Wire #109

  • Payor Provider Plumbing: Turquoise Health’s Head Of Strategic Partnerships Tejas Inamdar put out a great introduction to the behind the scenes plumbing of payor provider transactions. It’s pretty eye-opening to see the administrative maze that needs to be navigated to accomplish something as simple as confirming health coverage for a patient, and this writeup is about as enjoyable as revenue cycle commentary gets so it’s worth checking out if you’re curious about the space.
  • Unmet Home-Based Care Demand: A Mount-Sinai study showed that homebound patients over the age of 65 are hospitalized over twice as frequently as those who aren’t homebound (40% vs. 20% annually), leading to additional Medicare spending of $11,346 per patient. The authors stress that meeting the demand for home-based care is critical for health systems as it targets an important population for quality improvement and spending reductions.
  • EHR Improvements for Behavioral Health: A JAMA physician viewpoint makes the case that EHR standards need to be “refocused” to incorporate behavioral risk preventative services similar to current cancer screening best practices. The authors recommend that EHRs should be updated to mirror the multistep process of behavioral health screening and adapt as patient data is entered to provide referral support as at-risk individuals are identified, thus ensuring the intervention is fully delivered.
  • Plume Scores $24M: Plume raised $24M in Series B funding to help expand its virtual transgender care platform nationwide while also entering the primary care market. Plume offers gender-affirming care through a $99 per month membership that includes prescriptions for hormone therapy, support groups, and medical letters of support for name and gender marker changes.
  • AI-Guided Pain Care: AI-guided cognitive behavioral therapy for chronic pain isn’t inferior to standard phone therapy, according to a new 10 week study of 278 patients in JAMA Internal Medicine. The AI group received daily automated calls then either a short therapist phone call or an individualized voice message depending on their responses, while the comparison group received weekly 45 minute therapist phone calls. Both were equally effective, suggesting that AI-guided treatments could help open up bandwidth for therapists to see more patients.
  • Upfront Acquires PatientBond: Patient engagement company Upfront acquired PatientBond as it looks to integrate PatientBond’s psychographic segmentation model into its existing communications platform. Originally developed by CPG brands, psychographic segmentation incorporates personality and lifestyle factors to gain insight into people’s motivations and communication preferences, so it’s easy to see why Upfront is aiming to translate the technique to its patient engagement solution.
  • Cyber Attacks Shift to Small Hospitals: Critical Insight’s 2022 Healthcare Data Breach report revealed that cybercriminals are refocusing from large health systems to smaller hospitals, with attacks against providers and business associates climbing over 10%. The report anticipates that attackers will continue to target smaller entities for ease of attack, as well as for evasion of media attention and escalation with law enforcement.
  • McLaren RPM: Michigan-based McLaren Health Care is expanding its RPM program to 7,000 people after a successful pilot that reduced hospital readmissions for patients with chronic conditions. The program texts and emails patients with a series of disease-specific questions, then alerts nurses if the responses indicate possible complications, which allows a single nurse to remotely oversee the care of 1,500 patients.
  • MA Plan Enrollment Reaches 28M: A Kaiser Family Foundation report revealed that more than 28M people are enrolled in a Medicare Advantage plan in 2022, which now accounts for 48% of all Medicare beneficiaries. The proportion of those enrolled in MA plans has doubled since 2007, and the Congressional Budget Office projects it will surpass 60% over the next decade.
  • Telemedicine for CV Disease: A systematic review published in The Lancet analyzed data from 34 studies (13,269 patients) to investigate telemedicine’s potential for patients with cardiovascular disease. Combined remote monitoring and consultation for patients with heart failure was associated with a reduced risk of cardiovascular-related mortality (risk ratio: 0.83) and hospitalization for a cardiovascular cause (RR: 0.71), although interestingly there was no significant effect on all-cause hospitalization or mortality.

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-- The Digital Health Wire team