ABL HEALTHCARE ONLINE
ABL Healthcare Member News & Industry Trendletter * October 2, 2018
Click on Headlines to Read Articles

HEALTHCARE MEMBER NEWS
WELCOME NEW MEMBERS!

>>> Suren Avunjian is Co-Founder and CEO of LigoLab Information Systems, a leading provider of innovative software to molecular, clinical, and anatomic pathology laboratories nationwide. As a comprehensive enterprise-wide solution, LigoLab AP/LIS goes beyond the core workflow support and provides modules for outreach support, document imaging, specimen security and tracking, client services, reference work tracking, digital pathology, and consultative diagnostic reporting. Prior to co-founding LigoLab in 2006, Suren served as an information system and business consultant on various projects for the healthcare sector. He played a critical role building several start-up businesses, as well as backing well-established organizations. His previous roles include Director of IT for the largest privately held lab in California, Health Line Clinical Laboratories, which was eventually acquired by LabCorp, prompting Suren to launch LigoLab. Suren has joined the Los Angeles Round Table.



>>> Vince Kach is President and Owner of Proactive Care Inc., a post-acute care and rehabilitation residential facility whose professional care team of registered and licensed vocational nurses, certified nursing assistants, and contracted providers supply high-quality medical management and restorative care to individuals with catastrophic injuries or illnesses. ProActive Care's licensure is as a Congregate Living Health Facility, which means it provides inpatient care that is typically more intense than that provided in skilled nursing facilities. In addition, Vince is President of Micro Endoscopy Surgical Inc., a complete source for all surgical instrument repair needs for over 25 years. Also, when a client needs an instrument that cannot be found in the market, Micro Endoscopy Surgical can design and produce it for them, according to their specifications. Referred to ABL by Mark Parinas of CVHCare Home Health, Vince has also joined the Los Angeles Round Table.

>>> Robin Raff is Founder and CEO of Boomer Business and Beyond, Inc., a healthcare marketing consulting firm where she has launched and grown multiple new healthcare brands using data-driven multi-channel strategies. She coaches clients after conducting a frank review of their assets and goals, provides marketing services, and connects them to additional resources as needed. Previously, she was Director of Medicare Marketing for Kaiser Permanente for five years, where she directed national Medicare campaigns across seven regions, leading a team of 34, with a $40 million budget. Robin and her team exceeded enrollment goals every year. Robin's healthcare clients have included Blue Shield of California, UnitedHealthcare, Oticon Hearing, GE Financial Assurance, California Department of Health Services, Essilor, and Resolution Health (acquired by Wellpoint). Robin has re-joined the Bay Area Round Table.

A couple of weeks ago I wrote about the importance of a company's culture - based on a foundation of values, mission, vision, and even taglines. My principle source was Chris Dyer, ABL Member and bestselling author of The Power of Company Culture. With this blog I'll be sharing Chris's "7 Pillars" that rise from that foundation for building a culture that improves productivity, performance, and profit, with examples primarily drawn from our ABL Members. CLICK TO READ REST OF BLOG. . .

 
UPCOMING ABL HEALTHCARE
ROUND TABLES
  • 10/03 - Orange County Round Table
  • 10/09 - Silicon Valley Round Table
  • 10/10 - San Francisco / Bay Area Round Table
  • 10/11 - East Bay / Bay Area Round Table
  • 10/18 - Sacramento Round Table
  • 10/19 - Los Angeles Round Table
ARTICLES
HEALTHCARE MEMBER NEWS
AgilisIT CEO Discusses Transforming Healthcare

Joyce Tang, CEO of AgilisIT, recently spoke at Kardia Ventures' panel on "AI + Data Science - Transforming Healthcare, BioTech and Clinical with Innovative Technologies." Joyce also commented on current investment trends in artificial intelligence. (Joyce Tang, Orange County)

Alvaka to Host Compliance Workshop & Webinar

On October 17, Alvaka Networks will present a combination live event and webinar - How to Comply with NIST 800-171 Requirements Now That the DFARS Compliance Deadline Has Passed - an opportunity to receive valuable information on how you can obtain certification of compliance, and the best steps to get you there as soon as possible. The session will run from 11:30 a.m. to 1 p.m. (Oli Thordarson, Orange County)

