ABL Healthcare Member News & Industry Trendletter * March 3, 2020

>>> Russell Zukin is Founder and CEO of Alphascript Specialty Pharmacy and Positive Outcomes Rx, which serve patients with complex disease states needing specialty medications. URAC-accredited Alphascript has 20+ years of experience serving patients and providers throughout California. Patient services include personalized care management, medication therapy management, coordination of benefits, outreach calls, mail and courier service, and prescription compounding. Services for providers include prior authorization support, proactive communication, clinical support, and streamlined prescription ordering. In addition, Alphascript partners with payers to improve outcomes, including providing comprehensive and customizable reporting so that payers are able to understand utilization and outcomes to inform cost-saving and business strategies. Positive Outcomes Rx's services include compounding customized medications, medication therapy management, immunizations, third party billing, and a range of home healthcare products. Russell is also an Advisor to FreshMynd, which has developed the first science-backed, kid-friendly, and parent-friendly combination supplement for ADHD. He began his career as a pharmacist. Russell has joined the Silicon Valley Round Table.


PREVENTION: How Several ABL Members Are Responding to COVID-19

by Mimi Grant

Since the majority of the (currently) 45 confirmed COVID-19 cases in California are in the Bay Area (26), yesterday I reached out to several of ABL's Northern California Members to see how they're responding to the troubling news. Particularly in light of the highly infectious nature of the virus, I first spoke with ABL/East Bay Member Mike Stacey, MD, the former Director of Solano County's Medical Services Division, where he played a key role in managing the response to communicable disease outbreaks. Given Travis Air Force Base is in Solano County -- ground zero for the returning Diamond Princess passengers (22 of whom are now confirmed to have the virus), we first discussed the state of testing for COVID-19...

CLICK HERE TO READ REST OF BLOG, which also includes remarks from Arup Roy-Burman, MD, CEO of Elemeno Health; Grace Li, CEO of On Lok; Debbie Toth, CEO of Choice in Aging; Cecile Currier, El Camino Hospital's VP of Corporate & Community Health Service and CEO of Concern (EAP); and Marshall Toplansky, a professor at Chapman University.
Photo Credit: San Francisco Chronicle's Coronavirus Tracker

Click on Headlines to Read Articles
Alegre Care Shares Apps to Help Those with Disabilities

In 5 Apps That Help People with Disabilities, Alegre Care shares their top five picks of apps that benefit caregivers, seniors, and people with disabilities. They also point out that the advancement of technology has often gone hand-in-hand with assisting people who have disabilities. Many of our everyday products and services were first designed for or by people with disabilities, such as automated doors - which means that everyone benefits when we create a more accessible world. (Charles Symes, Bay Area)

Alvaka Networks Discusses How to Protect Your Business from Cybercrime

In two recent blog posts - SMBs are at a significant risk of cyberattacks and The Evolution of Ransomware: How to Stay Protected - Alvaka Networks stresses that having only antivirus software and firewalls are nowhere near enough to protect your business from cybercrime. Ensuring your network remains safe demands multiple controls, including multi-factor authentication, software patching, networks segmentation, limitation of access rights, filtering emails and monitoring DNA, 24/7/365 network monitoring, daily backups on a disconnected system, and admin credential limitations and tracking. But even following these guidelines doesn't make you immune, which is why it's absolutely crucial to have tested business continuity and disaster recovery plans and solutions in place. (Oli Thordarson, Orange County)

Anthem Blue Cross Invests $400+ Million for a Healthier California

Anthem Blue Cross announced that it has topped $400 million in direct investments in the health of Californians. Since 2005, Anthem has been directing funds through the Investment in a Healthy California Program to assist rural and urban healthcare facilities across the state to secure capital for construction, renovation, and sustainability projects that strengthen their ability to support vulnerable communities. Anthem's investment totaled over $34 million in 2019, bringing its level of support for the program to more than $400 million. (David Pryor, MD, Los Angeles)

