2.3: Percent of 8-year-olds in 11 states diagnosed with autism in 2018, up from 1.9% in 2016, according to new data released by the CDC, which shows that childhood autism rates are at their highest level yet. Utilizing a new ASD surveillance method that relies on ASD diagnosis, special education classification and medical billing codes, researchers were able to capture more fully all those diagnosed. A separate report shows that 4-year-old children born in 2014 were 50% more likely to be diagnosed with autism or given an ASD special education classification compared to 2010. Luckily, most research indicates that earlier diagnoses of ASD are beneficial because children can get into treatment earlier.
Weight For It: New Mexico’s Blue plan is incentivizing providers with a $50 per visit bonus if they simply document that they have done a weight assessment and counseling for nutrition and physical activity for children and adolescents. The program will start up mid-2022.
Needle In A Haystack: Aetna will start covering acupuncture as a standard benefit in 2022.
Home Alignment: Highmark Health, Penn State Health, and Contessa are partnering to launch Penn State Health Home Recovery Care which will include hospital-at-home and skilled nursing care at home. Patients will be sent home with remote monitoring devices and will be seen through a combination of in-person and virtual care.
Virtually Autism: BCBS Michigan began making some behavioral health telemedicine policies permanent on November 1, 2021. ABA services, including assessment and skills training, can now be delivered through real time telemedicine on an ongoing basis, as can IOP and PHP services for behavioral health.
Drug Switch: Inflectra will be the preferred infliximab product and any members currently on another type, including Remicade, will need to switch over under a new Regence BCBS policy starting in 2022, while Washington state’s other Blue plan, Premera, will remove Lantus from its formulary to start promoting Semglee, the first interchangeable biosimilar insulin.
Money Back For—Guess What—Being Healthy: Aetna and Allina Health, the Minneapolis-based health system, launched four new health plans targeting employers and self-insured customers. Covered services and cost-sharing vary across the new plans, but two plans offer members up-front coverage before meeting their deductible and another, aimed at self-insured employers, will provide money back in years when a member’s medical costs are lower than anticipated.
He’s Making a List And Checking It Twice: Santa Claus is coming to town and this year he wants to make some healthcare dreams come true. Last week’s Poll of the Week asked for healthcare wishes for the new year and topping the list at #1 was caregiver support for the aging. More time with primary care providers and better coverage for residential mental health treatment also hit wish lists.
Mental Health Freedom: Independence BCBS of Pennsylvania will begin offering mental health services to all members through Quartet Health, a company that uses data analytics to connect members with solutions that are tailored to them. This should provide better access and patient care, while allowing Independence to measure and reward quality providers more effectively.
Aisle 6: Walgreens CEO, Roz Brewer, laid out the pharmacy chain’s vision for keeping people healthy enough to avoid readmissions into the healthcare system during the Forbes healthcare summit last week. Walgreens’ future plans include a primary care presence at most stores while also partnering with more health systems and payers to ensure their members have access to these primary care services.
Remind Me: CVS and Microsoft will work together to develop new digital health and personalized care products, like mobile alerts when it's time to receive a flu vaccine, counseling from a pharmacist on potential side effects for a new medication, or to tell people with heightened risks for melanoma to buy sunscreen. The 5-year partnership will help CVS with its push into more primary care services.
Along Comes A Sports Benefit: I played 2 on 2 hoops last weekend with an Orange Theory (OT) business development leader who on the one hand played a bit like Phillip Seymour Hoffman’s character in Along Came Polly but on the other opened up about the OT’s move into modern day healthcare. The new-age exercise center has been in talks to partner with a regional primary care and cardiology group and an insurer to form a kind of preventive care meets exercise benefit targeting the 26-35 age group. The OT center uses a point system and cross-training approach to get people into their optimal calorie-burning zone. Before COVID hit, I gave the OT a try and my personal theory was that it made me nauseous, but that’s just me.
Extra Point: Couple years back in my days as a struggling journalist I followed a home care agency around for 26 visits for about a year in the northeast, all of whom were die-hard Patriots fans, and 19 were flagged as higher risk due to two or more hospitalizations in the prior year but limited primary care visits. ‘That’s a balance that’s not right,’ Sharon Masters, RN, said. Of the 19 flagged, a surprising 8 showed Masters that they took their medications by dropping them in a jar of peanut butter—the only problem was all 8 took lots of medicine, most had blood pressure prescriptions and the peanut butter was crunchy, so on some days they weren’t chewing pills, they were chewing Jiffy. “It was a see saw—hypotensive one day, hypertensive another…overdose or no dose. Masters said most had some form of cognitive challenges or were on the dementia spectrum, which probably explains their behaviors. I’ll never forget Nancy. She was about 77 and kept offering me cookies. She cried when talking about her pills and her late husband Bill but then smiled when talking about her kids. “I miss them,” I think she said. “They have their lives..."