Anthem Blue Cross & Imperial Offer Medicare Advantage Plan

Anthem Blue Cross is teaming with Imperial Health Holdings Medical Group to provide Medicare-eligible consumers high-quality, affordable healthcare. The joint effort will be through Anthem MediBlue Select (HMO), a 2019 Anthem Medicare Advantage health plan. The collaboration will give consumers access to care throughout various regions of the state, including Fresno, Sacramento, and San Diego. (Jack Asher, Silicon Valley)

AT&T Helps Create Network-Connected Device for Prosthetic Limbs

AT&T and Hanger, Inc. a leading provider of orthotic and prosthetic patient services and solutions, have developed a trailblazing proof of concept for the industry's first standalone, network-connected device for prosthetic limbs. The prototype, designed to attach to below-the-knee prostheses, is simple and highly mobile as it syncs directly to the cloud via AT&T's network without relying on Wi-Fi, Bluetooth, or a separate mobile device. (Judi Manis)

CAREMINDr Chosen by Robert Wood Johnson & Rutgers

Healthcare IT News recently profiled Robert Wood Johnson (RWJ) Medical School's use of the CAREMINDr care management tool, which allows clinicians to communicate and share data with their chronic care patients through their smartphone or other mobile device, including results from tests patients take at home with monitoring devices for blood pressure, blood sugar, and others. The data is then automatically analyzed and reported to the provider's care coordinators. Also, the CAREMINDr tool is now part of the new Rutgers Premier health plan - see a flyer here, with more information to come soon. (Harry Soza, Silicon Valley)

Cigna & Omada Expand Personalized Diabetes Prevention Program

Cigna and Omada Health are expanding their Diabetes Prevention Program, to deliver an expanded suite of personalized, user-friendly digital health tools to help people prevent the onset of diabetes and other chronic diseases. Expected to be available to Cigna's national and regional employer clients effective January 2019, the program may empower participants to make impactful and sustainable behavior changes under the guidance of a personal health coach and with support from a peer group. Cigna will offer employers the opportunity to provide incentive programs such as premium discounts or contributions to health savings accounts that reward progress. (Chris De Rosa, Orange County)

CoveredCA for Small Business Announces ~4.6% Premium Increase

Covered California for Small Business has unveiled the health plan choices and rates for small-business employers and their employees for the upcoming 2019 plan year. The statewide weighted average rate change will be 4.6%, which represents the lowest annual increase in the program's five-year history. Meanwhile, CoveredCA was recently honored for its public policy research, studies, and reports on the Affordable Care Act at the PR News Platinum Awards, a national contest recognizing outstanding public relations efforts. CoveredCA was named the top organization in the External Publications category and received honorable mention in: Media Event, Multicultural Campaign, and the WOW! Award. (Kathy Keeshen, Sacramento)

Dignity Health to Anchor Medicaid Transformation Project

Dignity Health will co-lead the Medicaid Transformation Project to advance care specifically for the Medicaid population by scaling digital innovations for these communities. The two-year project, led by Andy Slavitt, former acting administrator of CMS, will implement innovative solutions to improve health for underserved individuals and families across the U.S. The 17 participating health systems span 21 states and have 53,000+ hospital beds. These organizations will collaborate and share best practices in order to address the needs of this vulnerable population in the areas of behavioral health, substance use disorders, women and infant care, and avoidable emergency department visits. (Marvin O'Quinn)

ElderConsult Event to Address Early-Onset Dementia

On the evening of October 4, in Foster City, Elizabeth Landsverk MD, of ElderConsult Geriatric Medicine, will present Dementia and the Challenging Discharge: Challenges of Early-Onset Dementia, where she will discuss the issues to consider when discharging a hospital patient with early-onset dementia, how to identify dementia and prevent elders with memory impairment from falling prey to frauds and scams, and issues of pain and medications and how they affect a discharge from the hospital. (Elizabeth Landsverk MD, Bay Area)

GeBBS' iCode Assurance Selected by The Johns Hopkins

The Johns Hopkins Health System Corporation has chosen GeBBS Healthcare Solutions' iCode Assurance SaaS solution to help enhance their revenue stream, improve productivity, and increase efficiencies within their coding and auditing functions. iCode Assurance software is used by leading health systems to improve coding compliance and auditing across facility inpatient, outpatient, and physician office settings. (Nitin Thakor, Los Angeles)

