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ABL Healthcare Member News & Industry Trendletter * October 7, 2019
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HEALTHCARE MEMBER NEWS

Primary Care Centers Are Popping Up Near You

                       Vlog by Mimi Grant

With 9,600 CVS Health locations and 1,500 HealthHUBs on the way, the neighborhood pharmacy - that used to sell cigarettes - has become one of the most innovative healthcare companies in America -- Find out how! . . . CLICK HERE TO WATCH MIMI GRANT'S 4:52-MINUTE VLOG

 
UPCOMING ABL HEALTHCARE
ROUND TABLES
  • 10/08 - Silicon Valley Round Table
  • 10/09 - San Francisco Round Table
  • 10/10 - East Bay/Oakland Round Table
  • 10/18 - Los Angeles Round Table
  • 11/06 - Orange County Round Table

  • 12/04 - HOLD THE DATE! Combined Orange County-Los Angeles Session
  • 12/11 - HOLD THE DATE! Combined Bay Area Session
EXPANDED ARTICLES
HEALTHCARE MEMBER NEWS
LOS ANGELES ROUND TABLE
Anthem Blue Cross Expands Benefits to Address Whole-Person Health

Anthem Blue Cross has announced enhancements to its wellness services offered in many of the company's 2020 Medicare Advantage plans, including giving its members access to wellness services such as nutritional support, in-home support, respite care, and household pest control. Eligible members will have access to this package of wellness benefits, at no extra cost. (David Pryor, MD)

BSC Promise: Some Medi-Cal Patients to Get Free Rides to Appointments

Blue Shield of California has launched a 12-month pilot program in Southern California and Sacramento, which provides free Lyft rides to eligible patients for primary care appointments, X-ray, lab, and pharmacy visits. In SoCal, the program will evaluate usage by members in Medi-Cal plans, while in Sacramento, it's for eligible members in commercial plans. (Read Article: Sacramento Bee, 9/20/19) (Greg Buchert, MD)

CareAcademy's Recent Webinars Available On-Demand

CareAcademy has made recordings of its recent webinars available on-demand on its website. Titles include: HCAOA + CareAcademy Webinar Series: How Top Agencies Reduce Caregiver Turnover (with written key takeaways from the webinar published here); and Agency Growth Secrets: Differentiating Factors of Top Home Care Agencies (with written key takeaways from that webinar available here). (Helen Adeosun)

Inglewood Imaging Center Acquires ICM's Radiology Business Unit

Inglewood Imaging Center (IIC) recently acquired ICM Medical Group's radiology business unit, expanding IIC into a full-service radiology provider that includes mammography, MRI, CT, PET/CT, x-ray, DEXA, and ultrasound imaging. Meanwhile, IIC announced that it will soon be "modernizing the Western USA's diagnostic imaging landscape" with the following enhancements: a facility renovation; digital iPad check-in, in which q-code will link patient exams to IIC's EMR software to support accuracy; modernized mammography internal EMR software; added artificial intelligence for breast ultrasound exams; expanded facility hours; and lowered cash prices, including $45 x-rays. (Brad Schmidt)

Nelson Hardiman on Healthcare Fraud, Opioids, & Purdue Pharma's Bankruptcy Filing

On October 17, Harry Nelson, of Nelson Hardiman, will speak about Defending White Collar Health Care Fraud Cases at the 16th Annual Healthcare Law Compliance Symposium, in Los Angeles. And, on October 31, Harry will speak at the Western States Opioid Summit, in Newport Beach. Meanwhile, Harry was recently interviewed on Spectrum News 1, discussing Purdue Pharma's recent filing for bankruptcy protection as part of their settlement in the many opioid lawsuits against Big Pharma. Harry also comments on the future of healthcare in the U.S. as the 2020 elections draws closer. (Harry Nelson, JD)

BAY AREA ROUND TABLES
Axene Health Partners Delve Into Healthcare Topics

Recent blog posts from Axene Health Partners - available here - include: "Closing the Loop on Value Based Reimbursement and Incentive Programs;" "The Cost of Consolidation;" "How is Your DOFR (Division of Financial Responsibility) Doing?;" "Developing Financial Projections for Start-Up Health Plans;" and "Defining a Bundled Payment Rate for Bone Marrow Transplants." (John Price)

