Today's News and Commentary

About health insurance

MaineHealth, Anthem team up for joint insurance venture: A new Medicare Advantage plan is not really news, but the coalition forming it is noteworthy. “MaineHealth and health insurance provider Anthem Blue Cross and Blue Shield of Maine are collaborating on a joint venture with the intent to offer Medicare Advantage health insurance plans for 2020.”

The Collapse Of A Hospital Empire — And Towns Left In The Wreckage: How do you save your local hospital? In a fee for service world, insurance fraud is a tempting option. Read this fascinating story.

Cigna seeks sale of group benefits insurance business - sources: Sources close to the company said Cigna is seeking to sell its non healthcare businesses (disability, life and accidental death and dismemberment insurance). The sale could be worth $6 billion. In the past, insurance companies covered many different types of insurances. Over the past 2-3 decades, they have specialized in certain segments or shed focused divisions. Is the era of the comprehensive insurance company really gone?

About the public’s health

After Trump blames mental illness for mass shootings, health agencies ordered to hold all posts on issue: ”A Health and Human Services directive on Aug. 5 warned communication staffers not to post anything on social media related to mental health, violence and mass shootings without prior approval.”

Children of Anti-Vaxxers Should Have Access to Doctors’ Offices Restricted, Say Almost 75% of Parents: The headline is the bottom line of the survey conducted by the C.S. Mott Children's Hospital (University of Michigan) National Poll on Children's Health. Perhaps peer pressure will help get more children vaccinated?

Acute Effects of Electronic Cigarette Aerosol Inhalation on Vascular Function Detected at Quantitative MRI: Even the aerosol in e-cigarettes causes problems in the lining of the blood vessels.

Migrants in US border detention centers won't receive flu vaccine: Policy and political views aside, this decision is bad for the public’s health.

About healthcare IT

2019 Predictive Analytics in Health Care Trend Forecast: Among the findings of this study by the Society of Actuaries:

—60% of executives are using predictive analytics within their organizations, which is a 13-point year-over-year increase from 2018 (47%) and a 6-point increase from 2017 (54%).
—60% of payers and providers expect to dedicate 15% or more of spendingto predictive analytics in 2019. And, they’re expecting the investment to pay off: nearly two-thirds of executives (61%) forecast that predictive analytics will save their organization 15% or more over the next five years.
—16% of providers cite “too much data”as the top barrier to implementing predictive analytics, while payers cite “lack of skilled workers” (15%) as the greatest hurdle.

New HL7® FHIR® Accelerator Project Aims to Improve Interoperability of Social Determinants of Health Data:  “Health Level Seven® International (HL7®), the global authority for interoperability in health information technology, and the American Academy of Family Physicians (AAFP)… announce that the Gravity Project is now part of the HL7® FHIR® Accelerator Program.

The Gravity Project aims to standardize medical codes to facilitate the use of social determinants of health-related data in patient care, care coordination between the health and human services sectors, population health management, value-based payment and clinical research. Social determinants of health (SDOH) are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.” [For more on FHIR, see Chapter 8 of the text.]

Pharmacy Customers Slow to Adopt Digital Offerings but Satisfaction Increases When They Do, J.D. Power Finds: Among findings of this study: “Mobile app users more satisfied, but usage is stagnant: Only 20% of customers use a pharmacy’s mobile app, but those who did have satisfaction scores as much as 23 points higher than those who do not.” In addition to this IT finding: “Health and wellness customers spend more at the pharmacy: About two-fifths (42%) of customers who are aware of their pharmacy’s health and wellness services have used one of the services in the past year. While those who have taken advantage of health and wellness services spent 12.5% more on their most recent prescription order, significantly less health and wellness customers received a prescription as a result of their participation in 2019 as compared with 2018.” This latter revelation bodes well for CVS’s HealthHub initiative.