What You Should Know:
– In partnership with JP Morgan Chase; United Way; top
healthcare organizations including Anthem, Centene, One Medical and Epic; and
other non-profit and community partners, Lyft’s goal is to facilitate 60M safe
rides to vaccination sites.
– Lyft’s vaccine access campaign will help the communities who need it most safely travel to receive the vaccine. These rides will be facilitated through its business segment, Lyft Healthcare, and social impact initiative LyftUp.
Inc. announced the launch of a nationwide campaign to support universal
access to the COVID-19
vaccine. The goal of this effort is to provide 60 million rides to and from
vaccination sites for low-income, uninsured, and at-risk communities, when the
vaccine becomes available.
Corporate partners JP Morgan Chase and Anthem Inc. and community partner United Way will be working alongside Lyft to lead the effort, with many other businesses, healthcare, and technology partners preparing to join the campaign as vaccines become available in the coming weeks.
Additional program partners signing on to launch the effort include Epic, Centene Corporation, Modern Health, One Medical, National Hispanic Council on Aging, National Asian Pacific Center on Aging, National Urban League, and the National Action Network.
Lack of Transportation Could Prevent Millions of People
from Being Vaccinated
Lyft’s on-demand transportation network provides critical
access to healthcare services for at-risk communities disproportionately
affected by COVID-19, including non-emergency medical transport for home-bound
seniors, people living with disabilities, and dialysis patients. Many of these
patients belong to vulnerable populations who will be prioritized for early
vaccine distribution, and Lyft’s healthcare transportation services will play a
critical role in transporting them to and from vaccination sites.
“Access to reliable transportation represents a major barrier to care for millions of Americans across the country,” said Megan Callahan, MPH, VP of Lyft Healthcare. “In fact, lack of transportation is one of the top reasons people miss medical appointments. The COVID-19 pandemic has exacerbated this problem, creating a huge challenge in making sure vulnerable populations have access to the vaccine — especially for seniors living alone, low income workers, and parents with young children. We estimate that 15 million Americans will face transportation issues trying to get to vaccination sites. That’s where Lyft can make a difference.”
LyftUp Initiative to Serve Underserved Communities
The universal vaccine access campaign is part of the
company’s LyftUp initiative, a partnership of companies, community
organizations and individuals working together to make sure everyone has access
to affordable, reliable transportation to get where they need to go. Working
together using Lyft’s transportation platform, companies and social impact
organizations will help underserved communities access vaccination appointments
by providing subsidized rides for employees and members, and free or discounted
rides for those in need.
In addition to directly funding rides, corporate partners
will leverage their customers and member networks to promote individual
contributions to the campaign as well as provide social media and marketing
resources to connect people in need with community partners. Community
partners will then route ride credits to those in need.
The U.S. Centers for Medicare & Medicaid Services (CMS) last month released new Medicare Advantage (MA) figures highlighting a massive expansion of plans offering home-focused supplemental benefits in 2021.
The agency shared additional data on Wednesday — and it now appears the ongoing home care MA movement is even bigger than originally anticipated.
“These benefit offerings are growing,” Tyler Cromer, a principal at Washington, D.C.-based research and advisory firm ATI Advisory, told Home Health Care News. “And they’re growing substantially.”
CMS’s Medicare Advantage preview from September revealed that 738 plans are offering supplemental benefits under the “primarily health-related” pathway in 2021, a 46% increase compared to the nearly 500 plans that did so in 2020.
The preview similarly showed that 920 plans are offering benefits under the Special Supplemental Benefits for the Chronically Ill (SSBCI) pathway next year, a nearly four-fold increase compared to the 245 plans that did so this year.
The latest data from last week offers deeper insights around the primarily health-related pathway, according to ATI analyst Elexa Rallos.
“These data show all of the benefits that the entire universe of Medicare Advantage plans offers,” Rallos told HHCN. “We’re able to go in and really dig into which plans are offering what, then pull all the information on a high level about the availability of these benefits.”
So what’s the big news for home care operators? Of the 738 plans operating in the primarily health-related MA pathway in 2021, 430 are offering “in-home support services,” or services that typically fall under a home care agency’s core business mix.
For context, just 223 plans offered in-home support services through the primarily health-related MA pathway in 2020.
“When we are able to dig into the data a little bit more, we’re able to see that there’s almost a two-fold increase in in-home support services,” Cromer said. “There’s also more than double the number of plans offering home-based palliative care compared to 2020. There’s a lot of growth here — and that growth is being driven by services provided in the home.”
