Healthcare Industry Trends * ABL Member News * April 17, 2018

Sajid Ahmed is CEO of WISE Healthcare, which delivers artificial intelligence strategy and workflow engineering to healthcare organizations looking to improve healthcare delivery. WISE is launching an AI-based mobile healthcare tool that will help accurately diagnose patient symptoms and provide convenient access to care. Also, WISE has developed a virtual care (telehealth) strategy to meet the needs of a growing healthcare consumer base. It covers a range of services and approaches, including increasing access to psychiatry, connecting members in rural areas and underserved urban areas to specialists, using electronic consults to enhance communication between providers, and integrating physical and mental health. Previously, Sajid was the CIIO of MLK, Jr. Community Hospital in LA, where he led its $70M HIT initiative and innovation hub. Sajid now serves as an advisor to the current CIIO. Earlier, he was the Director of Health IT and Innovation for L.A. Care Health Plan, where he created HITEC-LA (Health Info. Tech. Reg'l Ext. Center for LA County) for EHR adoption and implementation. Sajid also created and launched eConsult in partnership with the L.A. County DHS, a telehealth system that allows for virtual consultations and collaboration with specialists, and a national model for the standard for care coordination and access to specialty care in the U.S. Earlier, Sajid was the visionary behind SelfMD, where he developed AI tools. Sajid has joined the Los Angeles Round Table.


MIRACLES ON DEMAND: from Rx to Organs

Once thought to be in the realm of science fiction, the FDA has already approved the first 3D-printed drug: Spritam®. Using Aprecia Pharmaceuticals' "ZipDose" technology, coupled with an active ingredient, these aspirin-sized tablets for the treatment of epilepsy disintegrate within a few seconds after taking a sip of water - enabling patients who struggle to swallow pills to get them down. Big Pharma is also using 3D-printed tissue as an effective means of testing new pharmaceuticals, so they can be thoroughly assessed and brought to market more rapidly, without harming animal test subjects... READ MORE >>> [Photo Credit: extremetech.com]

California Aims to Tackle Healthcare Prices in Novel Rate-Setting Proposal

Backed by labor and consumer groups, a California lawmaker has unveiled a proposal calling for the state to set health care prices in the commercial insurance market. Assembly Bill 3087 calls for an independent, nine-member state commission to set health care reimbursements for hospitals, doctors and other providers in the private-insurance market serving employers and individuals. The bill faces formidable opposition from physician groups and hospitals. (Click for Full Article: California Healthline, 4/10/18)

Trump Administration Issues Rule "Further Watering Down" ACA

The Trump administration recently took additional steps to allow U.S. states to relax the rules on what insurers must cover and giving states more power to regulate their individual insurance markets. That could lead to less generous coverage in some states, according to Avalere Health, a research and consulting firm. The new CMS rule also allows states the possibility of modifying the medical loss ratio (MLR) formula, the amount an insurer spends on medical claims compared with income from premiums that is also a key performance metric. A state can request "reasonable adjustments" to the medical loss ratio standard if it shows that it could help stabilize its individual market. Insurers could also have an easier time raising their rates under the new rule. The ACA mandated that premium rate increases of 10% or more in the individual market be scrutinized by state regulators to ensure that they are necessary and reasonable. The new CMS rule raises that threshold to 15%. (Click for Full Article: New York Times, 4/9/18CMS Press Release, 4/9/18)

California Seeks to Intervene to Defend ACA in Court

California Atty. Gen. Xavier Becerra announced he is part of a coalition of 16 attorneys general who have filed a motion to intervene in the lawsuit filed in February by Texas, Wisconsin and other states seeking to overturn the Affordable Care Act, which provides tax credits for coverage and requires coverage for patients with pre-existing conditions. (Click for Full Article: Los Angeles Times, 4/9/18)

Executive Order Calls for Revamp of Federal Aid Programs, Including Medicaid

President Trump recently signed a broad executive order urging a revamp of federal government aid programs to require that more participants prove they are working or trying to find jobs. The order is primarily aimed at programs such as Medicaid, which covers 74 million people, food stamps, which covers about 43 million, and housing programs, an official said. (Click for Full Article: Wall Street Journal, 4/10/18)

Employees "Jump" at Genetic Testing

Levi Strauss & Company introduced a novel benefit for employees at its San Francisco headquarters last fall: free genetic screening to assess their hereditary risks for certain cancers and high cholesterol. Chip Bergh, Levi’s chief executive, said he had hoped that the tests would spur employees to take preventive health steps and in that way reduce the company’s health care costs. Of the 1,100 eligible Levi’s employees, more than half took the genetic tests. Now, he wants to extend the benefit to employees in other cities. (Click for Full Article: New York Times, 4/15/18)

