ABL Healthcare Member News & Industry Trendletter * November 6, 2018
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>>> Vishal Ghandi is the founding Managing Director of Keval Health, a boutique, healthcare-focused mergers and acquisitions advisory firm, whose professionals have done extensive work alongside public and private healthcare organizations and private equity firms. Keval's team has deep experience in providing M&A advisory services; facilitating capital-raising efforts across debt, equity, and hybrid products; and offering sell-side advisory services, divestitures, corporate carve-outs, royalty monetization advice, and strategic and commercial partnerships. Year to date 2018, Keval has advised on closed deals greater than $1.0 billion in aggregate transaction value. Vishal has been an investment banker for almost 15 years, including as a senior healthcare investment banker at MTS Health Partners, in New York City; part of the global healthcare investment banking group at Jefferies & Company; and beginning his career with Banc of America Securities. He serves as an independent advisor to Mount Sinai Innovation Partners, Elyton Capital, and several early-stage healthcare technology companies. Vishal has joined the Los Angeles Round Table.

>>> Michelle McGowen is Senior Director Strategic Planning at El Camino Hospital (ECH), a two-campus, $750 million hospital enterprise serving Silicon Valley. ECH is recognized as a national leader in the use of health IT and wireless communications, and has been awarded the Gold Seal of Approval from The Joint Commission as a Primary Stroke Center, as well as three consecutive ANCC Magnet Recognitions for Nursing Care. Michelle works with the business development, service line, finance, and performance improvement staffs to structure, analyze, and evaluate complex problems in support of long-range plans. She is responsible for strategic analytics, plan development and phasing, and performance reporting, and leading her team to research key trends, forecast shifts, assess competitive advantage, build strategic and analytic capabilities, address business challenges, and assess performance. She also works within and outside of ECH to advance strategic partnerships and develop key relationships. Her healthcare career began with Lewin Associates, and later with Washington and Sequoia hospitals, she also served as Director of Clinic Financial Operations at Stanford Hospital & Clinics, prior to joining ECH in 2012 and stepping into her current position in July 2015. Michelle has joined the Silicon Valley Round Table.

  • 11/07 - Orange County Round Table
  • 11/08 - East Bay / Bay Area Round Table
  • 11/13 - Silicon Valley Round Table
  • 11/14 - San Francisco / Bay Area Round Table
  • 11/15 - Sacramento Round Table
  • 11/16 - Los Angeles Round Table
10 Finalists Selected for Innovations in HealthcareTM ABBY Awards; Winners to Be Chosen on December 5th & 12th, in Southern & Northern California

Ten of healthcare's most innovative companies have been selected as Finalists to present their health IT, digital health, diagnostic, and med device solutions, as well as innovative approaches for reducing the cost of quality care at ABL Organization's 19th and 20th Innovations in HealthcareTM ABBY Awards Dual Events, to be held on December 5, 2018, in Long Beach, and December 12, 2018, in San Francisco. The ABBY Awards events, which will be presented for the 19th time in Greater LA and for the 20th time in the Bay Area, will be hosted by the Adaptive Business Leaders (ABL) Organization. ABL's first Awards event was held in 1999, and since then has recognized over 60 innovative organizations whose approaches and technologies are making dramatic inroads in the quest to improve the quality of care and health outcomes - while reducing its cost. For the first time, this year literally half of the Finalists' offerings blend "technologies with human providers, caregivers, or coaches" to achieve their quality-improving/ cost-saving results.

AND THE FINALISTS ARE: For the Southern California Event: Advanced Pathways; Amenity Health, Inc.; Catasys, Inc.; healthPiper, LLC; and ImpediMed, Inc. For the Northern California Event: Atlas Lift Tech; Care3, Inc.; Help-Full; Modio Health, Inc.; and NEOFECT. Click Here to Learn More About the Finalists.

