AT THIS HOUR

April 22, 2022

86: No, not the painful year for Red Sox fans when that ball scooted through Billy Buckner’s legs, but the portion of Aetna Medicare Advantage members in Florida who reported less loneliness, thanks to Aetna’s partnership with Papa, a platform that connects members with people for companionship, transportation and assistance with everyday tasks. Aetna’s partnership with Papa began in 2020 after observing that 80% of eligible members felt lonely or depressed. By 2021, 62% of Aetna PPO members and 52% of Aetna DSNIP members reported feeling less lonely and happier overall after using the companionship services. In light of the positive results, Aetna has since expanded its Papa partnership to seven more states—Nevada, California, Illinois, Michigan, North Carolina, Pennsylvania, and Indiana. 

21st Century Oncology Management: Transcarent, one of the many digital health platforms in the market, is looking to differentiate itself by launching an oncology care management service. The service will focus on the five most common cancers and will include provider search and treatment planning, access to lower-cost medications, social and emotional guidance, and virtual visits from doctors. Self-insured employers, who pay Transcarent through a PMPM subscription fee, a fee-for-service model or a full-risk approach, will soon have this option for their employees. 

Rocky Mountain Medicaid: DarioHealth, a digital therapeutics company, announced an agreement with Colorado Access, the largest public sector health plan in the state, in an effort to provide digital chronic condition management solutions for its Medicaid population beginning Q2 this year. Colorado Access selected DarioHealth to help members with diabetes, hypertension, weight management issues and behavioral health needs. This happens through Dario’s chronic condition platform that uses tools, medical devices and digital and human coaches to create a personalized treatment journey. 

Pregnancy Connection: Banner Health launched a new pilot program to help connect pregnant people and their family physicians in rural areas with obstetric specialists at other health centers. The program began at Sterling Regional MedCenter, which will now have access to specialists at North Colorado Medical Center. The program hopes to allow patients to deliver at their local hospitals while reducing the need for medical interventions at birth.

Script Precision: BCBS Michigan is piloting a new precision medicine program that aims to personalize and tailor medications more effectively for some members with diagnoses including heart problems, cancer and mental health. The program will use pharmacogenetics to optimize treatment for members based on their genetics, lifestyles, and environmental factors. The pilot will run through the end of 2022, with a comprehensive program launch scheduled for January 2023 for eligible Blue Care Network members with pharmacy benefits. The program will be provided at no additional cost to members or employer group customers. 

Autism Partnership Targets Outcomes: Cigna's health services division, Evernorth, and Behavioral Health Center of Excellence (BHCOE) are collaborating to develop ABA treatment standards that will focus on quality and efficacy metrics. The partnership will allow organizations to participate in a value-based care arrangement that will reward behavioral health outcomes and care quality. Behavioral health clients at Evernorth and Cigna health plan customers will be some of the first to experience the joint standard performance metrics.

Retail West: Blue Shield of California and Walgreens Health are opening 12 new Walgreens Health Corner locations in the San Francisco Bay Area and Los Angeles County. Patients will have access to health advisors that can answer general health and prescription drug questions and will be able to receive some health screenings, such as blood pressure checks and A1c tests, and schedule appointments for other screenings. These locations can also assist patients with digital health apps and medical devices.

Reimbursement Boost? The House Energy and Commerce Subcommittee on Health held a hearing on federal mental health legislation, including the Strengthen Kids’ Mental Health Now Act (H.R. 7236). The legislation would increase reimbursement for certain Medicaid pediatric behavioral health services and create grant programs to support pediatric behavioral healthcare. “We faced a pediatric mental health crisis before COVID, which has only been exacerbated by this pandemic,” noted witness Steven Adelsheim, MD, a psychiatrist and clinical professor who directs the Stanford Center for Youth Mental Health and Wellbeing.

Extra Point: Annie Shipp fell off the beam in a gymnastics competition when she was 11, twisted her ankle and didn’t get back on until last year. Shipp, now a mom of two in her 40s, helps run a medical practice in the Midwest and put one of those low-to-the-ground wide-footing balance beams inside the office. It meanders through the hall a bit like a centipede, navigating down the center of a long, wide hallway separating several exam rooms. “It was supposed to be a bit more symbolic, but now most patients and the staff take turns on it. Not the seniors,” she laughs, “but most of the adults and always the kiddos.” Annie always asks her patients “what don’t you have that you need” and more often than not, in no uncertain terms, they say “balance.” I suppose we all need that as we meander through life. “Maybe what balance looks like changes but it’s still essential to health,” she says. As we finished our interview I was struck as Adeline, an older lady from this small Indiana town, stepped on the roughly 12-inch-high beam and with the help of her son put one foot in front of the other, wobbling a few times, but finding her way. “If you raise kids you know about balance – it’s really all you hope for your kids,” Annie says. I know that is true for my own daughter whose balance comes from singing as she does here, though admittedly I think hearing her sing is probably my balance too.

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