Overall Telehealth Use Decreases, But Telemental Care Increases

January 11, 2022 - The pandemic continues to wear on the psyche, increasing stress, fatigue, and a general sense of malaise. But telehealth is removing obstacles to mental healthcare.

Telehealth Use Dips Overall, But Telemental Care Rises

National telehealth use declined by nearly 7 percent in October 2021, but mental health conditions remained in the top spot for the most common telehealth diagnoses in every region, according to FAIR Health’s Monthly Telehealth Regional Tracker.

From July to September last year, the country’s use of telehealth services continued to increase each month, but that changed in October. In September, telehealth accounted for 4.4 percent of all medical claim lines on a national level. That percentage dropped to 4.1 percent in October, amounting to a 6.8 percent decrease in claim lines.

Although there was an overall decrease in telehealth utilization, virtual care remained popular for mental health services. As in September, mental health conditions were the most common diagnosis in the country and every region in October.

What’s more, the share of telehealth claims for mental health conditions increased nationally by 1.5 percent, going from 61.2 percent of claims in September to 62.7 percent of all claims in October. READ MORE

Physician Orgs Back AMA-AHA Lawsuit Over Surprise Billing Process

A coalition of physician organizations filed an amicus curiae brief stating HHS’ surprise billing independent dispute resolution (IDR) process will result in an increase in healthcare consolidation, fewer patient choices, and higher costs for out-of-network services.

The several physician groups are led by the Physicians Advocacy Institute (PAI), American Association of Neurological Surgeons (AANS), and Congress of Neurological Surgeons (CNS), and joined by seven national medical societies and 16 state medical associations. The public statement supports a lawsuit filed by the American Medical Association and American Hospital Association against the federal government last month accusing the IDR process of unfairly favoring insurers.

The coalition stated that the regulation undermines Congress's original intent of establishing a balanced process to resolve payment disputes between physicians and payers in cases of surprise out-of-network billing. The group accused lawmakers of issuing a rule that gives payers an unfair advantage by relying on one factor — qualifying payment amount (QPA) — instead of multiple factors as stated under the law. Under a final rule for implementation of the No Surprises Act, the QPA is determined by the payer’s median contracted rate for the same or similar service in the area. READ MORE

Artificial Intelligence Helps Reduce Unnecessary Radiation Exposure

Case Western Reserve University researchers are using artificial intelligence to identify which patients with certain head and neck cancers would benefit from reducing the intensity of treatments, including radiation therapy and chemotherapy. 

Using AI tools like those they developed over the last decade, researchers asked the computer to analyze digital images of tissue samples taken from 438 patients with a type of head and neck cancer, known as human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPCSCC) from six hospital systems. 

The computer program successfully detected a subset of patients who could benefit from a significantly reduced dose of radiation therapy. According to the research team, their next step is to test the AI method’s accuracy in clinical trials. READ MORE

Centene Completes Acquisition of Magellan Health

Centene has completed its acquisition of the behavioral healthcare platform Magellan Health, which will allow the payer to provide members with low-cost integrated healthcare services. The payer first announced plans to acquire Magellan Health in January 2021, with a proposed transaction of $2.2 billion.

The acquisition aims to help Centene offer integrated behavioral and physical healthcare services to its members across the country.

Centene currently offers health plan benefits to Medicaid and Medicare members, individuals and families on the health insurance marketplace, TRICARE members, and individuals in correctional facilities.

Now that Centene has acquired Magellan Health, the behavioral healthcare platform will be available to 41 million members. The payer will also gain an additional 5.5 million Medicaid and Medicare members and 18 million third-party customers from Magellan Health. READ MORE

Novartis, Alnylam Collaborate to Advance siRNA Technology

Novartis and Alnylam recently collaborated to leverage proprietary siRNA technology to develop liver-targeted therapy as an alternative to transplantation for patients experiencing liver failure.

During the three-year collaboration, the companies will leverage siRNA technology to inhibit a target discovered at the Novartis Institutes for BioMedical Research. Once the companies identify a lead candidate, Novartis will lead the development and clinical research.

End-stage liver disease (ESLD) is a progressive illness that often results from cirrhosis. ESLD accounts for over one million deaths globally each year.

Currently, a liver transplant is the only treatment for ESLD. But a transplant is an invasive procedure and dependent on there is a limited supply of organs available for patients in need, a Novartis spokesperson explained. Therefore, medical alternatives to regenerate liver tissues and restore the essential metabolic and synthetic processes are vital.

Pandemic Having Outsize Impact on Low-Income Parents

More than half of low-income parents said they delayed or went without some type of healthcare within the past 12 months, largely because of social determinants of health carving out steep income-based health disparities, according to the latest from the Urban Institute.

The report, comprised of data from an April 2021 survey, showed that 61.5 percent of parents making less than $30,000 — an income at or below 138 percent of the federal poverty level (FPL) — went without care because of cost, challenges taking time off work, challenges arranging childcare, or transportation barriers.

High patient financial responsibility particularly stood out as burdensome for low-income parents. About a third said they were having trouble paying family medical bills, which is twice the number of middle-income parents making between 139 and 399 percent of FPL who said the same. Only about 4 percent of high-income parents with incomes at or above 400 percent of FPL said they had trouble paying for family medical bills. READ MORE