In preparation for this year's Dual Events, ABL's Finalist Selection Committee - a group of Healthcare Executives with deep domain knowledge in the areas represented by this year's Semi-Finalists - spent a recent morning presenting and discussing some 30 ABBY Award-nominated Semi-Finalists to the Group. Following discussions about each nominated organization, the Committee voted by secret ballot to select the ten Finalists. At both the December 5th and 12th dual ABBY Awards events, following live presentations made by the leaders of the Finalist companies, each audience member will cast their secret ballots to determine one ABBY Awardee in Southern California and one ABBY Awardee in Northern California; both winners will take home coveted ABBY Awards. Further information about the Innovations in HealthcareTM ABBY Awards event/s is available by emailing laura@abl.org.

Agilist a Finalist in HHS Competition to Advance Care Through Patient Assessments

Agilist has been named a Finalist in the HHS/AHRQ Step Up App Challenge: Advancing Care Through Patient Assessments, in which the Agency for Healthcare Research and Quality has chosen teams to design, develop, and pilot a user-friendly application that simplifies the process of collecting, interpreting, aggregating, and sharing patient-reported outcomes (PRO) data related to physical function outcomes in the ambulatory care setting. PROs are defined as "any report of the status of a patient's health condition that comes directly from the patient, without interpretation of the patient's response by a clinician or anyone else." The competition has three phases that proceed from the development of a business proposal, to development of the app, and finally, to testing the winning app in nine practice settings affiliated with MedStar Health in Washington, DC. Cash prizes will be awarded at each phase with the grand prize winner receiving as much as $87,000. AHRQ received 50+ applications, from which 10 finalists, including Agilist, were selected to move on to phase 2. (Joyce Tang, Orange County)

Alinea Medical Imaging Highlighted on L.A. News

Fox 11 Los Angeles/ Good Day L.A. news program recently featured Alinea Medical Imaging's collaboration with radiologist Dr. Lisa Curcio of Breastlink, in a television segment that highlighted Alinea's mobile mammography bus. Meanwhile, for several days in October - which was Breast Cancer Awareness month - Alinea partnered with fashion designer/ businesswoman Tamara Mellon to provide free mammograms in multiple locations around L.A. (Monish Laxpati, Orange County)

Alvaka & Dept of Homeland Security to Present Security Strategy Workshop

On November 15, Alvaka Networks and the Department of Homeland Security will present Connect, Plan, Train, & Report: National Strategy to Protecting our Nation's Infrastructure, at Alvaka's Irvine headquarters, from 11:30 a.m. to 1:30 p.m. The event will cover the current physical and digital threats to businesses and critical infrastructure, growing challenges of defense, and ways that we can all make our communities safer. Meanwhile, Alvaka has published To patch or not to patch? And what is patching anyway? (Oli Thordarson, Orange County)

Anka Behavioral Health Wins Grant, Announces Event

Anka Behavioral Health recently received an award from the Tuscola Community Foundation, Janks Fund, to support the purchase of new beds for the veterans in Anka's transitional housing program in Akron, MI. Meanwhile, on November 9, in Concord, CA, Anka will present a service to memorialize the homeless men and women who have lost their lives over the last year in Contra Costa County: More information. (Naja Boyd, Bay Area)

CAREMINDr Publishes Article on Benefits of Mobile-Enabled Remote Patient Monitoring

Harry Soza, CEO of CAREMINDr, co-wrote an article for Medical Economics - Increase revenue, improve patient care with mobile-enabled remote patient monitoring - which discusses how medical practices that are looking for ways to make Medicare's Chronic Care Management program more efficient and less costly, are utilizing mobile-enabled remote patient monitoring. The technology can greatly enhance communication between providers and patients; patients become more aware and engaged in their own care; it enables consistent monitoring between face-to-face appointments; and it has advantages compared to phone-based monitoring. In addition, CMS recently unbundled another level of remote patient monitoring, using a different CPT code, allowing providers to bill separately for these broader services. (Harry Soza, Silicon Valley)

