In this first of three-part video series, Craig Samitt, CEO and president of Blue Cross Blue Shield of Minnesota talks with MHE about healthcare utilization among its members and the elimination of low-value care.
In an interview with Managed Healthcare Executive, we spoke with Craig Samitt, CEO and president of Blue Cross and Blue Shield of Minnesota.
Samitt shared at this time, BCBS Minnesota is in what he calls a "double peak" in healthcare use among its members.
By double peak this means the COVID-19 case frequency and the hospitalization rate in Minnesota are the highest it's been since the pandemic began.
He adds the state is now seeing patients who didn't have COVID, but had other chronic diseases and were afraid to come in to the doctor or the hospital earlier in the pandemic, are now more sick and need the care.
"So it's a double peak right now because we're both seeing high COVID cases and we're seeing high non-COVID cases, which put us in a very tenuous spot in terms of hospital capacity," Samitt said. "We're at a very challenging time, especially heading into the holidays, where utilization could go up further in the absence of sufficient capacity to care for patients. And so it's incredibly scary at this time, and we're very much worried about how we're going to successfully care for everyone who needs care in Minnesota over the course of the coming months."
This double peak is not really seen much in cancer patients, thankfully, according to Samitt. Cancer patients are receiving proper care from BCBS of Minnesota partners he adds. For example, the volume in oncology clinics and infusion clinics have stayed relatively stable through the course of the pandemic because patients on a chemotherapy cycle are likely to continue those treatments.
"I think the underutilization has mostly been seen in chronic diseases that require regular follow up," he said. "So cardiac disease, congestive heart failure, diabetes, pulmonary disease, things that do require more regular touch base and regular maintenance. Those are the sorts of things that I think we're concerned about the implications of insufficient care and service on a regular basis."
In relation to insufficient care, Samitt adds while he's not so much seeing concerns about utilization related to people who have already been diagnosed with cancer, he's more concerned that they're seeing in higher volumes, are the the output of a deferred screening, and prevention and wellness strategies.
In this second part of a two-part podcast episode, Managed Healthcare Executive's Managing Editor Peter Wehrwein spoke with Ceci Connolly and Margaret "Meg" Murray about Medicare Advantage utilization and challenges, highlighting proposed CMS payment cuts and prior authorization issues.
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