To Cromer’s point, just 61 MA plans offered home-based palliative care under the primarily health-related pathway last year. More than 130 will do so in 2021, a trend that illustrates older adults’ overwhelming preference to age in place and avoid facility-based care.
“I think, again, that reflects the desire to meet Medicare beneficiaries where they are,” Cromer added. “The idea is to give them services that really add value and allow them to stay at home, to live their lives the way they want to.”
Anthem Inc. (NYSE: ANTM) and WellCare are the leading MA plans offering in-home support services in 2021, according to ATI’s analysis. Both Anthem and WellCare offer in-home support services in more than 100 plans, Rallos noted.
Martin Esquivel, VP of product management and strategic initiatives for Anthem, previously discussed the insurance giant’s approach to supplemental-benefits design with HHCN.
“We recognize that beneficiaries that experience limitations in [ADLs] are at … greater risk for a fall, greater risk of social isolation and more likely to have access-to-care issues,” Esquivel said in October 2019. “Helping create a stable, safe environment in the home, we see that as a first step toward helping beneficiaries down a path toward a more comfortable, sustainable health care experience.”
In addition to those offering in-home support services and home-based palliative care in 2021, 127 plans will offer adult day health services, 176 will offer therapeutic massage and 95 will offer some type of service aimed at caregiver support.
In terms of geography, the MA plans offering in-home support services under the primarily health-related pathway next year operate in 36 states and Puerto Rico. On a county level, there appears to be a particularly strong concentration in New York, Michigan, Indiana, Maine and a handful of other states.
Exactly 11 states have MA plans offering home-based palliative care in at least one county in 2021, according to ATI.
While home care operators should be excited about the spike in plans offering in-home care benefits, they should also remember that most plans are working with limited resources. That means benefits aren’t always robust or equivalent to what home care agencies do for their typical, private-pay client.
“These are limited benefits … that MA plans are providing with limited dollars,” Cromer said. “Benefits we’re seeing are generally ranging from, let’s say, roughly 24 hours to 200 hours a year of services, or per discharge from the hospital.”
Stay tuned on SSBCI
ATI Advisory is currently working on an even deeper analysis of CMS’s Medicare Advantage data dump from Wednesday. Toward the end of this week, the firm hopes to share detailed information on what plans are doing state by state, county by county.
Part of that effort is to give home care operators a better understanding of what MA plans are doing in their individual markets.
As for the SSBCI pathway, which is arguably the even bigger opportunity for the home care industry, ATI Advisory likely won’t have anything new to share until early 2021. CMS releases its MA numbers as part of what’s called the “plan benefit package files,” updated quarterly.
“We expect an additional tranche of data to come out in early 2021,” Cromer said. “And that will include information about Special Supplemental Benefits for the Chronically Ill, along with some other information.”
CMS first introduced the primarily health-related flexibility under MA in 2018 for the 2019 plan year.
Broadly, “primarily health-related” can include services that diagnose, prevent or treat an illness or injury. It can also include services aimed at lessening or improving some sort of functional impairment that hinders an individual’s ability to perform activities of daily living.
The post Number of MA Plans Offering In-Home Support Services to Increase by 93% in 2021 appeared first on Home Health Care News.
What You Should Know:
– Walmart announced it will begin selling Medicare
insurance plans during this year’s annual enrollment period, Oct. 15 through
announced the launch of Walmart
Insurance Services, LLC, a licensed insurance brokerage, which will assist
people with enrolling in insurance plans—and simplify what’s historically been
a cumbersome, confusing process. Walmart Insurance Services will begin selling
Medicare insurance plans during this year’s Annual Enrollment Period (AEP),
Oct. 15 through Dec. 7.
Walmart Insurance Service Offerings
Starting today, Walmart Insurance Services will provide Medicare plans (Part D, Medicare Advantage, and Medicare Supplement plans) offered by Humana, UnitedHealthcare, Anthem Blue Cross Blue Shield, Amerigroup, Simply Health, Wellcare (Centene), Clover Health, and Arkansas Blue Cross and Blue Shield. More carriers may be added in the future. The brokerage is licensed in all 50 states, plus Washington D.C. Walmart has built a team of licensed insurance agents who can help people find the right insurance plan for them.
