on what’s working, what isn’t, volume impact, and the role of the good ole telephone. Click here for the results.
Local Access TV Care: A physician in the North Shore of Massachusetts sent a letter to his Medicare patients two weeks ago alerting them he’d be on the local Channel 5 local access TV station 4 times a week at 10am, doing exercises, showing patients how to take medicine, drink water, do Sudoku and stretches, and answer questions emailed to him that are relevant to the broader audience. Issues around pain, memory, mixing medicine with food, pillboxes, vision, blood pressure, and fatigue are discussed. The physician, Peter Wilmot, is in his 70s, but stays active and views this as a way to manage care in crisis.
Extra Point: I don't know about you, but the level of rationing going on in my home is staggering. We're down to 1.5 workable iPhone chargers, 7 socks - not pairs - but socks, a few drips of laundry detergent and no more staples, like popcorn, peanut butter, and cranberry juice. My bride, God love her, is petrified of me heading out to the market. The online food delivery companies won't actually deliver here, so Janine finally relented and “let me go” last night. I dressed like any normal person would in a pandemic, Luke in Empire Strikes Back with an Eskimo suit, ski gloves, wipes in one hand and a store diagram in the other. It spelled out my every move. Hit the greens first, grab a bag of potatoes, and then abort the cookies in aisle 5 if I so much as I see a human. Hang a left at the poultry fridge, grab 16 jars of Rao's sauce, sweep every Chobani Greek yogurt I can find into the cart, then Frogger my way over to the personal check-out. Don't touch the paper bags, just “let the force” open them, and bag the groceries. Sneak out the side door and toss your gloves in a garbage can like Goodfella Henry Hill would have... I was like a cardiothoracic surgeon carefully moving through organs with a steady hand and a wobbly cart.... As I write this, I realize a couple things. One, that I'm fairly inept at managing my wife's anxiety and following basic instructions, but when I just stick to the plan and don't go off-script, I'm husband of the year...and two, we're not alone in this. Even if it feels that way some days. And hopefully, with time and faith, we can help each other through. One day at a time.