ABL Healthcare Member News & Industry Trendletter * March 6, 2019
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Life in the Golden Age of Talk Therapy

                       by Mimi Grant

The stigma that has so long been associated with getting help with behavioral issues - even mental health disorders, is melting away. As Peggy Drexler recently wrote in The Wall Street Journal, "Millennials Are the Therapy Generation": "People in their 20s and 30s seek mental-health help more often, as new habits and technologies change the nature of treatment." [PHOTO CREDIT: The Wall Street Journal]

In fact, according to data from 147 colleges and universities, the number of students seeking help with their mental health issues increased at five times the rate of new students starting college, between 2011 and 2016. And the Blue Cross Blue Shield Association found a 47% increase in depression diagnoses among 18-to-34-year olds, in the three years between 2013 and 2016.

This data is certainly supported by what we hear in our confidential Round Tables - both by parents of college-age students, and our Member-providers of behavioral health services, who are having difficulty finding enough LCSWs, MFTs, CBTs, and counselors in general, to meet the demand.

Of course, one of the main reasons for the growth of Behavioral Health is that it's increasingly paid for... CLICK TO READ REST OF BLOG

  • 3/06 - Orange County Round Table
  • 3/12 - Silicon Valley Round Table
  • 3/13 - San Francisco Round Table
  • 3/14 - East Bay Round Table
  • 3/15 - Los Angeles Round Table
Alvaka Networks Declares a New Era of Ransomware

In Ransomware v2.0 Recovery - Now, encrypted or deleted backups!, Alvaka Networks warns of a "new, even more malicious era for ransomware that's hitting mid-market companies particularly hard." This new phase is characterized by significantly larger ransom demands, along with well-planned attacks that can also encrypt backup drives. Alvaka shares some of their own recent experiences in working with victims. (Oli Thordarson, Orange County)

Bayer, Aptos & RWTH Collaborating to Study Human Disease Patterns

Bayer, an international life science company, Atos, a global leader in digital transformation, and RWTH Aachen University are working together - using the Atos Quantum Learning Machine, the world's highest-performing quantum simulator, to research the evolution of multi-morbidity human diseases from large data repositories. The project is based on anonymized real-world data of intensive care patients, to analyze and identify correlations between comorbidities and relevant patterns of disease evolution. This concept complements the approach of clinical trial studies that usually focuses on a limited number of patients and well-structured data to analyze disease criteria. (Dirk Schapeler, Silicon Valley)

CAREMINDr Highlights Patient Engagement as a Benefit of Remote Patient Monitoring

In the article, Patient engagement: An unexpected benefit of mobile-enabled remote patient monitoring, recently published in Becker's Health IT & CIO Report, Harry Soza, CEO of CAREMINDr, reports that new remote patient monitoring (RPM) codes added to the Medicare fee schedule for 2019 finally attach a definitive payment for general physiological remote monitoring of chronic conditions. This new, long-overdue reimbursement, and the fact that services from clinical staff - and not just physicians - can now be reimbursed, means providers and health plans will undoubtedly launch new RPM programs in the coming year. And as they do, they will likely notice an unexpected but powerful benefit: improved patient engagement. (Harry Soza Silicon Valley)

Center for Elders' Independence to Celebrate Guardian Grand Re-Opening

The Center for Elders' Independence (CEI) will celebrate the grand re-opening of its Guardian Adult Day Health Center, on the afternoon of March 7, in El Sobrante. Come enjoy refreshments, meet staff, tour the new activities lounge, dining area, rehabilitation gym, updated courtyard, and learn about CEI's Program of All-inclusive Care for the Elderly, which offers fully coordinated 24-hour medical, dental, podiatry, and home care services in addition to the day center. (Linda Trowbridge, Bay Area)

Choice in Aging Recognized for 70 Years of Service

The Contra Costa County Board of Supervisors recently honored Choice in Aging for its 70 years of service to the community, presenting CEO Debbie Toth with a resolution. (Debbie Toth, Bay Area)

