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Teaching people how to regulate their breathing can eliminate their PTSD or panic disorders
Bambi Francisco Roizen interviews Ann Garnier, Bob Cuyler, Chief Clinical Officer of Freespira and Mark Rakowski, Chief Operating Officer of CCHP.
In September, Freespira, the first FDA-cleared digital therapeutic to eliminate or reduce symptoms of post traumatic stress disorder (PTSD) or panic attacks or panic disorders over 28 days, and Children's Community Health Plan (CCHP) extended their partnership to offer Freespira to CCHP's mostly Medicaid population. As part of the extension, Freespira will help CCHP identify who's suffering from such conditions but are undiagnosed.
Here's some takeaways...
-- CCHP is a free-standing health plan affiliated with Children’s Hospital. It covers 165,000 individuals in Eastern Wisconsin. Of that number, 150,000 are part of Medicaid. And of that 150,000, 90,000 are children. CCHP contracts with Children’s Hospital as well as other major health systems.
-- Behavioral services lightbulb: While the pandemic ignited a surge in telehealth visits for primary care, behavioral care services appear to be the ones resonating with patients who need ongoing care.
-- The majority of CCHP’s investment has been in pregnancy. But other priorities include asthma, diabetes and depression. Recently, the insurer discovered that many of its members suffer from PTSD and panic disorder and many others probably don’t realize they have these conditions. About 10,000 members are diagnosed with either of these conditions. Another 30,000 are likely to be suffering from these conditions but have not been diagnosed.
-- Those with PTSD/panic disorders are costly. They tend to use the emergency room frequently. By analyzing the claims data, a member’s utilization pattern can imply that they have these conditions, despite not being diagnosed. For example, symptoms include a racing heart or dizziness, which can appear to be physiological vs psychological. Some 70% of symptoms for panic attacks are physiological therefore confusing people about their condition. Many may feel they’re having a heart attack. A person who has non-cardiac chest pain may actually be suffering from PTSD or panic attacks.
-- Freespira is a 28-day treatment program that is done at a person’s home. CCHP provides the program for free to its members. It pays Freespira $1500 a month per member who undergoes the 28-day program. The package includes hardware that can be reused across 15 patients, as well as coaching. It helps people normalize their breathing. The intervention is giving people feedback about their Co2 levels. People are shown a graph of their breathing levels and are coached into how to stabilize their breathing. They listen to a rising and falling audiotone to sync their breathing. People who do this regularly will see a big improvement. Six months post treatment, half the patients don’t qualify for a PTSD diagnosis.
-- Epidemiological data shows that more than 10% of the US population suffers from PTSD or panic attacks. Freespira and CCHP believe this figure undercounts the true percentage.
-- Sometimes symptoms can be manifested by drug abuse. The way to tell the difference is to use standard clinical symptom scales that show the presence of recurring panic symptoms. For instance, if someone has obsessive compulsive disorder without panic, they’re likely suffering from something else. If someone has major depression without trauma, then they’re suffering something else.
-- Freespira has been cleared for panic and PTSD by the FDA prior to Covid. But after Covid, they have extended use to offer the treatment to kids 13-17.
-- Freespira is billed like medical equipment.
-- Efficacy? Some 1,000 members engaged with the treatment. Studies show that 70% completed the treatment and there’s been significant reduction in symptoms.
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