ABL HEALTHCARE ONLINE
ABL Healthcare Member News & Industry Trendletter * February 5, 2019
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HEALTHCARE MEMBER NEWS
WELCOME NEW MEMBER!

>>> Lisa Deal is the recently appointed CEO at Mission Hospice & Home Care. She began her career at Mission in 2010, as a Nurse Case Manager, then went on to serve as Mission's Director of Palliative Care, and then Director of Clinical Outreach. In 2014, she became the organization's Chief Clinical Officer, and has been responsible for the operations of Mission's continuum of care, which includes an array of programs to support patients and families during the final phase of life. Mission Hospice is a local, independent, nonprofit organization serving patients and families in the San Mateo and Santa Clara County area, offering quality, compassionate end-of-life, palliative home health, and transitional care, as well as grief support and an array of community offerings. Previously in her career, Lisa was Program Officer at David and Lucile Packard Foundation in Los Altos, and Editor of the Foundation's "Future of Children" Journal. She was also a Public Health Nurse at HIV and Family Planning Clinics, in Seattle, and a Visiting Nurse/ Cardiology Nurse, in Boston. Referred to ABL by Mission's former CEO, Dwight Wilson, Lisa has joined the Bay Area Round Table.

  At the crossroads: Social Determinants of
Health, and Homelessness
by Mimi Grant

A few weeks ago my Waze Navigation app determined the fastest way to get back down to Orange County from Downtown LA was drive across 6th Street, from west of the 10 Freeway, due southeast to the Santa Ana Freeway. It's only about four miles. But in late afternoon traffic, I crept along at sub-teen speeds. So there was plenty of time to see the homeless encampments on either side of the street for nearly the entire four miles – and I was just on one street.

This past Saturday, the Los Angeles Times published an Op-Ed piece entitled "Psychiatric patients need hospital beds, not jail cells," recalling that LA County leaders often call their jail system "the nation's largest mental hospital." Unfortunately, in LA, jail is frequently where people who really need to be in psychiatric hospitals, community-based rehabilitation programs, or supportive housing are warehoused - until they're released back to the street. Then, it's just a matter of time until another mental health crisis leads them to a confrontation - or they're judged to be of harm to themselves or others, and returned to jail, often with a pit stop at a local hospital in between. It's estimated that one in three of LA County jail's inmates are diagnosed with mental health disorders (roughly the same percentage that's on the street). That means over 5,000 psych patients are incarcerated in LA County jail alone. And once in jail, if a mentally ill person acts out, their overseers respond with force and isolation, rather than "care-oriented responses geared toward improving behavior and encouraging recovery or at least better management of symptoms," according to the Op-Ed piece.

If you look closely at the accompanying photo, taken by Good Samaritan Hospital CEO Andy Leeka, above the tents the tall building in the background is LA's iconic City Hall. Which prompted Andy to reply to the editorial: "The answer to dumping thousands of people who should be receiving the proper care in psychiatric hospitals, community-based rehabilitation programs, and supportive housing lie inside these walls, not jail cell walls." CLICK TO READ REST OF BLOG

 
UPCOMING ABL HEALTHCARE
ROUND TABLES
  • 2/06 - Orange County Round Table
  • 2/12 - Silicon Valley Round Table
  • 2/13 - San Francisco Round Table
  • 2/14 - East Bay Round Table
  • 2/15 - Los Angeles Round Table
ARTICLES
HEALTHCARE MEMBER NEWS
County of Santa Clara Moves Forward with Purchase of Hospitals

On January 30, the U.S. Bankruptcy Court in Los Angeles denied a request from the California Attorney General to block Santa Clara County's purchase of O'Connor Hospital, Saint Louise Regional Hospital, and DePaul Health Center. Barring an appeal by the Attorney General to his dismissed stay order, this action allows the County to complete the transaction and continue offering critical healthcare services in these hospitals. The Verity Health facilities in Santa Clara County will be owned by the County and will be operated as community hospitals with appropriate local control by the physicians at the hospitals and by local administrators. (Read: County Press Release, 1/30/19; MountainView Voice, 2/3/19)