“We want customers to feel confident in selecting a Medicare plan that best fits their needs, budget and lifestyle,” said David Sullivan, general manager of Walmart Insurance Services. “And we want to be a trusted partner on their health care journey. Helping customers select the right Medicare insurance plan to meet their needs aligns with Walmart’s mission of helping people save money and live better.”
What You Should Know:
– Anthem extends the use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users.
– doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.
Anthem, today announced it is extending its partnership with doc.ai, an enterprise AI platform accelerating digital transformation in healthcare to power its digital health offerings. The expanded relationship extends Anthem’s use of doc.ai’s platform and portfolio of privacy-first technologies and artificial intelligence software services to drive the personalization of Anthem’s digital assets and create improved value for users. Payors, pharma, and providers license doc.ai’s enterprise AI platform that unlocks the value of health data.
Most recently, Anthem licensed Passport, doc.ai’s privacy-first COVID-19 evaluation tool for a safer entry to the workplace, and Serenity, a guided mental health chat companion that helps manage anxiety and depression. In addition, doc.ai’s technology has streamlined Anthem’s ability to create an ecosystem of developers. doc.ai’s product offerings are deployed on its cloud-agnostic and zero-trust infrastructure that lets clients like Anthem launch products faster and at lower costs.
Appoints New CEO and Chief Scientific Officer
In addition to the expanded relationship with Anthem, doc.ai
has announced key executive leadership appointments: Sam De Brouwer, co-founder
has been named its new CEO; Walter De Brouwer, co-founder takes on the newly
created role of Chief Scientific Officer. Dr. Nirav R. Shah, MD, MPH has been
appointed as its first Chief Medical Officer.
Sam De Brouwer, co-founder, and previous Chief Operating Officer has taken on the role of Chief Executive Officer, with a focus on scaling its enterprise offerings. Co-founder Walter De Brouwer has transitioned from CEO to the new role of Chief Scientific Officer where he will focus on vision and will lead research, innovation, and engineering efforts for the company. As doc.ai’s first Chief Medical Officer, Dr. Nirav R. Shah, MD, MPH will lead the clinical focus and medical research of the platform company. These new appointments will join doc.ai’s leadership team alongside current CTO Akshay Sharma and CFO Greg Kovacic.
“What doc.ai has accomplished in a remarkably short period of time is impressive, and I’m excited to join such a talented team,” said Dr. Shah. “Doc.ai has brought cutting-edge technologies to the market that will help break down many of the silos in healthcare, and will ultimately increase the pace of innovation and create pathways to better health outcomes.”
Dr. Shah is a Senior Scholar at the Clinical Excellence Research Center, Stanford University School of Medicine. His expertise spans across the health industry as a member of the HHS Secretary’s Advisory Committee, a Senior Fellow of the Institute for Healthcare Improvement (IHI), and as an independent director for public and private companies and foundations.
He served as Senior Vice President and Chief Operating Officer for clinical operations at Kaiser Permanente in Southern California, where he oversaw the region’s health plan and hospital quality while ensuring effective use of technology, data, and analytics to produce better patient health outcomes. In addition, he served as Commissioner of the New York State Department of Health, where he was responsible for public health insurance programs covering more than five million New Yorkers and led public health surveillance and prevention initiatives.
The amount of data generated by the healthcare industry is staggering—and constantly increasing. Healthcare data encompasses the personal information of patients, doctors, nurses, and administrators. It includes diagnostic information, test results, ultrasound images, x-ray images, and of course insurance and financial information. With so much sensitive patient information there for the taking, it comes as little surprise that the healthcare industry—perhaps more than any other sector—has become a primary target for cyberattacks. Now, more than ever, it is critical that healthcare organizations take decisive action to protect their data.
There has been no shortage of major (and notably costly) data breaches in recent years. The Equifax breach, for example, affected nearly half of all Americans. Last year’s Facebook breach was also headline news, thanks in large part to the number of users affected. Then there was a lesser-known yet costly LifeLabs breach—the largest in Canadian history—affecting more than 15 million people and prompting a lawsuit seeking north of $1 billion in damages for failure to adequately protect data.
Healthcare data heists yield a premium, making them particularly attractive to hackers. The Center for Internet Security (CIS) notes that the “average cost of a data breach incurred by a non-healthcare related agency, per stolen record, is $158,” compared with $355 for healthcare records.
Though large, the LifeLabs incident isn’t even close to the largest healthcare data breach in history. That dubious honor goes to Anthem, which suffered a breach in 2015 that resulted in nearly 80 million compromised records. Although Anthem was able to reach a settlement with the victims for the relatively paltry sum of $115 million, both the standards for data protection and the expected remediation for failure have changed considerably in the five years since the attack.