Ascension Charts New Strategic Direction

Ascension CEO Anthony Tersigni, EdD, told the St. Louis Post-Dispatch the organization's new strategic direction will focus more on improving patients' overall health. One of its goals is to better leverage outpatient care sites, such as urgent care centers. Ascension also aims to become profitable off Medicare rates - 64% of its patients rely on government payers. Ascension is taking several steps to remain financially viable and to improve patient care. Dr. Tersigni said clinicians are creating a playbook dubbed "Ascension Way" to eliminate clinical variance. The system also aims to wipe out preventable disparities in health outcomes. (Click for Full Article: Becker’s Hospital Review, 4/4/18)

Too Much Sitting May Thin Part of Brain That's Important for Memory: Study

In a first-of-its-kind study, researchers have found that in people middle-aged and older, a brain structure that is key to learning and memory is plumpest in those who spend the most time standing up and moving. At every age, prolonged sitters show less thickness in the medial temporal lobe and the subregions that make it up, the study found. (Click for Full Article: Los Angeles Times, 4/13/18)

How Mega-Mergers Are Changing the Business of Medical Care

Is the doctor in? Matt Feit, a 45-year-old screenwriter in Los Angeles who visited an urgent care center eight times last year, says: "I can go just about any time to urgent care, and my co-pay is exactly the same as if I went to my primary doctor.” That’s one reason big players like CVS Health and Walmart are eyeing deals with Aetna and Humana, respectively, to use their stores to deliver medical care. Meanwhile, office visits to primary care doctors declined 18% from 2012 to 2016, even as visits to specialists increased, insurance data analyzed by the Health Care Cost Institute shows. (Click for Full Article: New York Times, 4/7/18)

JPMorgan CEO: Health Venture to Start Small, Take Years to Rollout

Jamie Dimon, CEO of JPMorgan Chase, hinted at the timeline and ambitions of his company's joint venture with Berkshire Hathaway and Amazon in his annual letter to stakeholders April 5, noting that the companies would be updating investors on their progress in "coming years." This suggests the three are envisioning a long road ahead. He added they will be hiring a strong management team to address critical problems and issues. Some of its goals include: Aligning incentives among physicians, insurers and patients; Reducing the amount spent on fraud and waste costs; Affording employees more access to telemedicine and better wellness programs; Determining why costly medications are both over- and under-utilized; and examining why so much money is spent on end-of-life care. (Click for Full Article: Becker's Hospital Review, 4/5/2018)

Docs Should Ask Patients: "What's Your Sense of Purpose in Life?"

During a routine visit with your doctor, you anticipate questions about your diet, weight, smoking and drinking. But there’s one important health-related question that our doctors never ask, but should: "What’s your sense of purpose in life?” Research clearly shows that individuals who smoke, are obese or have diabetes may lose, on average, five to ten years from their life expectancies - yet key scientific findings indicate having a sense of purpose can equal or even outweigh these common factors. (Click for Full Article: Wall Street Journal, 2/25/18)

As Burnout Spreads, Healthcare Organizations Scramble for Answers

A new survey shows that the effects of healthcare career burnout extends to all clinicians and up to the C-suite. 83% of organizations labeled burnout a moderate or severe problem, according to NEJM Catalyst’s latest Insight Council survey. Major national medical organizations - including the Mayo Clinic, the AMA, and the Association of American Medical Colleges - recently endorsed a medical charter encouraging stakeholders at all levels to address burnout. (Click for Full Article: Fierce Healthcare, 4/13/18)

Applying Silicon Valley Smarts to Age-Old Diseases

Customized iPhones are just one example of devices that can be used to combat health threats in developing countries. They are helping scientists in California and Cameroon attack the parasite that causes river blindness, an African scourge. (Click for Complete Article: California Healthline, 4/11/18)

Alegre to Participate in "Updates on Dementia" Conference

Alegre Home Care will be exhibiting at the 20th Annual Updates on Dementia Conference, on May 10, in South San Francisco, the largest educational conference focusing exclusively on dementia on the West Coast. Aimed at professionals in the field, the conference will feature renowned researchers and clinicians presenting their research and experience in dementia and aging from a variety of perspectives: social, biological, psychological, and cultural. It will emphasize the practical applications of that research for treatment or for better coping with the symptoms of dementia. (Charles Symes, Bay Area)

Care1st Changing Name to Blue Shield of Ca Promise Health Plan

Care1st Health Plan will operate as Blue Shield of California Promise Health Plan starting in January 2019. Care1st was acquired by Blue Shield of California in 2015 to help the nonprofit health plan fulfill its mission of providing all Californians access to high quality, affordable care. Under its new name, Blue Shield of California Promise Health Plan, along with its clinics in Palmdale and Lancaster, will continue to serve 500,000+ Medi-Cal and Medicare beneficiaries in Los Angeles and San Diego counties. (Greg Buchert, Los Angeles)