Carl Zeiss Gets FDA PMA Approval for ReLEx SMILE

Carl Zeiss Meditec (ZEISS) has received FDA Premarket Approval for ReLEx SMILE, expanding myopia treatment to patients with astigmatism. The approval also provides for a small entry incision to be made, allowing the SMILE procedure to be potentially less disruptive to corneal surface tissue. To date, there are 1700+ surgeons using SMILE in over 70 countries, and the technology behind SMILE was recently featured in the Scientific Background on the Nobel Prize in Physics 2018. (Angelo Rago, Bay Area)

Ceresti Expands Program with Landmark + Gets Capital Investment

Landmark Health and Ceresti Health are expanding Ceresti's coaching, education, and support pilot program to additional markets where Landmark Health currently operates. Ceresti's solution leverages its proven digital platform, remote coaches, evidence-based content, and a proprietary personalization engine to help family caregivers understand their loved one's health challenges and develop the know-how required to take a more active role in managing their loved one's health. Meanwhile, Ceresti announced a capital investment by Stella Development, a division of the same parent company (Stella) as Blue Cross and Blue Shield of Minnesota. (Dirk Soenksen, Orange County)

County of Santa Clara Hosts Binational Health Week

The County of Santa Clara recently concluded its 14th Annual Binational Health Week, which occurs every year in October, bringing together community, government agencies, and thousands of volunteers to host a series of health education and health promotion events. It's one of the largest mobilization efforts in the Americas to improve the health and well-being of immigrants from Latin America living in the U.S. and Canada. The Santa Clara County Public Health Department partners with the Consulate of Mexico in San Jose, hospitals, clinics, community-based organizations, and volunteers, collaborating to coordinate and host this event. (Tyler Haskell, Silicon Valley)

Felton Institute Celebrates Children's Education

Recently, 59 preschoolers in tiny purple graduation gowns and mortarboards reached a milestone on their educational path at Felton Institute's Cradle to College Preschool Graduation. This is the second year that the Children, Youth and Family Division has held the jubilant ceremony at San Francisco State University. Felton CEO Al Gilbert thanked the parents for allowing Felton to play a role in each child's success story, adding, "We've created a lot of innovative programs and services specifically with the intention of making your family stronger, increasing your resources, and supporting the achievements of your young people." (Al Gilbert, Bay Area)

GeBBS Chosen by NYC Cancer Center & Large Florida Health Center

GeBBS Healthcare Solutions announced that Memorial Sloan Kettering Cancer Center, of New York, and Lee Health, of southwest Florida, have selected their iCode Assurance SaaS solution to help enhance revenue integrity, compliance, and productivity. Meanwhile, GeBBS is making available their professional fee evaluation/management (E/M) leveling calculator tool - offered to the HIM community in appreciation for their service to the healthcare industry. (Nitin Thakor, Los Angeles)

Gorman Health Group Reports on Bundled Payments & 2019 Checklist

In Bundled Payment Report Issued, Dave Sayen of Gorman Health Group (GHG) reports that bundling payments is one of the few value-based approaches that CMS and the Innovation Center have fielded that works, but not yet for taxpayers. The newer advanced Bundled Payments for Care Improvement initiative, which is getting started now, will put providers at risk, and sophisticated providers are ready to play in this new space, Dave shares. This is where health reform is happening, he says, in initiatives that align providers' incentives with the goals of public programs. Meanwhile, following CMS's recent publication of its annual Readiness Checklist, which provides an overview of key operational requirements for the coming plan year, GHG has summarized important things to consider as the 2019 plan year approaches. (Dave Sayen, Bay Area)

Health Coach Institute to Present Conference

Health Coach Institute will present HCI Live in Austin, TX, November 9-11, an event which will provide health coach training, education, and more. Meanwhile, recent blog posts from HCI include Why Life Coach Training Isn't Just for Coaches and How to Become an Online Health Coach. (Eric Neuner, Bay Area)

Kaiser's Medicare & Workplace Wellness Programs Among Nation's Best

CMS has awarded Kaiser Permanente (KP)'s Medicare health plans in California, Hawaii, and the Mid-Atlantic States its highest rating: 5 out of 5 stars. And KP Medicare plans in the Northwest, Colorado, Georgia, and Washington earned 4.5 out of 5 stars, CMS' second-highest rating. Also, for the eighth consecutive year, the National Business Group on Health honored KP with Platinum for having one of the best workforce health and well-being programs in the nation, with demonstrated results. (Walt Meyers, Bay Area)

