Managed HealthCare Executive Week in Review

March 14, 2020

This week’s favorites ran the gamut from tech to COVID-19.

The Apps Healthcare Execs Can’t Live WithoutManaged Healthcare Executive asked (before COVID-19) a dozen leaders what apps they have on their phones, for work or play, and got responses ranging from LinkedIn to Quanum for e-prescribing to Headspace for mindfulness. Management and travel tools were popular, too. Check out our story from the March issue to see if your favorites made the list.

Health IT in 2020: 3 Trends That Will Disrupt the Market
Digital therapeutics to manage chronic conditions, genomics to diagnose rare conditions in children, and artificial intelligence tools to detect kidney disease before clinical symptoms emerge-all 3 developments are attracting attention, and they rely on interoperability that has eluded healthcare until now. Sharing data among stakeholders will be key to success, and final interoperability rules could help. Read our story here.

Insurers Had Moved to Waive COVID-19 Testing OOP Before the Pence Announcement

This week’s announcement from Vice President Mike Pence that major health insurers had agreed to drop copays for coronavirus testing had the veneer that the administration had forced this change. But a blog post from America’s Health Insurance Plans (AHIP) dated March 6 shows the change was already in works for a host of large players, including Aetna, Anthem, Cigna, and UnitedHealthcare. New York Gov. Andrew Cuomo ordered waiving out-of-pocket fees March 2, including emergency room, urgent care, and other costs. 

Medicare Advantage to Offer More SDOH Benefits
Social factors such as housing, nutrition, and access to recreation all affect a person’s health, numerous studies show, and Medicare Advantage (MA) plans can now pay for services that these social determinants of health (SDOH). However, a report showed only 102 plans offer these new benefits, and one reason may be the limited rebates that plans receive for offering these services.

The Oncology Care Mode and Its Heir Apparent
The alternative payment mechanism created by CMS to reward oncologists for better outcomes in Medicare and provide a monthly fee to invest in things like better care coordination and 24/7 access to records has made a difference for patients, even if it hasn’t quite hit the mark on figuring out how to fund high-cost drugs. In our March issue, we explore how things could change under the next iteration, called Oncology Care First, which moves close to a bundled payment in cancer care, with better differentiation by cancer type. Experts see some positive but say there’s work to do.