Covered California: Drop in New Consumers Signals Need to Restore Penalty

Covered California announced that 1.5+ million consumers selected a health plan for 2019 coverage during the recent open-enrollment period, a figure in line with last year's total. There was a 7.5% increase in the number of existing consumers renewing their coverage and a 23.7% drop in the number of new consumers signing up for 2019. "The federal removal of the individual mandate penalty appears to have had a substantial impact on the number of new consumers signing up for coverage," said CoveredCA Executive Director Peter V. Lee. CoveredCA conducted analysis and has released an issue brief, Covered California 2019 Open Enrollment: Early Observations and Analysis, that examines its open enrollment plan-selection demographic compared to last year. CoveredCA found larger differences in the share of Bronze consumers, unsubsidized consumers, and those populations in which English is not the preferred spoken language. However, other demographics do not appear to be a factor. (Kathy Keeshen, Bay Area)

El Camino Hospital Noted for Transparency Efforts in Modern Healthcare

A recent Modern Healthcare article, Hospitals vary in publishing CMS chargemaster prices, reports on the new CMS requirement that hospitals must now publish their list of retail charges for individual services and diagnosis-related groups in online spreadsheets. MH notes that officials at hospitals, such as El Camino Hospital in Mountain View, CA, that have invested in online tools allowing patients to get reliable estimates of how much they would pay out of pocket for various services, hoped publicity about the new sticker prices would draw attention to their more consumer-friendly transparency efforts. Regarding this matter, El Camino's Michelle McGowan remarked to ABL: "ECH has had a policy of transparency from the beginning - we are a public hospital and we strive to make sure that each patient knows the likely cost of service. The new system allows accurate and timely information to help inform the consumer before they receive a service - better for them and better for us." (Michelle McGowan & Cecile Currier, Silicon Valley)

Center for Elders' Independence Presents Dinner Event

On the evening of February 5, the Center for Elders' Independence will present its 5th Annual Eldership Dinner, which will include networking, a light dinner, a tour of CEI's San Leandro location, and the chance to participate in a guided discussion on aging with renowned aging and elder care expert, Nader Shabahangi. (Linda Trowbridge, Bay Area)

ElderConsult Announces Upcoming Dementia Conference 2019

On March 20, in Emeryville, ElderConsult Geriatric Medicine will hold its Living In the Moment - Dementia Conference 2019; Dementia Challenges: The Journey, Pain and Family Dynamics, a conference for families and elder care professionals. Among the presentations, Elizabeth Landsverk MD will discuss the challenges of behaviors in dementia and the steps to take to determine the cause and relieve the suffering of the person with dementia - without Ativan, sleeping pills - and work to keep them as engaged and independent as possible. Also, on February 13, in Menlo Park, Elizabeth will hold How to Talk to Your Doctor, where she'll discuss advocating for yourself, loved one, resident or client in order to receive the best possible care. (Elizabeth Landsverk MD, Bay Area)

Felton Institute Completes Pilot Program for Transitional Age Youth

Felton Institute recently celebrated the completion of "Welcome to My World," a 12-week multi-disciplinary arts pilot program collaboration between Felton's Teenage Pregnancy and Parenting Program, Full Vision Arts Foundation, and Young Family Resource Center. The program's objective was to engage Felton clients who are transitional age youth and provide them with positive means of self-expression and creative options for problem solving, conflict resolution, and coping skills. (Al Gilbert, Bay Area)

GeBBS on Modern Healthcare's List of Largest Revenue Cycle Management Co's

GeBBS Healthcare Solutions is #14 on Modern Healthcare's current list of the nation's 20 largest revenue-cycle management (RCM) companies. The list recognizes the nation's top RCM companies ranked by total number of contracts in 2017, and includes firms that have dedicated practice areas and staff to address the needs of the healthcare revenue cycle process. This marks GeBBS's third year on the list. (Nitin Thakor, Los Angeles)