ChromoLogic's Covisus Chosen for Ski Lift Pitch Competition

Covisus, a ChromoLogic company, was selected from startup companies across the U.S. to participate in the recent Ski Lift Pitch event, held in Taos, New Mexico. To be considered, companies must exhibit "early customer validation and traction for a disruptive value proposition; high-growth potential and scalability; and an appetite for building relationships with venture and angel investors." Covisus was identified as developing "technology to forge secure, transparent supply chains, helping companies ensure the integrity of their products." (Naresh Menon, Los Angeles)

Cigna Exceeds Goal of Having 50% Alternate Payment Arrangements

Cigna announced that it has exceeded its value-based care goal of having 50% of U.S. Medicare and commercial healthcare provider payments through alternative payment arrangements in the company's top 40 markets by year-end 2018. Cigna established the goal in 2015 to accelerate the transition to alternative payment models that link healthcare provider payments to both quality and affordability. The move has helped the company shift 50.5% of provider payments to alternative payment arrangements, and improve the quality of healthcare for customers, resulting in medical cost savings of $600+ million from 2013-2017. In addition, it has contributed to Cigna maintaining the industry's lowest medical cost trend for six consecutive years. (Chris De Rosa, Orange County)

County of Santa Clara Finalizes Purchase of O'Connor & St. Louise Hospitals

After repeated attempts by California Attorney General Xavier Becerra to block the deal, at midnight on February 28 Santa Clara County became the owner of O'Connor and St. Louise Hospitals and DePaul Urgent Care Center, as the $235 million purchase closed. The County bought the facilities from bankrupt Verity Health Systems, declaring them essential to the lives of residents who would have been left without nearby emergency care. (Tyler Haskell, Silicon Valley)

El Camino Hospital Foundation Receives $5 Million Donation

El Camino Hospital Foundation recently received a $5 million donation from John and Susan Sobrato - one of the largest single commitments ever made to the Foundation. The gift will secure naming rights for the hospital's new integrated medical office building, to be called the Sobrato Pavilion, a seven-story, 265,000-square-foot building currently under construction and expected to open in the fall of 2019. (Michelle McGowan & Cecile Currier, Silicon Valley)

ElderConsult to Present Dementia Conference 2019 in March

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 March 28, in Burlingame, Elizabeth will speak about Elder Financial Abuse at the Senior Round Table event, for elder care professionals and anyone interested in the topic. Meanwhile, ElderConsult announced upcoming workshops at The Connected Horse Program for those with early dementia and their care partners. (Elizabeth Landsverk MD, Bay Area)

Health Coach Institute Taking Registrations for HCI Live Spring 2019

Eric Neuner, CEO of Health Coach Institute (HCI), made a speech at HCI Live (watch video here), in which he shared the trauma from his childhood that created defenses that closed his heart and built walls around him. He talks about what enabled him to discover the light in the darkness inside him. Meanwhile, registration is now open for HCI Live Spring 2019, in Phoenix, AZ, on April 25-27. This event for coaches and health practitioners combines learning, connection, personal transformation, hands-on skill-building, and fun. (Eric Neuner, Bay Area)

Hospice East Bay Announces Western-Themed Dinner Event

On the evening of April 27, Hospice East Bay will present its Sparkles & Spurs: Celebration of Care for 2019, an opportunity to honor patients and their loved ones, while celebrating those who contribute their time, energy and financial resources. The western-themed event will feature cocktails, wine, dinner, silent and live auctions, and entertainment at the Round Hill Country Club in Alamo. (Cindy Hatton, Bay Area)

Inglewood Imaging Center Promotes Participation in Susan G. Komen 5K Walk

Inglewood Imaging Center (IIC) encourages everyone to take part in the Susan G. Komen 5K Walk on Saturday, March 9, at Dodger Stadium in Los Angeles. Brad Schmidt, CEO of IIC, who has served on the Komen Board for several years, reports that the event is tremendously helpful for families impacted by breast cancer, and it's also a lot of fun. The 5K supports physical fitness, community involvement, purpose and emotional support, and proceeds go to research and local patient support. Brad encourages ABL participants to meet at the "mitt" after the race. (Brad Schmidt, Los Angeles)

