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HEALTHCARE BUSINESS & CONSUMER NEWS & TRENDS
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Costco Members Now Have Access to $29 Online Healthcare Visits |
Costco is now offering members online health checkups for as low as $29. The retailer is offering the new service in partnership with Sesame, a direct-to-consumer health care marketplace that connects medical providers nationwide with consumers. Costco members can book health care visits directly through their memberships in all 50 states. Sesame said its platform doesn't accept health insurance because it primarily caters to uninsured Americans and those with high-deductible plans who prefer to pay cash for their health care. It said its model helps keep prices of services low for its users. The services listed on Costco Pharmacy's homepage include virtual primary care visits for $29, health checkups (a standard lab panel and a virtual follow-up consultation with a provider) for $72, and online mental health visits for $79. (https://www.cnn.com/2023/09/25/business/costco-online-healthcare-members/index.html)
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Best Buy Health Shows First Signs of Success with Geek Squad Helping At-Home Patients |
As part of a pilot partnership with Geisinger Health System to help monitor patients with long-term chronic illnesses, Geek Squad members were able to significantly reduce the amount of time it took to set up a patient's at-home care while at the same time increasing their use of the monitoring devices. This has helped validate Best Buy's decision to start a health division so it can leverage its knowledge and technology as an asset to health care providers while branching beyond the electronics and appliances for which it's known. (https://www.startribune.com/best-buy-health-shows-first-signs-success-geek-squad-helping-at-home-patients-geisinger-electronics/600304197/)
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The New Science on Making Healthy Habits Stick |
Any healthy choice seems doable for a day. Building consistent good habits around exercise, sleep and nutrition in the long term is harder. Recent research is uncovering how long it takes to cement different kinds of habits - and gives fresh insight into how to make them stick. Simple health habits like handwashing, for instance, take a couple of weeks to develop, while more complicated ones like going to the gym take four to seven months, according to a recent study. One big lesson if you're trying to establish a new healthy habit: You will have better luck if you can simplify the process and repeat it often. Finding ways to make it fun and setting realistic expectations about how long it will take to establish the habit will help too, other research has found. A recent Wall Street Journal article shares some of the best science-backed strategies that can help you build healthy habits more efficiently. In summary, they are: simplify and repeat; plan but be flexible; expect to feel worse at first; and make it fun. (https://www.wsj.com/health/wellness/healthy-habits-research-science-7f373f67)
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CDC Recommendations & GoodRx Information re Latest Flu Shots, High-Dose Vax & COVID-19 Boosters |
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HEALTHCARE & GOVERNMENT
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California Lawmakers Approve Nation-Leading $25 Minimum Wage for Health Workers |
A sweeping agreement between labor and the health industry would gradually raise the minimum wage for hundreds of thousands of health workers in California to a nation-leading $25 an hour while ending a years-long battle over dialysis clinics. The pact approved recently by state lawmakers would phase in the wage increase for hospitals, nursing homes, and other medical and psychiatric services providers. A spokesperson for Gov. Newsom said the governor will evaluate the bill on the merits before his Oct. 14 deadline to act on the legislation. [The issue is complicated by the state's Medicaid program, which is the main source of revenue for many hospitals. The Newsom administration has estimated the wage increase would cost the state billions of dollars in increased payments to health care providers. Labor unions that support the wage increase point to a study from the University of California-Berkeley Labor Center that said the state's costs would be offset by a reduction in the number of people relying on publicly funded assistance programs].
