News 6/19/20

Top News

Member-owned health plan Health Care Service Corporation will create a Payer Platform to connect its health plans to in-network Epic-using health systems for reviewing patient data, managing claims payment and prior authorization, and facilitating care management.

HCSC is the country’s fifth-largest health insurer, with 16 million members enrolled in Blue Cross Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas.

HCSC acquired care management solutions vendor Medecision for $121 million in mid-2008 and is a partial owner of clearinghouse operator Availity.

Reader Comments

From Cellular Terrorist: “Re: COVID-19. You should call out the states that refused to apply sound public health measures and are now having record-breaking case numbers.” The problem with the federal government allowing states to do whatever they want is that we as a country can’t or won’t curtail unencumbered travel, so a Florida resident or visitor who parties down mask-free could spread COVID to more responsible areas in the “weakest link” theory. COVID-19 has demonstrated that we Americans don’t care much about science and can’t be bothered with inconveniences like wearing masks unless they promise to save us instead of someone else, so perhaps the “we’re all going to get it eventually anyway” crowd is right. What happens in Vegas doesn’t unfortunately stay in Vegas when it comes to coronavirus.

From Contact Tracy: “Re: contact tracing. See this press release for what my company is about to launch.” As an occasional bearer of bad news, allow me to level-set you: (a) use of any contact tracing app in the US will be under 15% and will drop quickly, making zero difference, and what little adoption there is will be all Apple and Google; and (b) contact tracing in general in the US won’t work because nobody trusts anybody, especially anyone connected with government in any form, enough to give them any personal information, much less their contact names and information, and they won’t even answer phone calls and emails from public health officials. We had better excel at developing a vaccine since every prevention strategy that worked elsewhere — lockdowns, masks, widespread testing, contact tracing, travel limitations, and immunity passports – requires nearly universal adoption and won’t fly in a fatally divided country like ours. Not to mention that we are a lot unhealthier than much of the developed world and will experience a higher rate of coronavirus-related deaths as result. We’re at 120,000 now, more than two Vietnam Wars’ worth (and to paraphrase Chief Brody said in “Jaws,” you’re gonna need a bigger wall). 

HIStalk Announcements and Requests

The grocery chain pharmacy (those are always cheaper than drugstore chains in my experience) filled my 360-day prescriptions for blood pressure and cholesterol meds with a 91-day supply even though I wanted a full year’s worth and was paying cash using a GoodRx coupon. They said GoodRx rejected the 360-day quantity, so I called GoodRx and was quickly connected to a pleasant, actual human who verified that some vaguely described policy limits fills to a 91-day supply in some cases. She could not describe those cases or explain why the app would issue a coupon that was not valid. I still got a year’s supply, paying $82 instead of the expected $60, and only then because the pharmacist found a coupon from a GoodRx competitor. At least the recent federal change that prohibits PBMs gagging pharmacists from telling patients about lower-cost options worked for me and I was impressed with GoodRx’s customer service. Meanwhile, CNBC reports that the software guys who started GoodRx have built a business worth $3 billion in finding yet another illogical loophole in our illogical healthcare non-system.

Webinars

None scheduled soon. Previous webinars are on our YouTube channel. Contact Lorre to present your own.

Acquisitions, Funding, Business, and Stock

PatientPing confirms the reader rumor that I recently ran: the $60 million Series C fund raise that it announced last week was actually completed in February 2019. The company told me that it held the announcement “to peg it to exciting company milestones and product capability rollouts,” which was explained to the Boston business paper as waiting on CMS to publish legislation that requires hospitals and EDs to send ADT notifications, a core capability of PatientPing. That CMS action was delayed, so the announcement was held as well. Experts note that private companies like PatientPing can announcing funding whenever they want or can skip an announcement altogether. It doesn’t feel right to me to hold off for 16 months, but only because a prospect might infer overly optimistic business conditions during a pandemic in which health systems have been nearly shut down for months.

Redox confirms a reader-reported rumor I sent their way, acknowledging that it laid off 44 people, about 25% of its headcount, on Tuesday. The company says it had planned to double its size in 2020 as it had in 2019 and hired accordingly, but COVID-19 changed the focus of financially strapped health systems. Redox is working with customers and partners to place those of its employees who were affected  –contact christine@redoxengine.com.

Social services referral software vendor Unite Us acquires Staple Health, an analytics company that focuses on social determinants of health.

Signify Research reviews the plan of Mednax to sell its radiology groups and Virtual Radiologic teleradiology business, with the company renaming itself back to its original name of Pediatrix Medical Group as a pediatrics and obstetrics business. Signify notes that the company paid $500 million for VRad in 2015, added 10 practices, and grew revenues by 10% to $3.5 billion, but piled on debt and saw EBITDA slide 24% over the four years. VRad is the world’s largest teleradiology provider. The company announced in early April that it would cut executive salaries, furlough and reduce the pay of non-clinical employees, and cut non-essential expenses in reaction to COVID-19. Signify expects VRad to benefit from its work on AI algorithms over the past several years.