Irvine Health Foundation Participating in Aging 2.0's Caregiving Collective

Aging 2.0 has announced the Caregiving Collective, an initiative to build a data-driven insight, solutions and matchmaking platform that connects innovators in aging with providers looking for next-generation and cost-effective solutions. Founding charter partners of the initiative include Irvine Health Foundation, P&G Ventures, SOMPO Digital Lab, Genworth, and the Centre for Aging + Brain Health Innovation, powered by Baycrest. More information. (Ed Kacic, Orange County)

Kaiser Permanente Medical School to Offer Free Tuition

Kaiser Permanente (KP) School of Medicine, in Pasadena, announced that it will waive tuition for all four years for the school's first five classes of students. The private, nonprofit medical school, which is not affiliated with any university, has received initial accreditation and will begin accepting applications from prospective students in June 2019 for admission to the school's first class in the summer of 2020. The inaugural class will have 48 students. Meanwhile, KP was recognized by Fortune as one of the Best Big Companies to Work For in 2019, and named one of the World's Most Ethical Companies for 2019 by the Ethisphere Institute. (Walt Meyers, Bay Area)

King & Spalding Holding Health Law Forum & Examining Health Headlines

King & Spalding's 28th Annual Health Law & Policy Forum will take place March 18, in Atlanta. Meanwhile, the firm's recent issue of Health Headlines includes these articles: > Senator Grassley Renews Probe into Non-Profit, Tax Exempt Hospitals; > CMS Seeks Public Comments on Proposed Changes to Hospital Quality Star Ratings; > Vanguard Healthcare Agrees to Pay More Than $18 million to Resolve FCA Lawsuit; and > Plaintiffs Seek Leave to File Amended Complaint in Case Against Anthem for Paying Patients Directly for Rehabilitation Services. (Marcia Augsburger, Bay Area, & Travis Jackson)

KMD Architects Works on Hospitals in Tacoma & Hollywood

Take a look at this video tour of the new Wellfound Behavioral Health Hospital in Tacoma, WA, which KMD Architects helped design and build. Wellfound will begin receiving patients this this month. Meanwhile, KMD is also participating in the updates to Hollywood Presbyterian Medical Center, which recently celebrated its new Virgil Street Parking Garage, and announced that its new bed tower is on schedule to be completed in Fall 2020. (Rob Matthew, Bay Area)

Mazzetti Envisions Emergency Department of the Future

Mazzetti, along with the Facility Guidelines Institute, American College of Emergency Physicians, and DC Design, recently convened 100+ clinicians, design professionals, and students to "reimagine the ED," to help shape the emergency department of the future. Their solutions are summarized in this white paper. (Walt Vernon, Bay Area)

Mission Hospice Dinner-Dance to Benefit Hospice House

On the evening of March 23, in San Mateo, Mission Hospice and Home Care will present its 11th annual Night of Fun, a dinner-dance to benefit the Woodside Hospice House Campaign. The lively evening will include a special Italian dinner, dancing, raffle, and silent and live auctions. (Lisa Deal, Bay Area)

Nelson Hardiman's Harry Nelson Pledges $1 Million to End U.S. Opioid Crisis

Attorney Harry Nelson, of Nelson Hardiman, an expert on America's healthcare future, a Forbes author, and an international educator on advancing standards in addiction treatment, has pledged to donate $1 million from the online profits of his soon-to-be-released new book, The United States of Opioids: A Prescription for Liberating a Nation in Pain, to charities across America in 2019. Also, Harry discussed opioid litigation and his new book on a recent Bloomberg Law podcast episode. (Harry Nelson, Los Angeles)