Carl Zeiss Meditec Debuts Digital and Industry Firsts

Carl Zeiss Meditec recently presented several new technologies advancing the digitalization of eye care and high-resolution imaging, including EQ Workplace, the latest addition to the ZEISS Cataract Suite offering surgeons a digital solution to connect and streamline the refractive cataract workflow. Also, ZEISS has expanded its CIRRUS Optical Coherence Tomography portfolio with the launch of its new CIRRUS 6000, the next-generation, ultra-fast 100kHz system whose scans are 270% faster than prior CIRRUS generations. And, ZEISS unveiled its premium slit lamp SL 800, which allows for outstanding visualization with extremely high contrast and resolution. Further, the company announced achievement of the CE mark for ARTEVO 800, the first digital microscope in ophthalmic surgery, and for miLOOP, a micro-interventional device designed to deliver zero-energy endocapsular lens fragmentation. (Angelo Rago)

Health Coach Institute to Present "HCI Live" Event

On November 7-9, Health Coach Institute will present HCI Live: The Must-Attend Event for Coaches & Health Practitioners, in Dallas, TX. Speakers will include Eric Neuner, CEO of HCI, and topics will cover the hottest trends in the health coaching industry; emerging, lucrative coaching opportunities; and what HCI is doing to support and advocate for coaches. (Eric Neuner)

Kaiser Permanente Health & Employee Wellness Plans Lauded in Surveys

In the NCQA's annual report which rates 1,000+ health plans, including Medicare, Medicaid, and private (commercial plans), five Kaiser Permanente (KP) plans received a 5.0 rating - the highest possible. Only 11 plans nationwide achieved this rating. This was the fifth consecutive year that KP has more 5.0 plans than any healthcare system in the nation. And for the second year in a row, KP has the highest rated commercial and Medicare plan (or is tied for the highest) in every geographic region it serves. Meanwhile, for the ninth consecutive year, the National Business Group on Health has honored KP for having one of the best workforce health and well-being programs in the nation. (Walt Meyers)

King & Spalding's Upcoming Webinar to Discuss Surprise Billing Laws

On October 16, from 10-11 a.m. Pacific, King & Spalding (K&S) will present a free webinar - Surprise Billing Laws – which will discuss: the prevalence, causes and concerns of surprise medical bills; states that have passed legislation aimed at addressing them; a comparison of the approaches and applications of state laws; limitations on the jurisdiction of state laws and the potential effects of federal legislation; and the current status of federal surprise medical bills legislation, what it might look like, and the odds of its successful passage. Meanwhile, in this video, watch K&S partners discuss healthcare fraud and abuse, a top priority for the Department of Justice. Also, read the latest issues of K&S Health Headlines newsletter. And, the 12th Annual King & Spalding Pharmaceutical University will take place on November 12, in Philadephia. (Marcia Augsburger, JD, & Travis Jackson, JD)

Lifelong Medical Care's Trust Health Center Spotlighted in Industry Journal

The California Health Care Foundation recently featured Oakland's Trust Health Center, a federally qualified health center operated by LifeLong Medical Care, in an article entitled, Trust Our Patients So They Can Trust Us. The Center serves adult residents of Alameda County who have no home or are at risk of losing their home. LifeLong provides primary care services, mental healthcare, and social services support. 50% to 60% of the clinic's new patients come through word-of-mouth referral, and the Trust Partners want to visit nearby encampments to educate residents about the clinic's services. In effect, the Partners would serve as community health workers, frontline workers whose experiences help them connect and build trust with the community they serve. (Mike Stacey, MD)

