ABL Healthcare Member News & Industry Trendletter * January 3, 2019
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  3+ Healthcare & Government Predictions for 2019
by Mimi Grant

Making predictions in any area is always a dicey proposition. But after listening to our astute Healthcare Members throughout the year, reading the tea leaves - and a lot of articles, blogs, and op-ed pieces, I'm pretty confident in these three-plus predictions for Healthcare. They all reflect the impact of government's role in funding 64% of U.S. healthcare - and 71% in the Golden State, according to PNHP, the Physicians for a National Health Program.

My predictions are. . .

  • 1/09 - Orange County Round Table*
  • 1/10 - East Bay Round Table
  • 1/15 - Silicon Valley Round Table*
  • 1/16 - San Francisco Round Table*
  • 1/18 - Los Angeles Round Table
  • *Round Table dates moved from usual days, due to a conflicting Holiday or JP Morgan Conference
Alegre Home Care Lauded by San Mateo County

District 5 Supervisor David J. Canepa (pictured left) recently commended Alegre Home Care, and its CEO Charles Symes (pictured right), on the occasion of Alegre's 25th anniversary, for helping shape the landscape of the home care industry by providing the utmost quality care to seniors and physically challenged individuals in San Mateo County. With eight offices in the Bay Area, Alegre has some 430 caregivers helping families cope with the activities of daily living, as well as the challenges that go with specific disabilities of seniors. Alegre is also one of the few LGBT companies in the country, serving a diverse population. (Charles Symes, Bay Area)

Alvaka Networks to Host Software Patching Webinars in January

Alvaka Networks will present a live webinar - Software Patching: The First and Most Important Step in Securing Your System - on January 4, 11, 18 and 25, from 10-11 a.m. each time. Says Alvaka: "The majority of security threats you face today - viruses, worms, spyware and other malware - utilize some unchecked vulnerability in your software to compromise your system. Patches fix the 'holes' in the code. A recent study found 98.8% of breaches can be stopped by good patching practices." (Oli Thordarson, Orange County)

Blue Shield of Calif Promise Health Plan is Care1st's New Name

As of January 1, 2019, Care1st Health Plan now operates as Blue Shield of California Promise Health Plan. The plan, along with its clinics in Palmdale and Lancaster, continues to serve Medi-Cal and Medicare beneficiaries in Los Angeles and San Diego counties. "This exciting change reflects our new ability to expand our reach and serve more Californians under the Blue Shield name," said CEO Greg Buchert, MD. (Greg Buchert, MD, Los Angeles)

CareMindr CEO Reports on Benefits of Remote Patient Monitoring

In Four Ways Mobile Remote Patient Monitoring Can Improve Star Ratings, recently published in Managed Healthcare Executive, Harry Soza, CEO of CareMindr, discusses how healthcare organizations that administer Medicare Advantage plans can now directly address patient behavioral change by partnering with their providers to implement mobile-enabled remote patient monitoring. And, in How to Surf the Tidal Wave of Patient-Reported Data from Gizmos and Gadgets, Harry explains how physicians and health systems will be able to transform the data deluge from patient gizmos into a stream of meaningful and actionable insights - by capturing condition-specific data on a disciplined, clinically relevant schedule integrated into a prescribed care plan. (Harry Soza, Silicon Valley)

Choice In Aging CEO Wins Award & Announces 70th Crab Feed

Debbie Toth (pictured left), CEO of Choice In Aging, was recently presented with the Contra Costa Chair of the Board Award, by Karen Mitchoff, Chair, Board of Supervisors, District IV, recognizing Debbie for the very best in public service and dedication to the County's mission, vision, and values. Choice in Aging serves 600+ people each year through two adult day health, multipurpose senior service, and California transition programs. Also, Debbie educates policymakers on the outcomes and savings to taxpayers when people are given the care they need in community-based settings vs. institutionalizing them. Meanwhile, Choice In Aging will hold its 70th anniversary Crab Feed, on the evening of February 9, in Pleasant Hill. (Debbie Toth, Bay Area)

