Monthly Archives: July 2020

Providence, Humana back ad campaign urging patients to stop ‘medical distancing’

Posted on by • Posted in American Hospital Association (AHA), Coronavirus, Deferred Healthcare, Emergency Care, Health System, Hospital, Hospital Industry, Marketing, Medical Distancing, Mortality, Pandemic, Physician, Primary Care, Public Health, Public Safety, Social Distancing, Telemedicine, Vaccination, Vaccine • Leave a comment

https://www.healthcaredive.com/news/providence-humana-back-ad-campaign-urging-patients-to-stop-medical-distan/581172/

Dive Brief:

  • A coalition of providers, payers and other healthcare organizations on Tuesday launched an ad campaign to encourage patients not to put off important care during the COVID-19 pandemic.
  • The announcement encourages people to continue social distancing but not “medical distancing” by putting off routine care or avoiding checking on concerning symptoms. That could be either through telemedicine or an in-person visit.
  • The campaign will be on TV, in print and across social media. The 11 organizations behind it include Providence, Humana, Baylor Scott & White, LabCorp and Walgreens.

Dive Insight:

While some hospitals in hotspots in Texas, Florida, California and Arizona have had to once again put off non-emergency procedures, providers in other areas of the country are trying to ramp up regular patient volumes as the number of positive cases eases.

Surveys show, however, that people are wary of returning to the doctor’s office, either because they worry about exposure to the novel coronavirus or have lost coverage to help pay for care.

The new ad campaign seeks to ease these concerns. No dollar figure was attached to the plan, which advertising agency MullenLowe U.S. took on pro bono. It follows an ad the American Hospital Association launched in May to ensure the public facilities are still available for non-COVID-19 care.

Since the pandemic’s onset in the United States, health officials have been concerned about the short- and long-term consequences of routine and preventive care being delayed or put off entirely. Chronic diseases that are caught early can be managed more easily and less expensively.

Also, research shows even some crucial services aren’t being sought even for issues such as strokes and heart attacks. In April, emergency room visits nationwide dropped more than 40%, according to the Centers for Disease Control and Prevention.

Public health experts are also beginning to fear vaccinations may be avoided, which could cause trouble with the upcoming flu season.

For providers the reduction in patient volumes has meant a major revenue loss. Some patient volume has been recaptured, but that rolled back again in recent weeks with hospitals in large states like Texas and Florida again reaching capacity with a COVID-19 surge.

At the end of June, hospital traffic in Arizona, New York and Texas was down week over week, according to an analysis from Jefferies.

Primary care has particularly suffered. Visits to medical offices were down nearly 60% in March and April, meaning losses to those practices could top $15 billion this year, according to a recent Health Affairs study.

The ad campaign stresses that providers have guidelines in place to keep patients safe, such as isolation of those suspected of having COVID-19 and increased virtual options.

“While we understand the fears that many people have around contracting the virus, our country’s medical facilities have adopted CDC guidelines and best practices and even telemedicine options to make your visit as safe as possible to prevent the spread of the virus,” Humana CMO William Shrank said in a statement. “The intent of the campaign is to let people know that protecting yourself against getting this virus does not need to come at the expense of your overall health.”

 

 

 

 

Walgreens invests $1B in primary care clinics with VillageMD deal

Posted on by • Posted in Chronic Care Management, Chronic Conditions, Chronic Diseases, Consumerism, Outsourcing, Physician, Primary Care, Retail Healthcare, Retail Pharmacy, Telemedicine, Underinsured, Uninsured, Walgreens • Leave a comment

https://www.healthcaredive.com/news/walgreens-invests-1b-in-primary-care-clinics-with-villagemd-deal/581208/

Walgreens plans to open up to 700 primary care clinics as part of ...