As part of the deal, in a separate memorandum of understanding, SEIU-United Healthcare Workers West would drop its effort to impose regulations on dialysis clinics through legislation and at the ballot box. Voters defeated all three ballot initiatives, most recently last year, but the fight has cost the dialysis industry hundreds of millions of dollars. (https://californiahealthline.org/news/article/california-lawmakers-approve-nation-leading-25-minimum-wage-for-health-workers/)
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Administration Announces $600M to Produce Covid Tests + Will Reopen COVIDTests.gov to Order Them |
The Biden administration recently announced that it is providing $600 million in funding to produce new at-home COVID-19 tests and is restarting a website allowing Americans to again order up to four free tests per household - aiming to prevent possible shortages during a rise in coronavirus cases that has typically come during colder months. HHS says orders can be placed at COVIDTests.gov, (https://apnews.com/article/covid-tests-free-online-order-winter-6de740359e7648a85184dcac47aa96fa)
MEANWHILE, After Pfizer and Moderna hiked the prices of their Covid-19 vaccines this year, the federal government will now pay nearly three times more than it did previously for each dose. The change is partly because the federal government ran out of money to continue to buy the vaccines in bulk to distribute across the country, so the vast majority of vaccine purchases are instead flowing through normal channels and will be paid for by a variety of different insurance plans this year, including Medicare and Medicaid. (https://www.statnews.com/2023/09/28/covid-vaccines-higher-price/)
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California's CARE Court Program to Tackle Mental Illness Started October 1 |
California's controversial new CARE Court program, meant to address serious mental illness and the state's homelessness crisis, went into effect October 1. Under CARE (Community Assistance, Recovery and Empowerment), the court, family and others can file a petition in civil court if they believe a loved one is suffering from severe symptoms of an untreated psychotic disorder, such as schizophrenia. The program, however, does not cover other mental illnesses such as anxiety disorders, depression or post-traumatic stress disorder. A judge can then order a care plan for the person for up to 12 months, with renewal for an additional 12 months. The person will be set up with a team that will prescribe individualized treatment along with supportive services and a housing plan. The counties will be required to provide the services but are receiving additional funding from the state government, including for new housing units, treatment slots and behavioral health services. The court can order medications, but it cannot be forcibly administered and if a person refuses to take it, they will not receive a penalty. Seven pilot counties - Glenn, Orange, Riverside, San Diego, San Francisco, Stanislaus and Tuolumne - were required to launch CARE Court by Oct. 1. The remaining counties will be required to do so by December 2024. (https://abcnews.go.com/Health/californias-care-court-program-tackle-mental-illness-starts/story?id=103461370)
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CMS Announces Changes to ACO REACH Model |
CMS recently released guidance on changes to the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model starting in performance year 2024. The changes came about in response to stakeholder and participant feedback. (https://www.sheppardhealthlaw.com/2023/09/articles/centers-for-medicare-and-medicaid-services-cms/cms-announces-changes-to-aco-reach-model-for-2024/)
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Oregon Becomes 3rd in Nation to Seek Federal Approval for a Basic Health Program |
Oregon is asking CMS to approve a basic health program for lower-income individuals who make too much to qualify for Medicaid. According to a Sept. 12 press release from the Oregon Health Authority, coverage will be similar to that provided through Oregon Health Plan, the state's Medicaid program [expanded to include] for individuals with incomes between 138% and 200% of the federal poverty level. The program will help prevent people from cycling on and off Medicaid coverage as their incomes fluctuate, the state said. Insurers in the state have objected to the proposal, according to a July 10 report from Oregon Public Broadcasting. The basic health program will drive up premium costs on the state's ACA exchange, insurers say, by shifting thousands of people, and federal subsidies, out of the market. If approved by CMS, Oregon would be the third state to implement a basic health program, after Minnesota and New York. (https://www.beckerspayer.com/policy-updates/oregon-to-establish-basic-health-program-for-lower-income-adults.html)
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The FTC and Department of Justice Share Concerns Re Hospitals Merging Across Markets |
Cross-market deals accounted for more than half of all hospital mergers and acquisitions during the last decade, according to a paper from experts on antitrust law. Today, nearly 60% of health systems operate multiple hospitals in different geographic markets. Not only are such deals more common, but they can also increase costs for patients. Merged hospitals in the same state but in different markets raised prices as much as 10% compared with other hospitals, researchers found after analyzing past deals. A separate study found stand-alone hospitals raised prices 17% after they were acquired by a hospital company in another market. Draft merger guidelines, designed by the FTC and the Justice Department, are designed to crack down on mergers in multiple sectors, including health care. It's not yet clear if or how cross-market hospital mergers within a state could be affected. Still, the draft says consolidation should not "entrench or extend a dominant position" by extending into "new markets." (https://californiahealthline.org/news/article/hospital-cross-market-mergers-acquisitions-state-regulation/)