Cigna Completes Combination with Express Scripts

Cigna Corporation successfully completed its combination with Express Scripts Holding Company, effective December 20, 2018. And, consistent with its commitment to support local communities and improve societal health, Cigna also announced an incremental investment of $200 million to its charitable foundation and communities and the launch of Healthier Kids for Our Future, a community engagement program focused on addressing the well-being of children globally. In 2019, the program will focus on eradicating childhood hunger and improving nutrition. (Chris De Rosa, Orange County)

County of Santa Clara Oks $123M for Supportive/Affordable Housing

The County of Santa Clara Board of Supervisors has approved $123 million from the Measure A Affordable Housing Bond for nine supportive housing and affordable housing developments. Supervisor Joe Simitian, President of the Board of Supervisors, said the efforts are "benefiting families, veterans, teachers, nurses, single parents, senior citizens, the disabled, foster youth, the homeless, and individuals with special needs in our community. It's not enough, but it's real and tangible progress." (Tyler Haskell, Silicon Valley)

GeBBS Healthcare Sells Majority Stake to ChrysCapital

ChrysCapital, a marquee Indian private equity fund with a global technology services footprint, has acquired a majority stake in GeBBS Healthcare Solutions. GeBBS will continue to be led by Nitin Thakor and Milind Godbole who, together with the existing management team, have been instrumental in driving the company's growth. Meanwhile, GeBBS has been named for the fifth year in a row to Black Book Market Research's list of leading outsourced revenue cycle management companies - ranked #1 for RCM outsourcing for hospitals between 101 to 200 beds, and #3 for RCM outsourcing for hospital chains, systems and integrated delivery networks. (Nitin Thakor, Los Angeles)

Good Samaritan Declared an Aetna Institute of Quality for Cardiac

Good Samaritan Hospital has been designated an Aetna Institute of Quality for Cardiac Medical Intervention, Cardiac Rhythm and Cardiac Surgery. Aetna recognizes hospitals and facilities in its network that offer specialized clinical services for certain health conditions, and facilities are selected Institute of Quality for consistently delivering evidence-based, safe care. Good Sam offers comprehensive cardiac care services, including inpatient cardiac care, cardiac catheterization, and cardiac surgery. It also has one of the largest Structural Heart programs in the U.S. consisting of transcatheter aortic valve replacement, left atrial appendage closure, mitral valve repair, patent foramen ovale and atrial septal defect closure. (Andy Leeka, Los Angeles)

HumanGood Accepts Beacon Development Group

Beacon Development Group (BDG) has re-aligned to sit under the larger HumanGood umbrella, effective January 1. BDG works with West Coast nonprofits and housing authorities to facilitate the funding, design, and construction of affordable housing developments for HumanGood and its client partners. This change will help BDG align its resources in order to grow into new opportunities, such as developing solutions for the middle market. (Tara McGuinness, Bay Area)

Kindred Healthcare & Netsmart Partner on Next-Gen Post-Acute Platform

Kindred Healthcare and Netsmart have partnered to create a technology-driven clinical platform that surpasses the traditional boundaries of electronic medical records and aligns with the needs of the evolving value-based care environment. The Netsmart portfolio of enterprise solutions combined with Kindred's longstanding experience in long-term acute care hospitals, rehabilitation, and care management, will create a clinical platform that meets the distinct requirements of aging services and post-acute care. (Adam Darvish, Los Angeles)

King & Spalding: Opioid Epidemic Webinar, Health Law Forum & More

On January 15, King & Spalding (K&S) will present a webinar - The Opioid Epidemic: What Hospitals Need to Know, from 10-11 a.m. Pacific. And, on March 18, K&S's 28th Annual Health Law & Policy Forum will take place in Atlanta, GA, a one-day conference focusing on the latest legal and political developments impacting the healthcare industry. Sanjay Gupta will be the Keynote Speaker. Meanwhile, K&S published an alert - Trump Administration Calls for Heightened Scrutiny of Competition in the Healthcare Industry. (Marcia Augsburger, Bay Area, & Travis Jackson)