NxStage Medical Acquired by Fresenius

Fresenius Medical Care has successfully completed the acquisition of NxStage Medical, Inc., which develops, produces, and markets an innovative product portfolio of medical devices for use in home dialysis and critical care. The acquisition will enable Fresenius to leverage its manufacturing, supply chain, and marketing competencies across the dialysis products, services, and Care Coordination businesses in a less labor- and capital-intensive care setting. (Bob Funari, Orange County)

On Lok Joins PACE 2.0 West Coast Collaborative

In Everything You Have Always Wanted to Know About On Lok PACE 2.0, On Lok explains that the National PACE Association has launched the PACE 2.0 project, an initiative that will expand access of PACE services to many high-need populations across the country. As part of PACE 2.0, On Lok is among nine PACE organizations across California, Oregon, and Washington which have formed the West Coast Collaborative and committed to enroll 2,000 new participants by October 1, 2019. (Grace Li, Bay Area)

OneLegacy Urges Physician-Patient Conversations About Organ Donation

The Journal of America's Physician Groups recently published Organ Donation: A Physician-Patient Conversation Worth Having, written by Tom Mone, CEO of OneLegacy. Tom asserts that physicians can be of great value by suggesting to their patients that they have a meaningful conversation with a donation specialist and make their organ donation decision known. Physicians are also uniquely positioned and charged with helping patients address their end-of-life planning. This planning should include becoming comfortable with the idea of donation and seeing it as an opportunity to give greater meaning to their loved ones or their own lives. This is especially true and valuable for patients whose cultural backgrounds and places of birth never exposed them to donation and transplantation. Just as physicians routinely ask their patients about their health and lifestyle habits, they should also take the time to ask patients if they are registered to be organ or tissue donors. (Tom Mone, Los Angeles)

Royal Ambulance Discusses Employee Growth & Standards

EMS1 recently published an interview with Royal Ambulance - Q&A: How to encourage employee growth and maintain high standards, which discusses a variety of strategies, including: why it's important to encourage employees' career growth; how to maintain high standards in an industry known for turnover; qualities to look for in potential recruits; how the Disney Institute helps with training; helping employees get to the next stage of their careers; and innovation in retention strategies. (Steve Grau, Silicon Valley)

Satellite Healthcare Buys Majority of Tri-County Vascular Care

Satellite Healthcare has purchased a majority ownership of Tri-County Vascular Care, a freestanding vascular access surgery center located in South San Jose, to provide South Bay dialysis patients with timely, high-quality vascular access surgical services. Satellite will assume leadership of Tri-County Vascular Care, in partnership with many other area physicians. Vascular access is imperative for dialysis patients because it makes lifesaving treatments possible. The combined expertise of Satellite and Tri-County takes into consideration the individual patient's needs for optimal dialysis access, including fistulas, grafts and peritoneal dialysis catheters. These access options support patients who receive care in dialysis centers or perform dialysis at home. (Rick Barnett, Silicon Valley)

SAVI Group Suggests How to Prevent Denied Claims

In How to Prevent Denied Claims: A Look at Denial Management in Healthcare, the SAVI Group shares that the first step in dealing with denial management is identifying why you're experiencing a high rate of denials. SAVI Group then delves into: looking at the root cause when dealing with denial management; discovering where mistakes are most often made; creating interdepartmental teams; learning good communication skills; prioritizing areas with the greatest impact on your budget; implementing a policy that checks patient eligibility throughout the entire care process; boosting employee education; creating an effective claims processing system; and incorporating IT tools to increase productivity and decrease denials. (Sumit Mahendru, Orange County)

Share Our Selves to Present Wild & Crazy Taco Night in April

Share Our Selves' 26th Annual Wild & Crazy Taco Night will take place on April 4, in Costa Mesa, a fun and festive evening where Orange County's finest chefs and restaurants each prepare an unusual and unique taco. Event proceeds benefit the SOS Food Pantry, which feeds more than 235 Orange County families each day. (Karen McGlinn, Orange County)