Kindred & Mercy Iowa City Announce Plans for Inpatient Rehab Hospital

Kindred Healthcare and Mercy Iowa City have created a joint venture to construct and operate a 40-bed inpatient rehabilitation hospital in Coralville, IA, and received approval from the Iowa State Health Facilities Council. Kindred will manage day-to-day operations of the new hospital, expected to open by the second quarter of 2020. It will care for adults recovering from conditions such as stroke, neurological disease, injury to the brain or spinal cord, and other long-term illnesses or injuries. (Adam Darvish, Los Angeles)

King & Spalding Highlighted in Industry Journals

In its recent issue of Health Headlines, King & Spalding (K&S) provides updates on: CMS Releases the following: > Final 2019 Outpatient Prospective Payment System Rulemaking, Finalizing Site Neutral Payment Policy for Off-Campus Provider-Based Departments; > Final Rule for Medicare Physician Fee Schedule and Quality Payment Program; > Home Health Prospective Payment System Final Rule; and > Contract Year 2020 Medicare Advantage and Part D Flexibility Proposed Rule. It also covers: > HHS Proposes to Halt Further Delays of 340B Oversight and Enforcement Rules; and > District Court Orders HHS to Clear Medicare Appeals Backlog By 2022.

Meanwhile, a recent American Lawyer article profiles the growth and momentum of K&S, while Benchmark has again awarded the firm top individual and practice area rankings in its guide to the top law firms for litigation, including achieving national Tier 1 for General Commercial Litigation, International Arbitration, Product Liability, and White-Collar Crime. Also, Los Angeles healthcare partner Travis Jackson will be a featured speaker at the American Health Lawyers Association's Fundamentals of Health Law Conference on Nov. 12 in Chicago. And, on November 13, K&S will hold its Annual Pharmaceutical University, in Philadelphia. (Marcia Augsburger, Sacramento, & Travis Jackson)

Mazzetti on Building Value for All Healthcare Facility Experts

In Building Value for All Healthcare Facility Experts, Globally, Mazzetti CEO Walt Vernon discusses his recent presentation to the International Federation of Hospital Engineering (IFHE), where he represented the Health Care Institute and the U.S. Walt shares that IFHE will be focusing on the following areas in 2019: > Develop extensive award programs available to all healthcare organizations, so that each has opportunities for international recognition for their work. > Develop online peer-to-peer communications, similar to a list serve, to create a global community of resources. > Develop an expertise bank, to identify people with particular expertise. (Walt Vernon, Bay Area)

Mission Hospice Opens Woodside Hospice

This fall, Mission Hospice received final licensing for its new Woodside hospice house in Redwood City, and has since welcomed the first patients to this beautiful six-bed home, providing intensive, round-the-clock care for those whose end-of-life needs cannot be managed in their own homes. While hospice houses are common in other parts of the country, the Bay Area has only a handful, due to the high cost of land in the area. (Dwight Wilson, Bay Area)

Nelson Hardiman Examines Current Legal Issues in Healthcare

Nelson Hardiman (NH)'s managing partner, Harry Nelson, was interviewed by The Paper Grown, Zocdoc's healthcare newsletter, where he provides his expert analysis on frequently asked questions regarding open enrollment for the coming year and concerns behind the repeal of the individual mandate. Also, NH has published SUPPORT for Patients and Communities Act, regarding the comprehensive bill designed to address the current opioid crisis; and California Enacts New Hospital Discharge Process Requirements for Homeless Patients. Meanwhile, NH is offering office-space subleases within its new Westwood office building: More information. (Harry Nelson, Los Angeles)