On Lok's "Laughter Yoga" Highlighted on ABC News

ABC 7 News KGO recently featured an On Lok Lifeways senior center and its "laughter yoga" sessions, a practice created by a doctor in India, focusing on stretching, chanting, clapping, and a good chuckle to encourage playfulness. On Lok's activity therapy specialist has seen a positive change in the seniors since the program started several months ago. It's an activity that can be done in just 20 minutes, no matter the participant's age or what language they speak. Laughter yoga is cardiovascular, provides stress relief, increases happy hormones, and has been linked to pain reduction. (Grace Li)

ORANGE COUNTY ROUND TABLE
Alinea Medical Imaging Performs Mammograms on TV Talk Show

Monish Laxpati, CEO & Medical Director of Alinea Medical Imaging, shared with us that his company was featured this past Friday, October 4, on an episode of "The Real," an afternoon talk show. Monish and Alinea staff did a quick interview and performed mammograms for a couple of the hosts and an audience member. (Monish Laxpati, MD)

Alvaka Networks + CloudAccess Provide Security & Network Performance Monitoring Services

Alvaka Networks has teamed with CloudAccess to provide a unique set of bundled security services to midsize and enterprise customers. Alvaka has made significant investments upgrading and improving core components of their enterprise network management, monitoring, support and security platform. By partnering with CloudAccess's Security Operations Center platform, Alvaka increases security visibility, alerting, and reporting capabilities over separate siloed solutions. Meanwhile, Alvaka will host a live, interactive webinar - Software Security Patching: "Why you are struggling with this essential task?!", on multiple dates in October, November and December. (Oli Thordarson)

Cigna Expands Exchange Offerings + Offers Affordable Life-Changing Therapies to Patients

Cigna is expanding its individual healthcare exchange offerings to new geographies for 2020, with health plans now available in 19 markets across 10 states. This includes expansion into select counties in Kansas, South Florida and Utah, as well as new counties in Tennessee and Virginia. Meanwhile, Cigna is introducing Embarc Benefit Protection, which brings together the health services, medical management, and specialty pharmacy expertise of Express Scripts, eviCore, Accredo and CuraScript SD to make breakthrough medicines more affordable and ensure access for those who need it. Consumers will have no out-of-pocket payments related to the cost of the medicine and will receive personalized and expert care to assist them through their health journey. Cigna's intention is to include Luxturna, the first FDA-approved prescription gene therapy for people with inherited retinal disease, and Zolgensma, a gene therapy for children under two years old with spinal muscular atrophy, in the Embarc solution. Additional therapies may be added in the future. (Chris De Rosa)

SAVI Group Provides Tips on Improving the Medical Billing Claims Process

Recent blog posts from SAVI Group, available here, include "A Comprehensive Guide to the Medical Billing Claims Process," which provides a 'simple step-by-step guide that will peel away any anxieties your practice may have;' and "How to Improve Your Medical Billing Process," which discusses avoiding late filings; staying on top of the action; working with professionals; not fearing denials; and tracking patient information accurately. (Sumit Mahendru)

Share Our Selves to Hold Celebrity Chef Dinner

On the evening of October 11, in Huntington Beach, Share Our Selves (SOS) will present its 29th Annual SOS Celebrity Chef Dinner, a fundraising event to benefit the many services SOS provides to meet the basic needs of homeless and low-income residents of Orange County. Take in stunning ocean views while enjoying hors d'oeuvres, beer and wine tastings, live music, silent and live auctions, and a three-course dinner in the ballroom with outstanding chefs pairing up to prepare each course. (Karen McGlinn)

SILICON VALLEY ROUND TABLE
Bayer Teams with Hospitals on Research Targeting Chronic Lung Diseases

Bayer and Partners HealthCare's founding members Brigham and Women's Hospital (BWH) and Massachusetts General Hospital (MGH) have launched a joint lab to research new drug candidates to treat chronic lung diseases. The joint lab will host scientists from all three parties and Bayer is investing more than $30 million to fund joint research projects over the next five years. (Dirk Schapeler)

El Camino First to Commercially Offer Robotic Lung Nodule Biopsy Procedure

El Camino Health's Mountain View Hospital announced it was the first in the world to perform a commercial case utilizing the minimally invasive peripheral lung biopsy Ion Endoluminal Robotic Bronchoscopy System. El Camino Health conducted its first procedures in September using the new system which was approved for commercial use by the FDA in February 2019. This major medical advancement offers doctors unprecedented stability enabling the precision needed for biopsy far into the peripheral lung and to more easily diagnose lung cancer earlier than ever before. (Cecile Currier & Michelle McGowen)

