In the early days of the U.S. COVID-19 outbreak, BlueCross BlueShield of North Carolina (Blue Cross NC) stepped up as one of the first health insurance plans to announce reimbursing telehealth visits “at parity” with face-to-face office visits for all providers and specialists. Chief Medical Officer Rahul Rajkumar talks us through the strategy behind that decision to “flip the switch” for telemedicine — which was made in just one meeting (!) – and what metrics and outcomes the Blue plan will be looking at post-pandemic to decide if the switch remains on.
Changing reimbursement policies to cover ALL COVID-19 testing and treatment
6:45 min: The role of virtual care during COVID-19 and reimbursement at parity
11:11 min: How will telehealth be evaluated post-epidemic?
13:58 min: Telehealth innovation, B2B use, remote monitoring (looking to providers to lead the way)
17:25 min: What’s going to happen with healthcare costs in 2021?
For more on how health tech companies in digital health, telehealth, remote monitoring, health data, and more are responding to the COVID-19 crisis, check out the other interviews in this special series at www.wtf.health/covid19.
As hospitals, health systems, and physician practices look to quickly scale up their digital health, telehealth, and remote monitoring offerings to adjust their delivery systems to the COVID-19 pandemic, what questions should they be asking health tech companies in order to make the right decisions? And, how can these health tech businesses, many of them startups, meet these ready customers half-way?
Ashish Atreja, Chief Innovation Officer for Medicine at Mount Sinai Health System (and also founder of digital health credentialing organization, Node.Health, and platform-builder Rx.Health) leans in with some critical advice at a time when health system sourcing, vetting, and contracting for digital health has never moved so fast.
“This COVID-19 solution you’re gonna bet on can be a catalyst for your entire digital health strategy and platform,” says Atreja, speaking as a health system innovator giving advice to others in similar roles. “There’s no pressure to bet on the right horse, but I think this is a moment of opportunity where you can see what is gonna give you long-term benefit.”
In the face of Covid-19, health tech startup Evidation Health is leveraging their relationships with the 4-million people on their Achievement app, the “always on” stream of behavioral data these folks bring to the table via wearables, sensors, and surveys, and everything they’ve learned from years of studying and modeling flu outbreaks to examine the Covid-19 virus in the context of people’s everyday lives.
Evidation’s CEO, Deb Kilpatrick, and Sr. Data Scientist, Ernesto Ramirez, stop by to talk about their company’s efforts for large-scale, frequent symptom surveillance of Covid-19 to add new insights to our understanding of the pandemic and, possibly, even help with making predictions about its spread and severity.
The company is already publishing some of its findings in a weekly report called “Covid-19 Pulse” that is already gleaning insights from a 150,000+ person cohort asked to weigh-in specifically on what they’re doing and how their lives are changing as a result of the pandemic. What’s unique in Evidation’s spin is that they’re adding that critical data from “daily life” that is more or less missed by just looking at the data reported from those who’ve entered the hospital.
“Those folks that are presenting into the medical system — that’s not the full picture of what’s going on,” says Ramirez. “What we need to do is better understand, really, what’s going on at the community level to understand community spread, to understand surveillance efforts, to understand mitigation efforts that may or may not be having impact around the spread of Covid-19.”
“[Employers’] top priority is getting their employees and their family members the appropriate care, but there are a lot of unknowns about how this is going to impact their actual total cost of care…”
As Covid-19 testing and treatment rise in U.S., many people — and their employers — may be starting to wonder: who is going to pay for this? How much is this going to cost?
Castlight Health’s CEO, Maeve O’Meara, talks to us about all-things healthcare cost, coverage and benefits administration, drawing from her position leading a company that focuses on helping people make sense of the health insurance benefits they receive through their employers or directly from health plans.
What has employers and health plans most concerned? Making sure people are aware of changes to their plans so they know what’s covered (and what’s not), and when and where to go for care are the top of the list, according to Maeve.
“It’s fair to say that, in Italy, we are doing 10 years of digital health evolution in 10 days.”
Our “man-on-the-street” in Italy (well, man-sheltered-in-place in Italy) Roberto Ascione, CEO of Healthware, reports in on the Covid-19 outbreak and what’s happening with digital health startups, health system partners, and hospitals as Italians continue battling at the forefront of the coronavirus outbreak.
A few weeks ahead of the U.S., there are many things to learn about Covid-19 testing, treatment, outcomes, and timing from the experience in Italy, including some foresight on how pathways for telehealth and digital health continue to evolve as conditions become more serious and the outbreak progresses. (For all you Gretzky fans, this is “skating to where the puck will be” kind of stuff…)
Some navigational guidance on this chat which took place March 26, 2020:
Update on Italian Covid-19 outbreak from health industry insider
10:25 minute mark: Digital Health startup case study, Paginemediche, self-triage chatbot data from 70K Italians, data sharing with Italian government & WHO, telehealth model flipping to give overwhelmed physicians opportunity to triage and “invite” patients based on needs
19:10 mark: How to work with Italian digital health startups to advance Covid-19 work
Jamey Edwards, CEO of one of the larger in-hospital B2B telehealth startups in the US, Cloudbreak Health, is already seeing changes in the way hospitals are using his company’s telemedicine services in the wake of COVID-19.