Regulations Raise the Stakes for Security
As the regulatory environment surrounding data breaches of all types grows more strict, hospitals and insurers have found themselves in the crosshairs of an increasingly brazen and sophisticated set of attackers. Part of the reason for this targeting stems from the relative value of healthcare records. There is a reason why “HIPAA” is an acronym known to most Americans, while other data protection laws are not.
Personal Health Information (PHI) tends to be more valuable than standard Personally Identifiable Information (PII) in large part due to its static nature. Patients can change a compromised credit card number or social security number, but not their medical history—and scammers prepared to exploit that history may render victims more vulnerable to certain types of fraud.
New regulations are further raising the stakes for compliance. Although the California Consumer Privacy Act (CCPA) is not specifically targeted at healthcare organizations, the sector represents potentially one of the most vulnerable industries under the new law. If an organization is found to be in violation of CCPA, they have 30 days to rectify the situation or be subject to a fine of up to $7,500 per record exposed.
To put this in context: if CCPA were adopted nationwide, the LifeLabs breach that affected 15 million individuals would potentially be subject to a fine of $112.5 billion. That $1 billion lawsuits that LifeLabs is facing might sound like a lot, but under CCPA, it might mean getting off easy. This should underscore the necessity of protecting data of any kind today—let alone healthcare records.
Ecosystems Span Email to Equipment
With the healthcare industry becoming an increasingly popular target and the penalties for breaches growing steeper, it’s important to consider that every endpoint, from desktops to devices, present attack paths for hackers. Measures as simple as stronger email security can make a big difference: in 2018 alone, Business Email Compromise (BEC) attacks resulted in more than $1.2 billion in victim losses. Spear phishing attacks, which are carried out using social engineering techniques to convince the target to relay confidential personal or financial information to what they believe is a legitimate recipient, represent an increasingly common method for attackers to gain access to user credentials or even directly obtain PII or PHI. Securing email with S/MIME (Secure/Multipurpose Internet Mail Extensions), which authenticates the sender of an email, enables employees not only to digitally sign and encrypt email communications but also to detect whether an email received has been authenticated or should not be trusted or opened.
Digital certificates are an essential part of protecting medical devices. Because they can be incorporated during the manufacturing process, these certificates allow device identity and integrity to be established from the moment they are first powered on. They also eliminate the potential for device spoofing, which protects against the possibility of counterfeit devices connecting to the network. These certificates serve as an effective proof point for savvy healthcare organizations. When vetting device suppliers and manufacturers, asking about their approach to device identity is essential. By learning to trust only manufacturers with a responsible approach to authentication, healthcare organizations can help protect one of the areas most susceptible to costly breaches.
Medical equipment itself has also become more vulnerable. Today’s diagnostic devices are rarely standalone—most are connected to the internet, and anything connected to the internet can potentially be compromised. In fact, this compromise could occur before devices even leave the factory, potentially undermining even the most secure networks and leading medical device manufacturers to consider security starting at the assembly line; the point where device identity measures and digital certificate authentication become critical. Technologies such as secure boot can protect the integrity of a device or piece of software from the first time it is powered on. Similarly, embedded firewall and secure remote update technologies help ensure that software updates are authenticated before installation and that any communication with unauthorized devices stops before harm can be done.
Moving Forward with New Security Strategies
Today, health insurers, hospitals, and other patient care organizations must manage a truly massive amount of data. It is simply a fact of life. That data comes in many forms, and it can be valuable to cyber attackers for a multitude of reasons. At its core, this data is the healthcare industry’s most valuable asset—one that it must protect at all costs.
Vulnerabilities can take many forms, from a human error to compromised devices. And while no solution can shield every possible form of attack, data and IT security administrators (and even OEMs) can take concrete steps to protect their organizations, patients, or chipsets against common attack vectors and better comply with today’s strict data protection regulations. Yes, the cloud has introduced new vulnerabilities, but it also has helped enable new security strategies and solutions that ensure every application, cell phone, server, or other connected “thing” has an authenticated digital identity. The stakes are simply too high, and hackers have become too savvy, to rely on yesterday’s security status quo.
