July 16, 2020 | Too much, too fast?

INDUSTRY NEWS

Walmart to sell Medicare-related products.

Walmart has formed an insurance agency in Texas that will sell Medicare-related products and services, the Arkansas Democrat-Gazette reports. The full-time licensed agents will work from a Dallas-area call center or remotely. Walmart has allowed agents from individual insurers to set up in its stores to answer questions and enroll customers for years. Walmart Insurance Services allow the company to sell directly to customers for the first time. (Arkansas Democrat-Gazette)

Convergence of dental and medical

Health insurers are increasingly offering dental benefits, according to a report from consulting firm West Monroe. Its survey of health plan executives found 80% of health insurers are offering dental products, up from 68% in 2018. In addition, 48% of health insurers are offering adult dental benefits, a percentage that has doubled in the past two years. Nearly all the executives interviewed said the merging of the two benefits is already happening or will eventually happen. (Becker's Hospital Review; report announcement)

INNOVATION & TRANSFORMATION

ACO, PCMH associated with lower costs

Stand-alone ACO and PCMH models were associated with slightly lower health care costs compared with hybrid models, according to research published in the American Journal of Managed Care, based on 2016 data. “Care received in ACO and PCMH models is associated with lower health care costs compared with standard care. However, hybrid models are associated with slightly higher health care costs compared with stand-alone models.”  (AJMC)

CONSUMERS & PROVIDERS

Most COVID cases due to “silent” transmission?

Asymptomatic and presymptomatic transmission of COVID-19 could account for more than half of infections, according to a new mathematical model by U.S. and Canadian researchers. “Our results indicate that silent disease transmission during the presymptomatic and asymptomatic stages are responsible for more than 50% of the overall attack rate in COVID-19 outbreaks. Furthermore, such silent transmission alone can sustain outbreaks even if all symptomatic cases are immediately isolated. The results corroborate recent contact tracing studies indicating a substantial role of presymptomatic transmission…” The findings were published in the Proceedings of the National Academy of Sciences. (ABC News; PNAS)

Pandemic driving exchange enrollment

The pandemic could drive more patients to ACA insurance exchanges, according to analysis from Avalere. Already, more than 750,000 people have signed up since the end of open enrollment—mostly the previously uninsured and those losing employer-sponsored coverage. “Given that exchange enrollees tend to maintain their exchange coverage in subsequent years, the political and judicial climate concerning the ACA may result in new access and plan affordability changes for exchange enrollees,” according to Avalere. (Avalere analysis; Fierce Healthcare)

Scaling back telehealth coverage?

Telehealth will continue to grow, but some insurers will soon scale back telehealth benefits, USA Today reports. For example, for Blue Cross Blue Shield of Texas, the extended expiration date for telehealth expansion is August 31. Most other insurers plan to reduce coverage of the visits in September. Medicare and Medicaid are likely to continue expanded coverage through the end of the year. Changes include resuming out-of-pocket payments and requiring prior authorizations. Other insurers have announced deadlines when they will stop covering remote visits and start charging co-pays again. Nearly all insurers say they are continually reevaluating their coverage. (USA Today)

NEW & NOTED

Workers comp and COVID: Health care workers infected by COVID-19—and the families of those who died—are struggling to obtain workers’ compensation benefits, according to a Kaiser Health News investigation. In some states COVID-19 falls into a category of conditions—such as a cold or the flu—not covered by workers’ compensation. Other states force workers to prove they contracted the virus at work. (KHN)

More money for a safety net: The Department of Health and Human Services will provide an additional $4 billion in COVID-19 aid to safety net and rural health providers who may have been excluded from earlier distributions. It has designated another $1 billion for providers with specialty rural designation or suburban facilities that may take care of a large rural population. (Healthcare Dive)

PPIs and susceptibility: People who use proton pump inhibitors may be more likely to get COVID-19, according to research published in The American Journal of Gastroenterology. (Medscape; American Journal of Gastroenterology)

MULTI-MEDIA

Too much research published too fast? 

The recent flood of coronavirus-related research papers published in journals and posted online prior to publication has led some scientists to question if they can really trust what they read. (NPR)

MARKETVOICES...QUOTES WORTH READING

“It is becoming apparent that the health and dental insurance industries are on the verge of convergence, threatening to upend the standalone-dental business model.”—Will Hinde, managing director and West Monroe’s Healthcare & Life Sciences practice leader, in a prepared statement, quoted in Becker's Hospital Review