Recap of 2022

BOSTON-January 16, 2023: In 2022, Payer+Provider helped numerous managed care and healthcare delivery organizations address both operational and strategic questions. While not all work led to outputs that are visible to the public, there are several items that can be shared. In each case, Payer+Provider contributed to the item’s development:

  • In January, Value in Health Regional Issues published an analysis of health insurance claims trends in Andhra Pradesh, India. Dr. Powell additionally presented a Master Class on healthcare IT at the Indian School of Business that month.
  • In February, Vascular and Endovascular Surgery published an analysis examining the outcomes experienced by patients whose orders for peripheral artery revascularization were reviewed by a prior authorization program
  • In March, the Journal of Surgical Research published a study exploring how socioeconomic status impacts gastric cancer surgical outcomes. Additionally, a poster examining the association between patient race and prior authorization outcomes was presented at the annual meeting of the National Comprehensive Cancer Network (NCCN).
  • In April, PLOS ONE published a study exploring how the characteristics of a patient’s healthcare provider may influence the interventions they receive following catheterization
  • In June, JMIR Formative Research published an examination of the relationship between use of 16-slice versus 64-slice computed tomography imaging and downstream care. Meanwhile, the American Society of Clinical Oncology published an abstract examining racial disparities in stage 3 lung cancer treatment. Additionally, Payer+Provider Syndicate helped facilitate the first annual meeting of the Society for Digital Mental Health.
  • In July, Dr. Powell appeared on National Public Radio to discuss mental health and how digital tools can be used to help foster it
  • In August, the Journal of Participatory Medicine published an opinion piece discussing why moving to personalized medicine requires personalized health plans
  • In October, a study on how the use of radiation therapy for the treatment of breast cancer evolved during the COVID-19 pandemic was presented at the annual meeting of the American Society for Radiation Oncology (ASTRO)
  • In November, Sleep Medicine published an observational study exploring how testing for sleep-disordered breathing evolved during the COVID-19 pandemic. Findings from the study were additionally presented the following month at AcademyHealth: Dissemination & Implementation.

Outside of the above, Payer+Provider continued to engage with clients on a confidential basis and to develop new research which will be published in subsequent years. The above list of publications, which spans behavioral health, cardiology, diagnostic imaging, oncology, sleep medicine, and vascular surgery, provides a sense of the breadth of topics that Payer+Provider has addressed.

Celebrating a Decade

BOSTON-March 1, 2022: Exactly ten years ago, Payer+Provider Syndicate was founded to build a bridge between health services research and practice. In the years that have followed, numerous peer-reviewed studies have been authored, conference abstracts have been presented, operational analyses have been conducted, and strategies have been developed. While a significant portion of Payer+Provider’s work has been committed to the public record, there is likewise a vast volume of work that has occurred behind the scenes.

Reflecting on the anniversary, Payer+Provider’s President, Adam C. Powell, Ph.D., remarked, “The past decade would not have been possible without the patronage of Payer+Provider’s clients – organizations each committed to improving healthcare. I am confident that the work has made a positive impact on several facets of the healthcare system, and feel fortunate to have been able to have participated. In the years ahead, Payer+Provider will redouble its efforts to improve the quality of healthcare, evaluate the impact of interventions, and help organizations plan for the future.”

Ten Payer+Provider-related publications to celebrate ten years:

  1. Powell A, Savin S, Savva N. Physician workload and hospital reimbursement: Overworked physicians generate less revenue per patient. Manufacturing & Service Operations Management. 2012 Oct;14(4):512-28.
  2. Powell AC, Landman AB, Bates DW. In search of a few good apps. Jama. 2014 May 14;311(18):1851-2.
  3. Powell AC, Torous J, Chan S, Raynor GS, Shwarts E, Shanahan M, Landman AB. Interrater reliability of mHealth app rating measures: analysis of top depression and smoking cessation apps. JMIR mHealth and uHealth. 2016 Feb 10;4(1):e5176.
  4. Powell AC, Ludhar JK, Ostrovsky Y. Electronic health record use in an affluent region in India: Findings from a survey of Chandigarh hospitals. International journal of medical informatics. 2017 Jul 1;103:78-82.
  5. Powell AC, Bowman MB, Harbin HT. Reimbursement of apps for mental health: findings from interviews. JMIR mental health. 2019 Aug 6;6(8):e14724.
  6. Powell AC, Rogstad TL, Winchester DE, Shanser JD, Long JW, Deshmukh UU, Rao VM. Discordance in Clinical Recommendations Regarding the Use of Imaging. American Journal of Medical Quality. 2020 Mar;35(2):117-24.
  7. Powell AC, Rogstad TL, Jacob NM, Long JW, Deshmukh UU, Loy BA, Mirhadi AJ. The association between use of hypofractionation and treatment completion among recipients of radiation therapy post-mastectomy. Practical Radiation Oncology. 2020 Jul 1;10(4):e244-9.
  8. Powell AC, Neary M, Schueller SM. Mental Health Apps: Ensuring Quality and Reimbursement Through a Dynamic Payment Formulary. Psychiatric Services. 2021 May;72(5):614-.
  9. Powell AC, Ceylan M, Long JW, Deshmukh UU, Loy B, Mirhadi AJ. Rate of Whole-Breast Hypofractionated Radiation Therapy Before Versus After Virtual Tumor Board Implementation. JCO Oncology Practice. 2021 Jun;17(6):e809-16.
  10. Singh P, Powell AC. Utilization Trends of a Government-Sponsored Health Insurance Program in South India: 2014 to 2018. Value in Health Regional Issues. 2022 Jan 1;27:82-9.