HCI Reports Rise of Health Coaching Jobs Within Healthcare Organizations

In its recent article - Health Coaching Jobs on the Rise Within Healthcare Organizations, Health Coach Institute shares that health coaching was a $6 billion market in the U.S. in 2017 - an increase of 15% from 2014, and that there are about 109,000 health coaches working to advise and educate clients. Also, a growing number of healthcare organizations are now recruiting health coaches to help them facilitate actionable, sustainable health behavior change in rising and high-risk populations, across a continuum of delivery platforms, according to a 2018 study conducted by the Healthcare Intelligence Network. (Eric Neuner, Bay Area)

HumanGood Opens Low-Income Senior Housing in South San Francisco & Silicon Valley

HumanGood recently opened its newly developed Rotary Terrace, an 81-unit residence for low-income seniors, located in South San Francisco, developed in partnership with the South San Francisco Rotary Club. It joins the HumanGood family of affordable housing communities, currently totaling 59 located throughout California and in Washington State. Also, another HumanGood affordable housing community - 208-unit Life Garden - recently celebrated its grand re-opening in Sunnyvale, California, following its two-year renovation project. (Tara McGuinness, Bay Area)

Kaiser Permanente Helps Fund Affordable Housing & Receives Civic Honor

Kaiser Permanente announced that it spent $5.2 million to help acquire a 41-unit apartment complex in East Oakland as part of the healthcare giant's new effort to keep and expand affordable housing. Kaiser also said it plans to house 500+ homeless people in the city, age 50+ and with chronic health problems, plus create a $100 million loan fund to preserve affordable housing projects in places across the country where it operates. Meanwhile, Community Partners recently presented an Albert R. Rodriguez Civic Legacy Honor to Kaiser Permanente Southern California in recognition of its strong partnership and community health work with the organization. The award acknowledges spirited dedication to ethical integrity, public accountability, and fiscal prudence. (Walt Meyers, Bay Area)

King & Spalding Named a Law Firm of the Year + Announces Webinar, Conference & Article

Law360 has named King & Spalding (K&S) a "2018 Law Firm of the Year" for earning seven of its "Practice Group of the Year" recognitions, including in Health Care and Life Sciences. K&S was also one of four firms earning Law360's "Firms that Dominated in 2018" distinction. Meanwhile, K&S will present a webinar on February 27: Strategies for Challenging Health Plan Policies That Impact Coverage and Reimbursement. And, K&S's 28th Annual Health Law & Policy Forum will take place March 18, in Atlanta.

Also, Marcia Augsburger has written an article, Judge Grants Summary Judgment in Favor of OCR for HIPAA Violations Ordering a Texas Cancer Center to Pay $4.3 Million in Penalties, in which she discusses an administrative law judge's ruling that the U.S. Department of HHS and its Office for Civil Rights properly imposed penalties against MD Anderson Cancer Center for failing to encrypt laptops and USB thumb drives, in violation of HIPPA. (Marcia Augsburger, Bay Area, & Travis Jackson)

KMD Architects Anticipates New Behavioral Health Hospital's Opening

KMD Architects recently celebrated the open house of Wellfound Behavioral Health Hospital, in Tacoma, WA, a new facility built in collaboration with MultiCare Health System, CHI Franciscan Health, CBRE, and BN Builders. Expected to open to patients in March, 120-bed Wellfound will greatly improve access to adults needing inpatient mental healthcare and improve bed availability, nearly doubling the average bed capacity per 100,000 residents in the region. (Rob Matthew, Bay Area)

MYnd Analytics & Emmaus Life Sciences Announce Merger/Spin-Off

MYnd Analytics, Inc. recently entered into a merger agreement with Emmaus Life Sciences, a leader in sickle cell disease treatment, whereby Emmaus will become a wholly owned subsidiary. However, it's anticipated that the surviving company will change its name to Emmaus. In connection with the transaction, MYnd Analytics intends to transfer all of its assets and liabilities into its wholly-owned subsidiary, MYnd Analytics California, which is expected to commence trading as an independent company following the spin-off. MYnd Analytics California intends to continue operating, integrating and growing its technology-enabled telepsychiatry and teletherapy businesses in order to provide enhanced access to behavioral health services, improve patient outcomes, and help lower the costs associated with behavioral health issues. (George Carpenter, Orange County)