About Tim Callan, Senior Fellow at Sectigo
Senior Fellow Tim Callan contributes to the company’s standards and practices effort, industry relations, product roadmap, and go-to-market strategy. Tim has more than twenty years’ experience as a strategic marketing and product leader for successful B2B software and SaaS companies, with fifteen years’ experience in the SSL and PKI technology spaces.
What You Should Know:
– Ginger announces $50 Million in Series D funding to expand
access to its on-demand mental healthcare system led by Advance Venture
Partners and Bessemer Venture Partners; joined by Cigna Ventures and existing
– Company has more than tripled revenue over the past year, now brings access to on-demand mental healthcare to millions around the world through 200+ employer clients and leading health plans.
Ginger, a San Francisco, CA-based provider of on-demand
mental healthcare, today announced a $50 million Series D funding round led by
Advance Venture Partners and Bessemer Venture Partners. Additional participants
include Cigna Ventures and existing investors such as Jeff Weiner, Executive
Chairman of LinkedIn, and Kaiser Permanente Ventures. This latest round of
investment brings the company’s total funding to over $120 million.
On-Demand Mental Health Support
Founded in 2011, Ginger’s on-demand mental healthcare system
brings together behavioral health coaches, therapists, and psychiatrists, who
work as a team to deliver personalized care, right through your smartphone. The
Ginger app provides members with access to the support they need within
seconds, 24/7, 365 days a year. Millions of people have access to Ginger
through leading employers, health plans, and its network of partners.
By delivering evidence-based behavioral health coaching,
therapy and psychiatry right from a smartphone, Ginger is the only end-to-end
telemental health provider designed to meet this skyrocketing demand at a
fraction of the cost of traditional care.
Key benefits of Ginger’s on-demand mental health platform
On-demand, anywhere: On average, members in 30
countries around the world can text with a Ginger behavioral health coach
within 44 seconds, 24/7, 365 days per year; first available video appointments
with a therapist or psychiatrist are available on average within 10.5
Measurement-based: The company’s proprietary
collaborative care model has been proven to be more than twice as effective as
standard therapeutic interventions; 70 percent of people using Ginger
experience an improvement in their depression symptoms within 10-14
Loved by members: Ginger members give an average
rating of 4.7 out of 5 stars after each session.
COVID-19 Underscores Record Demand for Mental Health
This announcement comes at a time when the world’s mental
health crisis has reached an all-time high following the onset of the COVID-19
pandemic. According to Ginger’s 2020
Workforce Attitudes Toward Mental Health Report, nearly 70 percent of U.S.
workers believe this is the most stressful period of their careers, including
major events like the September 11 terror attacks, the 2008 Great Recession and
others. Ginger has observed record-high demand for mental health support;
during July 2020, weekly utilization rates were 125% higher for coaching and
265% higher for therapy and psychiatry when compared to pre-COVID-19 averages.
Millions of people have access to Ginger through the
company’s partnerships with innovative employers, health plans, and strategic
partners. Today, over 200 companies ranging from startups to Fortune 100s,
including Delta Air Lines, Sanofi, Chegg, Domino’s, SurveyMonkey, and Sephora,
partner with Ginger to cost-efficiently provide employees with high-quality
mental healthcare. Ginger members can also access virtual therapy and
psychiatry sessions as an in-network benefit through the company’s
relationships with leading regional and national health plans, including Optum
Behavioral Health, Anthem California, and Aetna Resources for Living.
The company recently announced the formation of the Ginger Advisory Board, bringing together world-renowned experts from MIT, Massachusetts General Hospital, and the University of Washington to advance mental health research and innovation.
“Our mental healthcare system has long been inadequate. But in the midst of a worldwide pandemic and a tumultuous sociopolitical climate, we’re facing uncharted territory,” said Russell Glass, CEO, Ginger, “People are demanding better care, and the largest payers of healthcare are recognizing the need to respond. Ginger is uniquely able to reverse the course of this crisis at scale. With this investment, we can accelerate our work to deliver incredible mental healthcare at a fraction of the cost to the hundreds of millions of people around the world who deserve it.”
Episode 133 of Health in 2 Point 00 is brought to you by the letter P — that’s P for PBMs, of course. In this episode, Jess and I talk about Genome Medical extending their series B and getting another $14 million on top of the $23 million they already raised for their remote genetic counseling services, the FCC adding another $198 million to their rural health program, bringing the funding to a whopping total of $802 million, Anthem’s PBM IngenioRx acquiring pharmacy startup Zipdrug, and Capital Rx, a startup PBM, announced a deal with Walmart. —Matthew Holt