Rants

COVID-19 Death Rates

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Survivability for every age range infected under 75 is 96%. Under 60 is 98%.
C-19 adds 44 deaths per 100,000 to the normal 864 per in America. So about 5%.

We have this price we pay for a 5% bump.

  • 40m on unemployment and about(7x normal range past 10 years)
  • 12m renters lose moratorium on eviction today and
  • 40% of all businesses may not reopen. 60% of restaurants are permanently closed ( Yelp ). Small biz is the absolute driver of employment growth in America.
  • Bankrupt: Penney’s. Nieman Marcus. Brooks Brothers. Pier One, GNC, J Crew, Golds Gym, 24 Hour Fitness, Hertz, Catholic Archdiocese of New Orleans, FAMSA Grocery, True Religion, Ann Taylor, Lane Bryant. Dozens more national brands.
  • Chapter 11 is up 48% vs May, 2019.

Meanwhile, C-19 death rates plummet like a rock in a pond.

CDC data
Number of deaths: 2,813,503; Death rate: 863.8 deaths per 100,000 population

The Herd Immunity Threshold (HIT)

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Herd Immunity Threshold (HIT) appears to be not 60-70% but 10% or less. The charts in this article tell the story of

  • crashing death rates
  • extinguishing virus severity

A strong argument for:
The non reckless policy of protecting our elderly
and medically at risk and
🌟reopening the economy.

Excerpt

One of the most vocal members of the scientific community discussing COVID-19’s HIT is Stanford’s Nobel-laureate Dr. Michael Levitt
Back on May 4, he gave this great interview to the The Stanford Daily where he advocated for Sweden’s approach of letting COVID-19 spread naturally through the community until you arrive at HIT. He stated:

If Sweden stops at about 5,000 or 6,000 deaths, we will know that they’ve reached herd immunity, and we didn’t need to do any kind of lockdown. My own feeling is that it will probably stop because of herd immunity. COVID is serious, it’s at least a serious flu. But it’s not going to destroy humanity as people thought.

Guess what? That’s exactly what happened. As of today, 7 weeks after his prediction, Sweden has 5,280 deaths. In this graph, you can see that deaths in Sweden PEAKED when the HIT was halfway to its peak (roughly 7.3%) and by the time the virus hit 14% it was nearly extinguished.

https://jbhandleyblog.com/home/2020/6/28/secondwave

Good News about COVID-19?

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Big and good news C-19 is now 6 strains with separate clusters of symptoms and appears to be weakening. #virus mutates rapidly so as to not kill the host. Their survival genius. That’s why we don’t have vaccines for SARS. Avian Flu. Mad Cow. Ebola. Previous coronavirus. Strains weaken by the 5-7 year time the vaccine is developed. The opposite seems to occur with #hospitals bugs as we get closer and closer to a much bigger problem than a #pandemic –#drugs resistant #bacterial infections and fungi which are treated unevenly with bleach. Better with xenon ray robots Xenex Disinfection Services, special air filters built into lighting VidaShield UV24 and more.
Different microbes accelerate and strengthen. Viruses weaken. Different rules.

Excerpt

COVID-19 cases may be on the rise in at least 20 states, but some doctors suspect the severity of the disease may be decreasing a bit.

Doctors at University of Pittsburgh School of Medicine say people with COVID-19 don’t seem to be getting as sick, and those who recently tested show a lower viral amount than what was being detected in people earlier in the pandemic.

According to the doctors at UPMC, the number of COVID-19 patients needing ventilators has also decreased.

A similar trend was recently observed in #italy

Amazon Piloting Primary Care for Employees

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Adopting direct primary care now is Amazon in 5 pilot stores onsite its distribution centers. Hundreds are planned. Has direct contracting got your attention yet?

Excerpt

Interestingly, Amazon is calling the clinics Neighborhood Health Centers. It plans to start with five locations: Dallas, Phoenix, Louisville, Detroit and California’s San Bernardino Valley. Crossover Health already has one site open in Las Colinas, Texas, according to its website.

“Across the U.S., an increasing number of patients do not have easy access to a primary care physician and instead utilize emergency or urgent care options, which is not only more expensive for patients, but also overlooks important preventative care opportunities,” Amazon Vice President of Human Resources Darcie Henry said in a news release.

The clinics will provide primary care and behavioral health services, physical therapy, pediatric services and health coaching. If the pilot is successful, Amazon said it would expand it to more cities.

PBMs on Their Heels in Courts

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PBMs on their heels in courts including the SupremeCourt.
The age of the Middles is soon over – Bezos

Excerpt

The brief features Ohio prominently, including references to former state Auditor Dave Yost’s blockbuster PBM audit that revealed more than $220 million in PBM spread from the Medicaid managed care program, the Columbus Dispatch feature that exposed Medicaid data showing CVS Caremark reimbursing its own pharmacies far more than their competitors, and another feature from the Dispatch that showcased a study done by Ohio’s Eric Pachman and Antonio Ciaccia that revealed how PBMs selectively overpaid for certain specialty drugs that PBMs tended to steer toward their PBM-owned pharmacies.

