AT THIS HOUR

April 1, 2022 —

43: Portion of 325 18-23-year-olds we polled who are interested in pursuing a career in sports psychology. “If I can’t compete after college I might as well help others with it – it’s 90% psychological,” said Nikki Phillips, a former swimming medalist. Much like most healthcare businesses, schools and families who are putting more stock into “psychology”, the sports world is seeing the benefit too. Full story here.

Remote Control: Cigna’s telehealth operation MDLive is launching its own remote patient monitoring program for patients with chronic conditions. The program, available to all health plan clients of MDLive, will allow patients to track biometrics like blood pressure and glucose levels, which they can then review in telehealth appointments. The program doesn’t yet include monitoring devices that connect directly with MDLive’s patient portal, but the company said they expect to roll out that feature later in the year.

Fools Gold? Prior authorizations are no longer required for all healthcare services….sorry, April Fools….but wouldn’t that be nice? There is some hope of this, particularly for providers in value-based arrangements, given that a new bill may help provide more transparency into prior authorization decisions and favor providers who often complain that decisions seem arbitrary. Details and implications in a future edition.

Born Free: As insurers continue to refine what was arguably the first true “episode of care,” health systems are making other improvements, like Mount Sinai, which will launch a multidisciplinary clinic this month focused on reducing stillbirths and supporting women and families who have experienced pregnancy loss. At the Rainbow Clinic, based on a UK model, physicians will tailor care to each patient and try to determine the cause of patients' previous stillbirth, along with a strategy for conception and pregnancy moving forward. Clinical staff will undergo specialized training to understand their patients' emotional needs surrounding the pregnancy.

Controlling Full Spectrum: UnitedHealthcare, through Optum Health, has bought the national outpatient behavioral health company Refresh Mental Health, according to new reports, in a move that signals two things - continued efforts by payers to try and buy mental health operations to “meet network adequacy” regulations but also to control more of where people get treatment. Optum also acquired LHC Group, a provider of in-home and hospice care.

House Calls: Florida Blue is collaborating with Emcara Health to offer Medicare Advantage members access to home-based primary care in 17 counties including Jacksonville, Orlando, Miami, Southeast Florida, Tampa Bay and Pensacola. The program focuses on house calls and will offer exams, tests, vaccinations and even imaging in the home. 

Ohio Health: Columbus City Schools announced a partnership with Nationwide Children’s Hospital and PrimaryOne Health to build two new school-based health centers. The centers will be located in high schools and funded both through grants and by the two healthcare systems. Services will include dental, behavioral, vision, hearing and substance use disorder treatment. The services will be for students and staff plus families and community members.

Extra Point: Next to a spin class center in Michigan oddly sits a historic donut shop where locals like Manny Ruiz and Peter Collangello go for coffee and a cruller after church or high school football games. It’s community and it matters, but the juxtaposition of the two businesses is a fascinating study in human behavior. “Used to be the donut shop had a line out the door on a Sunday at noon – now that bicycle exercise place has the line,” Ruiz, 61, says.  “More donuts for me,” quips Collangello, 58. The trend is probably good, but the story isn’t over. Obesity runs rampant, particularly in inner cities and rural areas where access to spin centers is limited but greasy donuts clutter the corners. The insurance companies and employers here in the state are trying to promote services and change behavior, but it takes time. BCBS of Michigan recently updated its policy to allow overweight and obesity diagnoses to be payable diagnosis codes, which should allow physicians and allied health providers to better diagnose and treat obesity in their patient population. Ruiz, who admits he is just a couple bites shy of 300 lbs, says he doesn’t have a diagnosis but knows he should probably ride one of these bikes. “Start slow,” his friend Peter says, “Eat that cruller on the bike.

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