From a noted rise in the rate of infectious disease consults, to “quarantine rooms” where telemedicine equipment is cleverly deployed to practice “clinical distancing” to minimize risk to front-line healthcare workers (and also preserve PPE), Jamey talks about what he’s seeing among hospital clinicians and what they seem to need most right now from telehealth providers amid the COVID-19 outbreak.
With changes to licensing regulations, HIPAA policies, and reimbursement changing the very infrastructure around telehealth, will we finally see virtual care become a true part of the healthcare system at-scale?
“One of the hardest things to do in our healthcare system is match cost to acuity,” says Jamey. “I’m not going to say we’ve overvalued the in-person encounter, but we certainly have been very hesitant to step away from it.”
“The fact of the matter is that that’s a bias. And so it’s up to us to look at these biases and say, ‘Well, no. What is the right way to do this?’”
“What’s happening in COVID is those of us living with these chronic conditions are at highest risk — not to contract the disease, but highest risk for outcomes. Our unique ability to be able to see what’s happening in that population and deliver that care remotely is incredibly valuable always, but, particularly, in this strained time.”
Livongo Health has always been committed to helping its members (people with diabetes, heart disease, and other chronic conditions) manage their health “where they are.” Collecting loads of patient data along the way. As the traditional health system grapples with caring for those infected with COVID-19, what changes? What role will digital health companies like Livongo play as they continue to provide front-line, day-to-day care to their members and customers amidst the challenging environment of this pandemic?
Dr. Jennifer Schneider, Livongo’s President, stops by to chat about what’s happening at Livongo now as the country looks to virtual care solutions to help shore up capacity for the traditional health system. As the spotlight is turned to digital health, we get Jenny’s perspective on what it will take for health tech companies like hers to continue to prove their value to healthcare incumbents and to patients who have a growing need for their help managing their everyday health.
“Health tech providers — this is the make-or-break time. If you can’t prove your value in the next, say, eleven weeks, then you should NOT be in the health care game. It’s time to get serious.”
Bruce Greenstein, former CTO at HHS and current Chief Strategy and Innovation Officer at LHC Group, one of the country’s largest home health care providers, stops by to share what he’s learned about the federal government’s response to the COVID-19 pandemic.
Bruce represented the home health industry during last Friday’s (3/13/20) White House meeting, which culminated in a Rose Garden press conference starring the ‘who’s who’ of American health care, retail, and pharma leadership. (Bruce was the guy who elbow bumped Trump.)
Lots of attention on virtual care and telehealth during that presser, and Bruce weighs-in for our health tech and digital health audience about how they can get involved and what big health care companies like his are looking for in digital solutions right now (LHC Group works with 350 hospitals caring for 100K patients.) And how about those HHS Interoperability Rules that have been basically lost in this news cycle? We get Bruce’s feedback on how HHS did, plus his insider info on the HHS “hack.”
Some guidance to help you navigate this chat. Hot Tip: Open up the transcript in YouTube and navigate to these different breaks in the conversation.
The ‘Trump Bump’ & Gossip from the Rose Garden Press Conference & White House Meetings
8:40 mark — Advice for health tech startups (must-watch)
15:25 mark — Find out what startups can do that would lead Bruce to “put them in Health IT Hell for the rest of their existence”
Dr. Niti Pall has experience working in 41 different health systems around the world in her roles as Global Medical Director for KPMG, Senior Mobile Health Advisor for AXA, and as a General Practitioner in the U.K. With that type of diverse experience across health systems rich and poor, tech-enabled and not, OF COURSE we had to ask which was the best health system ‘hack’ she’s seen so far. The answer takes us to Bangladesh, involves a huge telecom company, and leads to a completely new category of healthcare provider. Is this a model we’ll see Amazon, Apple, Google or other non-traditional healthcare players take up as they head into the health industry? Niti talks about how tech is the underpinning of “proper 21st Century healthcare,” but that’s not all it will it take to overcome global clinician shortages and help consumers feel like they are getting value out of their healthcare dollars worldwide.
Filmed at Barcelona Health Hub Summit in Barcelona, Spain, October 2019.
Sara Holoubek, Founder & CEO of Luminary Labs, a strategy and innovation consultancy — and the recognized “Queen” of identifying the undercurrents and sub-text of conversations at healthcare conferences — dishes about those undercurrents running just-below-the-surface at JP Morgan Healthcare 2020. Where’s the digital health market headed? Says Sara, “When you see too much bottle service at the parties…that’s when you should watch your back!”
Filmed at J.P. Morgan Healthcare Conference in San Francisco, January 2020.