The Flavors of Direct Primary Care

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What do various flavors of DirectPrimaryCare save employers? OneMedical (‘Exceptional Primary Care”) saved Google 🔳8% according to its S1. Meh. NexteraHealth measured 🔳29% in its most recent study. Exceptional. PaladinaHealth 18% on outpatient comparables.

Excerpt

Qliance offered it had 27% fewer ER visits, 60% fewer hospital days and cost their employers 🔳20% less on average than similar non-Qliance patients in the area.

IoraHealth says 83% of the patients in its practices with high blood pressure have it under control; the national average is 63%.

RHealth, a Philadelphia-based group, says it can save self-funded employers 🔳15% on their total costs, and has high rates of cancer and cholesterol screenings, medication adherence and blood-sugar control. R-Health has teamed up with Aetna and Humana to offer unlimited primary care at four of its practices to New Jersey state employees. It hopes to enroll as many as 60,000 of the 800,000 eligible workers . “We need to hire a lot of doctors,” says Mason Reiner, R-Health’s CEO.

And therein lies a big challenge: Scaling up the model significantly could exacerbate the shortage of primary-care doctors.

Buried Treasure

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What’s the diff? An ancient buried treasure worth millions or unlocking EBITDA millions buried in healthcare spending. This calculation is happening soon daily:
The average corporate spend:
$5000/employee is recovered using

Direct contracting with

  • Hospitals, surgeons, independent imaging, wholesale pharmacy and specialists like mental health and physical medicine like PT/ chiropractic
  • Direct Primary Care
  • Virtual Primary Care
  • On-site clinics
  • Reference-based pricing
  • Navigators to Centers of Excellence

But unlike sunken ships packed with doubloons, these millions are one great benefit advisor away from reality. Here’s the best secret I’ve learned living in this solution two years as an employer: Company Culture STARTS with my people feeling safe. Maslow was right. Feeling safe is widening the messaging highway so this can get through.

  • Vivid vision
  • Mission
  • Values

Here are my goosebumps :

  • Requires no marches, banners, pitchforks nor stump speeches, no lobby no pitches, torches, endless meetings, backroom deals.
  • This move makes heroes of true leaders.
  • This raises life quality for 80% ✔️hope for a nice neighborhood.✔️six-figure mortgages✔️retirement spigots ✔️credit repair/ repaid

I live in a future where everyone wins. Do you?

Daddy Was Wrong

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We grew up from “A Because Daddy Said So” mentality. Daddy was wrong. The day our healthcare outcomes placed us between Croatia and Cuba. Two combined GDPs equal to ?

SanAntonio the poorest of top 20 metros with 25% in poverty , my hometown.

We spend almost double per capita Switzerland the second biggest spender and half as much @ 7% of our peer countries on primarycare
Dimon says this outcome to spend ratio is embarrassing
Buffet calls healthcare a tapeworm on our economy.
Bezos says this is the era of disappearing middles
Military leaders say the state of our healthcare is a national security threat. Up there with Iran. North Korea. Terrorism. American Healthcare.

The day the music died is when this all came together for us.

I live in a future for two years now where everyone wins.

  • Employers
  • Employees
  • Docs
  • Population Health
  • Costs

DirectPrimaryCare
VirtualPrimaryCare
DirectContracting
OnSiteClinics
ReferencedBasedPricing

Bigs Simply Not Prepared for Spread of Coronavirus

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We depend on China’s shutdown heartland for the vast majority of our pharma and basic medical supplies. This potential of spread overwhelming Bigs who simply are not prepared for this double whammy. Hope I got that wrong. This is a classic clog in the narrow neck of the healthcare hourglass.

Excerpt

US hospitals prepare for coronavirus outbreak to become global pandemic A COVID-19 outbreak across the U.S. could overwhelm emergency rooms and cause shortages of face masks and other crucial medical supplies. “At some point, we are likely to see community spread in the U.S. or in other countries,” she warned. U.S. hospitals from San Diego to New York are taking heed.

The threat of the new virus comes at an already busy time for most U.S. hospitals. Another serious respiratory illness, the seasonal flu, is at its peak in the United States, with more than 26 million cases and many hospitals stretched thin. A larger spread of the new virus across the U.S. could overwhelm emergency rooms and quickly cause supply shortages of some crucial medical supplies, according to half a dozen interviews with doctors, U.S. hospitals and health systems.

No Audits Ever Required?

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Oh my. I just realized if Direct Primary Care or Direct Contracting with wholesale price transparent pharmacies, surgery, imaging no audits are ever required. Those consultants, lawyers, and accountants who thrive on audit misery are now under the bus. These edible headlines for those folks won’t carry water anymore.

“HHS OIG Flags $2.2 Billion in Potential
Medicare Advantage Overpayments for CMS Audits”
National Law Review

“How firms are delivering
value with audit data analytics”
Journal of Accountancy