KMD Architects' Projects Progress in Hollywood, South Korea & Tacoma

A recent Urbanize Los Angeles article - Final Phase of $350-Million Hollywood Presbyterian Expansion Takes Shape - describes the new 85-foot glass-and-metal patient tower being built at CHA Hollywood Presbyterian Medical Center, which was designed by KMD Architects. At completion in 2020, the project will include an expanded ED; new maternity and neonatal ICU; medical/surgical unit; and new dietary department and other ancillary functions. Other KMD projects underway include the CHA Ilsan Life Center, near Seoul, South Korea, which is focused on healthcare for OB/GYN patients and post-maternity care and relaxation, as well as the Wellfound Behavioral Health Hospital, in Tacoma, WA, a new 120-bed inpatient behavioral health facility, which will be a referral point for nine hospitals in the South Puget Sound Region. (Rob Matthew, Bay Area)

Mazzetti CEO Calls for Update to Healthcare Device Requirements

In his blog post, Healthcare Device Requirements - Why research now, Walt Vernon, CEO of Mazzetti, shares that the Guidelines for Healthcare Design and Construction for many years has included tables listing minimum requirements for the number of electrical, medical gas, and nurse call devices at various locations throughout a healthcare facility. True to its mission to create "evidence-advised guidelines," the Facility Guidelines Institute has worked diligently, in recent years, to ensure its documents are based on an appropriate balance between evidence, benefit, and cost. However, the device tables have not been subject to such scrutiny. Walt declares that it's time to re-examine the appropriateness of the device requirements, on the basis of research. (Walt Vernon, Bay Area)

Mission Hospice to Celebrate 40th Anniversary

On the afternoon of January 27, Mission Hospice & Home Care will celebrate its 40th anniversary at a festive event in Menlo Park - to which all are invited - featuring hors d'oeuvres, hosted bar, the premiere of Mission's new video, and more. (Dwight Wilson, Bay Area)

Nelson Hardiman Discusses Affordable Treatment for Opioid Addiction

The Penny Hoarder recently interviewed Nelson Hardiman Managing Partner Harry Nelson for their article, How to Find Affordable Care if You Need Treatment for Opioid Addiction. Harry gave an overview of what financial obstacles one would face as they work to treat drug addiction. (Harry Nelson, Los Angeles)

NorthBay Healthcare Teams with OLE Health

NorthBay Healthcare and OLE Health have officially made their innovative partnership public with a recent grand opening event. NorthBay is providing OLE Health, a federally qualified health center, with 2,000 square feet of space on the first floor of its NorthBay Health Plaza in Fairfield. It's a win for NorthBay because disadvantaged patients who might otherwise come to the emergency department for non-emergent care can now be directed across the street to OLE Health. It also provides a new option for discharge planners to connect uninsured and underinsured patients to comprehensive primary care and social services. (Elnora Cameron, Bay Area)

On Lok Featured in Wall Street Journal & Bay Area Reporter

A recent Wall Street Journal article - The Loneliest Generation: Americans, More Than Ever, Are Aging Alone - reports that baby boomers are aging alone more than any generation in U.S. history, and the resulting loneliness is a looming public health threat. The article highlights On Lok as a San Francisco Bay Area nonprofit that coordinates medical care and weaves social activities into a senior's visits. Meanwhile, the Bay Area Reporter published On Lok helps LGBT seniors this holiday season, which describes On Lok's recently launched Mission Nutrition, an initiative to bring awareness to its popular community and home-delivered meals program, as well as its Falls Prevention Program. (Grace Li, Bay Area)

OneLegacy Shares "Rhythm of the Heart" on Rose Parade Float

The 2019 Donate Life Rose Parade float was produced by OneLegacy again this year, and made possible thanks to 41 sponsoring donation, transplant, healthcare, and family care organizations and individuals. As the world's most visible campaign to inspire organ, eye and tissue donation, the Donate Life Rose Parade float inspires viewers to help the over 1 million people in need of organ, eye or tissue transplants each year. The float's theme, "Rhythm of the Heart," invited parade audiences to experience the music, cultures, and countries of Africa in a vibrant, colorful float. (Tom Mone, Los Angeles)

PreludeDx Presents Promising Research in Stage 1 Breast Cancer Patients

Prelude Corporation (PreludeDx) recently announced its compelling data from research, which shows that PreludeDx's newly-developed assay can stratify risk of local recurrence in stage 1 breast cancer patients. The study data demonstrated that the new test was able to stratify patients where those in the low risk group had a 6% local 10-year invasive recurrence risk with surgery alone or surgery and radiation therapy. Patients in the elevated risk group had a 49% risk of local invasive recurrence when treated with surgery alone but had a substantial benefit from radiation therapy. As outcomes for early-stage breast cancer patients improve, the oncology community has asked for more specific data on local control as they move from looking at distant metastases to local recurrence risk. (Dan Forche, Orange County)