NxStage Sees Significant Increase in Connected Health Platform Adoption

The number of home hemodialysis (HHD) patients using NxStage Medical's Nx2me Connected Health platform has increased 220% in the past year. Nx2me is designed to enhance the connection between NxStage System One HHD patients and clinicians, and has been shown to improve patient retention and training graduation rates. Meanwhile, NxStage announced a new study highlighting significant improvements in first-year survival for incident patients across all age ranges, performing more frequent home hemodialysis with System One, and new findings demonstrating significant survival benefit and lower cardiovascular hospitalization with more frequent home hemodialysis using System One within the skilled nursing facility setting. (Bob Funari, Orange County)

Royal Ambulance Honored on Modern Healthcare's Best Places to Work

Royal Ambulance has been named to Modern Healthcare's "2018 Best Places to Work," ranked at #38. Each year, this program singles out and recognizes outstanding employers in the healthcare industry on a national level. (Steve Grau, Silicon Valley)

SAVI Group Examines HIPAA & Medical Billing

In Everything You Need to Know About HIPAA Compliance, SAVI Group provides a comprehensive list of all the HIPPA identifiers. And, in The Future of Medical Billing - Trends & Integrations, SAVI explores some of the latest innovations and trends, including blockchain technology, computer-assisted coding, and aligning electronic health records. Also, in Common Medical Billing Mistakes to Avoid, SAVI discusses unbundling codes, upcoding, billing multiple times for the same service, and mistakes in patient information. (Sumit Mahendru, Orange County)

Shriners Hospitals for Children - Northern California Hosts Orthopaedic Residents

Shriners Hospitals for Children - Northern California recently hosted the inaugural PediOrtho WEST (Western Education & Surgical Techniques) Resident Education Course, which brought together young doctors from throughout the West to introduce them to the field of pediatric orthopaedics. The leading pediatric surgeons in the state formed the faculty for this first-ever event. In addition to comprehensive lectures and presentations of specific topics, participants were exposed to hands-on, individualized surgical simulations skills labs at the Northern California Shriners Hospital. (Maggie Bryan, Sacramento)

Tulare Regional Medical Center Reopens

Tulare Regional Medical Center reopened to patients on October 15, after being shuttered for nearly a year due to the hospital declaring bankruptcy in October 2017. Recently, the Tulare Local Healthcare District and Adventist Health agreed to lease terms whereby Adventist will pay the Healthcare District $2.335 million each year to lease the hospital building. Adventist also agreed to give the district a $10 million loan to pay off debts needed to reopen the hospital. Adventist has also spent $200,000 over the last few weeks to renovate the hospital. The agreement has a maximum length of 30 years, with five-year renewals. (Larry Blitz, Silicon Valley)

VivaLNK Partners with Reckitt Benckiser

VivaLNK has teamed with Reckitt Benckiser (RB) to market and distribute VivaLNK's wearable continuous temperature monitor worldwide. RB, the company behind brands such as Enfamil and Nurofen, will carry the product under the names Enfasmart FeverSense and Nurofen FeverSmart. Both products are available now to parents who wish to automatically track temperature changes in their child and take immediate action upon detecting a fever. FeverSense and FeverSmart continuously monitor changes in body temperature over a multi-day period. The small, comfortable patch is rechargeable and can be worn seven days straight on a single charge. (Jiang Li, Silicon Valley)

WIPFLi Enlists Cybersecurity Program to Help Businesses Reduce Data Risk

WIPFLi has joined the NormShield partner program to expand its current cybersecurity solutions with state-of-the-art, on-demand, and standards-based cyber risk scorecards. The enhanced portfolio will provide Wipfli with a powerful tool to improve and reduce the risk associated with its clients' supply-chain partners, third-party vendor networks, and sensitive data. Meanwhile, WIPFLi has published Why You Should Measure Employee Engagement - and How to Use the Results. (Rich Gianello & Jeff Johnson, Bay Area; Tony Taddey, Los Angeles; Larry Blitz, Silicon Valley)

Catasys Expands Solution to Florida & Georgia

Catasys, an AI and technology-enabled healthcare company, has expanded its OnTrak-A solution into Florida and Georgia with one of the nation's leading health plans. Eligible 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. (Rick Anderson, West Los Angeles Technology)

