From COVID-19 To Retail Health: Fierce Healthcare’s Biggest Stories Of 2020

December 29, 2020

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Source: Fierce Healthcare, by Paige Minemyer & Heather Landi

2020 was a year dominated by the fallout from a generational global pandemic.

So perhaps it’s no surprise that COVID-19 headlines also governed much of our coverage over the course of this year, as we shared the latest on how the coronavirus pandemic was impacting you.

However, over the course of the year, other key topics of interest emerged: including a contentious presidential election, new models for health insurance, and tech giants’ continued push into the market.

Here’s a look at some of the topics that made headlines this year.

COVID-19 driving significant industry change

Over the course of the year, COVID-19 touched every facet of the healthcare industry. And the pandemic’s reach forced providers, payers, and health tech companies alike to rethink their approach in a number of areas.

Slammed with cases, hospitals were forced to overhaul their supply chain thinking. That included building more local ties to secure needed supplies, as well as elevating the voice of supply chain executives as obtaining necessary items proved a challenge.

Some large health systems purchased a stake in a personal protective equipment manufacturer in a bid to mitigate the supply chain challenges for those items.

Major health insurers, meanwhile, are well-positioned to weather the pandemic financially but used their muscle to back studies on the virus, such as Cigna researchers examining lingering effects or UnitedHealth Group analysts teaming with Eli Lilly to study its antibody therapy.

Pharmacy benefit managers have had to take a second look at how they approach specialty pharmacy and distribution, especially as two vaccines for the virus are now coming to market.

Telehealth boom isn’t going away

One of the biggest trends under the pandemic was the massive growth in telehealth use as people avoided in-person visits to the doctor.

Early in the pandemic, the Trump administration eased barriers to Medicare reimbursement for telehealth services, including telephonic visits, which allowed for more providers to offer such services to patients.

Telehealth companies’ business was also booming this year. Teladoc, for example, saw its telehealth visits grow 163% over the first three quarters of 2020, reaching 7.6 million visits compared to 2.9 million in 2019.

Teladoc’s revenue skyrocketed in tandem, increasing by 79% over the first nine months of the year. Amid the strong financial performance, Teladoc quickly finalized an $18.5 billion deal to acquire virtual care company Livongo, creating a digital health behemoth.

The telehealth boom has proven especially crucial for mental health services, particularly as stress and anxiety due to the pandemic has weighed heavily on many Americans.

Virtual mental health startup Ginger reported use of its text-based platform was up 309% this year compared to pre-COVID levels, and Doctor On Demand saw record levels of teletherapy visits in September and October.

Biden battles for the White House

The pandemic coincided with a contentious battle for the White House, which saw President Donald Trump face off against former Vice President Joe Biden.

Biden’s victory paves the way for significant change in how the federal government approaches healthcare policy. The Obama administration VP has pushed for fixes to enhance and stabilize the Affordable Care Act, including greater subsidies and the launch of a public insurance option.

A Biden administration could also be quite aggressive in the push for value-based care, which would carry on a trend set under both President Barack Obama and Trump, experts said. Value-based care has largely been a “nonpolitical” issue under both administrations.

Biden has also proposed lowering the eligibility age for Medicare to 60.

There are multiple steps the incoming president could take through executive action, as well, experts said. For one, he could begin to unwind waivers for Medicaid work requirements approved under the Trump administration.

In addition, a Biden administration could launch a special enrollment period on the ACA exchanges as a response to the Trump administration’s decision to cut back the length of open enrollment.

Retail healthcare’s influence continues to grow

Walmart, CVS pharmacies, Walgreens, Rite Aid, and other big names in retail healthcare have continued to expand their reach in the market over the course of this year.

CVS and Walgreens have been key players in the lead up to vaccine distribution, with both partnering with the Trump administration to rapidly deploy COVID-19 vaccines in nursing homes beginning this week.

Retail pharmacies and sites like Walmart stores have also been critical in testing efforts. CVS Health alone administered 6 million COVID-19 tests between March and the end of Q3.

But while they’ve played a major role in the pandemic response, these companies haven’t slowed their efforts to chip away business from traditional players. Rite Aid launched its RxEvolution store overhaul this year, which aims to keep the company competitive in the market.

The new stores harness the connection of pharmacists to patients to provide a more holistic care experience, though they will not include specialty or primary care clinics. Walgreens and CVS have both grown their in-store primary care clinics.

Walmart, meanwhile, is planning to continue opening its health clinics in several states, which offer a slew of services at a flat fee to patients with or without insurance. It also launched an insurance brokerage earlier this year, and co-branded Medicare Advantage plans with Clover Health.

The retail giant has also worked with Oak Street Health to open clinics at its supercenters.

New commercial insurance models emerging

Employers were eyeing ways to avoid continuing to shift additional health costs to workers before the pandemic, and the economic effects of COVID-19 are only intensifying that interest.

Insurers like Aetna are aiming to meet the demand for alternatives to traditional high-deductible plans with new approaches, such as the payer’s new Upfront Advantage and Flexible Five benefit designs, which both offer access to free services for members before they pay their deductibles.

Aetna also launched a new plan design that centers parent company CVS Health’s services as a way to control costs.

PBMs, meanwhile, are going to be forced to take a good hard look at how they do business now that the Trump administration has finalized a rule that would eliminate safe harbors for drug rebates in Part D.

In addition, a recent Supreme Court ruling could lead to states increasing oversight of how PBMs operate.

Startups like RxAdvance have begun to plot out what the PBM model looks like without rebates and are embracing technology to chart a new course forward.

Big tech makes major healthcare moves

Microsoft, Google and Amazon Web Services (AWS) are all pushing deeper into healthcare in a battle to provide cloud computing and data storage technology to hospitals.

The COVID-19 pandemic seems to have only accelerated the big tech giants’ push into the healthcare space as the companies quickly launched new tools to aid in fighting the health crisis, such as AI-based chatbots to help triage patients.

Apple and Google also teamed up to create digital contact tracing technology that can be used by public health agencies to track COVID-19. Apple and Google’s exposure notification application programming interface (API) is now available to states, public health agencies and governments to build apps that will notify people via smartphone if they’ve come into contact with someone with the coronavirus.

The tech companies continue to build out their capabilities in healthcare and all three have signed partnership deals with major health systems and payers.

Microsoft this year rolled out a new cloud service designed specifically for healthcare. Microsoft Cloud for Healthcare brings together existing services like chatbots, Microsoft 365, Teams and Azure as well as future capabilities that deliver automation and efficiency on high-value workflows.

Amazon has grabbed the biggest headlines and ramped up healthcare competition among national pharmacy giants lives CVS and e-prescribing service Surescripts with the rollout of its own online pharmacy. Amazon Pharmacy, a new store on Amazon, will allow customers to complete an entire pharmacy transaction on their desktop or mobile device through the Amazon app,

In a bid to compete with Apple in the virtual health research space, Google recently launched a new mobile app that lets smartphone users participate in virtual health studies. Its new Google Health Studies app with an initial focus on respiratory illnesses, including influenza and COVID-19.

The tech giant is playing catch-up to competitor Apple, which has made strides in remote research efforts since rolling out its first virtual health study in 2017.

Google Cloud also rolled out new tools and services to help providers and payers advance data interoperability in advance of upcoming federal deadlines, among other initiatives.

 

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