Dive Brief:

  • Walgreens on Wednesday announced plans to open up to 700 primary care clinics across the country over the next five years in partnership with medical services provider VillageMD, and “hundreds more” after that.
  • As part of the agreement, Walgreens will invest $1 billion in equity and convertible debt in Chicago-based VillageMD over the next three years, including a $250 million equity investment Wednesday. VillageMD will use 80% of the funds to pay for opening the clinics, called Village Medical at Walgreens, and integrate digitally with Walgreens.
  • Walgreens, which saw its stock rise slightly in early morning trading on the news, anticipates owning 30% of VillageMD once the investment is done. More details on the partnership will be released in the first quarter next year.

Dive Insight:

Retail clinics, which can generate additional script-writing and drive front-of-store sales for their owners, have seen renewed interest in recent years from giants like pharmacy rival CVS Health and retail behemoth Walmart. But Walgreens is the first national pharmacy chain to work toward building out a primary care infrastructure in stores across the U.S.

The move represents a massive investment in the healthcare delivery space for the Illinois-based company, which began trialing the full-service doctor’s offices in its stores late last year with five clinics in Houston, Texas. The pilot was successful, Walgreens said, driving high patient satisfaction scores.

Additionally, the integrated pharmacy model is correlated with increased medication adherence and better patient outcomes, according to internal VillageMD data — important factors in managing chronic conditions, which drive roughly 85% of all U.S. healthcare spend.

As such, Walgreens plans to open 500 to 700 stores over the next five years, staffed by more than 3,600 primary care physicians recruited by VillageMD, along with nurses, social workers and therapists working alongside Walgreens’ pharmacists in 30 U.S. markets.

The two companies are still finalizing what those initial markets are going to be, but the very first will be in Texas and Arizona, Walgreens’ Director of Pharmacy and Healthcare Services Communications Kelli Teno told Healthcare Dive. More than half of the clinics will be located in government-designated medically underserved areas such as Houston, which have a large share of low-income populations, migrant workers and Medicaid beneficiaries.

The stores will accept a broad array of insurance options, according to the release. Many plans VillageMD works with have a zero dollar to $10 co-pay for primary care services, Teno said.

The clinics use a sliding scale payment model for patients who don’t have insurance to try to make care more affordable for the broad range of primary care services provided, like preventative visits, acute infection or minor trauma care or chronic condition management.

Telehealth will be available around the clock for consumers via Walgreens’ healthcare marketplace app, called Find Care, or via VillageMD’s internal capabilities. VillageMD doctors can also provide at-home doctor visits for vulnerable populations, such as senior citizens or the immunocompromised.

Walgreens already has 14 in-store primary care clinics operated by different partners like Partners in Primary Care, Southwest Medical — part of Optum’s physician group — and VillageMD. Late last year, Walgreens announced it was closing 160 of its internally staffed walk-in clinics, though it still has more than 400 clinics nationwide, most staffed or run by local health systems or physician groups.

Its outsourcing model flies against CVS, which built out its health-focused store network, called HealthHUBs, through acquisitions and builds. HealthHUBs designate at least a fifth of floor space to health and wellness focused products. CVS plans to have a chain of 1,500 locations by the end of 2021 as part of its enterprise growth strategy, adding to its almost 10,000 retail locations and more than 1,100 walk-in medical clinics.

For its part, Walgreens’ clinics will be between 3,300 and 9,000 square feet and use existing space within Walgreens’ locations. To make room, clinic-linked stores will offer fewer unhealthy front-end products like snacks and sodas. Tobacco products will not be sold in the first 200 Village Medical at Walgreens locations.

“Many of the stores that we’re initially looking at to build these clinics naturally sell more pharmacy and health and wellness products,” Teno said. “It will really depend on the needs of that local community.”

VillageMD, through its subsidiary Village Medical, includes more than 2,800 doctors across nine markets. The seven-year-old company, which competes with other primary care management companies like UnitedHealth-owned Optum has raised $216 million in total funding across three rounds from investors like Oak HC/FT and Town Hall Ventures, a firm founded by Andy Slavitt, former CMS administrator under President Barack Obama.