VivaLNK Launches IoT-Enabled Medical Wearable Sensor Platform

VivaLNK has announced its IoT-enabled medical wearable Sensor Platform, complete with a range of sensors, edge computing technologies, and an Internet of Health Things (IoHT) data cloud. This unique platform captures human vitals and biometrics, and delivers data from the patient to edge computing devices, as well as to the cloud, for application integration and analysis. Available through the VivaLNK Developer Program, the Sensor Platform enables IoHT solution partners to easily capture streams of patient data, such as heart and respiratory rates, temperature, ECG rhythms, activity and more. Partner Vitalic Medical is developing a bedside monitoring solution using the platform. Meanwhile, CEO Jiang Li has published, Why cardiac care is a key focus for the internet of healthcare things, in IoT Agenda. (Jiang Li, Silicon Valley)

Get Visible CEO Provides Formula for Digital Marketing Success: Video

Jason Ciment, CEO of Get Visible, recently gave a seminar to 50 attorneys in a special group within the Provisors community in Southern California. Jason has adapted his 18-step formula for digital marketing success into a how-to presentation for healthcare organizations - you may watch this 20-minute webinar here to see how easy it is for any healthcare organization to become its own chief digital marketing officer. Jason covers search engine optimization (SEO), social media marketing, and website design and conversion, with some extra advice for companies running WordPress-powered websites. (Jason Ciment, West Los Angeles Technology)

The Development Factory Debuts Get Help LA App

Los Angeles city leaders and Get Help recently debuted the Get Help LA app, which was created by The Development Factory. The app provides tools to refer people who are homeless to services, using geo-coding to show hospitals, addiction care centers, sexual assault resources, shelters, and other nearby resources. Los Angeles first responders have begun using the app in a pilot program, with a plan to release it to the general public after a six-month test period. Future features will include showing the number of available shelter beds in real time, and information about faith-based organizations that assist people experiencing homelessness. Get Help LA will provide training on use of the app and data tracking so that the City can measure the use and efficacy of this tool. (Andrew Bodis, Monrovia Technology)

U.S. House Democrats Introduce Sweeping 'Medicare for All' Bill

Democrats in the U.S. House of Representatives unveiled an ambitious proposal on February 26 to move all Americans into the government's Medicare health insurance program. The bill, unveiled by Democratic Representative Pramila Jayapal from Washington state, would transition the U.S. healthcare system to a single-payer "Medicare for All" program funded by the government in two years. The legislation is the party's most high-profile and ambitious single-payer proposal in the new Congress and has more than 100 co-sponsors, many from the party's progressive flank.

Medicare currently serves about 60 million Americans who are age 65 or older, or disabled. Jayapal's legislation would eliminate the age threshold. The new Medicare would not require any beneficiaries to pay premiums or deductibles and would not charge patients co-pays or out-of-pocket costs after receiving care. It does not include new or increased taxes or other additional revenues to pay for the healthcare overhaul. Jayapal said possible ways to pay for the bill include a tax on millionaires and billionaires, employer premiums and closing tax loopholes for the wealthy. The House proposal would not eliminate private health insurance entirely, as it would allow patients to purchase supplemental coverage. (Read Article: New York Times, 2/26/19)

California Counties Experiment with Linking Healthcare & Social Services for Most Vulnerable

More than 85,000 of California's most vulnerable low-income residents, including those who are homeless and have been recently incarcerated, are so far enrolled in a pilot project designed to link healthcare to social services. 25 counties and the city of Sacramento are participating in the Whole Person Care project, a $3 billion initiative funded by the state and CMS. The five-year project is an experiment to find alternatives to fee-for-service care, a system where the government pays medical providers for treating low-income residents.