CEI Prepares for 10th Annual PACE Party

The Center for Elders' Independence will celebrate its 10th PACE Party on the evening of May 3, at the University Club in Berkeley. The evening promises a night of spectacular views, inspiring entertainment, and fundraising, which will help give at-risk seniors access to high-quality personalized medical care, healthy meals, socialization, training and access to technology, and resources for caregivers. (Linda Trowbridge, Bay Area)

Ceresti CEO Explains How Dementia is a Significant "Multiplier"

In his article - What CMS Missed by Eliminating Dementia from HCC Calculations - Implications for Managed Care Payers and Providers - Dirk Soenksen, CEO of Ceresti Health, explains that the medical cost of dementia are exceptionally high when a person living with dementia is also unable to self-manage their other chronic conditions, such as CHF, diabetes, or COPD. Persons living with dementia are often unable to accurately report their symptoms, follow their physicians’ instructions, and have stressed and inexperienced family members who provide support. These are the reasons why patients with dementia are much more likely to go to the ER, be admitted to the hospital, and utilize more post-acute care (e.g., skilled nursing or home health). The truth is that dementia is a significant "multiplier” on the costs of chronic conditions, similar to the known multiplier effect that depression has on costs. Managing any chronic condition is two to three times more expensive in the presence of dementia. If health plans and providers understood this reality, they’d be lobbying CMS for a reinstatement of the HCC codes for dementia, as a multiplier. (Dirk Soenksen, Orange County)

Choice in Aging Active in "California Senior Rally Day 2018"

The Seniors Count Coalition, of which Choice in Aging is a member-participant, will present California Senior Rally Day 2018, on May 8, at the State Capitol in Sacramento. Senior Rally Day acts as a catalyst to bring together California's aging community and its advocates to propel the state Legislature to establish and maintain seniors’ rights. A variety of California Senators and Assembly Members will be speaking at the event. (Debbie Toth, Bay Area)

El Camino Uses Robotic Platform for Lung Cancer Diagnosis

The Taft Center for Clinical Research at El Camino Hospital announced that its interventional pulmonology team has successfully performed an innovative robotic bronchoscopy procedure to view the inside of the lungs and obtain a tissue sample. This procedure, the first of its kind performed in the U.S., took place as part of a clinical trial of Auris Health’s FDA-approved Monarch Platform. With this, El Camino is embarking on a paradigm shift in how it diagnoses suspicious nodules in the lung. Since the robotic bronchoscope has the ability to travel deeper into the lung and precisely guide a biopsy instrument to even the most difficult nodules, the technology offers the potential to diagnose lung cancer at an earlier stage. (Jeff Gruer & Cecile Currier, both Silicon Valley)

ElderConsult to Take Part in Geriatric Care Discussion

On the afternoon of May 16, Elizabeth Landsverk MD, of ElderConsult Geriatric Medicine, will participate in Three Geriatricians Discuss Geriatrics, a panel discussion that will examine the issues and challenges of treating geriatric patients, including the most important issues for elders and their families to help live the best lives possible. Taking place in Santa Rosa, this event is primarily for elder care professionals. (Elizabeth Landsverk MD, Bay Area)

GeBBS Healthcare Receives PCI Compliance Certification

GeBBS Healthcare Solutions has successfully completed its PCI audit and received the certification of compliance for PCI DSS 3.2 for the company’s Manila operations. The Payment Card Industry Data Security Standard (PCI DSS) provides a baseline of technical and operational requirements designed to protect account data. PCI Standards apply to all entities involved in payment card processing, including merchants, processors, acquirers, issuers, and service providers. Many clients rely on GeBBS's systems to process/store sensitive data. As a result, GeBBS has implemented best-practice controls demanded by its customers to address information security and compliance risks. (Nitin Thakor, Los Angeles)

Gorman Health Group Prepares for Next Week's Forum

The Gorman Health Group 2018 Forum will take place April 25-26, in Las Vegas, providing an intensive cross-functional examination of the state of government healthcare programs to support health plans, providers, and their business partners. It will also focus on cost-effective, innovative, and best-in-class solutions to improve health plan operations and elevate the member experience. (Dave Sayen, Bay Area)