Nelson Hardiman's Harry Nelson Writes Book on Opioid Crisis

Harry Nelson, of Nelson Hardiman, was recently interviewed on Gurvey's Law, on KABC Radio, where he discussed his beginnings in healthcare law and his latest book, The United States of Opioids: A Prescription for Liberating a Nation in Pain. Harry's book will be released in March; pre-order now at harrynelson.com. In addition, Harry was recently interviewed by Eileen Drage O'Reilly with Axios about his thoughts on a new phone app developed to reduce the number of opioid overdose deaths by using sonar to detect symptoms and urgently message family, friends or emergency responders. (Harry Nelson, Los Angeles)

NorthBay Healthcare Lauded for Stroke & Cardiac Care

NorthBay Healthcare recently earned The Joint Commission's Gold Seal of Approval and the American Heart Association/ American Stroke Association's Heart-Check mark for Advanced Certification for Primary Stroke Centers. NorthBay underwent a rigorous onsite review in October to earn this recertification. And, the American College of Cardiology has again recognized NorthBay for its expertise and commitment in treating patients with chest pain, awarding it Chest Pain Center Accreditation with Primary PCI. The accreditation is based on rigorous onsite evaluation of the staff's ability to evaluate, diagnose, and treat patients who may be experiencing a heart attack. (Elnora Cameron, Bay Area)

On Lok to Launch Dementia Care Center & Services for LGBTQ Elders

On Lok's Montgomery Dementia Care Center will open in spring 2019 at 1000 Montgomery Street in San Francisco, its first day center focused on specialized dementia care. The 2,000-square-foot Center will welcome 16 seniors enrolled in On Lok's Program of All-inclusive Care for the Elderly (PACE), and will also offer dedicated resources and support services to caregivers of family members with dementia. Meanwhile, San Francisco's Openhouse and On Lok are co-designing a program that addresses two critical issues in the LGBTQ community: accessing much-needed aging services, and ameliorating the LGBTQ elders' fears that life in a nursing home would drive them back into the closet. A recent Aging Today article interviews On Lok's Grace Li and Openhouse's Karyn Skultety about the partnership. (Grace Li, Bay Area)

OneLegacy Announces Record-High Organ Donations

Tom Mone reports that his non-profit organization, OneLegacy, set a new record for organ donors in 2018: 515, up from the prior year and previous high of 487. Total organs transplanted was 1519, founded on a record-high donation authorization rate of 78% - reflecting the increase in donor registration at the DMV, as well as family support for donation. (Tom Mone, Los Angeles)

PreludeDx's DCISionRT Examined in Downloadable Webcast

A recorded webcast is available for download, featuring PreludeDx Founder & CSO along with leading breast cancer experts, reviewing the latest predictive data supporting Prelude DCISionRT and discussing how DCISionRT is changing the way DCIS is managed today. The study presented showed that when using traditional clinical pathologic factors, 59% of the low-risk patients would have benefitted from radiation therapy (RT), while 29% of the high-risk patients would not. The doctors felt that this test helped patients feel more confident about their RT decision because it was personalized to them and not just in general. (Dan Forche, Orange County)

SAVI Group Shares "Everything You Need to Know" About RCM

In its continuing blog series, SAVI Group provides information on understanding and effectively utilizing RCM solutions. Recent posts include: "Revenue Cycle Management: Everything You Need to Know;" "Ways to Supercharge Your Medical Practice Revenue in 2019;" and "The New Age of Medical Billing: Outsourcing." (Sumit Mahendru, Orange County)

Select Data Offers Prep Tips for Upcoming Patient-Driven Groupings Model

In Prepping for PDGM - PPS final rule increases agencies' payments for 2019, finalizes PDGM, Select Data urges Medicare-certified home care agencies to begin now to prepare for the January 1, 2020 transition to a Patient-Driven Groupings Model. The proposed model is intended to remove current incentives to over-provide therapy services and changes the 60-day episode of care unit of payment to 30 days. Also, a new set of groupings for the patient - diagnosis and functional levels - will be introduced that determines the patient's reimbursement for the new 30-day episode. Select Data discusses several areas home care agencies should focus on in order to prepare. (Ed Buckley, Orange County, & Ted Schulte, Los Angeles)