Good Samaritan & Kindred Collaborate on Acute Rehab Services

Good Samaritan Hospital has opened a 23-bed inpatient acute rehabilitation services to care for patients with severe stroke, brain, orthopaedic, and multiple trauma injuries. Kindred Hospital Rehabilitation Services, a division of Kindred Healthcare, will provide the management and development of the hospital's services. Meanwhile, Good Sam is the first hospital on the West Coast to utilize Carto Vizigo, a bi-directional guiding sheath that can be visualized on the CARTO 3 System during a catheter ablation procedure, helping electrophysiologists reduce dependency on fluoroscopy - thereby reducing radiation exposure. (from Good Samaritan: Andy Leeka, from Kindred: Adam Darvish, both Los Angeles)

Hospice East Bay Provides "Hiking Through Grief" for Millennials

Taking note of the American Psychological Association's report that adults aged 18-30 are experiencing more stress than any other generation, Hospice East Bay has begun a new grief support group for millennial adults that features hiking through the Bay Area's many beautiful parks. Research indicates that young adults have unique bereavement needs and are a group that doesn't fit into the support group model for older adults. This same research shows that this demographic tends to receive little to no bereavement support, with sometimes devastating results. Hiking Through Grief, meeting on the third Saturday of every month, is currently the only regularly occurring young-adult grief group in the region. (Cindy Hatton, Bay Area)

Kaiser Permanente Northern & Southern Cal Get Top NCQA Ratings

Kaiser Permanente's Medicare health plans in Northern and Southern California received the highest rating from the National Committee for Quality Assurance - 5 out of 5. And KP's commercial health plans in Northern and Southern California were rated 4.5; no other commercial health plan in California is rated higher. The national group analyzed over 1,000 health plans in the nation - private, Medicare, Medicaid - for quality and service. Only 14 health plans in the country, or about 1%, were rated 5 out of 5. In all, KP has 9 of those highest rated plans. (Walt Meyers, Bay Area)

King & Spalding to Hold Conferences on Compliance & Pharma

On October 30, King & Spalding (K&S) will hold its annual Women In Compliance Summit, in San Francisco, an interactive event focused on exchanging ideas and benchmarking best practices with women in leadership roles across the compliance and investigations spectrum. And, on Oct. 25, K&S will present a webinar - Health Care Fraud Enforcement Priorities in 2018 and Beyond, from 10-11 a.m. Pacific. Meanwhile, Los Angeles Healthcare Partner Travis Jackson will participate in events: on Oct. 25, on a panel discussion - "Overview of Opioids," at the American Bar Association's 2018 Women in Products Liability Regional CLE Program in Washington, DC; and on Oct. 26, on a panel discussion - "They're Back! Sales/Conversions of Nonprofit Hospitals and Health Plans," at the American Health Lawyers Association's Tax Issues for Health Care Organizations event in Arlington, VA. Also, on November 13, K&S will hold its Annual Pharmaceutical University, in Philadelphia. (Marcia Augsburger, Sacramento, & Travis Jackson)

Look Ahead Examines Transportation Issues in Healthcare

In her article, Transportation in Health Care: It's Not a Transaction but Rather an Experience, Marcee Chmait, of Look Ahead, reports that, according to Harvard Business Review, "Each year approximately 3.6 million people miss or put off medical appointments due to transportation issues, leading to annual costs for healthcare providers in the billions of dollars. Therefore, Marcee suggests that a healthcare system needs to ask each of its members/patients, "How can we help you get the care you need?" "Transportation needs are personal," Marcee says. "We need to personalize the experience for each of our members. By understanding their specific needs, we can arrange, curate, match the EXACT service needed to complete the desired experience." (Marcee Chmait, Los Angeles)

Mazzetti Compares Hospital Ventilation Systems

In How do different ventilation systems compare, Mazzetti's Walt Vernon says, "A number of years ago, working with Kaiser Permanente, Partners Healthcare, and Providence Healthcare, we led a multi-year, multi-university research project focused on the use of displacement ventilation for healthcare facilities. To date, only one hospital, Stanford's Lucille Packard Children's Hospital, has deployed the strategy on a wide basis. Inexplicably (to us), the world seems more enamored with the notion of chilled beams as the 'next new thing' for healthcare ventilation." Both systems have advantages and offer opportunities, depending on particular climates and particular facility priorities." Walt then shares a comparison table. (Walt Vernon, Bay Area)