PSYCHeANALYTICS to Participate in Health Transformer Showcase

Dave Haddick, CEO of PSYCHeANALYTICS, will present at the 7th Annual StartUp Health Festival in San Francisco on January 8, and during the Health Transformer Showcase, will share an important progress update on PSYCHeANALYTICS' health moonshot to integrate behavioral and medical care for all 70 million people insured under Medicaid. PSYCHeANALYTICS' decision support technology speeds up clinical workflow by enabling physicians to see quickly the critical factors impacting patient care and delegate to the care delivery team with far less guesswork. "Bringing behavioral health screening and treatment into medical care has been shown for 50 years to provide the best outcomes, best patient satisfaction and lowest overall cost," said Dave. (Dave Haddick, Bay Area)

SAVI Group Addresses Choosing Payment Processing Systems & Building Profitability

In How to Choose the Right Payment Processing System for Your Healthcare Business, SAVI Group shares key features almost any processor should provide with a solution, plus a deeper discussion on data and security, integration, value over price, scalability, flexibility, and payment options. And, in Taking Steps to Build a Profitable Medical Practice, SAVI offers tips for: creating a plan to ensure your patients have the best possible experience when they come in for a visit; focusing on specific areas of medicine to leverage your expertise; and outsourcing more complicated areas of business to specialists. (Sumit Mahendru, Orange County)

Select Data Reports on OASIS-D Guidance Manual & Data Security

In CMS finalizes OASIS-D guidance manual ahead of January 2019 implementation date, Select Data reports that, according to a recent questionnaire conducted by DecisionHealth, about 75% of the 270 respondents believe OASIS-D will take more time overall to complete than OASIS-C2. And 70% of respondents expect it to take clinicians 70+ minutes to complete OASIS-D at start of care. And, in Report: 30 Percent of Healthcare Databases Exposed Online, Select Data declares that it's crucial that hospital systems and home health agencies take steps to ensure their networks are secure. And this is why SelectData has partnered with Sidepath, a Microsoft EMS Gold Partner specializing in network security. (Ed Buckley, Orange County, & Ted Schulte, Los Angeles)

Share Our Selves Helps 1,400 Families in Need for Holidays

Orange Coast Magazine and the Los Angeles Times Daily Pilot both spotlighted Share Our Selves' Adopt A Family Program, which facilitates donors adopting a family at the holidays, providing a meal and a few gifts. First launched in 1969, the program is now so big that it has to be coordinated at the Orange County fairgrounds. This year, 1,400 families were adopted, including 5,000 children. In addition to the holiday assistance, families in need are often connected with important services afterward. (Karen McGlinn, Orange County)

VivaLNK Chosen by Case Western Reserve University for Student Athlete Study

VivaLNK has agreed to loan its Vital Scout devices to the Case Western Reserve University Crew Team for a stress study. The devices will be used to examine the relationship between stress levels and metrics pertinent to physical exertion in participants, including heart rate, respiration rate, sweat rate, and acute-to-chronic workload ratio, as they affect student athletes. VivaLNK CEO Jiang Li said: "This study, using our wearable monitoring device, is particularly impactful as it will examine and accurately measure student athletes' stress to paint a clear picture of the effects of good and bad stress related to training for sport. Not only will this determine how a student athlete reacts and recovers from stressful events or periods, but also can provide insight about how physical activity plays a role in its management." (Jiang Li, Silicon Valley)

Innovations in Healthcare Recap: ImpediMed & California Schools VEBA Win 2018 ABBY Awards!

ABL Organization recently presented its 19th and 20th Innovations in Healthcare & ABBY Awards Events, in Long Beach on December 5, and in San Francisco on Dec. 12, respectively. Click here for a recap of the Long Beach event, in which ImpediMed Inc. took home the ABBY Award. And click here for a recap of the San Francisco event, in which California Schools VEBA won the ABBY.