Share Our Selves Spotlighted in Forbes Article

A recent Forbes article on organizations nationwide that will gladly accept donations of personal care items such as extra hotel toiletries featured Share Our Selves, noting it as a health center which provides resources to the Orange County community. Medical care, dental care, social services, and behavioral healthcare are some of the offerings provided to those in need - primarily homeless and low-income individuals and their families. Hygiene products and toiletry donations are accepted, and travel-sized items are especially encouraged. Donations can be dropped off during business hours at SOS's Costa Mesa location. (Karen McGlinn, Orange County)

Solano County Providing Free Blood Pressure Monitoring Program

The Solano County Department of Health and Social Services, Public Health division has launched a free program that lets community members borrow a blood pressure monitoring kit from any County Library branch with their library cards. Educational materials accompany the kits, such as learning how to use the adjustable blood pressure cuff, understanding the blood pressure numbers, communicating concerns with their healthcare providers, and a wallet-sized booklet to record blood pressure numbers. (Mike Stacey, Bay Area)

WISE Healthcare Partners with OCHIN's California Telehealth Network

WISE Healthcare and OCHIN, a nonprofit community-based healthcare IT collaborative which operates the OCHIN California Telehealth Network (CTN), have joined forces to provide WISE technology services to OCHIN clients, bringing the best of eConsult, telemedicine, workflow engineering, and implementation to rural and underserved communities in the counties of Los Angeles, Riverside, San Bernardino, Ventura, and San Diego. WISE will also become a trusted partner in OCHIN/CTN's ongoing research and evaluation of healthcare redesign. Together, this work aims to fundamentally improve and transform the delivery of care for vulnerable patients. (Sajid Ahmed, Los Angeles)

TECH MEMBERS' HEALTHCARE NEWS
Easy Breathe Offers First-Ever Colored CPAP Tubing

Easy Breathe has announced the availability of one-of-a-kind colored Ultra CPAP Tubing, which are manufactured in the U.S., and universally compatible with all CPAP and BiLevel machines. Also, Easy Breathe has published an article - Study: CPAP Reduces Migraine Intensity and Burden - which reports on a study that showed a decrease in the frequency of migraines among sleep apnea patients who underwent CPAP treatment, as well as a reduction in duration and intensity, and a decline in reliance on medication to treat their migraines. (Nick Weiss, West Los Angeles)

PCIHIPAA Chosen by SmartPractice & MedPro

PCIHIPAA has announced two recent partnerships - with SmartPractice, a provider of quality support, tools and products to optimize dental quality of care, patient production and revenue; and with MedPro, a leader in waste management disposal services - in order to protect these companies' clients from the onslaught of HIPAA violations, which include ransomware attacks and data breaches, that are impacting medical and dental practices throughout the U.S. (Jeff Broudy, West Los Angeles)

Tanner Research CEO to Present "Dinner and Movie Night"

On the evening of February 7, John Tanner, CEO of Tanner Research, Tanner Care Health and Wellness Center, and NuSci, will present a Dinner and Movie Night, featuring the film, "Forks Over Knives," which examines the profound claim that most, if not all, of the degenerative diseases that afflict us can be controlled, or even reversed, by rejecting animal-based and processed foods. Attendees will view and discuss the movie, and enjoy a healthy, plant-based meal in an informal setting, with convenient free parking. More information. (John Tanner, Monrovia)

HEALTHCARE & GOVERNMENT
California Moves Towards Healthcare for More, Not Yet for All

Two intertwined proposals in California Governor Newsom's budget would offer hundreds of thousands of middle-income families additional state subsidies to buy health insurance, and require every Californian to obtain health coverage or pay a tax penalty. This "state mandate" would replace the controversial federal mandate - a central component of the Affordable Care Act - that the Trump administration recently canceled. A few other blue states were quicker to create a replacement state mandate, but California's progressive lawmakers were wary of penalizing people who failed to buy health insurance unless the state also cushioned the blow by offering people more subsidies to lower the costs. Newsom also proposes to use $260 million in state funds to extend Medi-Cal to low-income undocumented immigrants ages 18 to 26. (Read Article: TechCrunch, 1/28/19) Meanwhile, the California Hospital Association has provided a summary of Gov. Newsom's healthcare agenda.

