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Ginger for Teens Puts “Full-family Approach” to Mental Health Care in Hands of Employers

By JESSICA DaMASSA, WTF HEALTH

Digital mental health unicorn Ginger has just launched ‘Ginger for Teens’ in an effort to help the 1-in-5 teens currently suffering from mental health disorders, amid what’s being called a “teen mental health crisis.” No doubt parents are at their wit’s end searching for care, and Ginger is hoping that its teen-friendly bundle of self-guided content, behavioral health coaching, and video therapy will support a “full-family” approach to mental health care that will help everyone feel a bit better.

Ginger’s Chief Clinical Officer, Dr. Dana Udall, and Adolescent Services Coordinator, Dr. Dena Scott, share their insights on the teen mental health crisis, including the myriad factors they had to consider as they re-tooled Ginger’s offering to meet the needs of this new client base. Ginger for Teens will roll out to all of Ginger’s nearly 650 employer clients by the end of the year, helping teens gain access via their parents’ health plans at work. And beyond Ginger’s employer-sponsored health plan base? Will Ginger for Teens roll out to its health plan clients too? Don’t think we forgot about that first-of-its-kind national contract with Cigna and the potential that partnership could hold to help millions of families nationwide. So, what are the big plans for bringing up the supply-side of teen mental health care? Find out more by tuning in…

Biden Should Extend a “Public Option” as a Message to “Health Care Royalists”

By MIKE MAGEE

In this world of political theatrics, with Democratic legislators from Texas forced into exodus to preserve voters’ rights, and Tucker Carlson rantings about Rep. Eric Swalwell riding shirtless on a camel in Qatar streaming relentlessly, Americans can be excused if they missed a substantive and historic news event last week.

On Friday, July 9th, President Biden signed a far-reaching executive order intended to fuel social and economic reform, and in the process created a potential super-highway sized corridor for programs like universal healthcare. In the President’s view, the enemy of the common man in pursuit of a “fair deal” is not lack of competition but “favoritism.”

To understand the far-reaching implications of this subtle shift in emphasis, let’s review a bit of history. It is easy to forget that this nation was the byproduct of British induced tyranny and economic favoritism. In 1773, citizens of Boston decided they had had enough, and dumped a shipment of tea, owned by the British East India Company, into the Boston Harbor. This action was more an act of practical necessity than politics. The company was simply one of many “favorites” (organizations and individuals) that “got along by going along” with their British controllers.  In lacking a free hand to compete in a free market, the horizons for our budding patriots and their families were indefinitely curtailed.

Large power differentials not only threatened them as individuals but also the proper functioning of the new representative government that would emerge after the American Revolution. Let’s recall that only white male property owners over 21(excluding Catholics and Jews) had the right to vote at our nation’s inception.

Over the following two centuries, power imbalances have taken on a number of forms. For example, during the industrial revolution, corporate mega-powers earned the designation “trusts”, and the enmity of legislators like Senator John Sherman of Ohio, who as Chairman of the Senate Republican Conference, led the enactment of the Sherman Antitrust Act of 1890.

He defined a “trust” as a group of businesses that collude or merge to form a monopoly. To Sen. Sherman, J.D. Rockefeller, the head of Standard Oil, was no better than a monarch. “If we will not endure a king as political power, we should not endure a king over the production, transportation and sale of any of the necessities of life”, he said.   The law itself stated “[e]very contract, combination in the form of trust or otherwise, or conspiracy, in restraint of trade or commerce among the several States, or with foreign nations, is declared to be illegal.”

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Matthew’s health care tidbits

Each week I’ve been adding a brief tidbits section to the THCB Reader, our weekly newsletter that summarizes the best of THCB that week (Sign up here!). Then I had the brainwave to add them to the blog. They’re short and usually not too sweet! –Matthew Holt

In this week’s health care tidbits, Shannon Brownlee and her fellow rebels at the Lown Institute decided to have a bit of fun and compare which non-profit hospitals actually made up for the tax-breaks they got by providing more in community benefit. A bunch of hospitals you never heard of topped the list. What was more interesting was the hospitals that topped the inverse list, in that they gave way less in community benefit than they got in tax breaks. That list has a bunch of names on it you will have heard of!

Given how many of that list run sizable hedge funds and then do a little health care services on the side, perhaps it’s time to totally re-think our deference to these hospital system monopolies. And I don’t just mean making it harder for them to merge and raise prices as suggested by Biden’s recent Executive Order.

