Overview
As the last two earnings cycles have demonstrated, employers have watched their benefit costs drop markedly as employees have delayed health care services, voluntarily and otherwise. In many cases, delayed or foregone care will have no impact. In others, it represents an accumulation of acuity whose costs represent a reversal of SG&A trends of the last year, perhaps more so.
Yesterday, John Quinn, CEO of Wellnecity, joined Health Policy Sector Head, Emily Evans and Tom Tobin, Health Care Sector Head to Hedgeye Studios. Wellnecity's mission is to help self-insured employers gain control over their health care spend while reducing benefits administration. They do this through a continuous monitoring of the employer's claims data coupled with analytical capabilities that offer actionable insights for cost management.
This discussion was relevant to large ASOs (CI, UNH), providers (HCA, THC, SGRY), diagnostics (DGX, LH, EXAS), and digital health (TDOC, DRIO). For private equity investors, the conversation will be especially interesting as John will share some of his experience reducing health care spend while keeping employees happy.
Replay
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Timestamps: 00:00 - 02:42 Introduction and about Wellnecity 02:42 - 10:10 Changes to utilization during COVID-19 and demand and utilization post-COVID-19 10:10 - 11:54 Effect on coloscopies (EXAS) 11:54 - 12:57 No return of cancer diagnosis - yet 12:57 - 15:25 Accumulated deficit of care and high cost claimants 15:25 - 18:30 Rise in benefit spend, stop-loss carriers and timing of impact 18:30 - 22:03 Worse case scenario and impact on aggregated risk and return of inappropriate spend 22:03 - 26:11 Strategies for keeping health care spend low ~2022 26:11 - 27:30 Maternity spend uninterrupted 27:30 - 28:19 Hospital quality and incentives for alternative sites of care 28:19 - 31:42 Depressed ER visits and changes to behavior and system waste (ACHC) 31:42 - 34:32 Behavior Health, increase in diagnosis and role of telehealth (TDOC) 35:55 - 38:40 2021 ER utilization in Q1 2021 38:40 - 42:01 Primary Care, how much is COVID? 42:01 - 42:56 Waste v needed care 43:06 - 47:35 MRIs are up; CT scans down 47:35 - 52:34 Accumulation of care on orthopedics and physical therapy (FAII, USPH) 52:34 - 55:54 Changes in employer attitudes toward benefit costs 55:54 - 1:00:32 Q & A
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Emily Evans
Managing Director – Health Policy
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