Another Payer Launches a Remote Patient Monitoring Program

February 01, 2022 - With remote patient monitoring proving to be a valuable tool for timely and effective care management, more and more payers are standing up their own RPM programs to benefit their members and remain competitive in an evolving market. 

Cigna: The Latest Payer to Enter the Remote Patient Monitoring Space

Health insurance giant Cigna, like its competitors Humana and UnitedHealthcare, is entering the remote patient monitoring (RPM) arena.

MDLIVE, a virtual care provider that is part of Cigna's health services portfolio, is launching its first RPM program. The program is available to all health plans offering MDLIVE primary care services to their members. It enables certain members to track and report biometrics, like blood pressure and glucose levels, to their virtual primary care providers who can then review the data with them during their visits. The company plans to expand the program later in the year to include digital devices that can transmit patient data automatically to the MDLIVE patient portal.

The move comes as healthcare consumers become increasingly interested in monitoring health metrics, like blood sugar and blood pressure, using applications and at-home tools. According to Deloitte, 28 percent of healthcare consumers in the U.S. said they used technology to measure health metrics in 2020, a massive jump from the 15 percent who said the same in 2013. Further, in 2020, about 75 percent of those with difficult chronic conditions said they would share their health data gathered from a monitoring device with their doctor, Deloitte found. READ MORE

No Surprises Act Compliance Proving Difficult for Practices

Physician practices are struggling to comply with the No Surprises Act’s good faith estimate requirements, which went into effect on Jan. 1, 2022. The new federal law requires all providers to give uninsured and self-pay patients, both orally and in writing, a cost estimate upon request or at the time of scheduling.

READ MORE: Skilled Nursing Facilities Are Facing a Staffing Crisis

Lawmakers designed the good faith estimate requirements to protect patients from unexpected medical bills, known as surprise bills. The requirements do this by delivering healthcare price transparency to those without insurance or who choose not to use their plan’s coverage.

However, medical practices are having trouble understanding the new good faith estimate requirements and implementing workflows to comply with the No Surprises Act, the Medical Group Management Association (MGMA) says. MGMA called on HHS and CMS to delay enforcement of the uninsured and self-pay good faith estimate requirements until practices have had time to digest the rules and execute a strategy. READ MORE

Patient Navigators Help Patients Avoid Racial Disparities in Primary Care

Patient navigators could be effective in closing racial disparities in primary care access, according to new data, with the healthcare professionals able to connect more Hispanic patients than if patients went at it alone.

The report, published in the Journal of the American Board of Family Medicine, particularly showed that Hispanic patients working with a patient navigator were three times more likely to have primary care access than those who did not.

This comes as Hispanic people face a significant disparity in primary care access, the researchers, who hailed from the Keck School of Medicine at UCLA, pointed out. Despite care access gains made following the Affordable Care Act passage, low-income Latino people were still less likely to have a primary care provider. Only about a third of Latino people report having a primary care provider, the researchers said.

READ MORE: How 3 Policies are Changing the Healthcare Payer Landscape

But community health workers, or community-based patient navigators, can help change that, the researchers found. In an analysis of the LA County Children’s Health Outreach Initiative (CHOI), which despite its name serves people of all ages, the researchers uncovered a boost in primary care access. READ MORE

Generic Drugs, Biosimilars Driving Drug Price Increases

The estimated drug price inflation rate for this year is expected to have a moderate price increase, according to Vizient’s 2022 Pharmacy Market Outlook.

The Vizient Pharmacy Program looked at forecasted projects on pharmaceutical products purchased throughout the healthcare system between July 2022 and June 2023 estimate the anticipated price change year-over-year.

In the study, the expected price change for Vizient member purchases is 3.09 percent, mainly driven by a balance between increased utilization of high-cost medications, generic drugs to market, and additional approval and launch of biosimilars.

Overall, Vizient predicted the price of essential medicines to increase by 2.1 percent and will use this information to initiate sourcing strategies that prioritize production.  READ MORE

Medicaid Failing to Provide Care for Teen Substance Use Disorders

READ MORE: Largest Hospital Networks Fail Price Transparency Tests

Adolescents enrolled in Medicaid who had substance abuse-related experiences, including opioid use disorder, had high rates of medical visits but were unlikely to receive substance abuse care, indicating a need for increased Medicaid services, an Urban Institute report found.

Only half of adolescents enrolled in Medicaid received substance use screenings at their last medical visits and few adolescents with substance use disorders accessed substance abuse care. Only one in five adolescents was involved with a substance use prevention program outside of school.

Substance use is common among adolescents and can lead to high rates of morbidity and mortality. Medicaid offers coverage for screening and intervention services related to substance use through the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefit, but low reimbursement rates and other Medicaid policies may lead to low utilization of these services.

The Urban Institute’s findings indicate a need for better resources to address substance use in adolescents. Medicaid has the potential to help by enacting policy changes. READ MORE

Artificial Intelligence to Aid Mental Healthcare Access

According to MIT and Massachusetts General Hospital researchers, artificial intelligence could improve the accessibility of mental healthcare.

To address health barriers researchers have been working collaboratively for over five years to create machine-learning algorithms that can assist in diagnosing and monitoring symptom changes in individuals with major depressive disorders.

To conduct the study, the research team recruited MGH participants with major depressive disorders who have recently changed their treatment. Thus far, 43 participants have enrolled in the study. Using smartphones and other wearable devices, the research team can gather detailed data on participants’ temperature, heart rate, activity levels, socialization, personal assessment of depression, sleep patterns, and more.

According to researchers, their goal is to develop machine-learning algorithms that can intake large amounts of data and identify individuals that may be struggling with their mental health. The hope is that the algorithms will provide physicians and patients with useful information regarding an individual’s disease trajectory and effective treatment methods. READ MORE