What's Next for the ACA after Texas v. US? What the Industry Needs to Know While the Case Is on Appeal

U.S. District Court Judge Reed O'Connor of the Northern District of Texas issued a ruling on December 14, 2018, declaring the Patient Protection and Affordable Care Act unconstitutional in its entirety. Judge O'Connor declared the ACA's individual mandate unconstitutional because of recent federal tax reform, which reduced to zero "shared responsibility payments" that unexempt individuals were required to pay if they chose not to be insured. Judge O'Connor held that by reducing the shared responsibility payments to zero beginning January 1, 2019, Congress effectively repealed the individual mandate itself since it carried no penalty. The ruling further reasoned that because the individual mandate could not be severed from the rest of the ACA, the ACA in its entirety is invalid. Supporters of the ACA have already expressed an intent to immediately appeal Judge O'Connor's decision, which will leave the ACA in place for the immediate future. Indeed, Judge O'Connor did not enjoin any provisions of the ACA and the Trump administration announced shortly after the opinion was issued that the ACA would remain the law of the land while appeals are pending. However, the ruling initiates a period of uncertainty throughout the U.S. healthcare system. This King & Spalding Client Alert summarizes Judge O'Connor's reasoning and the major implications of his ruling. (Read Alert, 12/17/18)

Major Changes to Medicare Shared Savings Program Impact Current & Prospective ACOs

CMS issued final rules on December 21, 2018, that were published on Dec. 31 in the Federal Register (ACO Final Rules) adopting major changes to the Medicare Shared Savings Program which impact currently participating and prospective accountable care organizations. The ACO Final Rules finalize proposed changes issued by CMS in its proposed rule in August 2018, provisions related to ACOs established by the Bipartisan Budget Act of 2018 and CMS's policy for extreme and uncontrollable circumstances for performance year 2017 initially established in an interim final rule issued in December 2017. The ACO Final Rules make the following changes. (Read Article: King & Spalding Health News, 12/31/18; Read: CMS Release, 12/21/18)

Federal Judge: HHS Overstepped Authority in Cutting 340B Payments

A federal judge has sided with hospitals in the ongoing battle over cuts to 340B drug discount payments, saying the Department of Health and Human Services' rule slashing money to the program overstepped the agency's authority. District Judge Rudolph Contreras from the District of Columbia has issued an injunction on the final rule and denied HHS' request for the hospital groups' ongoing litigation against the 340B payment cuts to be dismissed. (Read Article: Fierce Healthcare, 12/28/18)

California May Have Spent ~ $1B On Ineligible Medi-Cal Beneficiaries, Say Feds

Federal auditors estimate that California may have paid nearly $1 billion in 2014 and 2015 to provide Medicaid benefits for people who were ineligible for the government health program, according to a new report from the Department of Health and Human Services' Office of the Inspector General. California health officials, whose response was included in the audit report, said the potentially improper payments stemmed from a near perfect storm of events: a large increase in the number of Medicaid applicants and major policy changes brought on by the ACA, errors by caseworkers, and ongoing problems with the state's computer system for determining eligibility. (Read Article: California Healthline, 12/13/18)

Healthcare Industry 'Pays Tribute' to California's Influential Lawmakers

A California Healthline analysis of campaign data from California's secretary of state office found that the chairmen of the Senate and Assembly health committees together raked in more than $750,000 from drug companies, health insurance plans, hospitals, doctors and other health-related donors from Jan. 1, 2017, through Dec. 13, 2018. These big-money players have a vested interest in the decisions that Assemblyman Jim Wood and Sen. Richard Pan, both Democrats, will make as they preside over some of the most pressing healthcare issues in the new year - from legislation that would expand health coverage to unauthorized immigrants and other uninsured Californians, to efforts to slash drug prices. California voters in November's midterm elections ranked healthcare as their top issue, according to multiple polls, and the candidates who vowed to protect the Affordable Care Act won big - giving Democrats a sweep of statewide offices, including victories in traditionally Republican strongholds. Democrats now have a supermajority of 75% in the Assembly and 72.5% in the Senate. The leaders of the health committees say they have a clear mandate from voters to address healthcare access and affordability. But with more than a third of their campaign cash coming from the healthcare industry, it seems the industry is counting on having willing ears to listen to its concerns. (Read Article: California Healthline, 12/14/18)