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HHS Requests Public Input on Coverage of Over-the-Counter Preventive Services |
The Departments of HHS, Labor, and the Treasury are seeking public input on how best to ensure coverage and access to OTC preventive services, including the benefits of requiring most health insurance plans to cover these services at no cost and without a prescription by a health care provider. Items would include preventive care that can be purchased without a prescription, including contraceptives, tobacco smoking cessation products, folic acid during pregnancy, and breastfeeding supplies. Under the ACA, most plans and issuers must cover certain recommended preventive items and services at no cost, but are not required to be covered without cost sharing unless prescribed by a health care provider. (https://www.hhs.gov/about/news/2023/09/29/hhs-requests-public-input-coverage-over-the-counter-preventive-services-including-contraception-tobacco-cessation-breastfeeding-supplies.html)
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REACTIONS TO THE HIGH COSTS OF HEALTHCARE
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Indiana Employers Are Fighting Mad About Healthcare Costs |
The fight started with the simple goal of helping Indiana employers learn what they were spending on hospital services received by their workers. Gloria Sachdev, who is CEO of the Employers' Forum of Indiana, launched research that produced a stunning takeaway: They paid the most out of all the states studied. "Employers were literally pounding-on-the-table mad." 'A drive for legislation, ultimately supported by companies including the engine maker Cummins and Chrysler's parent Stellantis, turned into a brawl, when an employer-backed group targeted patients' phones with digital ads about high prices when they visited hospitals. Hospitals warned of cuts to crucial medical services and government price fixing. The resulting law, passed with bipartisan support, contained significant actions for tackling high healthcare costs. Now the Indiana campaign is getting attention well beyond the state. In places including Texas, Florida and Maine, employer groups are pushing for legislation blunting hospital costs, saying they are fed up with increasing rates and fees, as well as the failure of private efforts to contain them. (https://www.wsj.com/health/healthcare/these-employers-took-on-healthcare-costs-and-the-fight-got-nasty-54674114?mod=hp_listb_pos1)
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Going Where the Money Is: US Hospitals Paid Russian Ransomware Hackers $100 Million |
The Justice Department revealed U.S. hospitals have paid millions of dollars in ransom to a cybercriminal network with suspected ties to Russian intelligence, according to CNN. Healthcare companies overall are spending more than any other industry to recover from cyberattacks, according to an IBM analysis reported by The Wall Street Journal. Healthcare companies spend on average nearly $11 million to recover from a cyberattack, compared to around $6 million for financial companies and $3 million for retailers. The report also noted there have been more than 400 cyberattacks on healthcare companies and 61 million people have had their medical data stolen or exposed online in 2023 so far, which is up from previous years. (https://www.beckershospitalreview.com/cybersecurity/us-hospitals-paid-100m-to-russian-ransomware-hackers.html)
EDITOR'S NOTE: After reading the above article, ABL Member Oli Thordarson, CEO of Alvaka, commented, "I can concur that our healthcare cases have been among our highest billing and generally about twice the billing expense of clients in non-healthcare sectors."
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Transparent PBMs Form Coalition to Advance Industry Reforms |
A group of transparent PBMs, called Transparency-Rx, have formed a coalition to push for changes to the PBM model that would likely ruffle feathers at the industry's biggest companies. These include a ban on spread pricing as well as reforms to the rebate model that include the impact of group purchasing organizations. However, the initial coalition members represent only14.5 million lives across all 50 states, and Transparency-Rx is looking to continue to add new voices. (https://www.fiercehealthcare.com/payers/transparent-pbms-form-coalition-advance-industry-reforms)
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WORKFORCE NEWS & TRENDS
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Family Members Starting to Fill Nursing Gaps |
The national nursing shortage is prompting states - including California, Arizona, Colorado, California, Florida, Indiana, New Hampshire, New Jersey, and Pennsylvania - to tap family members to provide home-based care for children with complex health needs. CMS has permitted states to offer home health services for children with medically complex conditions under Medicaid since October 2022. However, the national nurse shortage is hindering states' ability to provide home-based skilled nursing care. Data from the Bureau of Labor Statistics shows 193,100 openings for RNs and 209,000+ openings for nursing assistants in the U.S. Now, a handful of states are working to close this care gap by allowing family members to become certified nursing assistants or home health aides to provide in-home care for children covered under Medicaid. (https://www.beckershospitalreview.com/nursing/how-family-members-are-filling-nursing-gaps.html)
