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Are Employer Plans Dying?, Amazon's New Telehealth Plans, Coughs Predict COVID-The HSB Blog 11/10/20

Slipping Away: Does the Employer-Sponsored Health Care System Have an Expiration Date?

Event: On November 3rd, Benefits Pro released an article stating that the employer-sponsored health care system may come to an end if employers don’t move more quickly to improve the system. According to former Florida Governor Jeb Bush’ “for those who believe in markets, choice and patient responsibility haven’t been offering creative 21st-century suggestions...there has been very little discussion about alternatives” to expanding Medicare.

Description: The article noted that unless the Employer-sponsored insurance (ESI) industry can deliver on much needed reforms, its day’s might be numbered. It added, that “while there is still time to step in with solutions that ease the pain”, by some estimates, “if the health care system can’t be righted within the next five years, we’ll be looking at a full government takeover”. It is also clear that existing healthcare industry participants are resisting change and that the current system is “riddled with throwing technology on top of broken processes” instead of fixing “the process and then [applying] the technology”. As a result many are looking to big names like Amazon (and its Haven health care venture), Google, Apple, and Microsoft to bring health care costs under control and improve outcomes.

Implications: ”Our country is creeping--in some cases jogging and even sprinting--toward a government dominated healthcare system” as pointed out by former Florida Governor Jeb Bush, but employer resistance to innovation and true improvement risks crippling the system. While COVID has laid bare the shortcomings of the system it has also dramatically accelerated the pace of change. Taking advantage of this opportunity now is especially important as Millennials, the largest generation in history who are expected to make up 75% of the workforce by 2025, are starting to get to the point where they interact with the healthcare system and demand more. Smart employers can take advantage of the opportunity to design a curated, more modern ESI healthcare plan or risk a permanent move toward a government-run healthcare system.

Amazon Teams up with 2 Ohio Health Organizations on Telemedicine Offering

Event: On November 2nd, The Daily Record reported that two Ohio healthcare companies have partnered with Amazon to offer telemedicine services with free prescription drugs to Amazon’s customers. This partnership serves as another significant strategic investment in Amazon’s quest to infiltrate the healthcare space to create better health options and outcomes for consumers.

Description: Since the early 2000’s, Amazon has worked diligently to enter the pharmaceutical market, investing in companies such as with plans of expansion. In June 2018, the company successfully did so with its $1B acquisition of PillPack, a pharmaceutical company with licenses in 49 states that would help to accelerate expansion in the market. The companies partnership with Healthcare Advisory Network, a healthcare consulting firm in Centerville, Ohio and BasiCare Plus, a national prescription and telemedicine program in Wooster, Ohio came together over the past two years to offer employer groups, colleges, and associations telehealth services. The partnership with Amazon was inspired by many patients opting to use telehealth services due to COVID-19 concerns instead of going to a doctor’s office for non-urgent medical issues. The organization also offers coverage with no copays or deductibles through telemedicine service MDLive for up to nine family members starting at $65 for a three-month subscription. Additionally, the program provides discounts on medications at more than 65,000 pharmacies. For patients to obtain these services, it is as easy as going on Amazon’s website and searching BasiCare Plus.

Implications: This partnership has extended Amazon’s penetration of the pharmaceutical market, increasing its leverage over other retail giants as they seek to gain a footing in the healthcare industry. The partnership also gives the businesses the opportunity to provide inexpensive health care to people who lack coverage and allows patients to avoid copays and deductibles when visiting a doctor, urgent care or emergency room for non emergency issues. Given the company’s extensive distribution network, Amazon can use this leverage to disrupt everything from the pharmaceutical supply chain to Medicare drug benefit management. Its continued move deeper into the healthcare realm will either drive changes in healthcare delivery or force the existing retail giants to become more competitive.

MIT Researchers’ AI Model Detects COVID-19 by Listening to Coughs

Event: On November 4th, an article in Mobihealthnews reported that MIT researchers developed an AI tool that can listen to a person’s cough and determine if they have COVID-19, whether or not they are symptomatic. The research, first published in IEEE Open Journal of Engineering, reported that for asymptomatic positive cases, the tool performed at 100% accuracy.

