October 21, 2021 | PCPs concerned about ongoing telehealth
INDUSTRY NEWS
Z codes for social determinants not being used
ICD-10 Z codes, useful for identifying and tracking Medicare beneficiaries' social determinants of health, were reported for only 1.59% of beneficiaries in 2019, according to a new CMS report. Among the reasons why it’s so rarely used: Z code documentation can be challenging for hospitals because they are not generally used for payment purposes, so there is no financial incentive to collect the data. The codes are also limited in scope, so they may not cover the full range of social and environmental health determinants. (Becker's Hospital Review; report)
INNOVATION & TRANSFORMATION
Study: BP self-management app has potential
Using a blood pressure monitor paired with a smartphone app that provides medication reminders and lifestyle coaching was associated with lowering blood pressure levels in more than 85% of adults with stage 2 hypertension after one year, according to research published last week in JAMA Network Open. "The level of engagement is something I have not seen in other digital hypertension management programs," lead author Dr. Alexis Beatty, a cardiologist and associate professor at UCSF School of Medicine, said in a prepared statement. (JAMA Network Open; Modern Healthcare*)
Mandatory virtual visits: Innovation or fragmentation?
New, often lower-cost, plans capitalize on the convenience of telemedicine—and patients’ growing familiarity with it. In fact, some insurers now require initial telehealth visits for non-emergency primary care. But consumers should weigh costs and care options before enrolling in a “virtual-first” plan, warns Kaiser Health News. Most insurers doing this rely on contracted physicians, mental health therapists and other staff members. Moreover, some may permit an in-person visit only if their virtual doctor, who may have never examined them in person, deems it necessary. (Kaiser Health News)
CONSUMERS & PROVIDERS
PCPs concerned about ongoing telehealth
Nearly two-thirds of clinicians reported relying on telehealth during the pandemic to maintain patients’ access to care, according to survey findings from the Larry A. Green Center and the Primary Care Collaborative. Clinicians also reported concerns about the continued widespread use of telehealth: 41% of responding clinicians worried that their practice would not be able to support telehealth going forward, and 21% said they had to cut back on telehealth use since payments were reduced. A particularly interesting finding: 25% of clinicians were concerned that primary care will become weakened by telehealth in the future. (Healio Primary Care)
Nurses feel stressed, worthless, insolated and—surprise—undervalued
More than half of nurses working in critical care said they were "not emotionally healthy," according to the latest COVID-19 survey on mental health and wellness conducted by the American Nurses Foundation. Three quarters of nurses across all roles said they felt "stressed," and 10% said they felt "worthless." Among nurses of all types, nearly half said they felt "undervalued," 20% reported increased alcohol consumption, 5% reported feeling isolated, 4% reported increased suicidal thoughts, 3% reported increased substance use and 1% reported "self-injurious behavior." (Medpage Today)
Keeping mental health on the QT
According to a new survey from AdventHealth, 21% of adults said they lie when it comes to discussing anxiety, depression or suicidal thoughts with their physician. In addition, 23% have been untruthful about smoking, drinking alcohol or recreational drug use. Overall, 59% said they were “comfortable” discussing such topics with their primary-care doctor. The percentage was higher among women than men (63% vs. 53%) and included 75% of people over age 50. (Orlando Sentinel)
Insurer/PBM tactic worsens mental health
Too often, health insurers and pharmacy benefit managers use coverage changes “to drive stable patients from the medication they're taking to one that's more profitable for the health plan,” says Dr. Rimal Bera, clinical professor of psychiatry at the University of California at Irvine writes in Modern Healthcare. Insurers and PBMs should be held accountable for ensuring patients mental health conditions can get the treatments their providers recommended. “When health plans insert themselves into treatment decisions, they only worsen the mental health crisis—at a cost to everyone involved.” (Modern Healthcare*)
NEW & NOTED
Funding to hire PCPs: The Department of Health and Human Services recently announced the availability of $100 million in American Rescue Plan (ARP) funding for state-run programs that support, recruit and retain primary care clinicians who live and work in underserved communities. (HHS)
Insulin resistance increases MDD risk: Insulin resistance doubles the risk of major depressive disorder, according to research published in the American Journal of Psychiatry. "The insulin-resistant folks had two to three times the rate of developing depression," says lead researcher Kathleen Watson, a postdoctoral scholar at Stanford University. (AJP; UPI)
Colorado LGBTQ+ initiative gets funded: CMS has approved a request to provide gender-affirming care in the individual and small group health insurance markets as part of Colorado's Essential Health Benefit benchmark effective Jan. 1, 2023. Gender-affirming care is considered a standard level of care by the American Medical Association, the American Academy of Family Physicians and the American Psychiatric Association. (HHS)
MULTI-MEDIA
Test your vaccine knowledge
How much do you know about COVID-19 vaccines? Medscape has created a short (five-question) quiz to test your knowledge. (quiz)
MARKETVOICES…QUOTES WORTH READING
“There’s a gestalt of seeing a patient and knowing something is not right, such as maybe picking up early on that they have Parkinson’s,” or listening to their heart and discovering a murmur, —said Dr. David Anderson, a cardiologist affiliated with Stanford Health Care in Oakland, on virtual vs. face-to-face care, quoted in Kaiser Health News