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Retailer Partnerships | New QHINs February 15, 2024
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Together with
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“If a health benefit falls in the woods and no one is around, does it make a sound?”
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Hatch Chief Growth Officer Adam Peebles
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A new viewpoint in the Harvard Business Review made the case that health systems and retailers are only scratching the surface of their partnership potential.
The authors – a trio of professors out of Harvard and UNC – outline four actions they believe health systems and retailers should take to better coordinate their complementary services.
Move Beyond Convenience. Retailers like CVS and Walmart are beginning to add services such as primary care, mental health counseling, and home care, yet even more robust solutions like Amazon Clinic still fall short of integrated care.
- Things like cancer treatments and surgeries remain well outside the realm of retail health, yet a close partnership between a retailer and a health system could help integrate the many elements involved in treating more-serious conditions.
Move Care Into the Home. Although retail clinics are more convenient and accessible than hospitals, patient homes have them beat on both metrics. Hospitals have begun offering more care in the home, but often lack the logistical prowess to supply patients with the monitoring tech needed for larger programs.
- Efficiently equipping patients’ homes with RPM devices is right in the retailer wheelhouse, and a partnership could fill the gap. Look no further than Best Buy and Geisinger for proof.
Leverage Data to Improve Care. The data held by retailers and health systems largely remains in separate databases, with some notable exceptions like Target-Kaiser Permanente.
- The authors point out that better integration could help with everything from flu outbreak prediction (grocery carts filled with tissues = sick people) to food-as-medicine programs (well-timed nudges and incentives).
Change Who Delivers Care. Labor shortages are one of healthcare’s biggest immediate obstacles, and few employers have a larger workforce than retailers. The article gives the example of Walmart, which subsidizes education for its employees to train for roles like pharmacy technician and medical assistant.
- Health systems could ensure these training programs meet quality standards and help graduates find jobs, creating a model where retailers attract more ambitious candidates and providers have a new talent pool to tap into.
The Takeaway
One way or the other, retailers are moving past the Retail Care 1.0 era, and it’s hard to argue against the case for tighter retailer-provider partnerships. Even if consumers might not jump at the idea of sharing their grocery list with their physician, the ideas outlined in this article are good food-for-thought for combining the complementary strengths of retailers and providers to improve the system as a whole.
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- New QHINs Make Debut: HHS added two more organizations to its Trusted Exchange Framework and Common Agreement (better known as TEFCA), with the CommonWell Health Alliance and Kno2 both receiving their QHIN designation. The pair of new QHINs join Epic, Health Gorilla, eHealth Exchange, KONZA, and MedAllies, which were among the original December cohort. CommonWell and Kno2 can immediately begin supporting data exchange under TEFCA, which aims to establish a universal policy for network-to-network health information sharing.
- Medical Debt On the Rise: The percentage of Americans with medical debt ticked up to 24% in 2022, according to a KFF analysis of national survey data. If you broaden the definition to include things like debt to family members, that percentage spikes all the way to 41%. Not exactly ideal, especially considering that those with medical debt are more likely to skip care when they have a problem (46% vs. 11% without medical debt), dip into their retirement to make ends meet (40% vs. 6%), and describe themselves as “just getting by” (58% vs. 28%).
- Omada Enhances GLP-1 Care: Omada Health rolled out enhancements to its GLP-1 program, adding detailed reporting for employers/PBMs/payors to support prior authorization, as well as expanded exercise programming to help maintain weight loss. The enhanced GLP-1 Care Track will augment Omada’s full cardiometabolic suite (prevention, diabetes, hypertension), providing patients with behavioral support, nutrition, and tailored exercise plans designed by Omada’s physical therapists to optimize muscle mass (~40% of GLP-1 weight loss can be muscle mass).
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- Private Equity Isn’t Going Anywhere: A report from the American Investment Council highlighted the increasing prevalence of private equity in healthcare, including over $15B that PE investors raised last year to deploy within the industry. The PE lobbying firm’s report argues that private equity makes the healthcare system more efficient, but it also arrives at a time when lawmakers are probing PE’s industry involvement and new research is indicating PE hospital ownership might not be ideal for patients.
- DiMe Physical Activity Resource: DiMe launched the final resources from its physical activity project, including a core set of digital measures to track what’s increasingly recognized as the “6th vital sign.” In typical DiMe fashion the complete project is publicly available, allowing anyone to better assess the impact of exercise on well-being. It also includes ontologies, a decision tool, and illustrative scenarios to help researchers, providers, and developers implement the new core measures.
- Medicare Advantage Projections: New projections from the CBO expect Medicare Advantage enrollment to max out at 60% of total Medicare beneficiaries before 2030. That would represent a fairly substantial slowdown from the past decade, which saw MA enrollment nearly double to 30.8M people in 2023, representing the first time in history that over half of all eligible Medicare beneficiaries were enrolled in a private MA plan.
- Virgin Pulse + HealthComp = Personify Health: Just a few short months after their $3B merger, Virgin Pulse and HealthComp are rebranding the combined company to Personify Health. The newly unified Personify Health will combine Virgin Pulse’s employee wellness platform with HealthComp’s revenue cycle suite to form a “health platform-as-a-service company” with 20M users and 1,000 employers. Love the wink from the design team.
- Healthcare’s Super Bowl Moment: Three healthcare-specific ads ran during this year’s Super Bowl, with Power to the Patients, Pfizer, and Roswell Park all enjoying 30 seconds of record viewership during their $7M ad slot (123M people tuned in). Patient advocacy group Power to the Patients brought out the celebrities to demand more transparency. Pfizer showcased some amazing scientific breakthroughs over a similarly amazing Queen soundtrack. Cancer center Roswell Park might have taken the cake with its tear-jerking commercial narrated by a golden retriever.
- $2B Medicare Scam: A potentially massive Medicare scam was uncovered involving seven companies that allegedly drove a nearly $2B increase in billings for catheters since 2022. The Washington Post reported that the seven companies all share the same address and leadership team, yet until two years ago they had only worked with 14 patients all together. The companies used real patient information (probably involving a breach), and it sounds like several federal investigations are now looking into the situation.
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