Sales

• MultiCare Connected Care (WA) selects Innovaccer’s Data Activation Platform and InGraph population health analytics.
• Stonewall Memorial Hospital District (TX) selects CPSI’s Evident EHR and TruBridge RCM software and services.
• AdventHealth will implement Virtustream’s Healthcare Cloud to power its new Epic system.

People

Craig Joseph, MD (Avaap) joins Nordic as chief medical officer.

Arcadia promotes Debbie Conboy to VP of risk adjustment and quality products and hires Catherine Turbett (Steward Health Care) as VP of ACO and health plan account operations.

Announcements and Implementations

OrthoIndy (IN) implements Saykara’s AI-based physician charting app.

COVID-19

NIH’s All Of Us research project adds three COVID-19 data collection components for researchers who are approved to study data from its 350,000 participants:

• Testing at least 10,000 samples from recent enrollees for COVID-19 antibodies, hoping to determine rates of exposure by region.
• An online survey that asks about COVID-19 symptoms, stress, social distancing, and economic impact that participants can take monthly to understand effects over time.
• EHR data analysis from the 200,000 participants who have shared their information, with plans to standardize the information to investigate patterns, symptoms, associated health problems, and the outcome of drugs and other treatments.

Scientific American explains the accuracy rates of COVID-19 antibody tests, which are particularly important since the results are often considered reliable without verification. The authors explain that false-positive results, which are the most impactful, are more likely with low infection rates. Example: the same test that has 95% specificity (few false positives) and 95% sensitivity (few false negatives) will give a false-positive rate of 14% when the infection rate is 25%, but will issue falsely positive results 50% of the time when the infection is 5%. In other words, COVID-19 antibody tests are likely to issue a lot of false positive results that may encourage people to return to normal life because they think they are immune (not to even mention that nobody has proven that people who have COVID-19 antibodies are immune from reinfection).

FDA will participate in the COVID-19 Diagnostics Evidence Accelerator, a real-time diagnostic testing evaluation program that is a companion to the previously announced Therapeutic Evidence Accelerator.

The Equal Employment Opportunity Commission says that employers can’t require employees to take COVID-19 antibody tests before returning to work, basing its decision on CDC’s warning that antibodies don’t equate to immunity and therefore testing for them should not drive workplace decisions.

Other

It’s not just COVID-related fears that are keeping people away from medical practices and hospitals – the New York Times reminds readers that millions of Americans have lost jobs, income, and health insurance during the pandemic and can’t afford the high cost of healthcare, especially after reading about the aggressive debt collection practices of hospitals and practices. I’ll add one more item – even those who are able to get new health insurance will see their deductibles reset, meaning that someone with an ACA plan could be looking at several thousand dollars of deductibles before insurance starts paying anything.

Epic employees will return to the company’s headquarters in Verona, WI in four stages during July and August. Over one-third of the company’s employees have already returned to office work. The company says it is slowly resuming essential travel.

Researchers note that patient race and ethnicity are often used by algorithms that drive clinical decisions even though nobody knows whether underlying genetics are causing the observed differences in outcomes. The researchers caution that it’s not wise to simply apply a race-based digital fudge factor without knowing if genetic differences are responsible rather than societal issues, economic factors, or past inequities. Otherwise, minority patients may be denied services because of misinterpreted risk factors or the assumption of suboptimal outcomes.

Sponsor Updates

• RamSoft adds QliqSoft’s virtual visit technology to its RIS/PACS solutions.
• Healthwise receives five Digital Health Awards during the Health Information Resource Center’s 2020 spring competition.
• Intelligent Medical Objects publishes a new white paper, “The Evolution of the EHR.”
• Medhost joins the Amazon Web Services Partner Network as a Technology Partner.
• Black Book ranks Netsmart #1 in 10 categories across behavioral health and post-acute settings, including top overall post-acute care IT services and solution vendor.
• BridgeHealth offers its members access to flexible physical therapy solutions through WebPT’s Networks program.
• MDLive CMO Cynthia Zelis, MD joins the NCQA’s Taskforce on Telehealth Policy.

Blog Posts

• First CGM Basal-Bolus Insulin Titration Study Shows Future Potential for Remote Patient Monitoring (Glytec)
• Data scientists assist medical researchers in the fight against COVID-19 (Google Cloud)
• Finding the telehealth-life balance (Greenway Health)
• HealthNxt: The Next Great Advance in Virtual Care (The HCI Group)
• The Right Skills at the Right Time for Healthcare IT (HCTec)
• Activity-Based Costing in Healthcare During COVID-19: Meeting Four Critical Needs (Health Catalyst)
• I am still a nurse: Supporting the clinical voice of our customers (Hyland)
• Role of Health Data Analytics in Post COVID-19 World (Imat Solutions)
• Use Your COVID-19 Work to Build Data Governance (Impact Advisors)
• How to avoid disruption from loss of technical expertise (Infor)
• An Unprecedented Challenge: Serving Our Customers Through Passion and Commitment (InterSystems)
• CFO Playbook – Turning Financial Trauma into Transformation (Loyale Healthcare)
• Key Tips to Address Technology Frustration Within Your Organization (Netsmart)

Contacts

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