 

 

 

IHME Model Projects 208,255 U.S. Deaths By November, But Estimate Falls Sharply If Mask Use Increases

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Economic Crisis, Economy Reopening, Infection Control, Infection Control Plan, Infectious Virus, Mortality, National Strategy, Pandemic, Partisanship, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Scientists, Social Distancing, Vulnerable Populations • Leave a comment

https://www.forbes.com/sites/mattperez/2020/07/07/imhe-model-projects-208255-us-deaths-by-november-but-estimate-falls-sharply-if-mask-use-increases/?utm_source=newsletter&utm_medium=email&utm_campaign=dailydozen&cdlcid=5d2c97df953109375e4d8b68#453db3d56f2e

IHME Model Projects 208,255 U.S. Deaths By November, But Estimate ...

TOPLINE

The University of Washington’s influential Covid-19 model, extended out to November 1 for the first time, estimates that 208,255 Americans will die from the virus by then, though, the death toll could be reduced by nearly 22% if mask use were to become widespread, researchers said.

KEY FACTS

The university’s Institute for Health Metrics and Evaluation (IHME) forecasts 162,808 deaths by November if at least 95% of people were to wear face coverings in public.

A Gallup poll released Monday found that 86% of adults wore masks in the past week.

Masks have become a political issue, with only 66% of Republicans reporting mask use in the poll, while President Trump continues to refuse to wear one in public and his campaign has declared them optional at recent public campaign events and rallies.

“Mask mandates delay the need for re-imposing closures of businesses and have huge economic benefits,” said IHME Director Dr. Christopher Murray.

The model anticipates a surge in deaths in September and October, with the IHME noting Tuesday that, “Current data show a strong statistical relationship between Covid-19 transmission and pneumonia seasonality, which is included as a covariate in the model.”

While many of the people infected during the current surge in cases worldwide have been on the younger side, and therefore at lower risk of death, the university warns its current projection could increase if the virus is spread to at-risk populations.

The U.S. is currently experiencing a surge in cases following the easing of social distancing policies, particularly in Southern and Western states, a situation that Dr. Anthony Fauci, the country’s top infectious disease official, characterized as “really not good” during an interview Monday.

CHIEF CRITIC

President Trump, who pushed back against Fauci’s comments on Tuesday. “Well, I think we are in a good place. I disagree with him,”Trump said, according to CNN. “Dr. Fauci said don’t wear masks and now he says wear them. And he said numerous things. Don’t close off China. Don’t ban China. I did it anyway. I didn’t listen to my experts and I banned China. We would have been in much worse shape.”

BIG NUMBER

57,718. That’s the new daily record for confirmed cases of Covid-19 in the U.S., reached on July 2, according to the CDC. The toll has been broken several times since June, the previous high coming in early April with 43,438. The U.S. leads the world in cases of the coronavirus with 2,981,602, as well as reported deaths with 131,248.

TANGENT

Both Fauci and Murry at the IHME agree that the U.S. is still deep into its first wave, as exemplified by Texas, which broke its records for cases, hospitalizations and deaths on Tuesday. Because of the situation, Houston Mayor Sylvester Turner urged Texas’ GOP on Monday to cancel its in-person convention set for next week.

 

 

 

 

Walmart confirms a new avatar — it’s also a health insurance agency

Posted on by • Posted in Health Insurance Industry, Medicare Advantage, Pharmaceutical Industry, Prescription Drugs, Price Transparency, Retail Healthcare, Retail Pharmacy, Walmart • Leave a comment

Walmart confirms a new avatar — it’s also a health insurance agency

Should I buy health insurance from Walmart? - Castaline Insurance ...

Walmart quietly launched a new health insurance business. The company, called Walmart Insurance, was filed with the Arkansas Secretary of State last month.

