Roundup: Digital health payer news for Q3 2017

By MobiHealthNews
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This quarter’s news from digital health payers consisted of CMS updates, new information on a few tech-centric insurer deals, and a spattering of employer insurance headlines. Read on for MobiHealthNews’ full roundup for Q3 2017.

CMS news

Potentially the most wide-reaching public insurance development of the quarter was the unanimous passage of Senate Bill 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017, or CHRONIC Act for short. Among other things, the bill, which was originally introduced in April by Senator Orrin Hatch (R - Utah), includes provisions that would expand Medicare coverage for telemedicine under Medicare Advantage Plan B in 2020 and giving Accountable Care Organizations more freedom to use telemedicine. Other key provisions in the CHRONIC bill extend the Centers for Medicare and Medicaid Services’ home-based primary care teams for people with multiple chronic conditions. 

Passage of the telehealth-friendly act would likely increase the middling implementation suggested in a recent HealthMine survey. The group’s poll of 500 Medicare users aged 65 years and older suggests that at least 57 percent of Medicare beneficiaries still either don’t have access to telemedicine options or aren’t aware of those options. Thirty-one percent said they were sure their plan didn’t offer the services, while just 12 percent offered an unqualified affirmative.

Even if awareness among state insurance beneficiaries is low, plans are still launching new programs. For example, Care1st Health Plan Arizona launched a pilot program this September offering Pacify Health’s live video chat app to new and soon-to-be mothers enrolled in the state’s Medicaid program. The Pacify service, which is also available to consumers on Android and iOS platforms, quickly connects users to lactation consultants, dietitians, and other pregnancy management specialists. The video chat service is now available to all of the health plan’s expectant mothers and those up to 12 months postpartum, explained Pacify Health CEO Ben Lundin, and on average will connect mothers and experts in 25 seconds at any time of the day or night.

Outside of telehealth, Dexcom provided an update this quarter on reimbursements for its continuous glucose monitor. CMS originally announced that it would reimburse for Dexcom’s — and initially only Dexcom’s — device in January, but CEO Kevin Sayer noted on an earnings call that his company has yet to see a check from CMS. Further, he explained that the company will be selling its devices for cheaper in Medicare bundles than they do in the private sector, but anticipates that Medicare’s monthly pricing model will eventually settle into a net benefit for the company in the long run.

Employee wellness

Fitbit’s wearable devices and services will soon be included in Japanese tech company Fujitsu’s corporate wellness program. The program will offer 10,000 employees of Mitsubishi Motors Health Insurance Society a chance to earn redeemable fitness points using the Fitbit Charge 2 and a cloud-based data system, thereby making it one of Fitbit’s largest corporate wellness agreements in Japan. According to a statement, Fujitsu chose to partner with Fitbit due to their device’s ease of use, and because the fitness wearable company’s open API allows easy incorporation into Fujitsu’s existing Health Points environment.

A recent survey of 148 large employers conducted by the National Business Group on Health also suggests telehealth offerings by employers are becoming nearly universal. Next year, 96 percent of employers plans are expected to offer telemedicine services to employees, up from 90 percent this year. NBGH has been doing this study for four years now, and the progression has been steep, with employers reporting just 48 percent adoption in 2014.

Insurer partnerships and disaster relief

Apple and Aetna have been holding talks in secret to bring the former’s health and fitness smartwatch to millions of Aetna’s members, according to CNBC. Sources speaking with the news outlet said discussions had taken place in California during August, and were attended by hospital chief medical information officers from around the country. The move is apparently an effort by Aetna to increase consumer interest in healthier lifestyles and diets, and supposedly would begin early next year. Aetna already offers its roughly 50,000 employees an Apple Watch, but covers around 23 million people under its programs.

In more concrete insurer news, Oscar Health is working with Humana to offer commercial health insurance to small businesses in a nine-county Nashville, Tennessee area. The tech-saavy insurance startup teamed up with incumbent Humana at a time when it’s just begun to expand from the individual market into working with employers through its Oscar for Business unit. Humana will provide licenses to operate in Nashville as well as the doctors themselves, but the plan will be administered via Oscar's technology framework.

However, insurers came together in a different way this September when hurricanes threatened the residents of Florida. Prior to Hurricane Irma, Cigna expanded access to its 24/7 telephone helpline to residents, and along with Cigna-HealthSpring lifted restrictions on early prescription refills, waived prior authorization requirements for acute medical care and behavioral health services, and waived claim filing deadlines for group disability insurance customers. UnitedHealthcare and Optum jumped into the fray as well by lifting certain service restrictions for customers, while Humana opened a toll-free crisis intervention hotline and counseling services to Puerto Ricans preparing for Hurricane Irma’s onslaught.

Finally, Sanofi and Innovation Health — an insurance company jointly run by Inova and Aetna — announced a pilot program in late September that will examine the impact of digital health strategies to improve care for Type 2 diabetes patients. The program will tap One Drop, a diabetes self-management app and Bluetooth blood sugar monitor, and Gocap, a mobile-friendly device and insulin dose management platform that emphasizes physician involvement, in an effort to improve medication adherence and patient outcomes.