Los Angeles County is operating the largest pilot project - it will receive nearly $1.3 billion over five years, and is expected to have as many as 370,000 people enrolled. The L.A. County initiative aims to find permanent housing for enrollees; build hundreds of recuperative care beds for homeless patients discharged from hospitals; and deliver substance abuse and mental health treatment. In addition to partnering with health plans and the L.A. County Sheriff's Department, the county has hired hundreds of new employees to do outreach and case management. (Read Article: California Health Report, 2/28/19)

HHS Launches Innovative Payment Model with New Treatment & Transport Options

HHS's Center for Medicare and Medicaid Innovation has announced a new payment model for emergency ambulance services that aims to allow Medicare Fee-For-Service beneficiaries to receive the most appropriate level of care at the right time and place, with the potential for lower out-of-pocket costs. The new Emergency Triage, Treat and Transport (ET3) model will make it possible for participating ambulance suppliers and providers to partner with qualified healthcare practitioners to deliver treatment in place (either on-the-scene or through telehealth) and with alternative destination sites (such as primary care doctors' offices or urgent-care clinics) to provide care for Medicare beneficiaries following a medical emergency for which they have accessed 911 services. In doing so, the model seeks to engage healthcare providers across the care continuum to more appropriately and effectively meet beneficiaries' needs. Additionally, the model will encourage development of medical triage lines for low-acuity 911 calls in regions where participating ambulance suppliers and providers operate. The ET3 model will have a five-year performance period, with an anticipated start date in early 2020. (Read: HHS Release, 2/14/19)

Growth in National Health Spending Over Next Decade Expected to Average 5.5%

National health expenditure growth is expected to average 5.5% annually from 2018-2027, reaching nearly $6 trillion by 2027, according to a report published by CMS's independent Office of the Actuary. Growth in national health spending is projected to be faster than projected growth in Gross Domestic Product by 0.8% over the same period. As a result, the report projects the health share of GDP to rise from 17.9% in 2017 to 19.4% by 2027. The outlook for national health spending and enrollment over the next decade is expected to be driven primarily by: > Key economic factors, such as growth in income and employment, and demographic factors, such as the baby-boom generation continuing to age from private insurance into Medicare; and > Increases in prices for medical goods and services (projected to grow 2.5% over 2018-2027 compared to 1.1% during the period of 2014-2017). (Read: CMS Release, 2/20/19)

New Rules Could Ease Patients' Access to Their Own Health Records

Federal health regulators have unveiled two major proposed regulations closely watched by health and technology companies, amid a growing flood of health data that has become an ever-more-valuable asset. The draft rules touch on a broad array of issues, including technology standards that are supposed to help unlock digital data stored in the electronic health records used by hospitals and doctors to track patients' care. The new proposals could benefit a growing list of companies that are building tools for patients to store real-time health information on their digital devices. Federal officials said they want to prod healthcare toward the digital norm in other industries like banking, where consumers routinely tap records on their smartphones. (Read Article: Wall Street Journal, 2/11/19)

FDA Plans Multifaceted Response to Opioid-Abuse Epidemic

The FDA plans new steps to combat the abuse of opioid painkillers, ranging from new dosage forms to small-quantity packaging and new research requirements on drugmakers. The new measures are a further effort to stem the opioid-addiction crisis that has led to an estimated 47,000 opioid-painkiller overdose deaths in 2017 alone. The agency plans for the first time to require makers of opioid pain pills to conduct long-term studies of their drugs' long-term effectiveness. The FDA has long mandated studies about safety, but the testing for possible long-term loss of effectiveness is a new authority for the agency in a law passed by Congress last fall. (Read Article: Wall Street Journal, 2/26/19)

SF Gets $3M State Grant for Mental Health, Drug Abuse Services for Homeless

San Francisco is receiving a $3 million state grant to expand badly needed mental health and substance abuse services for homeless people over the coming 18 months. The grant from the California Department of Health Care Services will fund a range of outreach, social work and case management expansions aimed at shepherding intensively troubled homeless people into programs that will help them get off the streets and into healthy, housed lives. (Read Article: San Francisco Chronicle, 2/26/19) Meanwhile, the governing board of CalOptima, Orange County's healthcare plan for its poor, allocated $1.6 million on Feb. 22, to start a mobile medical team to treat homeless people at shelters and other places they congregate, in response to a surge in homeless deaths. (Read Article: Orange County Register, 2/22/19)