Mission Hospice to Open Woodside House This Fall

Mission Hospice has announced that renovations to its Woodside Hospice House are complete, and it will soon open its doors to patients and families. Local clinicians and community partners recently toured the house to learn more about the care Mission provides. And thanks to generous grants from Sequoia Healthcare District and Stanford Health Care, Mission has raised $1.6 million toward its $4 million campaign. (Dwight Wilson, Bay Area)

MYnd Analytics Gets Breakthrough Device Designation from FDA

The FDA has granted Breakthrough Device designation for MYnd Analytics' next-generation product, PEER 4.0 (Psychiatric EEG Evaluation Registry), the company's proprietary clinical phenotype database comprising 40,000+ medication outcomes for 11,000+ unique patients, which is used to predict how a patient will respond to a specific medication. Meanwhile, MYnd's wholly owned subsidiary, Arcadian Telepsychiatry Services, has: > Expanded its relationship with Claremont Behavioral Services, a San Francisco EAP provider, to provide Claremont's members and employees outside of California with nationwide services; > Partnered with Integrated Behavioral Health, of Costa Mesa, to provide TeleEAP services to IBH's 7+ million members across the U.S.; > Partnered with Sanford Health to provide telebehavioral health and telepsychiatry services to Sanford's network of outpatient primary care practices located in the Dakotas; > Launched a new program to offer inmates of correctional facilities access to telepsychiatry, teletherapy, and other mental health services. (George Carpenter, Orange County)

Nelson Hardiman Provides Details on CURES - Now in Effect

Nelson Hardiman has published Client Alert: Mandatory Use of CURES Begins Oct. 2, which says in part: "If you are a physician, NP, CNM, PA, podiatrist, osteopathic surgeon, optometrist, neuropathic doctor, dentist, or any health care practitioner authorized to prescribe, order, administer or furnish a controlled substance, starting October 2, 2018, you are mandated to consult CURES (Controlled Substance Utilization Review and Evaluation System) prior to prescribing, ordering, administering, or furnishing a Schedule II-IV controlled substance. Please be aware, the investigators of the Medical Board of California, as well as other professional boards, can pull CURES reports of a particular practitioner to determine whether that practitioner is properly checking CURES. Failure to check CURES can be a basis for action against your license." (Harry Nelson, Los Angeles)

On Lok & Openhouse Join Forces to Help LGBTQ Seniors

Openhouse and On Lok, two San Francisco-based nonprofits, have announced a strategic partnership to co-design a program for LGBTQ seniors which would address two critical issues in their senior community: access to much-needed aging services, and the fear that life in a nursing home would drive most back into the closet. The program is expected to begin in summer 2019 and will be one of many Openhouse offerings at its new community center currently under construction, along with 79 units of LGBTQ-welcoming senior affordable housing. The overall project is also expected to be completed in summer 2019. (Grace Li, Bay Area)

SAVI Group Addresses Billing Errors & Growing Practice Revenue

Recent blog posts from SAVI Group include: > 5 Biggest Medical Billing Errors and How to Avoid Them, which discusses incorrect coding, late claims, duplicate claims, missing/incorrect client information, and denied vs. rejected claims. > 5 Ways to Grow Medical Practice Revenue, which explores improving staff efficiencies, lowering cancellation rates, outsourcing medical billing, optimizing your appointment schedule, and encouraging word-of-mouth referrals. (Sumit Mahendru, Orange County)

Shriners Hospitals Partners with Exploria Resorts

Club Exploria, LLC, developer of the Exploria Resorts brand, has entered into a corporate partnership with Shriners Hospitals for Children in support of the healthcare system's mission to bring hope and healing to children in North America and many other countries worldwide. Exploria will give a portion its quarterly proceeds, along with donations collected from 80,000+ owners and guests vacationing at the brand's resorts, to the pediatric healthcare system. (Maggie Bryan, Sacramento)