Payer-Driven Digital Health Initiatives Abound

Looking to the mental health space, Cigna has teamed up with Happify Health and Prevail in order to give clients new digital platforms designed to tackle stress, anxiety and depression. In January 2019, the payer plans to roll Happify and iPrevail into its Cigna Total Behavioral Health program. Happify helps users maintain well-being and targets preventing diagnosable mental health conditions. Users can access activities and games as well as medication apps.
During the enrollment season UnitedHealthcare announced updates to a slew of digital resources designed to provide employers insight on their employees' health, as well as encourage those employees to better apply their health benefits. These include: Health Plan Manager, an interactive analytics tool for self-funded health plans; Digital Onboarding, an online plan enrollment system; PreCheck MyScript, a tool integrated into existing EHR platforms that allows patients and providers to view medication costs; and Personalized Claims Videos, a system that offers bespoke video explanations of benefits and medical bills.
Humana is looking to offer more options to seniors living in isolation. Papa, a startup that schedules companion visits for lonely seniors, has teamed up with Humana to support those covered under Medicare Advantage. The Florida-based startup trains and provides college-aged assistants to meet and spend time with seniors in their home, and bills itself as a "grandkids on demand" service. (Read Article: MobiHealthNews, 12/27/18)

In Screening for Suicide Risk, Facebook Takes on Tricky Public Health Role

A police officer on the late shift in an Ohio town recently received an unusual call from Facebook. Earlier that day, a local woman wrote a Facebook post saying she was walking home and intended to kill herself when she got there, according to a police report on the case. Facebook called to warn the Police Department about the suicide threat. The officer who took the call quickly located the woman, but she denied having suicidal thoughts, the police report said. Even so, the officer believed she might harm herself and told the woman that she must go to a hospital - either voluntarily or in police custody. He ultimately drove her to a hospital for a mental health work-up, an evaluation prompted by Facebook's intervention. Police stations from Massachusetts to Mumbai have received similar alerts from Facebook over the last 18 months as part of what is most likely the world's largest suicide threat screening and alert program. The social network ramped up the effort after several people live-streamed their suicides on Facebook Live in early 2017. It now utilizes both algorithms and user reports to flag possible suicide threats. (Read Article: New York Times, 12/31/18)

Healthcare: Where the Jobs Are

More Americans are now employed in healthcare than in any other industry. The Bureau of Labor Statistics, which tallies job creation, says that for most of this year the health sector outpaced the retail industry. Only government, on all levels, employs more people. One of the consistent features of the BLS reports is that healthcare has reliably added thousands of jobs to the economy each month. (Read Article: Kaiser Health News, 12/18/18)

New Nursing Grads to Get Increased On-the-Job Training & Mentorship to Ease Burnout

In an effort to stem the turnover rate for new nurses working in some of the city's busiest hospitals, the New York City Department of Small Business Services is rolling out a nurse residency program that provides increased on-the-job training and mentorship. It will be open to newly graduated nurses, with either a four- or two-year degree, who are entering the field. In all, two dozen hospitals will be a part of the residency program. The Department of Small Business Services is providing $300,000+ to support the program; 500 new nurses will get the training in the first year. The residency includes a curriculum already in use at other private hospitals in New York City. (Read Article: Wall Street Journal, 12/17/18)

Big Pharma Returning to Price Hikes After Pause

Allergan, GlaxoSmithKline, Amgen, AstraZeneca, Biogen, Novartis AG, and Bayer AG are among nearly 30 drugmakers that have taken steps to raise the U.S. prices of their medicines in January, ending a self-declared halt to increases made by a pharma industry under pressure from the Trump administration, according to documents seen by Reuters. (Read Article: Reuters, 12/19/18)

Pfizer & GSK to Merge Consumer Healthcare Businesses

GlaxoSmithKline and Pfizer are combining their consumer healthcare businesses in a multibillion-dollar merger. The two pharmaceutical giants, which own household names like Advil and Tums, said that the new company would have combined sales of $12.7 billion a year. GSK will own just over two-thirds of the joint venture, with Pfizer holding the rest. After the tie-up, GSK said it plans to split in two by spinning off the new consumer healthcare business and listing it in London within three years. GSK's remaining operations will be focused on making prescription medicines and vaccines. (Read Article: CNN.com, 12/19/18)

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