#Healthin2Point00, Episode 222 | Funding for Availity, VisiQuate, Truveta, and Bayesian

Today on Health in 2 Point 00, Jess and I cover Availity raising $50 million bringing their total to $200 million and a valuation at over a billion. Revenue cycle management company Visiquate raises $50 million, bringing their total to $70 million. Truveta raises $95 million for its data analysis platform, and finally Bayesian gets $15 million using AI to predict sepsis. —Matthew Holt

The Call to Be a Primary Care Doctor

By HANS DUVEFELT

I suspect the notion of calling in narrower specialties is quite different from mine. Surgeons operate, neurologists treat diseases of the nervous system, even as the methods they use change over time.

Primary care has changed fundamentally since I started out. Others have actually altered the definition of what primary care is, and there is more and more of a mismatch between what we were envisioning and trained for and what we are now being asked to do. Our specialty is often the first to see a patient and also the last stop when no other specialty wants to deal with them.

We have also been required to do more public health, more clerical work, more protocol-driven pseudo-care and pseudo-documentation like the current forms of depression screening and followup documentation. And don’t get me started on the Medicare Annual Wellness Visit. How can we follow the rigid protocol and be culturally and ethnically sensitive at the same time?

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THCB Gang Episode 62 – Thurs July 15, 1pm PT- 4pm ET

Episode 62 of “The THCB Gang” will be live-streamed on Thursday, June 17th at 1pm PT -4PM ET. Matthew Holt (@boltyboy) will be joined by regulars futurist Jeff Goldsmith; policy expert consultant/author Rosemarie Day (@Rosemarie_Day1); Suntra Modern Recovery CEO JL Neptune (@JeanLucNeptune); and medical historian Mike Magee (@drmikemagee).

If you’d rather listen, the “audio only” version it is preserved as a weekly podcast available on our iTunes & Spotify channels a day or so after the episode — Matthew Holt

The Case to Realign Parkinson’s Disease Research

By STEVEN ZECOLA

If asked, the leaders of the research organizations working on Parkinson’s disease would say that they have made tremendous progress and are optimistic on finding a cure for the disease. 

In truth, this viewpoint understates the magnitude of the challenge and results in insufficient resources being devoted to PD. Given the size of the challenge versus the available resources, most research studies today don’t even include finding a cure for PD as part of their objective.

The time is ripe to get everybody on the same page when it comes to the objectives, resources, and timelines for PD research.

What We Know About Parkinson’s Disease

Parkinson’s disease (PD) is a chronic, progressive movement disorder that affects the lives of almost one million Americans. Roughly 50,000 of the inflicted people die each year, often by injuries from falling.  The incidence of PD is expected to expand to 1.6 million in the U.S. by the year 2037.

The characteristic motor symptoms of PD are tremors, stiffness, slowed movement and impaired balance. Over time, people with PD also experience non-motor symptoms including changes in mood, problems with attention and memory, sleep disturbances, fatigue, and changes in bowel and bladder function.  PD has a considerable impact on the quality of life.

The cost to treat PD has been estimated to be $50 billion a year, split equally between the direct cost of care and the indirect costs of lost opportunities for the patients and caregivers.

PD is a complex disease which is thought to result from an interaction between genetic and environmental risk factors.  More than 20 genes have been identified as having an impact on the onset of PD.  However, genetic variation is estimated to contribute only about 25% to the overall risk of developing PD. Moreover, like the majority of neurodegenerative disorders, little insight is available on how specific sequence variations contribute to disease development and progression.

In short, the exact cause of PD is unknown.  However, we know that that there is more than one manifestation of the disease. We can also reasonably conclude that more than one single element or therapy will be required to cure the disease.

What We Know About Parkinson’s Disease Research

PD was first discovered and described by James Parkinson in 1817 in London, England.

In 1911, the efforts of Kazimierz Funk, a Polish biochemist, paid off with the identification of Levodopa as a potential treatment.

By 1970, the FDA approved the use of Levodopa combined with Carbidopa for the treatment of PD. Since then, this combination has remained the gold standard for treatment.

During the last 50 years, many attempts have been made to improve this treatment and avoid its long-term complications.  While several enhancements have been approved by the FDA and have helped patients, no treatment has cured or slowed the progression of the disease.