PCIHIPAA Partners with IRIS Solutions & MBS Secure

IRIS Solutions and MBS Secure, two companies which provide IT solutions, have both recently partnered with PCIHIPAA to focus on protecting their clients from the onslaught of HIPAA violations which include ransomware attacks and data breaches impacting medical and dental practices throughout the U.S. (Jeff Broudy, West Los Angeles Technology)

Voters in Multiple States to Decide on Medicaid Expansion

On Election Day, Utah residents will be going to the polls to vote on whether the state will join 33 others and Washington, D.C., in expanding Medicaid coverage to a lot more low-income adults. Democrat and Republican states have expanded. Nebraska and Idaho also have the Medicaid question on ballots in their states. Idaho Gov. Butch Otter, a Republican, endorsed the expansion initiative Tuesday. And in Montana, voters will decide whether to approve a tobacco tax to continue that state's Medicaid expansion or let it roll back next year. (Read Article: NPR, 10/31/18)

What's the Difference Between Medicare-For-All and Single-Payer?

As politicians across the country toss about such health care catchphrases, sometimes interchangeably, many voters say they're "just confused." (Read Article: California Healthline, 11/2/18)

State Wants to Peg Rates to What Medicare Pays, but Hospitals Worry About Ripple Effects

North Carolina wants to reshape how it pays for its workers' healthcare - and save hundreds of millions of dollars - by scrapping the secret negotiations typically used to set rates with doctors and hospitals. The fate of the plan, from the state's treasurer, is expected to be watched closely by other employers eager to stem rising health costs. But hospitals are already fighting back. Meanwhile, at least one other state, Montana, has implemented a plan similar to the North Carolina proposal. (Read Article: Wall Street Journal, 11/4/18)

Telehealth from Home to Be Added to Medicare Advantage Plan's Benefits Under New Rule

Proposed changes issued today by CMS would allow Medicare Advantage insurers to be reimbursed for additional telehealth services, a benefit not available through traditional fee-for-service Medicare. Under the proposed rule, Medicare Advantage enrollees can receive telehealth services from their homes, rather than from a healthcare facility. More than a third of all Medicare enrollees choose the private, rather than government insurance and their number is projected to increase by 11.5% as a growing demographic of baby boomers ages into retirement. (Read Article: Healthcare Finance, 10/29/18)

Meanwhile, Four People Indicted for $931 Million Telemedicine Fraud Scheme

Federal officials indicted four people in Tennessee for an alleged scheme that involved using telemedicine to bilk insurers out of about $174 million. The defendants allegedly submitted at least $931M of fraudulent claims after tricking tens of thousands of patients and more than 100 doctors. The defendants and their companies worked with telemedicine company HealthRight to get fraudulent insurance coverage information and prescriptions from patients, according to court documents. After getting doctors to approve the prescriptions, which were invalid in the first place, the defendants would bill payers for greatly marked-up prescriptions, reaping the rewards of overpayment. They did this repeatedly over the course of three years, with the scheme ending in April 2018, the Justice Department alleged. (Read Article: Modern Healthcare, 10/15/18)

Suit Against Sutter Spawns Fight with Bay Area Hospitals Over Trade Secrets

In Silicon Valley, trade secrets are often thought of as a coveted technology or a patent for a lucrative device. But for hospitals, it is their confidential contracts with health insurance companies, which determine how they get paid, that they guard with their life. Nowhere is this more evident than in the legal maneuvering by more than a dozen California hospitals in a high-stakes, closely watched case they initially were not even a part of: the California attorney general's antitrust lawsuit against Sutter Health, Northern California's largest health system, which is unfolding in San Francisco Superior Court. Attorneys for Sutter, which stands accused of abusing its market power and charging higher prices, have subpoenaed 50 other California hospitals - including many of Sutter's competitors in the Bay Area - to hand over pricing information the hospitals consider proprietary, such as the terms of their contracts with insurers. The move has spawned fights between Sutter, which operates 23 hospitals in California, and many rival hospitals that bristled at the idea of ceding confidential information to a competitor. (Read Article: San Francisco Chronicle, 10/14/18)

