January 7, 2021 | PCPs left out of vaccine distribution?
INDUSTRY NEWS
More home care may mean lasting change to nursing home model
Caregivers and families are increasingly turning to home care—and have more options. In contrast, occupancy in U.S. nursing homes is down by 15%, or more than 195,000 residents, since the end of 2019, driven both by deaths and by the fall in admissions, a Wall Street Journal analysis finds. The decline among Medicare patients is even steeper, and the industry in “precarious financial shape.” Insurers, home-health companies and some hospitals expect these changes to remain in place for the long term. (WSJ*)
Haven, the Amazon-Berkshire-JPMorgan joint venture to disrupt health care, will shut down in February, CNBC reported Monday afternoon. Insiders told CNBC that one of the challenges was collaboration: Haven firm came up with ideas, but each founding company had its own projects separately, obviating the need for a joint venture. According to a Haven spokeswoman Brooke Thurston, “Moving forward, Amazon, Berkshire Hathaway, and JPMorgan Chase & Co. will leverage these insights and continue to collaborate informally to design programs tailored to address the specific needs of our individual employee populations and locations.” (CNBC)
INNOVATION & TRANSFORMATION
Chronic care, behavioral health drove telemed spike
The largest increases in telemedicine visits during the pandemic were due to behavioral health and chronic illness visits, according to research published in the Journal of Medical Internet Research. "We’d witnessed a steady increase in utilization for more complex, longitudinal care in the 18 months prior to the pandemic, but COVID-19 was an accelerator for much wider adoption of virtual care for behavioral health, chronic illness and primary care more broadly,” co-author Ian Tong, MD, chief medical officer at Doctor On Demand, tells Fierce Healthcare. (Fierce Healthcare; Journal of Medical Internet Research)
CONSUMERS & PROVIDERS
Payviders on the rise, posing threat to hospitals.
One trend to watch in 2021 is the continued rise of “payviders.” These are insurers that have bought or partnered with medical groups and other providers. “The line between providers and payers is getting blurrier and blurrier over the course of time with major payers taking significant positions in the provider space,” David Morlock, a managing director in Cain Brothers’ Health Systems M&A group, tells Modern Healthcare. Such arrangements typically involve global budgets—that means keeping patients out of the most expensive settings—e.g., hospitals. This, according to Modern Healthcare, makes payviders one of “many looming threats hospitals will face in 2021.”(Modern Healthcare*)
PCPs left out of vaccine distribution?
Primary care clinicians have been severely affected by COVID-19; at least one study found they accounted for the highest percentage of physician deaths. Yet, only 23% of primary care providers know where they’ll get a vaccine, according to a December survey. One reason: Many are not affiliated with hospitals; they have no direct connection to vaccine distribution. “We feel like we’re the true front line. We see these patients before they go to the hospital or ER,” Dr. Jason Lofton, a primary care doctor in De Queen, Ark., tells STAT News. “We want to make sure we’re not forgotten.” (STAT News)
Even wealthy Americans get poorer care
Even rich white Americans receive worse health care than the average citizen of 12 other developed countries, according to a study published in JAMA Internal Medicine. Researchers compared health outcomes of white Americans in the top 5% of rich counties to those of average patients from 12 other nations. In many areas, including infant mortality, maternal mortality and heart attack survival, U.S. patients fared worse. Breast cancer survival was the only area in which wealthy white American patients fared better. Comparison countries: Australia, Austria, Canada, Denmark, Finland, France, Germany, Japan, the Netherlands, Norway, Sweden and Switzerland. (JAMA Internal Medicine; Medscape)
NEW & NOTED
$100M investment in Black docs: Morehouse School of Medicine is teaming up with CommonSpirit Health in a 10-year, $100 million partnership to train more Black physicians and work toward health equity for underserved communities. (Atlanta Journal Constitution*)
Price transparency moves forward: As expected, a federal appeals court rejected the hospital industry's attempt to block new rules on price transparency from taking effect Jan. 1. So last Friday, hospitals had to start posting their negotiated rates online in a machine-readable format and, separately, list their negotiated rates for at least 300 shoppable services in a consumer-friendly manner. (Modern Healthcare*)
Insulin resistance associated with MDD: Two biomarkers of insulin resistance appear to be associated with current, but not remitted, major depressive disorder, according to research published in JAMA Psychiatry. The findings suggest that insulin resistance, “is a state, rather than a trait, biomarker of depression,” according to researchers. (Psychiatric News Alert; JAMA Psychiatry*)
MULTI-MEDIA
CME: Pediatric “convenient care” site demographics
A recent analysis of national health data revealed that more than one in four children were seen at an urgent care center or retail health clinic in 2019, MedPage Today reports. Visits were more likely among non-Hispanic white children compared with non-Hispanic Black and Hispanic children; utilization was also higher among the insured than the uninsured and among those with private or public health insurance compared with uninsured children. Amanda G. Montalbano, MD, MPH, of Children's Mercy in Kansas City, Mo., notes that most convenience care facilities are located in suburban areas—not in rural or inner city areas, where they could potentially fill gaps in care. (MedPage Today)
MARKETVOICES...QUOTES WORTH READING
Many Americans, especially the wealthy ones, think they are getting the best care possible, “but having the head of the hospital come to meet you in your nice private room doesn't equate with quality care.” —Dr. Ezekiel Emanuel, co-director of the Health Care Transformation Institute and vice provost for Global Initiatives at the University of Pennsylvania, quoted in Medscape.