I hear, and personally experience instances where the insurance company does not understand (or at least can explain to us…
Monday Morning Update 4/26/21
Top News
J2 Global will separate into two publicly traded companies, one of them being the healthcare-focused Consensus.
Consensus will offer the healthcare-focused EFax cloud fax and messaging business that it positions as an interoperability platform to integrate systems and workflows. That business has annual revenue of $340 million and a 35% EBITDA margin.
J2 Global operates Internet brands that include IGN, Mashable, Oookla Speedtest, Medpage Today, and PCMag.
Scott Turicchi, J2’s president and CFO, will move to CEO of Consensus.
Reader Comments
From Super Saver: “Re: healthcare costs. I see a lot of technologies that promise to lower them. Not necessarily for consumers, though.” Agreed. My experience is limited to healthcare systems, but few of the technologies we implemented to reduce cost ever really did so, especially if the savings involved labor that we just moved to some other area. It’s also safe to say that healthcare savings rarely trickle down to actual patients — they just swell the profits and executive payroll of billion-dollar health systems, insurers, and employers in the absence of a competitive, consumer-driven market where reduced costs would support lowered prices to gain market share.
From Alhambra: “Re: new job. Thanks for the recent mention. I’ve never had so many people reach out to me with the same screenshot letting me know I’m famous!” Thanks. Along those lines, I sometimes warn folks I’m interviewing that few people realize how many readers are out there, and that it’s possible that the interviewee will get a lot of emails and LinkedIn messages when the interview runs. Some have told me they got hundreds of messages within a few hours and one closed a long-delayed sale the next day that the customer attributed to being reminded by the interview. Many types of business would moan that customers – readers, in my case – rarely offer testimonials and word-of-mouth advertising, but I actually kind of like being a secret, guilty pleasure. Sometimes an industry luminary emails out of the blue to tell me they are a regular reader, direct feedback I appreciate as a solitary filler of empty screens.
From Are Ex: “Re: prescriptions. Here’s a brilliant comment.” I agree. FDA’s prescription-only requirements to require certain items to be used only under a doctor’s supervision are a bit paternalistic and anti-consumer, although they have created a vigorous market in telehealth, online pharmacies that offer minimally vetted prescriptions paired with shipment of their particular wares, urgent care centers, and even hospital EDs who are happy to write that prescription at a high cost with little actual value added. COVID-19 has brought the issue to the forefront, as consumers were not trusted to buy their own testing kits even though getting a prescription did little to improve their chances of safe, effective outcomes. We are one of the least-healthy industrial nations in the world, so it would be interesting to see how our rigorous prescription requirements compare to healthier ones, especially when obtaining said prescription is often a financial rather than a clinical exercise. Also interesting would be a poll of doctors of which prescriptions they write that they consider a waste of time versus the patient being allowed to buy it themselves.
HIStalk Announcements and Requests
The top discretionary reason of poll respondents to attend HIMSS21 is socializing.
New poll to your right or here: Do you hold shares or an ownership stake in a health-related technology company?
My brilliant idea of the week: some company should pay telehealth providers for the privilege of running ads on video visit screens for the patient to watch until the provider starts their encounter, kind of an Outcome Health model of cramming drug company advertising into waiting and exam rooms. I thought of this while being interrupted endlessly by YouTube targeted ads that injected themselves at the most inopportune moments of the concert video I was trying to watch.
Webinars
April 27 (Tuesday) noon ET. “The Modern Healthcare CMIO: Best Practices for Implementing Digital Innovations.” Sponsor: RingCentral, Net Health. Presenters: Nathan Gause, MD, assistant professor of medicine and orthopedic surgeon, University of Missouri Healthcare; Ehab Hanna, MD, MBA, VP/CMIO, Universal Health Services; Subra Sripada, MSIE, partner, Guidehouse; Jigar Patel, MD, VP/chief medical officer, Cerner Government Services. This panel of CMIOs will discuss how their organizations are leveraging digital medicine to improve patient outcomes and provider workflows. Topics will include AI and analytics, effectively implementing AI solutions, establishing data governance and oversight for AI-powered products, care and treatment changes on the horizon, and interoperability of large EHR systems.
Previous webinars are on our YouTube channel. Contact Lorre to present your own.
Here’s the recording of last week’s webinar, “Is Gig Work For You?”
