Saturday, August 27, 2022

Amazon Care Shuts down

Amazon Care to shut down by year’s end as corporate customers don’t see value

The demise of Amazon Care comes a month after Amazon announced plans to acquire One Medical for almost $4 billion.

Published Aug. 25, 2022

Amazon shared plans to dissolve its primary care offering Amazon Care in a memo to employees August 24, 2022. David Ryder via Getty Images

Amazon is planning to shut down its primary care delivery business Amazon Care by the end of this year in a surprise pivot for the tech giant’s healthcare ambitions.

Amazon eliminated the business because corporate customers weren’t seeing the value of the product, according to an internal memo sent Wednesday and shared with Healthcare Dive.

The tech giant has invested aggressively in its flagship care delivery product and health offerings, even announcing plans in July to acquire primary care network One Medical for $3.9 billion. But the company could have faced duplicative services running both Amazon Care and One Medical, or difficulties integrating the two, analysts said, suggesting it makes more sense for Amazon to buy healthcare services instead of building them in-house.

Amazon Care launched in 2019 as a pilot program for employees in Seattle, where Amazon is headquartered. Last year, it expanded the product — a hybrid of virtual and in-person primary care services, without physical locations — to employers nationwide, citing rising demand.

But Amazon has now determined it isn’t “the right long-term solutions for our enterprise customers,” Neil Lindsay, senior vice president of Amazon Health Services, wrote in the memo to Amazon Health Services employees.

“This decision wasn’t made lightly and only became clear after many months of careful consideration. Although our enrolled members have loved many aspects of Amazon Care, it is not a complete enough offering for the large enterprise customers we have been targeting, and wasn’t going to work long-term,” Lindsay said.

Amazon did not disclose the number of employees affected. But Lindsay said in the memo that “many Care employees will have an opportunity to join other parts of the Health Services organization or other teams at Amazon — which we’ll be discussing with many of you shortly — and we’ll also support employees looking for roles outside of the company.”

The news sent shares up for publicly traded telehealth companies. Teladoc and Amwell were up 5% and 4% in premarket trading Thursday, while other peers in the digital health space, including GoodRx and Hims & Hers, also gained in reaction.

The decision to shutter Amazon Care follows a number of recent expansion initiatives for the program.

In February, Amazon said the product’s in-person services were expanding to 20 additional U.S. cities this year, and that six companies including Hilton and Amazon-owned Whole Foods were using Amazon Care as a benefit for employees.

Amazon was also preparing to bolster Amazon Care’s behavioral health offerings through a partnership with mental health company Ginger.

But last week, The Washington Post reported there was growing tension between Amazon and its medical staff, who questioned how the tech giant was balancing medical safeguards with its drive for growth.

Amazon has also faced struggles scaling Amazon Care’s in-person benefit amid a national nurse shortage and proving the product’s value proposition to potential new customers.

The dissolution of Amazon Care mirrors the fate of Haven, another high-profile effort by large employers, including Amazon, to lower healthcare costs for their employees that flamed out in 2021 after a few years.

But it doesn’t mark the end of Amazon’s ambitions in healthcare, analysts said. Getting rid of Amazon Care is “more like just the beginning,” Citi analysts wrote in a Wednesday note.

Amazon will see you now: reading between the lines of the One Medical acquisitionBy Rebecca Pifer • July 25, 2022

Filed Under: Medical Groups, Telehealth

Tuesday, July 19, 2022

“Evil empire:” UnitedHealthcare schemes to intentionally underpay healthcare providers, lawsuits claims —

It’s no secret that UnitedHealthcare is reducing provider networks across the nation while boosting its record-setting profits.

And another company is fighting back: Envision Healthcare in Broward County, FL, filed a lawsuit against UnitedHealthcare in May, claiming UnitedHealthcare is scheming to underpay front-line healthcare providers and push them out-of-network. An article in Becker’s Hospital Review says that Envision is seeking to recover millions of dollars in alleged underpayments for medical care it provided to UnitedHealth members.