California's Medi-Cal Program Paid $4B to Recipients Who May Have Been Ineligible, Audit Shows

California paid at least $4 billion over four years in questionable Medi-Cal premiums and claims because it failed to follow up on eligibility discrepancies, according to a recently released audit. From 2014 through 2017, 450,000+ people marked as eligible for Medi-Cal in the state's system were listed as ineligible in county systems, the California auditor's office said. Half of those discrepancies persisted for more than two years. The Department of Health Care Services, which administers California's Medicaid program, said in a statement that it agrees with the auditor's recommendations, and is taking appropriate corrective actions. (Read Article: USNews, 10/30/18)

Hackers Breach Healthcare.gov System, Taking Files on 75,000 People

A government system used by insurance agents and brokers to help customers sign up for healthcare plans was breached, allowing hackers to siphon off sensitive and personal data on 75,000 people. The hacked system was connected to the Healthcare.gov website, the front-facing portal for anyone signing up for an insurance plan under the Affordable Care Act. In order to sign up for healthcare plans, customers have to give over a ton of personal data, including names, addresses, and social security numbers. CMS didn't say exactly what kind of data was included in the stolen files, nor did it say how the breach happened. (Read Article: Tech Crunch, 10/20/18)

HHS Wants List Prices of Drugs Costing $35+ a Month Displayed in TV Ads

Despite fervent objection by pharma companies, HHS proposed a law October 15 that would require drugmakers to disclose the list price of a drug in their TV ads if it costs more than $35 a month. If finalized, the new rule would apply to any direct-to-consumer ads for drugs offered through Medicare or Medicaid programs. Drugmakers would have to divulge the list price using legible text. And from the pharma lobby: A Closer Look At CMS' Drug Price Disclosure Proposal. (Read Article: Becker's Hospital Review, 10/16; Wall Street Journal, 10/15; Ropes & Gray, 10/26/18)

Meanwhile, Trump Offers Test Plan to Lower Medicare Drug Costs

President Trump recently announced a plan to drive down the price Medicare pays for some drugs, a move that could save taxpayers billions of dollars but also faces resistance from the pharmaceutical industry. The approach would test a plan to lower costs for some drugs over five years by basing them on their costs in other countries. (Read Article: Wall Street Journal, 10/25/18)

HHS Set to Implement Long-Delayed 340B Final Rule in January

HHS is planning an about-face on the long-delayed rule that would set price ceilings and monetary penalties in the 340B program, moving up its start date by several months. HHS issued a notice saying that it intended to finally implement the rule on January 1, cutting off seven months of time from a previously announced July 1 start date. The rule, which would set price ceilings for drugs and punish pharmaceutical companies that knowingly overcharge 340B hospitals, has been delayed five times by the Trump administration, most recently in June. The final rule was first issued in January 2017. (Read Article: FierceHealthcare, 10/31/18)

Drug Co's & Law Enforcement Struggle to Stop Online Sales of Fake Meds That Can Kill

The issue of counterfeit prescription medications like Xanax is a growing problem, attracting the attention of law enforcement organizations and pharmaceutical companies like Pfizer, which manufactures Xanax. Pfizer last year conducted a pilot with law enforcement testing 138 samples of Xanax purchased from the dark web and found only seven samples were authentic; the fakes and the real thing look identical. In June the FDA convened a meeting around the problem of illegal opioids sold online and through social media. At best, counterfeit medications aren't what they are supposed to be, like sugar pills. At worst, they're dangerous and even deadly, particularly when fentanyl is involved. (Read Article: Wall Street Journal, 10/8/18)

FDA Clears First Consumer Genetic Test for How Well Your Meds May Work

The FDA has cleared the first DNA test meant to be marketed directly to consumers to help them determine how well certain drugs may work for them. The test was developed by 23andMe and, as with other tests from the consumer genetics giant, customers will be able to simply mail in a spit sample to get results. (Read Article: Stat, 10/31/18)

