Friday, April 25, 2008

A potpourri of news: Wellpoint, American Well, Physician Travails, Inverness, SHPS and Nationwide Maternity Health

Commenting on the economics behind Wellpoint’s recent announcement that its last quarter’s positive earnings were lower than the first quarter of 2007 is outside the Disease Management Care Blog’s comfort zone. Nonetheless, the DCMB is smart enough to discern that the drop in earnings was largely due to an increase in claims expense sprinkled with some hits in investment (known as the ‘float’) income.

Wellpoint apparently intends to fix this by increasing premiums, riding the underwriting cycle and ramping up its ‘medical management’ activities. That presumably includes its subsidiary HMC. As further evidence of Wellpoint’s belief in the role of population-based care solutions to managing the business, the DMCB points to WellPoint’s recent acquisition of Resolution Health.

At the other end of the care spectrum, check out a ‘webilicious’ individual health care ‘solution’ called American Well. It achieved something of a starry-eyed rushing-the-stage rock star status at the last HMCC and Health 2.0. This privately held company will offer up a stable of primary care and specialist physicians who can provide fee-for-service virtual visits by phone, video-conferencing, telephone, chat, messaging and voicemail. The Disease Management Care Blog suspects the participating physicians won’t be ‘owned’ by AW, which means they’ll probably be paid FFS while AW keeps a cut. Other sources of revenue will include licensing and install/maintenance fees for entities like health insurers. The DMCB believes AW will ask its contracted health insurers to make its claims data available, so the physicians can access some version of past medical history during the encounter. [Yawn]. One more grab at a marginal piece of the broken one-on-one system of health care. Those of us who believe in population-based care solutions will probably fail to see how this will meaningfully address The Pressing Health Care Issues Of Our Time. What’s more, the DMCB suggests docs aren’t dumb and will quickly figure out how to cut out the middle man with their own IT access solutions.

That doesn’t mean docs are necessarily able to spot the bigger threats to their profession. Check out this interesting perspective at the Patient’s Doctor Blog. Physicians are consummate personal consultants who haven’t been given the skills to come up for air and look at the needs of the community or society. [Sigh].

Readers may recall that Inverness was pummeled by Wall Street following the announcement that it was acquiring Matria. Guess what: it’s alive and well. The DMCB continues look forward to seeing how this alliance of gadgets and disease management works out.

Forget about wondering just what ‘S’ ‘H’ ‘P’ and ‘S” actually stood for. You can start referring to it as ‘Carewise Health.’

And last but not least, Nationwide has a press release announcing a tripling of NICU savings with a maternity management program. When the DMCB went to the press release, it was unable to find the materials and methods behind the conclusion. There was also a “Get the Facts Scientology Video Channel” click ad in the middle of the web page when it loaded.

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