Description: To build the artificial intelligence tool, researchers solicited more than 70,000 audio recordings of individuals coughing, with an average of three coughs per subject in addition to accompanying information about a subject’s condition through an online website. Researchers trained and validated a convolutional neural network-based model using the cough recordings and an equal number of randomly selected COVID-19 negative samples. This was done by listening for specific acoustic biomarkers related to muscular degradation, vocal chord changes, sentiment or mood changes, and changes in the lungs or respiratory tract. The new artificial intelligence tool yielded 97.1% overall accuracy, 98.5% sensitivity, and 94.2% specificity.

Implications: MIT envisions its new AI tool as a low-cost COVID-19 pre-screener that can be deployed in settings where comprehensive diagnostic testing is unavailable or cannot scale for entire populations. According to the research, “this noninvasive, free, real-time prescreening tool may prove to have a great potential to complement current efforts to contain the disease in low-infected areas, as well as mitigate the impact in highly infected areas, where unconscious asymptomatics may [unknowingly] spread the virus.” The same MIT team has been developing vocal biomarkers for use in diagnosing respiratory conditions and Alzheimer’s disease, suggesting that there may be some other higher level biomarkers that can be used to diagnose diseases thought to be unrelated.

Curve Health Raises $6M Seed Round

Event: On October 29th, Citybizlist reported that Curve Health which delivers connected senior care via a platform that combines telemedicine, smart billing, health information exchange, and predictive analytics had raised a $6M seed round.

Description: Curve Health advances connected senior care by enabling physicians to remotely care for patients in skilled nursing facilities (SNFs), in the home, in ambulances or wherever they may be. Curve Health combines telemedicine, a health information exchange, predictive analytics, and smart billing into a single platform, resulting in higher quality care and significant return on investment. In addition this ensures a virtually seamless patient experience. Curve Health, which is built on, and expands, the Call9 platform, not only facilitates telemedicine but creates a true virtual hospital-level care experience for patients and providers. By bringing the hospital to the patient, Curve is able to improve outcomes, reduce unnecessary hospitalizations and improve bottom lines.

Implications: Patient transfers from SNFs to EDs can be stressful and traumatic for patients and expensive for providers, Curve is built on a platform that has been demonstrated to markedly reduce transfers to ED’s thereby improving patient experience while simultaneously cutting the risk of infection. In addition, by using telemedicine, Curve allows seniors to age-in-place longer enjoying the comfort of their own home. By reducing transfers and hospitalizations, services such as Curve can redirect high cost institutional care to a more appropriate setting and significantly reduce patient cost while improving care.

Patients Shirked Diagnostic Testing, In-person Preventive Care Amid Telehealth Boom this Spring

Event: In a recent article Healthcare Dive reported that during the Covid-19 pandemic while numerous patients opted for telehealth visits there were also substantial drops in diagnostic procedures and preventive elective care.

Description: While telehealth boomed during the pandemic, there are certain services that providers are not able to deliver virtually including routine diagnostic procedures used to detect major health conditions before they progress. Overall, healthcare utilization dropped 23% in March and 52% in April. Mammograms and colonoscopies dropped more than 65% in March/April compared to last year; musculoskeletal surgery, cataract surgery, and MRIs all dropped by 45% or more; chronic conditions including blood sugar tests fell 50%, chemotherapy dropped 4%, and, vaccination for children under 2 years dropped by 22%. Comparatively, telemedicine visits jumped 4,000% compared to the year prior, but only replaced about 40% of the drop in in-person visits.

Implications: Delaying diagnostic procedures poses a danger to high-risk patients since early signs of serious diseases may get missed leading to potential adverse outcomes. The pandemic has caused fear and anxiety among patients surrounding in-person visits unless they are absolutely necessary. However, providers and payers can use improved communication and a more collaborative environment to engage patients and ensure they get the necessary tests and treatments. Telemedicine can factor in by scheduling screening appointments to connect with patients and build confidence that will get them back to the facility for necessary testing and procedures. Not only would this benefit patients, but increases in diagnostic and elective services would help replace revenues lost during the pandemic and have positive financial implications on providers as well.


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