Acquisitions, Funding, Business, and Stock
Health and benefits solutions vendor Accolade will acquire PlushCare, which offers virtual primary care and mental health treatment. Accolade will pay $450 million, mostly in stock, for the company that had $35 million in 2020 revenue. Accolade acquired telemedicine second opinion startup 2nd.MD in March for $460 million.
Sales
- UT Health East Texas at Ardent Medical Services chooses TheraNow’s telehealth platform to provide telemedicine and remote physical therapy treatment.
People
Relatient hires Raj Bhavsar, MS (ConnectYourCare) as CTO.
Patient engagement and behavior change technology vendor The Affective Computing Company hires one of its investors and advisors, Matt Dobski (Amwell) as president. The company will also start styling itself as Affective.health.
Announcements and Implementations
Vermont Care Partners and four member agencies go live on Netsmart’s MyAvatar behavioral and addiction services EHR.
Long-term care pharmacy provider ExactCare connects to CarePort to offer hospitals coordinated medication management.
Symplr renames the provider data management platform of Phynd, which it recently acquired, to Symplr Directory.
Southern Sun Pathology, Australia’s largest skin cancer lab, goes live on Sectra digital pathology.
COVID-19
FDA approves resumed use of Johnson & Johnson’s COVID-19 vaccine, declining to limit it use to specific ages or gender, but with a label warning about possible rare blood clotting disorders. CDC’s advisory panel has identified 15 cases and three deaths due to the blood clotting issue of eight million doses that have been administered in the US, most of the cases involving young women. Critics say the pause accomplished little beyond making people unnecessarily wary of the J&J product and COVID-19 vaccines in general.
CDC reports that 8% of people who got their first dose of the two-shot Pfizer and Moderna COVID-19 vaccines haven’t completed their vaccination by the date due. Reasons: fear of side effects, the believe that one shot offers enough protection, lack of transportation or work time off, and providers cancelling second-dose appointments because of shortages of the vaccine that the patient received in their first dose. Still, the 92% second-dose follow-up is historically high.
Experts say that India’s COVID-19 death toll is 2-5 times higher than the official reports, as local officials and hospitals are reportedly being pressured to attribute suspected COVID-19 deaths to other conditions or to simply label all death certificates as “sickness.” A New York Times audit of funeral facilities in the city of Bhopal found more than 1,000 deaths in a 13-day period versus the officially reported 41 as crematories are operating around the clock. India is the world’s largest vaccine manufacturer, but less than 10% of its residents have received a dose. Daily new cases have jumped from 13,000 in March to 350,000. Brown University public health school dean Ashish K. Jha, MD, MPH urges in a Washington Post opinion piece that the US provide assistance to the world’s largest democracy and ally by sending excess testing kits, PPE, oxygen, drugs, and vaccine doses, particularly the 30 million stockpiled doses of AztraZeneca’s product that has not earned FDA’s authorization and is likely never going to be used here given ample supply of alternatives.
University of Oxford researchers report results of clinical trials of a malaria vaccine candidate, with the new product being the first to hit WHO’s goal of 75% efficacy. The commercial partner is US-based Novavax, whose COVID-19 vaccine will likely reach the US market soon after recent clinical trials results showed a 96% efficacy. The company is also working on a combination vaccine that incorporates its COVID-19 and flu vaccine candidates.
Other
The second-highest paid CEO of a publicly traded US company made $200 million in compensation in 2020, that being Amir Dan Rubin, CEO primary care practice chain 1life Healthcare (One Medical). Trading began in late January, with shares up 227% since in valuing the company at $12 billion.
Sponsor Updates
- GigaOm names Pure Storage’s FlashBlade a leader in its latest report on high-performance object storage.
- Vocera’s customer success team wins the Business Intelligence Group’s 2021 Excellence in Customer Service Award.
- The Federation of Royal Colleges of Physicians in the UK approves Wolters Kluwer Health’s UpToDate clinical decision support for continuing professional development.