Report Provides Roadmap for Lawmakers to Expand Health Coverage in California

Health policy experts have crafted a report that's aimed at guiding lawmakers as they seek to both expand access to health insurance and make those plans more affordable for those who already have them. The experts looked at two different approaches to achieving those means: one that's more sky's-the-limit and one that takes into account budget restraints, and the price tags on the options match how ambitious they are. (Read Article: Capital Public Radio, 1/31/19)

Support for 'Medicare-For-All' Fluctuates with Details: Poll

"Medicare-for-all" makes a good first impression, but support plunges when people are asked if they'd pay higher taxes or put up with treatment delays to get it. The survey, released by the nonpartisan Kaiser Family Foundation, comes as Democratic presidential hopefuls embrace the idea of a government-run healthcare system, considered outside the mainstream of their party until Vermont independent Sen. Bernie Sanders made it the cornerstone of his 2016 campaign. President Donald Trump is opposed, saying "Medicare-for-all" would "eviscerate" the current program for seniors. (Read Article: New York Times, 1/23/19)

Schultz Slams Sen. Harris' Healthcare Proposal: 'That's Not American'

Former Starbucks CEO Howard Schultz, who recently announced that he was considering a 2020 presidential run as an Independent, took a shot at the healthcare plan proposed by Sen. Kamala Harris (D-Calif.) that would abolish private health insurance (presented at a CNN Town Hall with Jake Tapper). "That's not correct, that's not American. What's next? What industry are we going to abolish next? The coffee industry?" asked Schultz on a recent TV appearance. He went on to say that he doesn't agree with the desire from many Republicans who want to get rid of the Affordable Care Act. He lamented that "it's far too extreme on both sides and the silent majority of America does not have a voice." (Read Article: HuffPost, 1/29/19)

HHS Proposes Rule Challenging Drug Manufacturer Rebates to PBMs and Payors

On January 31, HHS released a proposed rule that would modify the scope and reach of the federal Anti-Kickback Statute discount safe harbor in an effort to eliminate many pharmacy benefit manager (PBM) rebates and reduce patient drug costs. Specifically, the proposed rule would make clear that the Anti-Kickback Statute's discount safe harbor does not protect manufacturer rebates to PBMs or payors, but would create new safe harbors for rebates passed through to the point-of-sale and for fixed payments for PBM services. If adopted, the proposed rule could cause major changes to the current drug sale and distribution system. More details about the proposed rule can be found in a King & Spalding Client Alert, 2/4/19.

CMS Proposes MA & Part D Payment & Policy Updates to Max Competition & Coverage

CMS has released proposed changes that will take significant steps in continuing the agency's efforts to maximize competition among Medicare Advantage (MA) and Part D plans. These proposals will increase plan choices and benefits and include important actions to address the opioid crisis. The proposed changes will expand opportunities for seniors to choose MA plans that for the first time are providing new supplemental benefits in 2019. Beginning with the 2019 plan year, MA plans can provide certain enrollees with access to different benefits and services. For the 2020 plan year and beyond, under statutory changes and the proposed guidance on which CMS is soliciting comment, MA plans will have greater flexibility to offer chronically ill patients a broader range of supplemental benefits that are tailored to their specific needs, such as providing home-delivered meals or transportation for non-medical needs. CMS is also proposing new action to combat the nation's opioid crisis. (Read CMS Release, 1/30/19)

Meanwhile, a New App Displays What Original Medicare Covers

CMS's new "What's Covered" app lets people with Original Medicare, caregivers, and others quickly see whether Medicare covers a specific medical item or service. Consumers can now use their mobile device to more easily get accurate, consistent Original Medicare coverage information in the doctor's office, the hospital, or anywhere else they use their device. In addition to the app, through Blue Button 2.0, the agency is enabling beneficiaries to connect their claims data to applications and tools developed by innovative private-sector companies to help them understand, use, and share their health data. (Read CMS Release, 1/28/19)

