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Just how much telehealth fraud is there?
A new report from HHS’ Office of the Inspector General found that during the first year of the pandemic, 1,714 out of roughly 742,000 Medicare-certified providers billed for telehealth in ways indicating high risk of fraud, waste, or abuse, Mohana writes. Concerns about rampant fraud — and in turn, unnecessary Medicare spending — are among the holdups to permanently enshrining telehealth coverage expanded during the pandemic. The providers identified by the watchdog billed Medicare beneficiaries for nearly $130 million, but the relatively small number of providers and patterns in their billing, such as erroneously charging location-based fees, indicate cracking down on fraud may be manageable.
(And if you’re interested in more news about how Congress is approaching telehealth, check out our twice-weekly D.C. Diagnosis newsletter.)
Remote patient monitoring must show its value
Speaking of pandemic booms: A new study in Health Affairs reveals that within a large population of commercially insured people, general remote patient monitoring claims increased by more than four times from March 2020 to 2021. The authors slice-up the data to further insights, including that of patients onboarded to an RPM program, more than half remain on for six months and a very large percentage of claims were submitted by a very small number of providers. They note that while spending and usage are still very low, current trends indicate it could become a substantial burden on CMS and other payers.
Now, if that spending moves the needle on chronic illness management, convenience, or access, it could be worthwhile, but “evidence for the benefits of this service is still sparse,” the authors write.
What’s Amazon’s MSK endgame?
Amazon has made no secret of its health care ambitions, which is part of what makes newly published research validating a mobility health feature for its Halo wearable devices so intriguing. Released last year, Halo Movement Health uses a smartphone camera and app to assess a person’s functional mobility by observing five simple movements. New Amazon-funded research from the Shirley Ryan AbilityLab shows that the feature had a “moderate to strong” correlation to metrics from a motion capture suit and 13 functional movement tests conducted by professionals.
While the results are impressive, the feature has shortcomings and potential risks to users, experts told me. As with all of Amazon’s moves surrounding health care, it’s interesting to try to figure out just how the many pieces might fit together in the end. What’s Amazon’s endgame for musculoskeletal care? Does it even have one? Read more here.
Data beneath the deals
So far this week, we’ve seen two tremendous deals that come with an underappreciated asset: a trove of health data, which is critical for companies that want to overhaul health care with software and analytics.
First: CVS won out in the bidding battle for Signify Health. The $8 billion deal underscores just how much opportunity health care giants see in care delivered at home. But as Katie and Casey pointed out recently, Signify also happens to be sitting on a great source of data: It completed 1.9 million in-home health evaluations in 2021 alone.
And yesterday, Walmart and UnitedHealth Group inked a sweeping 10-year partnership, starting with the launch of a co-branded Medicare Advantage plan. UHG will also help Walmart Health manage care for MA patients more broadly, beginning with 15 of the retail giant’s clinics in Georgia and Florida. As STAT’s Tara Bannow reports, the deal and similar partnerships give UHG’s care subsidiary, Optum, demographic insights into local populations. That might prove useful should UnitedHealthcare, UHG’s insurance arm, ever decides to launch MA plans of its own in the areas surrounding Walmart Health clinics.
What we’re reading
- Apple introduces the Apple Watch Series 8 with a temperature sensor, crash detection and more, TechCrunch
- Amazon’s $3.9B One Medical purchase is being reviewed by FTC, filings show, Fierce Healthcare
- Google debuts a new AI tool in the global fight against tuberculosis, STAT