Blog Posts
- Abdali Hospital’s vision for the future of healthcare technology (Nuance)
- 4 Must-Know Clinical Practices for Revenue Cycle Success (Netsmart)
- CHIME Spring Forum thoughts: Create great user experiences for all the users (Nordic)
- How Providers Build Loyalty Through Transparency (PatientBond)
- Put Together the EHR and ERP Integration Puzzle (Pivot Point Consulting)
- How Baptist Health South Florida is Leading the Way in COVID-19 Therapeutics (Premier)
- Accelerate Real-Time Genomic Surveillance and Analytics (Pure Storage)
- How to Achieve Clean Claims with Less Effort (RCxRules)
- Expanded Vaccination Data Integration Capabilities (Redox)
- How TeleICU Solves the Challenge of Cost-Effective ICU Staffing (SOC Telemed)
- Hospital smart rooms: What to consider (Sonifi Health)
- Save the Date for Connect 21: Innovation. Interaction. Inspiration. (Spok)
- Moving Value-Based Care Forward (Surescripts)
- What is unique about real-world data from TriNetX? (TriNetX)
- Automating claim status checks to accelerate cash (Waystar)
- PT Perspectives: What Clinicians Are Saying About the Lasting Legacy of COVID-19 (WebPT)
- Well Health’s Top 10 Remote Moments (Well Health)
- Interoperability in healthcare: 5 ways to unlock value from new requirements (West Monroe)
Contacts
Mr. H, Lorre, Jenn, Dr. Jayne.
Get HIStalk updates.
Send news or rumors.
Contact us.
Re: “the absence of a competitive, consumer-driven market” in healthcare
How would this be achieved? I’ve always wondered what the pre-conditions for such a thing would be, and there doesn’t seem to be a working example to compare to.
I just saw an article about Joan Robinson – wouldn’t her “The Economics of Imperfect Competition” apply here as well?
I don’t think consumer driven is even needed, just competition. For a starting point, the aca exchange in New York State is as competitive as the health insurance marketplace can be. There is even a pretty legally simple model to scale it up. Take away tax subsidies for employer provided healthcare, make any healthcare benefits transferable to the exchange (like the Harris plan), then provide large income based subsidies for purchases on the exchange. Low wage employers will jump at the chance to shift the healthcare responsibility into the state. High income earners and unions won’t fight it since it is providing another option for them rather than taking something away. Employers will eventually stop offering core health insurance as a benefit and everyone will purchase their plan on the market. It isn’t the best outcome ever but it is competitive and it is achievable.
What is described above is competition among health insurance companies. How will that translate into competition among healthcare providers? And then into lower healthcare costs, which was the original context of the discussion.
Sure but it’s just one example and one that has a lot of knock on effects. Once states are on the hook for care, they have impetus to actually control prices. Once there is a non captured insurance market, insurance companies actually make money competing on rather than passing through costs.
Another aspect of the requirements for prescriptions is related to insurers requirements. There are a whole host of durable medical equipment items that can be easily bought at a surgical supply store if you pay out of pocket (e.g. catheters, Foley bags, ostomy supplies, chronic wound care products) yet it requires a script and repeated physician authorizations to have it paid for by insurance and even so they often won’t give sufficient amounts per month to meet patient needs. These kinds of authorization roadblocks have significant effects on patients’ quality of life as well as causing unnecessary burdens for health care providers.
Re: [your] brilliant idea of the week: some company should pay telehealth providers for the privilege of running ads on video visit screens for the patient to watch until the provider starts their encounter.
How about not!?! I think that would negatively impact virtual visits. Perhaps if it was appropriately targeted patient education vignettes or short generalized health info, that might work. But I sure wouldn’t want to be held captive to watching ads while waiting for my doc. Now maybe if you could Opt Out, you would get a few takers, but please…give me a choice at least!
I have led the implementation of telehealth twice now for different care providers. While Mr H’s idea is very viable, we contracted in a way to not let that happen. Why would we let anyone else dictate anything around our patient experience? We required the tele platform to give us a webpage that we host and can then use it to serve up our own patient educational material and other messaging. Plus, we actively monitor to ensure that the patient isn’t spending any meaningful time on the “waiting room” page. Patient experience has to be valued and protected!
Some enterprising tech firm could decide to employee the model used by social media or commercial TV — your virtual visit is free, but you have to watch the commercials!
I think we saw that movie in Practice Fusion with a cast that is currently looking at wearing orange for the next 18 months.
“Experts say that India’s COVID-19 death toll is 2-5 times higher than the official reports, …”
I saw a report out of India on this. The suggestion there was that the true death toll was 10x greater than the official numbers. Having some knowledge of India and the challenges there, I find the 10x estimate to be entirely plausible.
The BBC just reported, for example, that there’s a dramatic difference between hospital-reported death rates, and the increase in the number of funeral ceremonies being performed. They have also reported examples of people being turned away from hospitals. Due to the hospitals being entirely overwhelmed.
Well, if the hospitals are full, and a person dies outside the hospital setting, how exactly is the hospital going to report that death? How do they even know?