Excerpts from the Envision lawsuit shine a light on how UnitedHealthcare allegedly operates:

United, the country's largest commercial health insurance company, engages in a nationwide pattern and practice of intentionally underpaying frontline healthcare providers to boost its profits. United's scheme is simple: issue drastically reduced "take it or leave it" reimbursement rates during contract negotiations to force providers out of its networks, rather than pay them fair and reasonable rates for their services, including saving lives during an unprecedented pandemic.

Once United successfully forces a provider out of network, United then intentionally and significantly underpays the now "out-of-network" provider, often at rates even lower than the contract rates offered. United then lines its pockets with the money that providers have worked tirelessly to earn, money the providers deserve.”

This model is not limiited to United Health Group, nor is it a recent phenomenon.Every major health insurance plan has implemented this methodology against providers and institutions.It has been an ongoing model for two decades at the inception of preferred provider groups in the 1990s. At the same time health insurance premiums, deductibles, and copayments have increased. The victims are the patients using providers as the weapon. In Georgia it has reached the judicial level of adversarial contracting.

One lawsuit in one state may set a small precedent against the huge health insurance lobby.

“Evil empire:” UnitedHealthcare schemes to intentionally underpay healthcare providers, lawsuits claims

Health Care Industry, the effects of "Deskless Working"

Health Care Industry Consulting and Strategy | BCG

Massive changes—including breakthroughs in digital health, the emergence of novel therapies, the rise of personalized care, and value-based care—are transforming health care.

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Wednesday, July 13, 2022

Medicinal Cannabis, or Medical Marijuana,

Medicinal cannabis, or medical marijuana, has evolved from a controversial, misunderstood therapy, to a mainstream treatment option for a growing list of health challenges. As more states legalize marijuana for medical purposes—reducing pain, nausea and inflammation, decreasing anxiety, and aiding sleep, among other symptoms—interest in cannabis therapies has been growing among healthcare professionals.

In a past Sermo poll of 245 global physicians, 70% responded that they are interested in learning more about the power of cannabis medicine.

Despite a growing adoption and legalization movement—in the US alone, 37 states and Washington DC have legalized marijuana treatments—some in the medical field continue to question its efficacy, requesting more research and data before widely recommending treatment. In the same Sermo poll, only 22% of doctors said they have experience recommending cannabis to patients.

We want to hear from you and understand where you fall on the spectrum. Please fill out the poll below to give your thoughts on medical marijuana. We’d also love to hear about your patient cases and any additional thoughts in the comments section.

Iin addition to information about the herb, paraphernalia is a major source of contentment for users. These include roll your own joints, e-dispensers (akin to e-cigarettes). ceramic pipes, vaporizers, bongs, grinders and other creative tools.

The plant.

The leaf

,1 OF 5

In the past six months, have your patients asked you about medicinal marijuana to treat specific illnesses or conditions?

The Paraphernalia.

DeepDyve

Leave a comment﻿

Tuesday, June 21, 2022

How exercise, physical therapy help in the fight against cancer |

The BIG C and Physical Therapy

Not a week goes by without a patient asking me why an oncology physical therapist isn’t an automatic part of their cancer team from the beginning. They relay frustration about why it “took so long” for them to be referred to a specialist. Severe muscle loss seems to be a given. Cancer patients who work with a specialized physical therapist from the start of treatments fare better than those who try to regain strength after treatments leave them exhausted and unmotivated.

Appropriate, early intervention can help prevent physical decline, reduce inflammation and improve patient outcomes. What’s more, exercise during and after cancer treatments reduces and manages side effects, such as chronic pain, lymphedema severity, fracture risk and decreased balance from neuropathy. Early treatment of these issues can also reduce the financial burden of patients, insurance payers and hospital systems. Cancer patients should request physical therapy before, during and after treatments.