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RIFs Are Impacting Thousands of CommonSpirit and Centene Employees |
CommonSpirit Health implemented workforce reductions in the fourth quarter of the fiscal year ending June 30, resulting in about 2,000 job cuts. CommonSpirit has 150,000+ employees and 25,000+ physicians and advanced practice clinicians total, in 24 states, Overall, CommonSpirit posted an operating loss of $1.4 billion for the fiscal year ending June 30, compared to a $1.3 billion loss the year prior, as increasing costs and labor challenges affected its financial picture. (https://www.beckershospitalreview.com/finance/commonspirit-cuts-2-000-jobs.html)
ALSO, health insurer Centene is laying off approximately 2,000 workers, or about 3% of its total workforce. Employees will first be notified Oct. 2, and their last day of work will be Dec. 8, as first reported by Health Payer Specialist. Centene said it will support impacted employees with severance packages and outplacement services. (https://www.fiercehealthcare.com/payers/centene-lay-2000-employees)
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Return to the Office? These Workers Quit Instead |
As more companies enforce their office mandates, some workers are choosing to quit instead of complying and returning to the office. Even companies at the forefront of remote work during the pandemic, such as Meta, Google, Amazon and Zoom, are getting stricter about office returns. They say workers are more productive, collaborative and engaged in-person. Indeed, the percentage of remote workers in America's workforce is declining - from 17.9% in 2021 to 15.2% in 2022, according to the latest census data. However, workers are pushing back, penning letters to executives, staging walkouts and quitting despite the tight labor market. (https://www.washingtonpost.com/technology/2023/09/21/return-office-mandates-employees-quit/)
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AI & HEALTH TECH INNOVATIONS
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Scripps Sees MyChart Messages Increase by 50% |
Scripps Health said it saw a 50% increase in patient messages since the onset of COVID-19, the San Diego Business Journal reported. "There are 44 messages per day received on average, with some physicians receiving over 100 per day," David Wetherhold, MD, chief medical information officer of ambulatory systems at Scripps Health, said. "Each message takes 30 to 120 seconds to review and complete. This has some physicians spending an hour per day just on messages." Dr. Wetherhold said this task is one of the top five complaints that his physicians express. In order to help reduce this administrative burden, the health system is piloting generative AI in responding to patient messages. The health system is working with Epic Systems to refine the AI tool through weekly check-ins and clinician feedback. (https://www.beckershospitalreview.com/ehrs/scripps-sees-mychart-messages-increase-by-50.html)
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ChatGPT's Developer Gets Into Medical Transcription |
ChatGPT developer OpenAI has rolled out a new medical transcription service with Hint Health, a digital health company focused on direct primary care. The generative AI-based platform records and transcribes patient visits before generating a summary with OpenAI's large language models, which also power ChatGPT. Hint AI launched in beta mode Sept. 21 in the startup's clinical platform. (https://www.beckershospitalreview.com/digital-health/chatgpts-developer-gets-into-medical-transcription.html)
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Six Health Systems Teamed with Amazon, Apple, Google/YouTube, Meta + Microsoft |
Big Tech companies continue to assist health systems with their digital transformations. Here are nine collaborations from the past month:
1.) Dozens of hospitals and health systems, including Cedars-Sinai and Kettering Health Dayton, are using Meta's virtual reality headsets to train clinicians on complex procedures.
2.) Mayo Clinic said it created an AI algorithm that can take EKG data from an Apple Watch and predict if a patient has a low ejection fraction.
3.) YouTube said it's partnering with content creators including Mass General Brigham to make health information available to more people through AI.
4.) Leaders from Cedars-Sinai and Geisinger joined a Microsoft Health executive to advise a new generative AI collaborative from Avia.
5.) HCA Healthcare started using generative AI technology from Google to document ER visits and speed up nurse handoffs. (https://www.beckershospitalreview.com/digital-health/which-health-systems-teamed-up-with-amazon-google-microsoft.html)
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Cedars-Sinai Gets $25M for New Innovation Center |
Cedars-Sinai received a $25 million gift from Alfred E. Mann Charities to create a precision medicine innovation center that will work to advance single-cell biology research. Researchers at the Alfred E. Mann Single Cell Precision Medicine Center at Cedars-Sinai will look to identify the cause and develop treatments for developmental, neurological, immunological, cardiovascular, pulmonary and gastrointestinal diseases. (https://www.beckershospitalreview.com/capital/cedars-sinai-gets-25m-gift-for-new-innovation-center.html)
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