Zus Health CEO Jonathan Bush

Telehealth

Telehealth Flexibilities Reduced Opioid Overdoses

A new study in JAMA Psychiatry attracted a lot of attention last week after finding that pandemic-era telehealth flexibilities significantly lowered the odds of medically treated opioid overdoses among Medicare patients.

Researchers from the CDC, CMS, and NIDA examined data from Medicare beneficiaries with a prior diagnosis for opioid use disorder (OUD), separating them into a pandemic cohort of 71k patients who initiated OUD care after telehealth flexibilities were expanded and 105k who sought treatment prior to the onset of the pandemic.

The differences between the two groups were stark: 

• Roughly 1 in 8 beneficiaries in the pandemic group received OUD-related telehealth services, compared with just 1 in 800 in the prepandemic group.

• The expanded access to treatment helped 12.6% of pandemic beneficiaries obtain medications for OUD (e.g. methadone, buprenorphine, naltrexone), compared with 10.8% of the prepandemic group. 

• The pandemic cohort saw significantly lower odds of medically treated overdose (odds ratio: 0.67), as well as higher medication retention (OR: 1.27).

• Pandemic beneficiaries were also far more likely to access virtual behavioral health services than the prepandemic group (41% vs. 1.9%).

The Takeaway

The study served as a boon to telehealth advocacy groups, which have been pushing to make pandemic-era telehealth flexibilities a permanent fixture. The American Telemedicine Association pretty much summed it up in their press release, touting the study as “a strong signal to policymakers that telehealth can and should be a permanent part of healthcare delivery.”

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The Wire

• Walmart & UHG Partnership: The retail healthcare race took another leap forward on Wednesday with Walmart and UnitedHealth Group announcing a 10-year collaboration designed to transition Walmart Health facilities to value-based care. Through the partnership, UHG will provide Optum analytics and CDS tools to Walmart Health clinicians (starting with 15 Florida / Georgia locations in 2023), while also launching a co-branded Medicare Advantage plan in Georgia dubbed UnitedHealthcare Medicare Advantage Walmart Flex. Stay tuned for a deep dive in Monday’s DHW.

• Inflation Catches Up to Healthcare: A recent KFF survey of 2,375 U.S. adults found that four of consumers’ top seven financial concerns are now healthcare related, with 33% of respondents reporting that they’ve skipped medical treatment due to cost in the past year. Topping the list of health services most likely to be delayed are dentistry (35%), vision (25%), and doctor’s office visits (24%), and KFF expects deferrals to continue as inflation pressures consumers to prioritize their spending on household necessities instead of healthcare.

• Amazon Telehealth Returns: Business Insider recently got the scoop on a series of internal tests being conducted by Amazon for a new direct-to-consumer telehealth and online prescription service code-named Katara. The service aims to challenge D2C heavyweights like Hims and Ro by treating common conditions such as acne and hair loss without going through employers or health plans – seemingly the polar opposite approach to the now-shuttered Amazon Care program.

• Less Trust = More Pain: New research out of the University of Miami indicates that patients experience more pain when they perceive their physicians as less trustworthy, suggesting that “even small changes to the doctor-patient relationship may be enough to decrease patients’ pain.” Participants (n = 42) received painful heat stimulations from virtual physicians (images of doctors made to appear more or less trustworthy using an algorithm) while undergoing functional MRI, experiencing more activity in pain-related brain regions when the procedure was performed by “less trustworthy” physicians.

• 98point6 New Strategic Direction: 98point6 raised $20M to help it pivot away from selling its text-based virtual primary care platform directly to employers as it refocuses on licensing its solution to health systems. The company had previously raised nearly $250M as telehealth utilization expanded throughout the pandemic, and the sharp change in strategic direction feels like a bellwether for other care delivery startups struggling to reach scale as the digital health bubble continues to deflate.

• Dismal U.S. Life Expectancy: Although this probably won’t come as a shock to many readers, a new report from the Commonwealth Fund found that the U.S.’ 78.8 year average life expectancy trails far behind other developed nations such as Japan (84.4 years), Spain (84), and Switzerland (84). Deaths from avoidable causes and a weak commitment to community-based primary care were singled out as drivers for the poor performance, which looks even worse when considering that healthcare accounts for 20% of U.S. GDP, the highest among any country.

• Upfront Series C: Less than a month after its acquisition of PatientBond, patient engagement company Upfront Healthcare closed $10.5M in Series C funding to help integrate PatientBond’s psychographic segmentation into its communications platform. Upfront’s technology aims to promote positive patient behaviors (visit adherence, care gap closure, referral navigation) using proprietary psychographic-driven nudges that incorporate personality and lifestyle factors to improve performance.

• The Home Advantage: Kaiser Permanente researchers revealed that high-risk cardiovascular disease patients who received home-based cardiac rehabilitation (HBCR) were 21% less likely to be hospitalized within twelve months than those who received center-based rehab (n = 2.5k). Although the study illustrated a strong correlation between HBCR and reduced readmissions, it found that center-based cardiac rehab patients fared similarly when it came to medication adherence, blood pressure control, LDL cholesterol, and hemoglobin A1c at twelve months.

• SOC Telemed Acquires Forefront: SOC Telemed dramatically expanded its behavioral telehealth offering by acquiring Forefront Telecare, which provides vulnerable patients with timely virtual access to specialists. Apparently not content with one major announcement per press release, SOC Telemed also revealed a complete rebranding of the combined company, which will henceforth be known as Access TeleCare.

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