IIC CT Scan Prices Are $20K+ Less Than Some Florida Hospitals

Inglewood Imaging Center (IIC) has reported its rates for 2018 and CEO Brad Schmidt compares them to Florida hospitals' non-contrast CT rates, which were highlighted by a National Public Radio news segment in which charges from a hospital and outpatient imaging were compared. IIC's rate of $299 for a non-contrast CT scan is $21,774 less than the $22,073 charged for the same scan at Oak Hill Hospital in Brooksville, FL. (Brad Schmidt, Los Angeles)

Kaiser Permanente Commits to Gun Injury Prevention Research

Kaiser Permanente (KP) is investing $2 million in research to prevent gun injuries and death, including launching the Kaiser Permanente Task Force on Firearm Injury Prevention. This clinician-guided research will identify evidence-based tools to guide clinical and community prevention efforts, studying interventions to prevent gun injuries the same way they study cancer, heart disease, and other leading causes of preventable death in America.  Meanwhile, KP was named No. 1 on Indeed’s list of "The Best Healthcare Companies to Work for in 2018." Indeed developed the rankings based on the employee experience of healthcare companies with at least 100 reviews between January 2016 and January 2018, looking at a broad range of industries that impact healthcare. (Walt Meyers, Bay Area)

Kindred Stockholders Approve Acquisition Transaction

In December 2017, Kindred Healthcare, Inc.'s Board of Directors approved a definitive agreement under which Kindred will be acquired by a consortium of three companies: TPG Capital; Welsh, Carson, Anderson & Stowe; and Humana Inc. On April 5, 2018, Kindred announced that its stockholders approved the transaction, at a special meeting. The acquisition is expected to close in the summer of 2018. (Adam Darvish, Los Angeles)

King & Spalding Publishes Key Takeaways from Health Law Forum

Recently, 350+ healthcare law professionals attended the 27th Annual King & Spalding Health Law & Policy Forum to discuss emerging issues and hot topics; K&S is now providing Key Takeaways from the event.  And, on May 1, the 5th Annual K&S Cybersecurity & Privacy Summit can be attended as a webinar, from 9 a.m. to 3 p.m.  Meanwhile, a recent K&S Health Headlines covers: MedPAC Recommends Cuts to Urban Hospital’s Medicare Payments; OIG Releases Report Regarding Medicaid Fraud Control Units; First Circuit Rejects CMS FAQs Clarifying Medicaid DSH Payment Calculations; and Jeff Spigel to Speak at 2018 Antitrust in Healthcare Conference. (Marcia Augsburger, Sacramento, & Travis Jackson, Los Angeles)

NxStage Medical Releases MasterGuard Plus

The Medisystems products division of NxStage Medical has released MasterGuard Plus, its latest innovation in AVF needle safety. It leverages the proven safety features of the MasterGuard needle guard and offers new features designed to enhance dialysis staff safety by helping to prevent needlestick injuries. More specifically, MasterGuard Plus offers new intuitive ergonomic and patented safety features including a redesigned needle lock designed to increase security after retraction. (Bob Funari, Orange County)

On Lok Offers Active Mind/Healthy Brain Series and Benefit Gala

On Lok is collaborating with the UCSF Memory and Aging Center and the Global Brain Health Institute on a free lecture series discussing aging, active minds, healthy brains, and maintaining your physical and cognitive health. Sessions are every Thursday throughout the month of May, from 5-6 p.m.  Also, on the evening of May 18, On Lok will present Celebrates!, an event benefiting the organization's wide-ranging programs for seniors, including healthcare, social activities, wellness and fitness, and nutrition and meal delivery. In addition to conversation, live entertainment, drinks, and food tastings, the evening will feature Liam Mayclem, the Emmy Award-winning host of "Eye on the Bay" and "Eat Drink SF." (Grace Li, Bay Area)

Pathways to Provide Gatherings to Remember Loved Ones

Pathways Home Health and Hospice is offering two upcoming Afternoons of Remembrance - in Oakland on May 6, at the Chapel of the Chimes; and in San Mateo on May 20, at Skylawn Memorial Park. These events - designed to honor those who have died within the past year or two - will include a program with music, readings, support, refreshments, and the creation of a magnificent collective bouquet. Participants are encouraged to bring a picture or memory object of the person they are remembering, to share at the display table and take home after the program. (Barbara Burgess, Silicon Valley)

TheraChat Wins Innovation Challenge Award

TheraChat won third place in the recent Innovation Challenge at the RESI (Redefining Early Stage Investments) Conference in Toronto. The award recognizes scientists and entrepreneurs who push the boundaries of health and technology. Out of 120 participants, Life Science Nation chose the 30 most innovative applicants to present their technologies. "During a full day, people stopped by our poster and listened to how we believe we are changing the mental health field by empowering therapists to engage their clients in between sessions," TheraChat CEO Kouris Kalligas said. (Kouris Kalligas, Bay Area)

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