Elevate Addiction Services Provides Insights on Rehab Issues

Recent blog posts, available here, from Elevate Addiction Services include: "Examining Personalized Drug Treatment Programs"; "What Place Does Nutrition Have in Holistic Drug Rehab?"; "It's a Health Issue - Can We Treat Addiction as a Disordered Behavior?"; and "Treating the Whole Person: The Role of Holistic Treatment in Dual Diagnosis Cases". (Dan Manson)

TECH MEMBERS' HEALTHCARE NEWS
Eckert & Ziegler to Supply Radioisotopes to Alpha Tau

Eckert & Ziegler AG has signed a multi-year supply agreement with Alpha Tau Medical, of Tel Aviv, Israel, for the supply of Thorium-228. The radioisotope is used for the production of Alpha DaRT, an innovative new therapy for the treatment of a variety of solid tumors. Also, Eckert & Ziegler was recently given manufacturing authorization for additional production lines for its Ge-68/Ga-68-generators (GalliaPharm), by the FDA and the local German competent authority. (Frank Yeager, Monrovia Technology)

HEALTHCARE INDUSTRY NEWS & TRENDS
HEALTHCARE & GOVERNMENT NEWS
Medicare Advantage Premiums to Hit Lowest Point in Over a Decade

CMS said Medicare Advantage average monthly premiums are projected to hit their lowest point in 13 years in 2020. The agency also predicted that enrollment in the plans would continue its upward march as more seniors opt for Advantage over the traditional Medicare program. Average monthly premiums are expected to decrease 14.4% from $26.87 in 2019 to $23 next year - the lowest premium since 2007, according to CMS. Seniors enrolling in Advantage plans will have more plan choices, with the average number of plans per county increasing to 39 plans in 2020 from 33 plans this year. CMS also projected that enrollment in the plans will hit 24.4 million next year, an increase of 9.9% from 22.2 million currently*. Medicare Advantage open enrollment kicks off on Oct. 15 and ends Dec. 7 for coverage that begins Jan. 1, 2020. (Read Article: Modern Healthcare, 9/24/19) *According to Kaiser Family Foundation, in 2019, 34% of all Medicare beneficiaries are enrolled in Medicare Advantage plans, similar to the rate in 2017 and 2018.

How California Can Elevate Medi-Cal Managed Care Plan Quality

The California Health Care Foundation, working with researchers at the University of California at San Francisco, urged state legislators in a recent report to take bold steps to improve the quality of Medi-Cal managed care plans. Researchers and Foundation leaders pointed out that quality measures for for-profit health insurers paled, on average, when compared with those of nonprofit and public carriers, so the foundation advised lawmakers to "reconsider the role" that for-profit insurers play in the Medi-Cal arena. (Read Article: Sacramento Bee, 9/25/19)

Doctor-Backed Fix for Surprise Medical Bills Would Cost Billions, Says CBO

A Congressional Budget Office (CBO) analysis finds that a rival approach backed by doctors groups for protecting patients from getting massive "surprise" medical bills would increase the deficit by "double digit billions" of dollars. Powerful doctor and hospital groups are lobbying hard against the leading legislation, warning it would lead to damaging cuts to their payments. But the newly obtained analysis from the CBO shows that the rival approach favored by the doctors and hospitals would carry a hefty price tag, in contrast to the leading approach, which saves the government billions. The CBO analysis could put a dent in doctors' and hospitals' efforts as they fight the surprise billing legislation. (Read Article: The Hill, 9/24/19)

Meanwhile, Consumer Groups Launch Ads Backing Surprise Billing Legislation

Consumer groups have launched a campaign calling on Congress to end surprise medical bills, seeking to counter a push from private equity-backed physician staffing firms against legislation. The coalition of 14 groups is urging lawmakers to swiftly vote on legislation to prohibit surprise medical bills, which patients receive for unexpected out-of-network care. While lawmakers and the Trump administration have called for legislation, the effort has essentially stalled since two congressional committees approved legislation over the summer and industry groups have criticized the measures. (Read Article: CQ, 9/26/19)