Solano County Launches Mobile Food Pharmacy Program

Joining the "Food is Medicine" movement, Solano County has unveiled its Mobile Food Pharmacy Program, which employs a truck that delivers free fresh produce at various Family Health Services clinics. Patients will receive a prescription from their doctor that they can fill by going to the Mobile Food Pharmacy. The truck will be parked at a different community clinic each day. (Mike Stacey, Bay Area)

VivaLNK Provides Wearable for Stanford Study on Depression

Researchers in Stanford's Department of Psychiatry and Behavioral Science are using VivaLNK's Vital Scout, a Band-Aid-sized digital health patch that uses sensors, including electrocardiogram measurement, to continuously monitor heart and respiratory rate, sleep, activity, and other functions. In a project aiming to find a link between stress levels and teenage depression, the remote patient monitoring program is tracking stress levels and other vital signs in teens for 24-hour stretches. (Jiang Li, Silicon Valley)

WIPFLi Provides Webinar on Business Taxes & Article on Shared Responsibility IRS Notices

On October 3, 10-11 a.m., WIPFLi will present a webinar - SCOTUS Overturns Quill: What You Should Be Doing Today - intended for business owners, CEOs, CFOs, controllers, accounts payable and accounting staff, and others involved in state and local tax filing and reporting who need to understand the impact of the Wayfair ruling. Also, WIPFLi has published An Update on IRS Employer Shared Responsibility IRS Notices, applicable to employers with 50+ FTEs. Meanwhile, WIPFLi has joined the KnowBe4 partner program to provide more robust service offerings in the cybersecurity space. WIPFLi will leverage KnowBe4's suite of simulated phishing attacks, case studies, demonstration videos, and tests to better serve clients by deepening its understanding of the mechanics of spam, phishing, malware, and social engineering attacks. (Rich Gianello & Jeff Johnson, Bay Area; Larry Blitz, Silicon Valley; Tony Taddey, L.A.)

TECH MEMBERS' HEALTHCARE NEWS
Catasys Expands Solution to Iowa & Nebraska

Catasys, Inc., a leading AI and technology-enabled healthcare Big Data company, has expanded its OnTrak-A solution into Iowa and Nebraska with one of the nation's leading health plans. Eligible commercial and Medicare Advantage plan members in these states are now able to participate in the integrated 52-week program that identifies, engages, and treats members with unaddressed behavioral health conditions that impact co-morbid medical conditions. The OnTrak program is now available in 22 states to members of major health plans. (Rick Anderson, West Los Angeles Technology)

PCIHIPPA Chosen by DPI to Protect Healthcare Providers

Digital Practice Inc. (DPI) has partnered with PCIHIPAA to protect DPI clients from the onslaught of HIPAA violations, which include ransomware attacks and data breaches, impacting medical and dental practices throughout the U.S. The partnership comes on the heels of a recent announcement from the U.S. Department of Health and Human Services' Office for Civil Rights: "Just because you are a small medical or dental practice doesn't mean we're not looking and that you are safe if you are violating the law. You won't be." In addition, according to the HHS website, over 870,000 patient records were breached in the month of July 2018. (Jeff Broudy, West Los Angeles Technology)

Easy Breathe on: More Comfortable CPAP Treatment

In 8 Ways to Better Adapt to CPAP Treatment for More Comfort and Improved Sleep, Easy Breathe, Inc. points out that CPAP is going to become a very close and familiar part of life for those with obstructive sleep apnea, and the sooner they learn to deal with all of CPAP's most common discomforts - like a mask that doesn't fit quite right, leaks, dry mouth, soreness, claustrophobia, issues with facial hair, and/or sleeping on your stomach/side - the sooner they will discover all of CPAP's amazing healing and restorative powers. Easy Breathe also offers: 5 Ways to Reduce CPAP Mask Irritation Issues and Three Ways to Conquer CPAP Rainout for Good. (Nick Weiss, West Los Angeles Technology)