Orange County Approves $16.6M for 'First-Of-Its-Kind' Mental Health Center, Psychiatric ER

Orange County approved funding for a first-of-its-kind mental health center and psychiatric emergency room, filling a void that has left mentally-ill patients in the county with inadequate treatment and burdened local hospitals. The Board of Supervisors unanimously voted to allocate $16.6 million to the $40-million project, which will be co-funded and jointly-operated with two local hospital chains and CalOptima, the county's healthcare system for the poor, elderly and disabled. (Read Article: Orange County Register, 1/29/19)

VA Wait Times Now Shorter Than for Private Doctors

Wait times for an appointment at Veterans Affairs hospitals have decreased since 2014 and are now, on average, shorter than those in the private sector, according to a new study which covered four specialties: primary care, cardiology, dermatology, and orthopedics. In 2014 the average wait time in VA hospitals was 22.5 days, compared with 18.7 in the private sector, a statistically insignificant difference. But by 2017, mean wait time at VA hospitals had gone down to 17.7 days, while rising to 29.8 for private practitioners. (Read Article: New York Times, 1/22/19)

Report Provides Roadmap for Lawmakers to Expand Health Coverage in California

Health policy experts have crafted a report that's aimed at guiding lawmakers as they seek to both expand access to health insurance and make those plans more affordable for those who already have them. The experts looked at two different approaches to achieving those means: one that's more sky's-the-limit and one that takes into account budget restraints, and the price tags on the options match how ambitious they are. (Read Article: Capital Public Radio, 1/31/19)

Op-Ed: California Should Transition Retired Public Employees to Covered California

By transitioning retired employees to Covered California, unblending the medical insurance premium rates paid by active and retired employees, and limiting subsidies to retirees with less than $50,000 in household income, Glendale reduced in 2015 its retiree health liabilities and spending by more than 90%. If that model was applied to the state's 2017 retiree health liability, it would allow the state to reduce its liabilities by more than $80 billion and to save more than $2 billion per year. (Read Article: San Francisco Chronicle, 1/14/19)

HEALTHCARE INDUSTRY TRENDS
Dignity Health, CHI Merge into $29 Billion System

Englewood, CO-based Catholic Health Initiatives and San Francisco-based Dignity Health have completed a deal to combine their systems. The new $29 billion health system, called CommonSpirit Health, serves communities in 21 states and comprises 142 hospitals and 700+ sites of care. CHI CEO Kevin E. Lofton and Dignity CEO Lloyd H. Dean will jointly lead CommonSpirit Health; Marvin O'Quinn is promoted to President. (Read Article: Becker's Hospital Review, 2/1/19)

KPC Group Bids to Buy Four Verity Health Hospitals

Corona-based KPC Group has bid $610 million to purchase four of the nonprofit Verity Health System hospitals, including two in Southern California. The KPC Group is the initial "stalking horse" bidder for St. Francis Medical Center in Lynwood, St. Vincent Medical Center in Los Angeles, Seton Medical Center in Daly City, and Seton Coastside in Moss Beach. (Read Article: Los Angeles Times, 1/18/19)

Shriners to Cease Inpatient Care at 5th Hospital

Shriners Hospitals for Children - Tampa will end inpatient care and focus on outpatient care instead, citing dwindling inpatient volumes as the reason for the change. The Tampa, FL, hospital will end inpatient care in August, and will be the fifth Shriners hospital to switch to an outpatient care model, following the inpatient closures in Minneapolis, MN, Pasadena, CA, Erie, PA, and Lexington, KY. (Read Article: Becker's Hospital Review, 2/1/19)

Even in Best-Case Scenario, Opioid Overdose Deaths Will Keep Rising Until 2022

A new projection of opioid overdose death rates suggests that even if there is steady progress in reducing prescription narcotic abuse across the country, the number of fatal overdoses - which reached 70,237 in 2017 - will rise sharply in the coming years. (Read Article: Los Angeles Times, 2/1/19)

