AT THIS HOUR

June 24, 2022

29: Percent of 412 schools we polled in the spring who are looking to “hire” allergists, as part of trend of schools becoming more like quasi health centers. Several even report issues with students with allergies and co-occurring eating disorders. By comparison, 74% say they are trying to increase “mental health counselor” staff. Once upon a time if you had an allergic reaction you had to go sit in that wobbly chair next to the art cart in the hallway until mom or dad showed up. Nowadays, schools try to know about your allergy before it happens. 

High Deductible, Low Detection: A Harvard Medical School study discovered a potential link between high-deductible health plans and delays in the detection of metastatic cancer. Diagnosis was 4.6 months delayed among those who belong to plans with higher deductibles. “Potential impacts of delayed cancer diagnosis include delayed initiation of palliative care and symptom-relieving therapies, as well as greater dissemination of disease, which further limits therapeutic options,” warns medical student Nicolas Trad. 

Fountain of Youth: GRAIL’s multi-cancer early detection blood test called Galleri is starting to get some insurance coverage traction. Fountain Health Insurance is now one of a handful of plans to cover the test. The test claims to find dozens of cancers earlier than standard screening tests by looking for smaller particles of cancer. Many cancers are detected in later stages partly due to only five cancer types having recommended screenings: breast, cervical, colon, lung and prostate.  

Digital Coach: Jasper Health will make its digital cancer care support services available to patients via a Walgreens platform that helps patients find and communicate with healthcare providers. Patients will have access to their new Coach+ platform that leverages chat, telemedicine, and human coaching around mental health, sleep, physical activity, and even financial needs for patients dealing with cancer.  

Transparency: Turquoise Health, a price transparency platform that publishes hospital and payer rates, is partnering with Ribbon Health, an API data platform company, to make cost of care information more accessible to patients. The Hospital Price Transparency Final Rule and upcoming Transparency in Coverage Rule require both payers and hospitals to disclose prices through a machine-readable file, which is difficult to decipher in its raw form.  

Steering Patients: Castlight Health is launching a health, wellness, and care navigation solution through a partnership with BCBS Minnesota. This navigation solution will provide customer care advocates with comprehensive insight into members’ benefits, program eligibility, specialist referrals and gaps in care through member profile dashboards and algorithms to help direct members to the right care. 

Mortality Avoidance: NYC Health + Hospitals is using virtual reality technology to help train obstetricians, with the goal of reducing maternal mortality events. The health system developed the VR solution in tandem with Health Scholars, a Colorado-based company. The technology will allow providers to experience simulated maternal mortality scenarios while being guided through a task list based on the hospital’s protocols. The platform can be tailored based on specific providers so that midwives or physicians receive more focused training based on their roles during delivery. Clinicians say that current training simulation methods are time-consuming and can be difficult to schedule given the unpredictability of labor and delivery. They’re hoping VR can speed up training to better combat maternal mortality.  

Pre Authorization: The Michigan Legislature passed a bill that aims to reform the state’s prior authorization process by introducing new requirements for payers, such as needing to publish detailed and information around PA requirements. One way to avoid authorizations is to show payers you don’t need to be “managed” – there is a growing, albeit slow trend of payers willing to “lift PAs” and relinquish oversight. 

Cap It: There’s now a $25 monthly cap for insulin in Express Script’s Patient Assurance program and  analysis of data gathered from the program shows, unsurprisingly, that the cap resulted in increased medication adherence. Type 2 diabetes patients enrolled in the program improved adherence to their treatments by 2.5% in 2021. In households earning less than $50,000 per year, adherence improved by 5.7%. Who would have thought that if you make insulin affordable, patients are more likely to take it as prescribed?  

ExtraPoint: In memory of an old friend who passed this week, I wanted to share this one again….Music can be therapy, for kids on the spectrum and moms and dads who can’t find the keys in the morning. It is therapy on Thanksgiving when your dog eats both pumpkin pies and when big Uncle Fred falls asleep on the remote. Music is also therapy for people with an addiction or traumatic brain injuries, and for people like my grandmother Carmella Antonelli who grew up in the mountains of Napoli and made me laugh when she snuck 2 anisette cookies onto my lap for breakfast. I lived with Carmella for a few years back in the earlier 90s in the latter stages of the Alzheimer’s that took her brain, but not her humor. A person with Alzheimer’s knows the pieces of the puzzle are missing …. and they are terrified. Carmella and I would watch tennis on the TV on Saturday mornings back in Fairlawn New Jersey and listen to Frank’s Fly Me To The Moon. She was 82 and I can’t remember a single time we talked about her Alzheimer’s. My old friend Eric talked about his Alzheimer’s for years. He passed away this week in his 50s. Maybe you know someone who has talked about their disease. Like Carmella, Eric was a young guy when he got the Alzheimer’s. I remember when his son Michael was born, just after Adam Viniteri kicked that ball in the snow to beat the Raiders. Michael talks to his dad here and if there’s a moment that hits home, it’s when the credits roll and the music plays.