Patients Face Months-Long Waits to See Specialists at New York City Hospitals

New York City Health + Hospitals chief Mitchell Katz told members of the City Council during testimony recently that wait times to see medical specialists at some of the city's public hospitals can stretch to months, depending on where a person seeks care and incremental staffing changes. The question of wait times comes as the city seeks to deliver healthcare to some 600,000 uninsured and undocumented residents. In January, New York City Mayor Bill de Blasio announced the NYC Care program which will promote care offered at the city's hospitals and encourage those eligible to sign up for insurance. Already, the city's hospitals take all patients, regardless of ability to pay, and offer a sliding-scale fee system. The city will invest some $100 million annually when NYC Care is at full scale. (Read Article: Wall Street Journal, 2/25/19)

New Data Added to CMS Hospital Compare Website

CMS has updated hospital performance data on the Hospital Compare website and on data.medicare.gov to empower patients, families, and stakeholders with important information they need to compare hospitals and make informed healthcare decisions. This data includes specific measures of hospitals' quality of care, many of which are updated quarterly, and the Overall Hospital Star Ratings, which were last updated in December 2017. The data are collected through CMS's Hospital Quality Initiative programs.

Also, CMS posted potential changes to the Hospital Star Ratings for public comment. These changes under consideration, intended to respond to stakeholder feedback, seek to enhance the Star Ratings methodology by making hospital comparisons more precise and consistent, and by allowing more direct, "like-to-like" comparisons. One potential change, recommended by some hospitals, would place hospitals with similar characteristics into "peer groups" allowing, for example, small hospitals to be compared to other small hospitals instead of all hospitals. (Read: CMS Release, 2/28/19)

Hospital Price Growth Driving Healthcare Spending

Hospital prices are the main driver of U.S. healthcare spending inflation, and that trend should direct any policy changes going forward, according to a new study. For inpatient care, hospital prices grew 42% from 2007 to 2014 while physician prices rose 18%, according to researchers who studied the Health Care Cost Institute's claims data for people with employer-sponsored insurance from Aetna, Humana, and UnitedHealthcare Group. Similarly, for hospital-based outpatient care, hospital prices increased 25% while physician prices grew 6%, the new Health Affairs study found. Insurance costs a family of four about $19,000 a year. The reason costs vary so much across the country is because of the price of hospital care, which is the largest single component of healthcare costs in the U.S., said Zack Cooper, a study co-author and an associate professor of health policy at Yale University. (Read Article: Modern Healthcare, 2/4/19)

Why Payers are Gobbling Up PBMs

The crowded landscape has drastically changed from just a decade ago when PBMs were scooping up competitors and morphed the sector into one dominated by a few behemoths controlling the prescription drug benefit for millions of Americans. Over time, PBMs went from simply processing prescription claims, largely an administrative function, in the late 1960s to now serving as the gatekeeper to prescriptions through formularies and pharmacy networks. They also play a controversial role in pricing as they negotiate directly with drug manufacturers but reveal little about how those savings are passed onto consumers. Over the past few years, payers have become increasingly interested in bringing the function in-house, dissolving their relationships with independent PBMs to launch their own, or acquiring others to do so. By combining both the medical and pharmaceutical benefit under one umbrella, analysts say you can potentially achieve greater costs savings than may have been possible with separate entities. For example, if a patient is prescribed a particular drug the overall drug spend may increase, but it could result in savings on the medical side if it prevents a costly hospital visit. (Read Article: Healthcare Dive, 9/18/18)

Sugary Drink Consumption Down by Half in Berkeley Since Soda Tax Implemented - Study

Ever since Berkeley voters overwhelmingly passed the nation's first penny-per-ounce tax on sugary beverages in 2014, a team at UC Berkeley's School of Public Health has been interviewing people on the street about what kind of drinks they consume. Dr. Kristine Madsen, director of the Berkeley Food Institute, said researchers found that residents cut their consumption of sugar-sweetened beverages by 52% after the tax went into effect in 2015. Madsen said this means soda taxes encourage people to hydrate in a healthier way and could reduce medical conditions like diabetes, obesity and chronic heart disease. Her research was recently published in the American Journal of Public Health. (Read Article: KQED, 2/22/19)

