Over the last two years, dozens of telehealth companies have started to offer the wildly popular GLP-1 drugs. A new STAT examination has found that just a handful of networks of doctors, nurse practitioners, and physician assistants are writing prescriptions for the slew of websites offering the weight loss drugs, including the compounded versions that have been the subject of debate.

Many telehealth platforms do not disclose the medical groups they work with. But of the 81 in STAT’s analysis that did, the majority — nearly two-thirds — were affiliated with just four medical networks: Beluga Health, MD Integrations, OpenLoop Health, and Colchis Medical Group, the network associated with telehealth site Henry Meds.

Telehealth companies have been able to get off the ground in a matter of days by using the services of these “white label” medical networks, which have established themselves as an invisible but critical piece of the puzzle enabling the digital cash grab surrounding GLP-1s. That online “gold rush,” clinicians and digital health experts have warned, could put patients at risk by reducing the provision of care to the mere sale of a drug.

Read more from STAT’s Katie Palmer.

CONGRESSMedicare Advantage insurers ramped up use of technology to deny claimsAn investigation by the U.S. Senate Permanent Subcommittee on Investigations found that Medicare Advantage insurers denied more claims after they adopted predictive technologies designed to automate coverage decisions, STAT’s Bob Herman and Casey Ross report. The report cites STAT’s series last year that investigated the use of algorithms and artificial intelligence within Medicare Advantage plans.The Senate investigation, released this morning, shows that denials were concentrated among seniors who were requesting care in nursing homes, inpatient rehab, and long-term hospitals. It shows that UnitedHealth, CVS, and Humana, the three largest MA insurers, all used AI and algorithmic tools to aid in issuing denials. UnitedHealth’s rate of denials for post-acute services jumped 172% between 2019 and 2022, topping out at 22.7%, according to the report.Bob and Casey summarized the full findings, including an internal presentation from CVS.

businessPharma executives opine on the electionSTAT’s Matthew Herper picked Bristol Myers Squibb CEO Chris Boerner’s brain at the STAT Summit on all things related to the Inflation Reduction Act, and the upcoming election. Some highlights from their conversation:Boerner said the worst part of his first year as CEO was the “unexpected opportunity” to testify before Sen. Bernie Sanders’ HELP Committee. Boerner said BMS would be “front and center” in pushing for pharmaceutical companies to be able to offer patient assistance in the Medicare program. On the first round of Medicare drug price negotiations, Boerner said that he was “proud of how the team engaged with CMS,” and that Eliquis was actually the kind of drug that the system should be incentivizing: relatively low-cost, widely taken, and could help prevent hospitalizations in the future. On the election, Boerner said that BMS is a global company that operates on both sides of the aisle, and he stubbornly stuck to those talking points even when prodded about which presidential candidate would be better for his company. “Our focus as a company doesn’t really change depending upon who’s in the White House or who controls Congress,” Boerner said. Executives from Bayer and Sandoz also recently contributed First Opinion pieces outlining their priorities for a post-election world. Bayer is calling for both parties to “resist” price controls, and Sandoz warns against protectionism.investigationsInside UnitedHealth’s strategy to pressure physiciansIn the latest installment in STAT’s investigation into UnitedHealth Group’s business practices, the crew behind Health Care’s Colossus examines how managers at the company pushed doctors to see more patients, and bring in more money. Doctors who scheduled more appointments were offered additional bonuses, and the company started a program to offer patients gift cards if they completed a checkup. UnitedHealth shared with doctors in the practice a dashboard comparing the percentage of chronic diseases they found among their Medicare Advantage patients to other practices within the company.The full article is based on internal documents from a UnitedHealth practice, and is not one to be missed.

health

Exposing the exposome

You may be familiar with what a genome is, or a microbiome, but do you know what an exposome is? Just as your genome is all of the genes that make up you, the exposome is all of the chemicals you’ve uniquely been exposed to given your diet, the medicines you take, the products you use, and the quality of your water and air, etc.

(And let me, your friendly neighborhood chemist, remind you that literally everything is made up of chemicals — you’re exposed to hundreds of them every day.)

Researchers studying blood taken from pregnant women recently developed a way to screen for many more of these chemicals than was previously possible — identifying nearly 300 of them at the same time. In combination with an assay that measured whether neurons were stunted in their growth, the researchers were able to determine both that many of the mixtures of chemicals were bad for neural development, and that even if individual chemicals were found at low levels, the additive effect of them in a mixture was still bad. The research will help identify mixtures of chemicals we should screen for in the future.

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health care

Asian Americans in health care aren’t a monolith

After traveling to both Tokyo and Hong Kong on the same trip last year, I was struck by how shockingly different these two cultures were, even though they’re both East Asian countries. But in the U.S., people from both backgrounds would be categorized under the generic label of “Asian American.”

A new study in JAMA Network Open breaks down the Asian American category into 40 ethnoracial subgroups to investigate who is doing what jobs in U.S. healthcare. The results show that the overarching category hides inequities among different populations that the authors say go back to historical imperialism, colorism, and other injustices that have resulted in socioeconomic disparities.

While Indian and Chinese Americans comprise the largest proportion of Asian-American physicians, Cambodian and Hmong Americans are largely underrepresented. Filipinx Americans make up more than half of Asian American nurses and nursing assistants, and Bangladeshi and Chinese Americans made up the largest proportions of home health aides. Overall, Asian Americans represented an estimated 22% of physicians, 10% of RNs, and 8.3% of home health aides.

For more on how the Asian American label hides health disparities, read this award-winning piece from my colleague Usha Lee McFarling.