CBS News Investigates Hospital Pricing & Transparency

CBS News recently ran a series of stories on hospital pricing, called Medical Price Roulette, done in partnership with Clear Health Costs, a journalism organization focused on "bringing transparency to the healthcare marketplace by telling people what stuff costs." (Watch Videos: CBS News, Sept 2019)

Updates on Hospital Readmission Rates and Penalties

The MedPAC staff's preliminary analysis, made public last month, found that the frequency of Medicare patients being readmitted within 30 days of discharge dropped from 16.7% in 2010 to 15.7% in 2017. However, the analysis said the decrease was more significant once it took into consideration that the average patient was frailer in 2017 than in 2010 and thus more likely to end up back in the hospital, with all other things being equal. "On a risk-adjusted basis, it appears that readmissions have declined in 2010 to 2018 without causing a material increase in mortality," Jeff Stensland, a MedPAC analyst, told the commission. (Read Article: Kaiser Health News, 10/1/19)

Physicians Charged in $2.1 Billion Healthcare Fraud Scheme

35 people, including nine physicians, associated with dozens of telemedicine companies and cancer genetic testing laboratories were charged for their alleged roles in one of the largest healthcare fraud schemes ever, according to the Department of Justice. The defendants allegedly submitted more than $2.1 billion in fraudulent claims to Medicare through the scheme. According to federal prosecutors, the labs paid illegal kickbacks and bribes to medical professionals working with fraudulent telemedicine companies to refer Medicare beneficiaries for cancer genetic tests that weren't medically necessary. The physicians were allegedly paid to prescribe the testing without any patient interaction or with only a brief telephone call with patients they had never met. The results of the tests were often not provided to Medicare beneficiaries or were worthless to their actual physicians, according to the Justice Department. (Read Article: Becker's Hospital Review, 10/1/19)

FDA Clarifies How it Will Regulate Digital Health and Artificial Intelligence

The FDA has issued new guidelines on how it will regulate mobile health software and products that use artificial intelligence to help doctors decide how to treat patients. The guidelines clarify the agency's intent to focus its oversight powers on AI decision-support products that are meant to guide treatment of serious or critical conditions, but whose rationale cannot be independently evaluated by doctors. (Read Article: Stat, 9/26/19)

Drugmakers, Worried About Losing Pricing Power, Are Lobbying Hard

Worried drugmakers are stepping up efforts to blunt proposals in Washington that they view as some of the most serious threats to their pricing power in recent years. Pharmaceutical industry trade organizations and outside groups are spending millions of dollars on advertisements attacking the proposals, which would peg drug prices in the U.S. to prices paid overseas and force companies to pay rebates if a drug's price increases by more than the rate of inflation. Industry executives and lobbyists are urging friendly lawmakers to pass legislation blocking the plans. They are also pushing administration officials to pursue measures that would pressure industry middlemen such as pharmacy-benefit managers to provide some relief on patients' costs without directly curbing drugmakers' pricing power. (Read Article: Wall Street Journal, 9/24/19)

RETAIL, TECHNOLOGY & HEALTHCARE
Walmart Unveils Plan to Build Healthcare Workforce

Beginning Sept. 24, Walmart's 1.5 million workers in the U.S. can apply for one of seven bachelor's degrees and two career diplomas in health-related fields through Live Better U, Walmart's education benefit program. Employees pay only $1 a day for the duration of their college or career programs. The new programs will help train employees to fill healthcare jobs across Walmart and Sam's Club, which include more than 5,000 retail pharmacies, 3,000 vision centers, 400 hearing centers and Walmart Health, a standalone health clinic in Dallas, GA. Depending on the success of the standalone primary care clinic in Georgia, Walmart may open more Walmart Health clinics in the future. The retailer also plans to offer home health services and mobile units that offer specialty services, such as dermatology or women's health. (Read Article: Becker's Hospital Review, 9/24/19)