Meanwhile, the Clampdown on Opioid Prescriptions is Hurting Pain Patients

The recent clampdown on opioid prescriptions has had harmful consequences. Some patients told researchers that they were forced to quit working or go on disability when their medication was denied. Others are now homebound. Many mentioned the possibility of suicide. Patients also said that they were turning to alcohol or illegal substances to treat their pain. What began as an effort to protect patients may be morphing into one that is harming them. (Read Article: Los Angeles Times, 1/18/19) Also, the controlling family behind the maker of opioid painkiller OxyContin took home billions of dollars over the past decade, even as sales of the drug waned, newly revealed parts of court documents show. More than $4 billion was paid out between 2008 and 2016 to members of the Sackler family, owners of drugmaker Purdue Pharma LP, according to redacted portions of a civil complaint brought by Massachusetts Attorney General Maura Healey against Purdue for allegedly contributing to the state's opioid crisis. A newly unredacted version of the updated complaint, viewed by The Wall Street Journal, also illustrates alleged strategies Purdue's board considered to revive slumping sales at the Stamford, Conn.-based company, including branching into opioid-addiction treatment, the complaint says, as the company faced accusations that it had contributed to the nation's addiction crisis. (Read Article: Wall Street Journal, 1/30/19)

Will Tech Companies Change the Way We Manage Our Health?

As of September 2018, the top 10 tech companies in the U.S. had spent a total of $4.7 billion on healthcare acquisitions since 2012. The number of healthcare deals undertaken by those companies has consistently risen year-on-year. It all points to an increasing interest from technology companies in U.S. healthcare, which raises many questions as to what their intentions are, and what the ramifications will be for the health industry. (Read Article: TechCrunch, 1/31/19)

Employers Need to Address 'Caregiving Crisis,' Study Finds

A new study by a pair of Harvard Business School researchers finds that employers underestimate, to their detriment, the struggle their employees face in balancing their professional and caregiving responsibilities. Almost 75% of U.S. workers face some kind of caregiving responsibility, they found. Of those, 32% say they have left a job because they couldn't balance work and family duties, and more than 80% say their responsibilities at home keep them from doing their best at work. And 28% said their caregiving obligations had hurt their careers because they didn't receive challenging assignments or because they had been passed over for raises or promotions. Employers, as a result, have to deal with more labor turnover and less-productive workers. (Read Article: Wall Street Journal, 1/16/19)

Screen Time Inhibits Toddler Development, Study Finds

A study has found that kids 2-5 years old who engage in more screen time received worse scores in developmental screening tests. The apparent explanation is simple: when a kid is in front of a screen, they're not talking, walking or playing, the activities during which basic skills are cultivated. Importantly, the effect was not bidirectional or ambiguous - kids with more screen time usually had lower scores, but kids with lower scores didn't necessarily have more screen time. This strengthens the hypothesis that screen time leads to lower scores instead of an unknown variable or variables affecting both. (Read Article: TechCrunch, 1/28/19)

Optum Sues Exec Hired Away by Amazon-Berkshire-JPM

Optum, the fast-growing and increasingly lucrative health services arm of UnitedHealth Group, has sued former executive David Smith to protect its trade secrets from being shared with Smith's new employer, the joint Amazon-Berkshire Hathaway-J.P. Morgan health venture. The new company, referred to as ABC in court documents, hired Smith away from Optum in December. The lawsuit filed Jan. 16 accuses ABC of hiring Smith as part of a larger plan to "lift Optum's model or, at the very least, to duplicate or develop similar products and services." Two other recent ABC hires were mentioned in Optum's lawsuit - product director Caitlin Fleming and former advisor Jack Stoddard. Optum alleges in its lawsuit that Smith helped his new employer make those hires. (Read Article: Healthcare Dive, 1/24/19) In response, Smith said he didn't have any company files when he left Optum to join the ABC. He said the new venture isn't competing with Optum, and he would have no use for Optum files in his new role, according to the report. In response to questioning by U.S. District Judge Mark L. Wolf, Smith said scaling up innovative ideas and selling them to the broader market is "not the near-term goal," for the ABC venture. (Read Article: Becker's Hospital Review, 1/31/19)

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