Sunrise Senior Living Offers Medicare Advantage Health Plan

Sunrise Advantage Plan is a new Medicare Advantage health plan offered through Sunrise Senior Living, offering a unique model of care involving comprehensive care coordination that is focused on the distinct needs of each of its members, along with the continued input of the Sunrise community care team. The plan covers everything that Original Medicare covers under Parts A and B, and offers Part D pharmacy coverage, plus member-centric support and services. Members of the plan will have the support of a dedicated nurse practitioner-led team within their Sunrise community who will take care of the details. (sunriseadvantageplan.com)

To Fight High Prices, Utah Will Pay for Public Employees to Go Fill Rx's in Mexico

A Utah insurer, PEHP, which covers 160,000 public employees and family members, is offering plane tickets to San Diego, transportation to Tijuana, and a $500 cash payout to patients who need certain expensive drugs for multiple sclerosis, cancer and autoimmune disorders. (Read Article: Salt Lake Tribune, 10/29/18)

Epic Introduces App Orchard Low-Cost Option & Cuts Prices

Epic has reduced the price for startups to participate in its App Orchard developer program and revealed a new entry-level tier. The new option, dubbed Nursery, costs $100 a year. Epic also said it has cut the pricing on its three existing tiers by 33-80%. (Read Article: Healthcare IT News, 10/29/18)

Given Food as Medicine, Hospitals are Focusing on Nutrition

Invoking the mantra that food is medicine, hospitals across the country are taking measures to prevent and treat illness through diet. To nudge patients into eating well at home, they have opened food pantries that offer nutrition counseling and healthful fare. They are growing their own produce, adding farmers to the payroll and hosting greenmarkets. A few are even tiptoeing into the grocery business. (Read Article: Wall Street Journal, 10/22/18)

5 Apps & Services for Productivity & Wellness

The best apps and online services are helpful tools that seamlessly integrate into everyday life. TechCrunch has gathered some recommendations that can help with tracking work, improving on sleep, and taking a mental break. Included are apps for sleep tracking, meditation, and online therapy. (Re ad Article: TechCrunch, 10/6/18)

Dignity-CHI Merger Cleared by Vatican

The Vatican has given the ecclesiastical green light to the proposed merger of Catholic Health Initiatives and Dignity Health, a deal that would create the nation's largest not-for-profit hospital company by revenue - a combined system with 139 hospitals in 28 states with total annual revenue of nearly $30 billion. The merger still needs approval from state regulators in California, Arizona, and Colorado, CHI's CFO, Dean Swindle, said on an Oct. 11 call with investors. Under the merger's complicated structure, all but one of Dignity's non-Catholic hospitals, including seven in California, would be placed in a separate Colorado-based not-for-profit corporation and allowed to continue performing medical services such as post-delivery tubal ligations that are deemed immoral by the Church and that violate their Ethical and Religious Directives. (Read Article: Modern Healthcare, 10/16/18)

Amazon Exclusively Selling Connected Medical Device Brand for Diabetes, Cardiovascular Disease

Arcadia has launched a new exclusive line of consumer-use medical devices on Amazon, called the Choice brand, that has a clear focus on the digital. The plan is to kick off the brand with blood glucose and blood pressure monitors alongside accompanying apps, which have the ability to track a patient's measurements and data. (Read Article: MobiHealth News, 10/26/18)

Meanwhile, "If CVS Bets Big on Urgent Care, Hospitals Should Worry"

CVS Health, which already has 9,800+ locations with space allocated for healthcare services, may soon get into the urgent care business. And that could be a threat to hospitals and health systems and the growing market share they have been building in the urgent care space. (Read Article: HealthLeaders, 11/5/18)

And, Walmart Considers Adding Health Clinics in Its Parking Lots

Walmart stores in several states are transforming extra parking lot space into "town centers," some of which could include health clinics. Walmart provides details about a few of the new hubs on a website established for the projects, and Business Insider and the Atlanta Business Chronicle report that the retailer is evaluating whether to add health clinics in some of the new "town centers," as well as health and fitness services. (Read Article: Becker's Hospital CFO Report, 10/29/18)

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