Walmart is making clear what an executive declared in a virtual conference: that it is firmly in the healthcare business, not just in retail healthcare.

News emerged today that the company is planning to throw its weight around in another healthcare segment in need of an overhaul: insurance. A spokeswoman from the Bentonville, Arkansas retail behemoth confirmed that the company has created “Walmart Insurance Services LLC” to sell insurance policies. The business entity’s name was first filed with the Arkansas Secretary of State in late June.

“We currently offer access to insurance information in our Walmart Health locations, and we have a long-standing education program called Healthcare Begins Here to help people find the right insurance plan for them,” spokeswoman Marilee McInnis wrote in an email. “We’re expanding our current insurance services to now include the sale of insurance policies to our customers.”

A handful of job postings at a call center in the Dallas metro also match up with Walmart Insurance Services, as first pointed out by Talk Business & Politics. Walmart has listings for licensed insurance agents and Medicare sales supervisors.

“Yes, you read that right, Walmart now has an insurance agency,” the listings read.

It looks like the new subsidiary will be focused on selling Medicare Advantage plans, though the company was mum when asked for additional details. The spokeswoman’s statement about the “sale of insurance policies to our customers” also leaves open the possibility of Walmart expanding its services beyond senior shoppers in the future.

Medicare Advantage plans have been experiencing rapid growth in the past decade, with more than a third of all beneficiaries enrolled in a plan managed by a private insurer. That figure is expected to increase in the future.

 

Deeper into the pharmacy space

Separately, on Tuesday, Walmart announced that it had struck a partnership with  PBM startup Capital Rx, which provides health plans real-time information on prescription drug prices.

Walmart has been a big player in the pharmacy space for several years, and the company appears to be deepening that through this partnership. 

“‘Everyday low price’ has been a guiding principle at Walmart. We take pride in providing affordable prices to more than 160 million customers who shop Walmart each week,” Walmart Health and Wellness Vice President Luke Kleyn said in a news release. “Working with Capital Rx will allow us to do the same for prescription drugs,”

Capital Rx was founded just over two years ago by AJ Loiacono, a former insurance auditor, with the idea of providing drug prices as part of pharmacy benefit plans.

Loiacono started his career in the pharmaceutical manufacturing industry, where “everything that comes out of that plant has a price.”

When he moved over to the auditing and procurement side, working with payers and self-insured companies, he was shocked to find out that none of their contracts included drug prices. To solve this, the company uses Medicaid’s National Average Drug Acquisition Cost, rather than the average wholesale price, to calculate costs.

As a standalone company, Capital Rx was able to provide price information for retail drugs, but they weren’t able to do the same for mail and specialty drugs. The partnership with Walmart will “complete the model,” with Walmart providing mail and specialty drug fulfillment.

With the partnership, Capital Rx was able to quickly sign on some payers, though it hasn’t yet disclosed which ones.

“Walmart is a diversified company. We liked the fact that they were independent. They’re not part of a PBM or a health system today,” Loiacono said. “The other part of it is, they have scale.”

Loiacono also pointed to similar goals in price transparency — something Walmart emphasized when it shared the cash pay prices for its new health clinics.

“This is what we’re seeing a little bit more of as the future in the roadmap,” Loiacono said. “They’re making a serious investment in healthcare.”

 

 

 

 

Supreme Court says employers may opt out of Affordable Care Act’s birth control mandate over religious, moral objections

Posted on by • Posted in ACA, Birth Control, Birth Control Coverage, Health Policy, Supreme Court • Leave a comment

https://www.washingtonpost.com/politics/courts_law/supreme-court-obamacare-birth-control-mandate/2020/07/08/0b38a352-c123-11ea-b4f6-cb39cd8940fb_story.html?location=alert&pwapi_token=eyJ0eXAiOiJKV1QiLCJhbGciOiJIUzI1NiJ9.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.huz885amIR-ZrDl72t5E8qtHEI-itG-wa4GE-H-Z1UE&utm_campaign=wp_news_alert_revere&utm_medium=email&utm_source=alert&wpisrc=al_news__alert-politics–alert-national&wpmk=1

Supreme Court appears divided on Trump plan to limit contraception ...