HEALTHCARE & GOVERNMENT
DOJ Approves Cigna's $67B Merger with Express Scripts

The US Department of Justice has cleared Cigna's $67 billion merger with Express Scripts. The deal, announced in March, is aimed at cutting soaring healthcare costs. The sign-off by the DOJ was the last major hurdle the merger had to clear, after passing a shareholder vote at the end of August. The companies still need to get the OK from state insurance agencies, of which they've gotten 16 so far, the companies said recently. Express Scripts is one of three massive pharmacy benefit managers. When the deal closes, expected to happen by the end of 2018, it will end the days of a standalone PBM. (Read Article: Business Insider, 9/17/18)

Aetna Clears Path to $67.5 Billion CVS Merger

Aetna Inc. said it plans to sell its Medicare prescription-drug business to WellCare Health Plans Inc., a key step toward completing its $67.5 billion merger with CVS Health Corp. The divestiture of the Medicare Part D plans to WellCare may help resolve objections to the CVS-Aetna deal from U.S. antitrust regulators. (Read Article: Bloomberg, 9/27/18)

New Rehab Laws May Revamp Addiction Treatment in California

Gov. Jerry Brown signed a raft of bills into law last week that will begin imposing order on the "Wild Wild West" of California's addiction treatment system. Most take small steps in what reformers say is the right direction - toward stronger regulation. But one of the new laws could be a game-changer, forcing fundamental revisions in the kind of care offered to substance users. That bill is SB 823, by Sen. Jerry Hill, D-San Mateo, which requires licensed rehabs in California to adopt the American Society of Addiction Medicine's treatment criteria as the minimum standard of care. (Read Article: The Mercury News, 9/28/18)

Governor Brown Rejects SF's Supervised Drug Injection Plan

California Gov. Jerry Brown rejected legislation on Sunday that would have allowed San Francisco to open what could be the nation's first supervised drug injection site under a pilot program. Advocates of "safe injection" sites say the locations would save lives by preventing drug overdoses and providing access to counseling. (Read Article: New York Times, 10/1/18)

Healthcare Package Gets Gov. Brown's Signature, 'Public Option' Still in the Cards

Gov. Jerry Brown signed five bills recently that seek to make healthcare more accessible to low- and middle-income Californians. They include: > Democratic Senator Ed Hernandez authored SB 910 and SB 1375, which ban short-term insurance and put limits on association health plans respectively. > Democratic Assemblymember Jim Wood's AB 2472 creates a new council to conduct a feasibility study of a "public option" for healthcare. > The Trump Administration recently invited states to apply for Medicaid waivers that would allow them to add a work requirement to the program. Hernandez's SB 1108 prohibits California from seeking such a change. > AB 2499 from Democratic Assemblymember Joaquin Arambula requires health plans spend at least 80% of premium dollars on healthcare, rather than on marketing, administrative overhead, and other costs. (Read Article: Capital Public Radio, 9/24/18)

California Hospitals Must Offer Vegan Meals Under New Law

California Gov. Jerry Brown signed a bill into law mandating all healthcare facilities and prisons statewide make plant-based meal options available to patients at every meal. Senate Bill 1138 will require licensed California health facilities and state prisons to provide patients and inmates with meal options containing no animal products or by-products, including meat, poultry, fish, dairy or eggs. The bill was authored by state Sen. Nancy Skinner, D-Berkeley, and co-sponsored by the Physicians Committee for Responsible Medicine and Social Compassion in Legislation. A similar effort was passed by the American Medical Association in June 2017. The Healthy Food Options in Hospitals resolution calls on U.S. hospitals to improve the health of patients, staff and visitors by providing plant-based meals. (Read Article: Becker's Hospital Review, 9/20/18)

Ruling on Healthcare Subsidies Could Prove Costly for Government

A federal court ruled in September that a Montana insurer is entitled to federal compensation for subsidy payments under the Affordable Care Act that President Trump abruptly ended last October, a ruling that could reverberate through insurance markets and cost the government hundreds of millions of dollars. At issue are payments for so-called cost-sharing reductions, discounts that enhance the value of health insurance policies purchased from the ACA's marketplaces by reducing deductibles, co-payments, and other out-of-pocket costs for low-income consumers. (Read Article: New York Times, 9/22/18)