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Meet Wheel: The Mysterious, White-Label Telehealth Startup Bolstering ‘Next-Gen’ Virtual Care

By JESSICA DaMASSA, WTF HEALTH

Stealthy telehealth startup Wheel just closed a $50M series B and CEO Michelle Davey is here to reveal the mystery behind the company’s very behind-the-scenes approach to selling white-label virtual care. The business model is built on a network of clinicians that Wheel has curated and credentialed specifically for virtual care delivery – for a rotating cast of clients, under any brand, at any time. Unlike the market-leading incumbent telehealth co’s that also sell virtual care infrastructure, Wheel does NOT have a patient front door, isn’t angling for one, and is so protective of its clients’ brands that Michelle won’t even name names about who her company is working with. She simply describes her clientele as those in the biz of “next gen” virtual care: retail players, care-plus-pharmacy-delivery startups, asynchronous care providers, labs, remote patient monitoring companies, and so on.

Wheel experienced 300% year-over-year growth — and 1200% growth from Q4-2020 to Q1-2021 — but is it sustainable as the pandemic wans and other plug-and-play telehealth infrastructure services also gain market traction and funding? And, what about the common criticism that telehealth is too transactional and that both patients AND physicians prefer the opportunity to build deeper relationships? Do providers really want to practice for multiple companies at the same time? We get a look inside Wheel’s 90% clinician retention rate to see what else might be satisfying the clinician’s need to connect, and talk about areas for growth now that the company’s received fresh funds.

Can the Practice of Primary Care Medicine ever be Practical Again?

By HANS DUVEFELT

When I first lost power and then saw my generator fail during a storm last winter, two other failures struck. As I scrambled to fill my water containers for the horses, the failing generator delivered just enough electricity for dim lights and a slow trickle of water. And then, when the power came back on, I had no water and the furnace didn’t work.

I trudged through the snow to the pump house up in the woods and found the water pump clicking as if it tried to start, but couldn’t. I ended up a day or two later with a whole new water pump.

The furnace had power, but I saw a red light with what looked like a stick figure repair man. Other furnaces I’ve had all had a reset/start button. Not this technical wonder that I never had to mess with before.

The repair man showed me that the stick figure light was, in fact, a recessed reset button. He pushed it and the furnace started instantly. But he didn’t leave. He said he was going to make sure there were no other problems. That took half an hour and I later got a $250 bill for the emergency repair call.

I felt stupid for not having pushed the red light on my own and I don’t mind paying $250 for my stupidity. But did he really have to spend half an hour making sure that a furnace that fired and delivered heat REALLY was working?

This long story makes me think of how we practice medicine these days. Nothing is quick and easy. Everything has to be comprehensive. But some problems are really simple enough that we shouldn’t have to belabor them like my furnace repair man. His job was, or should have been, easier than the plumber’s.

Primary care, with our ongoing patient relationships, is in theory ideally suited for quickly taking care of minor problems. After all, we already have background information on our patients and shouldn’t have to start from scratch.

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Up, Please

By KIM BELLARD

When I think of elevator operators, I think of health care.

Now, it’s not likely that many people think about elevator operators very often, if ever.  Many have probably never seen an elevator operator.  The idea of a uniformed person standing all day in an elevator pushing buttons so that people can get to their floors seems unnecessary at best and ludicrous at worse. 

But once upon a time, they were essential, until they weren’t.  Healthcare, don’t say you haven’t been warned. 

Elevators have been around in some form for hundreds of years, and by the 19th century were using steam or electricity to give them more power, but it wasn’t until Elisha Otis debuted the safety elevator that they came into their own.  New engineering techniques such as steel frames made skyscrapers possible, but safe elevators made them feasible; no one wanted to climb stairs for 10+ stories. 

Those generations of elevators weren’t quite like the ones we’re used to.  The speed and direction had to be controlled manually, the elevator had to be carefully brought to a stop at a floor, and the doors had to be opened and closed.  Managing all this was not something that anyone wanted to entrust to passengers.  Thus the role of the elevator operator.

But, of course, technology evolved, allowing for more automation.  According to elevator engineering expert Stephen R. Nichols:

Elevator buttons were introduced in 1892, electronic signal control in 1924, automatic doors in 1948, and in 1950 the first operatorless elevator was installed at the Atlantic Refining Building in Dallas. Full automatic control and autotronic supervision and operation followed in 1962, and elevator efficiency has steadily increased in other ways.

Elevator operators gradually transitioned from being mechanical operators to concierges, helping passengers find the right floors and making them more comfortable.  A 1945 elevator operators strike in New York City had a crippling effect.  As Henry L. Greenidge, Esq. wrote on Linkedin, “The public refused to go near the controls despite having watched the operators work the levers numerous times. The thought that a layperson could operate an elevator was simply an outrageous thought.” 

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