|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
July ends on an uncertain note in the pandemic battle
After a week that brought the most disastrous economic data in modern history, the death of a former Presidential candidate from COVID, and signs of an alarming surge in virus cases in the Midwest, Congress left Washington for the weekend without reaching a deal on a new recovery bill. That left millions of unemployed Americans without supplemental benefit payments, business owners wondering whether more financial assistance would be forthcoming, and hospitals facing the requirement to begin repaying billions of dollars of advance payments from Medicare. Also remaining on the table was funding to bolster coronavirus testing, with the top health official in charge of the testing effort testifying on Friday that the system is not currently able to deliver COVID test results to patients in a timely manner. While the surge in cases appears to be shifting to the Midwest, there were early indications of positive news across the Sun Belt, as the daily new case count in Florida, Louisiana, Texas, Arizona and California continued to decline, while daily death counts (a lagging indicator) continued to hit new records. Nationally, the daily case count appears to have reached a new plateau of around 65,000, with daily deaths rising to a 7-day average above 1,150, matching a level last seen in May.
Meanwhile, new clinical findings continued to refine our understanding of how the virus attacks its victims. Reporting in JAMA Cardiology, researchers used cardiac MRI to examine heart function among 100 coronavirus patients, 67 of whom recovered at home without hospitalization, finding that 78 percent demonstrated cardiac involvement and 60 percent had evidence of active heart muscle inflammation—concerning signs pointing to possible long-term complications, even in patients with relatively mild courses of COVID infection. And yesterday in JAMA, investigators reported that while young children are typically less affected by COVID-19 than adults, children under 5 may harbor 100 times as much active virus in their nose and throat as infected adults. While the study does not confirm that kids spread the virus to adults, it is sure to raise concerns about reopening schools, which has generally been considered relatively safer for younger children. US coronavirus update: 4.8M cases; 151K deaths; 52.9M tests conducted.
Oscar offers free virtual primary care amid major market expansion
Start-up insurer Oscar Health announced it will offer family and individual plans in 19 new markets in 2021, expanding to a total of 47 markets across 19 states. The company will also offer enrollees free virtual primary care and urgent care, and will eliminate out-of-pocket costs for many prescriptions, labs, imaging studies, and “first-tier” specialist visits when prescribed by Oscar Primary Care. The plan will also bring care into patients’ homes, including lab draws and monitoring of vital signs. With 420K enrollees, the vast majority in the individual market, Oscar has yet to turn a profit, but hopes to benefit from the expected surge in exchange enrollment brought by the economic downturn. We’ve been very impressed with Oscar’s care coordination platform, outlined here by the company’s chief medical officer, Dr. Dennis Weaver, the goal of which is to create an individualized, consumer-focused experience. Oscar’s dramatic expansion of free virtual and in-home care is yet another sign of an impending battle between health systems and health plans for dominance in virtual and home-based solutions.
Humana invests $100M in home-based primary care company Heal
Humana, the nation’s second-largest Medicare Advantage (MA) insurer, is moving further into home-based care as well, by investing $100M in primary care startup Heal. Founded in 2014, Los Angeles-based Heal offers on-demand primary care physician house calls, virtual visits, and patient monitoring in seven states and Washington, DC, through a network of 150 physicians and nurse practitioners. Humana’s investment will enable Heal’s expansion into new markets, including Chicago, Charlotte, and Houston, where the insurer has a strong MA presence. Heal adds to Humana’s growing primary care delivery portfolio, including the recent private equity-backed expansion of its senior-focused subsidiary medical group, Partners in Primary Care and last fall’s partnership expansion with Iora Health. The insurer has also built a formidable set of home-based care services, focused on managing care for high-risk seniors and patients at the end of life, including a partnership with home-based care company Landmark Health, acquisition of home-hospice provider Curo Health Services, and investment in Kindred Healthcare’s home care division. Heal shifted to a “virtual first” model at the start of the pandemic, and has seen telehealth visits increase by 800 percent, and physician house calls increase by 35 percent. Combined, the assets provide Humana a foundation for comprehensive, cross-continuum management of the company’s Medicare Advantage population—and the ability to field a broader a virtual care solution for its consumer base.