Meanwhile, Sam's Club Testing Healthcare Service Bundles for Members

Walmart's Sam's Club is teaming up with several healthcare companies to offer discounts on everyday care its customers might delay or skip because of the cost. Starting early October, Sam's Club members in Michigan, Pennsylvania and North Carolina, will be able to buy one of four bundles of healthcare services ranging in annual fees from $50 for individuals to $240 for a family of up to six members. The pilot program could potentially be rolled out to members in all the states, said Sam's Club Health and Wellness. (Read Article: Associated Press, 9/26/19)

Amazon Launches Amazon Care, a Virtual Medical Clinic for Employees

Amazon has launched a virtual health clinic with in-home follow-ups for employees in Seattle, dubbed Amazon Care. The clinic offers a combination of telemedicine and in-person services. Its virtual offering includes an "in-app video visit with a doctor, nurse practitioner, or registered nurse ... for advice, answers, diagnosis, treatment or referrals," according to the web site. Employees will have an option to see a health provider via a mobile app or website, and they can text a nurse on any health topic in minutes. If an employee needs follow-up care, Amazon Care can arrange for a nurse to pay a visit at home. (Read Article: CNBC, 9/24/19)

Best Buy CEO Looks to Healthcare as Retailer's "Next Big Thing"

Best Buy, the nation's largest consumer electronics chain, is looking to healthcare as a big source of its future growth. Best Buy Co. recently announced that in five years it hopes to provide 5 million seniors with health monitoring services, which can range from sensors placed throughout a home to a pendant worn around the neck. It currently provides the service to 1 million. (Read Article: Associated Press, 9/25/19)

Android Users Now Able to Stream Audio Content Via Connected Hearing Aids

With a focus on hearing accessibility, Google has teamed up with Cochlear and GN Hearing to launch a new service that uses Bluetooth Low Energy so that customers will be able to use their hearing aids to tap into the audio from their Android device. The technology was developed with a particular emphasis on preserving battery life for hearing aids. (Read Article: mobihealthnews, 9/3/19)

ADDICTION & OPIOID NEWS
NIH Awards ~$1 Billion in Research Grants to Battle Addiction, Chronic Pain

The National Institutes of Health has just awarded nearly $1 billion to battle addiction and chronic pain, the largest financial commitment to one program ever by the government's premier biomedical research center. About 50 million adults suffer from chronic pain, and in 2018 about 10.3 million people aged 12 and older abused opioids, including heroin, NIH said. "We have effective tools, such as medication-assisted treatment, but we still need better ways to treat opioid addiction and manage pain in an effective, personalized way," Health and Human Services Secretary Alex Azar said in a news release. (Read Article: The Washington Post, 9/26/19)

Novel Plan Aims to Settle Addiction Suits

Endo International, Johnson & Johnson, and other drugmakers that face sprawling litigation over the opioid crisis are exploring an unusual way to settle the cases: by participating in Purdue Pharma's bankruptcy, according to internal documents and a person familiar with the matter. The move, if successful, could bring an end to - or at least dramatically shrink - one of the largest and most complex pieces of litigation the U.S. has ever seen. Drugmakers and distributors face some 2,500 lawsuits brought by virtually every state, as well as cities, counties, Native American tribes, and others accusing the pharmaceutical industry of helping fuel widespread opioid addiction. The cases have become political flashpoints as communities look for ways to recover money to address the costs of treating addiction, including overstressed hospitals and first responders, and to care for babies born with opioid dependence. (Read Article: Wall Street Journal, 9/30/19)

Johnson & Johnson Appeals Oklahoma's $572 Million Opioid Ruling

Consumer products giant Johnson & Johnson is appealing an Oklahoma judge's $572 million order against the company and its subsidiaries for helping fuel the state's opioid crisis. The company recently filed an appeal with the Oklahoma Supreme Court, arguing the ruling was an "unprecedented interpretation of Oklahoma public nuisance law." (Read Article: Associated Press, 9/26/19)

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