UnitedHealth Loses Case to Amazon-Berkshire-Chase Health Venture

UnitedHealth Group lost its case to prevent a former executive from working at the new health care venture formed by Amazon, Berkshire Hathaway, and JPMorgan Chase. A federal judge in Boston denied UnitedHealth's request to have the executive, David William Smith, immediately stop working. Mr. Smith was an executive at Optum, a unit of UnitedHealth, and it accused him of taking corporate secrets to what it claimed was a competitor. Mr. Smith has denied any wrongdoing. (Read Article: New York Times, 2/22/19)

Healthcare by 2028 Will Be Powered by Visual Technologies

Visual assessment is critical to healthcare - whether that's a doctor peering down your throat as you say "ahhh" or an MRI of your brain. Since the X-ray was invented in 1895, medical imaging has evolved into many modalities that empower clinicians to see into and assess the human body. Recent advances in visual sensors, computer vision, and compute power are currently powering a new wave of innovation in legacy visual technologies, and sparking entirely new realms of medical practice, such as genomics. Over the next 10 years, healthcare workflows will become mostly digitized, with wide swaths of personal data captured, and computer vision, along with artificial intelligence, automating the analysis of that data for precision care. Much of the digitized data across healthcare will be visual and the technologies that capture and analyze it are visual technologies. Three powerful trends - including miniaturization of diagnostic imaging devices, next-generation imaging for the earliest stages of disease detection, and virtual medicine - are shaping the ways in which visual technologies are poised to improve healthcare over the next decades (Read Article: TechCrunch, 2/5/19)

U.S. Hospital Owner Columbia Pacific Starts Sale of Asia Business

Columbia Pacific Management Inc. is trying to sell a collection of hospitals in Asia for close to $2 billion, according to people familiar with the matter. The Seattle-based owner of hospitals and healthcare facilities in the U.S. and around the world recently started a formal sale process for its Columbia Asia business, the people said. The first round of bids is due by the end of March. The Asia business commenced operations in 1996 and owns close to 30 healthcare facilities in Malaysia, India, Vietnam, and Indonesia. Its website says they are mostly midsize and offer a range of services. (Read Article: Wall Street Journal, 2/14/19)

Eric Topol Makes Case for How AI Can Improve Healthcare

The renowned cardiologist and author writes, in Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again, that not only will AI improve the accuracy of diagnosis and treatment of illnesses, but it will also restore compassion to medicine. Unlike those who fear AI could further dehumanize medicine, erode the doctor-patient relationship, and create more privacy concerns, Topol argues that AI will provide augmented performance, using voice recognition, and interpreting image and speech patterns. AI can also distill massive amounts of data quickly and accurately, as well as safely monitor patients in their homes, and be a "constant coach," helping people stay healthy. (Read Article: Wall Street Journal, 3/4/19)

Badly Designed Electronic Records Can Be Hazardous to Your Health

In an op-ed, a Mass General cardiologist writes that "On Feb. 11, a decade after the Hitech Act was passed, the Office of the National Coordinator for Health Information Technology, which oversee EHRs in the U.S., proposed draft rules that would eliminate existing and new gag clauses in EHR vendor contracts." Not a minute too soon, given "the harm EHRs can cause to patients" he writes about. (Read Article: Wall Street Journal, 3/4/19)

FDA Panel Assesses Risks of Women's Surgical Mesh

Officials should consider women's reports of pain, sexual dysfunction, and other maladies as they re-evaluate a medical device used in women's pelvic surgery that has triggered thousands of lawsuits, an advisory panel said. The panel of outside doctors, convened to advise the FDA, recommended that the agency evaluate women's medical self-reports as it decides whether synthetic mesh products should stay on the market. Such recommendations are generally, but not always, followed by the federal agency. (Read Article: Wall Street Journal, 2/12/19)

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