Indian Health Insurance Utilization Trends

HYDERABAD-December 6, 2021: The techniques used to evaluate the performance of a health plan are to some extent universal. Applying methodologies that he previously used to analyze American claims trends, Adam Powell worked with Preeti Singh to explore claims trends in a health insurance program for low-income people living in Andhra Pradesh, India. The article, Utilization Trends of a Government-Sponsored Health Insurance Program in South India: 2014 to 2018, was published by Value in Health Regional Issues, an Elsevier journal. In short, Singh and Powell found that the average cost per claim declined between 2014 and 2018, while mortality concurrently declined as well.

Since 2013, Adam Powell has served on the visiting faculty of the Indian School of Business (ISB). The Financial Times has ranked the Indian School of Business as the #1 Global MBA program in India, and #23 worldwide. In addition to teaching students at the post-graduate and executive level, Dr. Powell has engaged in research on the Indian healthcare system. It is of particular interest to him due to its structural commonalities with the American healthcare system. This publication is Dr. Powell’s third article written in an Indian context. He has previously examined electronic health record adoption and mHealth app privacy policies in India.

Generating and Quantifying Value

BOSTON-March 6, 2021: Measuring the value generated by administrative and technological interventions is at the core of Payer+Provider’s business. During 2020, Payer+Provider’s President, Adam C. Powell, Ph.D., published a trio of articles that examined value in healthcare from different angles.

Powell AC. Impact of the Artificial Nudge. Academic radiology. 2020 Jan 1;27(1):143-6. – Examined the financial impact of artificial intelligence on a radiology department

Powell AC, Torous JB, Firth J, Kaufman KR. Generating value with mental health apps. BJPsych open. 2020 Mar;6(2). – Described how mental health apps are currently generating value and being reimbursed

Powell A, Torous J. A Patient-Centered Framework for Measuring the Economic Value of the Clinical Benefits of Digital Health Apps: Theoretical Modeling. JMIR Mental Health. 2020;7(10):e18812. – Provided a methodology for quantifying the economic value of the clinical benefits that apps produce for individuals.

In addition to these academic contributions, Payer+Provider spent 2020 actively engaged in helping organizations measure the value that they deliver, frame their stories of past success, and plan for the future.

COVID, Employers, & Tele-Behavioral Health

BOSTON-May 1, 2020: Access to tele-behavioral health services, and employer coverage of services has increased in response to the COVID-19 pandemic. Working with Matthias B. Bowman, MBA, and Henry T. Harbin, MD, Payer+Provider’s Adam C. Powell, Ph.D., developed a white paper, titled, “Tele-Behavioral Health for Employees: Pre-COVID Practices and Recommendations for a Post COVID Path Forward” The white paper summarizes how the state of tele-behavioral health has changed in response to COVID-19, and provides employers and health plans with recommendations on changes to promote in order to foster tele-behavioral health going forward.

The white paper’s development was funded by the Mental Health Treatment and Research Institute LLC, a not-for-profit subsidiary of The Bowman Family Foundation. It was produced as a component of The Path Forward, a joint initiative of The National Alliance of Healthcare Purchaser Coalitions, American Psychiatric Association, American Psychiatric Association Foundation Center for Workplace Mental Health, Bowman Family Foundation and Meadows Mental Health Policy Institute.

The white paper is available online at: http://workplacementalhealth.org/getmedia/8dee107a-9561-4c92-92d8-723ce5fa7051/Tele-Behavioral-Health-for-Employees