The Supreme Court ruled Wednesday that the Trump administration may allow employers and universities to opt out of the Affordable Care Act requirement to provide contraceptive care because of religious or moral objections.

The decision seems to greatly expand an exception approved by the Obama administration, and the government estimates that it could mean that 70,000 to 126,000 women could lose access to cost-free birth control.

“We hold that the [administration] had the authority to provide exemptions from the regulatory contraceptive requirements for employers with religious and conscientious objections,” wrote Justice Clarence Thomas, who was joined by Chief Justice John G. Roberts Jr., and Justices Samuel A. Alito Jr., Neil M. Gorsuch and Brett M. Kavanaugh.

The decision sent the case back to a lower court and instructed it to dissolve a nationwide injunction that had kept the exception from being implemented.

Liberal Justices Elena Kagan and Stephen G. Breyer agreed with the court conservatives’ decision to send the case back to lower courts, but they did not join the majority opinion. Justices Ruth Bader Ginsburg and Sonia Sotomayor dissented.

At issue is the Trump administration’s decision in 2018 to expand the types of organizations that could opt out of providing cost-free access to birth control and the extent to which the government should create exemptions to the law for religious groups and nonreligious employers with moral and religious objections.

The Obama administration had narrower exceptions for churches and other houses of worship, and it created a system of “accommodations,” or workarounds, for religiously affiliated organizations such as hospitals and universities. Those accommodations would provide the contraceptive care but avoid having the objecting organizations directly cover the cost.

Under the Trump administration rules, the employers able to opt out include essentially all nongovernmental workplaces, from small businesses to Fortune 500 companies. And the employer has the choice of whether to permit the workaround.

The states of Pennsylvania and New Jersey initially challenged the rules, noting that when women lose coverage from their employers, they seek state-funded programs and services. Last summer, a unanimous panel of the U.S. Court of Appeals for the 3rd Circuit blocked the rules from taking effect nationwide. The court said the administration probably lacked authority to issue such broad exemptions and did not comply with requirements to provide notice and allow public comment on the rules.

In addition to the Trump administration, a charity called Little Sisters of the Poor defended the rules. The order of nuns, which runs homes for the elderly and employs about 2,700 people, points out that the government provided exemptions from the beginning for religious organizations such as churches. They say the accommodation provision violates the 1993 Religious Freedom Restoration Act, the law that says the government must have a compelling reason for programs that substantially burden religious beliefs.

In 2014, the Supreme Court in Burwell v. Hobby Lobby Stores ruled that certain closely held businesses do not have to offer birth control coverage that conflicts with the owners’ religious beliefs. But the court did not take a position on the accommodation provision, which requires objecting organizations to notify the government.

Two years later, a shorthanded court of eight justices declined to rule on the merits of another challenge to the contraceptive-coverage requirement and sent the case back to the lower courts. The unusual, unsigned decision was viewed as a punt by a court then equally divided along ideological lines.

 

 

 

 

U.S. Tops Three Million Known Infections as Coronavirus Surges

Posted on by • Posted in 2020 Election Issues, Clinical Testing, Contact Tracing, Coronavirus, Crisis, Crisis Management, Dept of Health and Human Services (HHS), Economic Crisis, Economy Reopening, Health System, Hospital, Hospital Industry, Infection Control, Infection Control Plan, Infectious Virus, Intensive Care (ICU), Mortality, National Strategy, Pandemic, Personal Protective Equipment (PPE), Public Health, Public Safety, Quarantine, Social Distancing • Leave a comment

https://www.usnews.com/news/top-news/articles/2020-07-07/us-coronavirus-cases-hit-3-million-stoking-fears-of-overwhelmed-hospitals

U.S. tops three million known infections as coronavirus surges ...