Court Rules Against UnitedHealth Group on California Fines

A California appeals court has ruled in favor of state regulators in their attempt to impose fines on a subsidiary of UnitedHealth Group related to 900,000+ alleged violations of a California law on insurance claims. Dave Jones, the insurance commissioner in California, issued a statement saying the recent court ruling paves the way for another court to affirm some $91 million in fines against PacifiCare, an insurance company that UnitedHealth Group acquired more than a decade ago. But UnitedHealth Group has said it would ask the California Supreme Court to review the matter and reinstate a lower court's decision in favor of the health insurer. (Read Article: Star Tribune, 9/21/18)

CMS Proposes Revising Medicare Conditions of Participation

On September 20, 2018, CMS published a proposed rule that the agency states is aimed at reducing the regulatory burden for providers by revising certain aspects of the Medicare Conditions of Participation and Conditions of Coverage for a wide variety of providers, including hospitals, ambulatory surgery centers, and hospices. (Read Article: King & Spalding Health Headlines, 9/24/18)

HEALTHCARE INDUSTRY TRENDS
California's Uninsured Rate Falls to Historic Low; National Rate Holds Steady

A new report from the U.S. Census Bureau shows that California's uninsured rate fell to a new historic low of 7.2% in 2017, representing a decline of 10% from the pre-Affordable Care Act rate of 17.2% - the largest decrease of any state in the nation over that time period. The report also showed that 3.7 million Californians have gained health insurance coverage since 2013, which is a greater number than the next three states - Florida, New York and Texas - combined. A recent study shows there are an estimated 3 million Californians who remain without comprehensive healthcare coverage. Of those that remain uninsured, an estimated 59% are not eligible to enroll in coverage due to their immigration status. When you exclude them, California's "eligible uninsured" rate drops to roughly 3%. (Read Release: Covered California release, 9/12/18)

Trump Health Chief: Premiums to Drop for Popular ACA Plan

Premiums for a popular type of "silver" health plan under the Affordable Care Act will edge downward next year in most states, HHS Secretary Alex Azar announced last week, dropping by 2% in the 39 states served by the federal HealthCare.gov website. And the number of marketplace insurers will grow for the first time since 2015, he added. Azar's numbers were in line with a broader independent analysis earlier last month by Avalere Health and The Associated Press, which found premiums and markets stabilizing nationwide. (Read Article: New York Times, 9/27/18)

Contracts with Insurers Allow Hospitals to Hide Prices from Consumers, Add Fees & More

Dominant hospital systems use an array of secret contract terms to protect their turf and block efforts to curb healthcare costs. As part of these deals, hospitals can demand insurers include them in every plan and discourage use of less-expensive rivals. Other terms allow hospitals to mask prices from consumers, limit audits of claims, add extra fees and block efforts to exclude healthcare providers based on quality or cost. The Wall Street Journal has identified dozens of contracts with terms that limit how insurers design plans. Restrictive hospital-insurer contracts have helped prevent even big employers, including Walmart Inc. and Home Depot Inc., from moving forward with plans they were exploring to try to lower costs and improve quality for their workers. (Read Article: Wall Street Journal, 9/18/18)

$200M Private-Equity Deal is Sign Investors See Opportunity in Health Services

Private-equity firm General Atlantic has agreed to invest $200 million in a startup that aims to manage independent cancer-treatment clinics, the latest sign investors see opportunity in the health-services sector. The investment makes General Atlantic the majority owner of OneOncology, a startup that launched this month. Its founders, three cancer-treatment practices in Tennessee and New York, are the other owners and its first customers. Healthcare services has emerged as an attractive investor target. At nearly $2 billion in the first six months of the year, investment in the sector has surged toward the 2015 high of $2.61 billion, Dow Jones VentureSource data show. (Read Article: Wall Street Journal, 9/12/18)

SF's New HIV Cases Hit Record Low, but Disparities Widen

Aggressive efforts to end transmission of HIV are paying off in San Francisco, where public health officials are reporting record-low new cases, and the city is far outpacing national trends that show much narrower declines. But at both the local and national level, disparities among age, race, and gender groups are becoming more pronounced. (Read Article: San Francisco Chronicle, 9/21/18)

207 East Memory Lane
Santa Ana, CA 92705

Phone: 714-245-2400 | Fax: (714) 245-1428
Email: Janet@abl.org

twitter
twitter
youtube
LinkedIn
Link
Copyright © 2018 Adaptive Business Leaders Organization. All Rights Reserved.