Research shows that tailored exercise and physical fitness also can improve the length and quality of life for people diagnosed with cancer. The American Cancer Society recommends physical therapy to improve function, reduce risk of recurrence and improve cancer survival. Ginsburg was diagnosed with pancreatic cancer in 2009; the vast majority of patients do not survive five years. She lived for another 11. While no one can say for certain how she beat the odds, it is my opinion that exercise played a role.

Richard Briggs, physical therapist, coined end-of-life exercise as, “rehab in reverse.” The more usual pattern in hospice and an unfamiliar concept for the therapist to apply is that of “rehabilitation in reverse” as identified by Briggs,[29] which includes exploring the process of functional adaptation and occupational engagement on a daily basis. Throughout each phase of decline during the dying process, new or adapted skills and abilities must be learned by the patient, as well as the care givers, to maximize functional independence and safety. The therapist has the knowledge and skill to assess current status; teach appropriate techniques such as transfers, bed mobility and positioning to decrease pain; collaborate with patients on relaxation techniques; adapt activities of daily living and mobility; and instruct in the use of needed equipment. Other team members may provide some basic instruction but the therapist should be consulted for further care. Therapists provide skilled therapy service that achieves the hospice goal of promoting safety, independence, meaning and quality of life, despite the physical and mental decline which is expected.

For example, the physical therapist might have a patient who has a brain tumor and is unsteady. The patient has been walking without a cane, and now the therapist has to teach him how to use a cane and teach family members to assist with balance. Then, a week or two later, the therapist need to fit him with a walker and teach him to use it. A month later, therapist needs to teach transfers from bed to a wheelchair. And one week later, the therapist might be positioning for pressure relief. As the patient’s health is declining, there is always some level of skilled care that the therapists can provide.[3]

What he meant was that appropriate physical therapy helps reduce the risk of falls, fractures and hospitalizations, all too common with frail patients. Physical therapists teach patients about safety, equipment and swelling management when patients are still walking, different guidance when patients become more sedentary and updated recommendations when patients are bed-bound. Studies show that when pain and other symptoms of a terminal illness are managed, people can work and live longer, just like Ginsburg.

REWARDS

While there is great opportunity for more physical therapists to make a difference in the hospice setting, this is clearly an area of practice that is not for everybody. Becoming involved in a family’s grief process can certainly be emotionally draining. But physical therapists with experience in this area of practice overwhelmingly report that the rewards of hospice care are indeed rich.[3]

Says Steve Gudas, “The spirit, the strength, the courage, the resiliency, and the determination that people have toward the end is amazing to witness. And it is a privilege to play a role in the process. It is actually life affirming.”[3]

Adds Nicole Gergich, “It is gratifying to connect with a person at this time in his or her life. We can offer the patient control, independence, and dignity. Yes, it is sad that the person is dying. But if I am the one who can help, Iam glad to have been part of it. It is rewarding and reinforces to me how very important my job is.”[3]

The number of cancer survivors worldwide is growing, with over 15.5 million cancer survivors in the United States alone-a figure expected to double in the coming decades. Cancer survivors face unique health challenges as a result of their cancer diagnosis and the impact of treatments on their physical and mental well-being. For example, cancer survivors often experience declines in physical functioning and quality of life while facing an increased risk of cancer recurrence and all-cause mortality compared with persons without cancer. The 2010 American College of Sports Medicine Roundtable was among the first reports to conclude that cancer survivors could safely engage in enough exercise training to improve physical fitness and restore physical functioning, enhance quality of life, and mitigate cancer-related fatigue.

Overall findings retained the conclusions that exercise training and testing were generally safe for cancer survivors and that every survivor should "avoid inactivity." Enough evidence was available to conclude that specific doses of aerobic, combined aerobic plus resistance training, and/or resistance training could improve common cancer-related health outcomes, including anxiety, depressive symptoms, fatigue, physical functioning, and health-related quality of life. Implications for other outcomes, such as peripheral neuropathy and cognitive functioning, remain uncertain.

How exercise, physical therapy help in the fight against cancer | The Seattle Times