 The U.S. coronavirus outbreak crossed a grim new milestone of over 3 million confirmed cases on Tuesday as more states reported record numbers of new infections, and Florida faced an impending shortage of intensive care unit hospital beds.

Authorities have reported alarming upswings of daily caseloads in roughly two dozen states over the past two weeks, a sign that efforts to control transmission of the novel coronavirus have failed in large swaths of the country.

California, Hawaii, Missouri, Montana, Oklahoma and Texas on Tuesday shattered their previous daily record highs for new cases. About 24 states have also reported disturbingly high infection rates as a percentage of diagnostic tests conducted over the past week.

In Texas alone, the number of hospitalized patients more than doubled in just two weeks.

The trend has driven many more Americans to seek out COVID-19 screenings. The U.S. Department of Health and Human Services said on Tuesday it was adding short-term “surge” testing sites in three metropolitan areas in Florida, Louisiana and Texas.

In Houston, a line of more than 200 cars snaked around the United Memorial Medical Center as people waited for hours in sweltering heat to get tested. Some had arrived the night before to secure a place in line at the drive-through site.

“I got tested because my younger brother got positive,” said Fred Robles, 32, who spent the night in his car. “There’s so many people that need to get tested, there’s nothing you can do about it.”

Dean Davis, 32, who lost his job due to the pandemic, said he arrived at the testing site at 3 a.m. on Tuesday after he waited for hours on Monday but failed to make the cutoff.

“I was like, let me get here at three, maybe nobody will be here,” Davis said. “I got here, there was a line already.”

In Florida, more than four dozen hospitals across 25 of 67 counties reported their intensive care units had reached full capacity, according to the state’s Agency for Health Care Administration. Only 17% of the total 6,010 adult ICU beds statewide were available on Tuesday, down from 20% three days earlier.

Additional hospitalizations could strain healthcare systems in many areas, leading to an uptick in deaths from the respiratory illness that has killed more than 131,000 Americans to date.

A widely cited mortality model from the University of Washington’s Institute for Health Metrics and Evaluation (IHME) projected on Tuesday that U.S. deaths would reach 208,000 by Nov. 1, with the outbreak expected to gain new momentum heading into the fall.

A hoped-for summertime decline in transmission of the virus never materialized as previously predicted, the IHME said.

“The U.S. didn’t experience a true end of the first wave of the pandemic,” IHME Director Dr. Christopher Murray said in a statement. “This will not spare us from a second surge in the fall, which will hit particularly hard in states currently seeing high levels of infections.”

‘PRESSURE ON GOVERNORS’

U.S. President Donald Trump, who has pushed for restarting the U.S. economy and urged Americans to return to their normal routines, said on Tuesday he would lean on state governors to open schools in the fall.

Speaking at the White House, Trump said some people wanted to keep schools closed for political reasons. “No way, so we’re very much going to put pressure on governors and everybody else to open the schools.”

New COVID-19 infections are rising in 42 states, based on a Reuters analysis of the past two weeks. By Tuesday afternoon, the number of confirmed U.S. cases had surpassed 3 million, affecting nearly one of every 100 Americans and a population roughly equal to Nevada’s.

In Arizona, another hot spot, the rate of coronavirus tests coming back positive rose to 26% for the week ended July 5, leading two dozen states with positivity rates exceeding 5%. The World Heath Organization considers a rate over 5% to be troubling.

The surge has forced authorities to backpedal on moves to reopen businesses, such as restaurants and bars, after mandatory lockdowns in March and April reduced economic activity to a virtual standstill and put millions of Americans out of work.

The Texas state fair, which had been scheduled to open on Sept. 25, has been canceled for the first time since World War Two, organizers announced on Tuesday.

In Ohio, Governor Mike DeWine said the state was ordering people in seven counties to wear face coverings in public starting on Wednesday evening.