CareAcademy Collaborating with Leading Educator on Dementia Training

CareAcademy is teaming with Teepa Snow, a leading educator on dementia and dementia care, whose company, Positive Approach to Care, educates, supports, and trains others in care strategies. CareAcademy has added nearly 100 hours of high-quality Teepa Snow dementia training to its course library, filling a growing specialization need in home care. In this webinar, Teepa Snow and CareAcademy CEO Helen Adeosun demonstrate how to use the dementia care classes on CareAcademy's platform to train and upskill caregivers. (Helen Adeosun, Los Angeles)

CEI's Annual PACE Party is Forthcoming

The Center for Elders' Independence (CEI) will present its annual fundraiser, PACE Party, on the evening of May 7, at the University Club in Berkeley. Attendees will enjoy spectacular views and inspiring entertainment, while supporting 1,000+ older adults and people with disabilities in remaining independent with dignity. (Linda Trowbridge, Bay Area)

Choice in Aging Gets City Funding Commitment Toward Affordable Housing Plan

The Pleasant Hill City Council recently committed $2.24 million toward a plan to add dozens of affordable homes for low-income seniors to the city's housing stock. To this end, Satellite Affordable Housing Associates (SAHA) is partnering with Choice in Aging (CiA) to build an 82-unit affordable housing development on CiA's four-acre parcel near Diablo Valley College. CiA also plans to rebuild its campus, which provides adult services, and the preschool it opened in 2017. CiA CEO Debbie Toth also reports that Saturday's annual "Crab Feed" was the nonprofit's most successful yet. (Debbie Toth, Bay Area)

Cigna Names Chris De Rosa to Lead National Accounts Business

Cigna has named Chris De Rosa to lead its national large employer business, a leadership role within the company's U.S. Commercial unit. Chris is now accountable for deepening relationships with national clients across Cigna's array of solutions for employer-based benefits that support whole person health. Cigna's national account business serves employers with 5,000+ employees located across multiple sites. Chris began his career with Cigna in 1992 and has held a series of progressively more responsible leadership roles within the U.S. Commercial unit. His new (elongated) title is President, National Accounts & BETS and Chief Operating Officer, US Commercial Markets. (Chris De Rosa, Orange County)

ConcernEAP Debuts Digital Mental Health Hub

ConcernEAP has launched a digital mental health hub - Luma by Concern - enabling easy access to licensed professionals, self-help tools, and digital therapeutics for enhanced support and expanded reach. Luma reduces stigma and member confusion on how to access behavioral health services. Users create a confidential personalized care plan, leading to more proactive and cost-effective management of mental health and physical health conditions. (Cecile Currier, Silicon Valley)

Covered California Announces Increased New Signups & Extended Open Enrollment

Covered California recently announced that 418,052 people had newly selected a health plan for 2020 during the most recent open-enrollment period. The total is more than 122,000, or 41%, higher than last year's figure of 295,980. Covered California also announced that effective Feb. 18 it would establish a special-enrollment period for those who were unaware of the new state penalty or the new financial help that California instituted for 2020. Consumers who fall into those categories, or who are currently insured off-exchange (directly through an insurer) and want to switch to Covered California to benefit from the new state subsidies, will have through April 30 to sign up for coverage. (Kathy Keeshen, JD, Bay Area)

Elemeno Health Partners with Gulf Coast Provider for Superior Patient Care & Workforce Development

Singing River Health System is the first in the Gulf Coast to join forces with Elemeno Health to implement a cloud-based solution for front-line care teams at Ocean Springs and Pascagoula Hospitals. Elemeno's solution facilitates the adoption of clinical best practices by providing real time support to providers at the point of care, accessible on any device, 24/7. Meanwhile, Elemeno's CEO Arup Roy-Burman, MD, has written Healthcare and Leadership: What 21st Century Hospitals can Learn from one of the 20th Century's Greatest Generals, which includes "[During] World War II, nearly 10% of the US population was on active duty - every individual had a personal stake - and we succeeded... [Today] with an aging population and soaring healthcare costs, ...economically sustainable healthcare is the greatest challenge of the 21st century - can we succeed?" (Arup Roy-Burman, MD, Bay Area)

Felton Institute Launches Early Intervention Program & Prepares for Upcoming Gala

Felton Institute recently celebrated the start of its early intervention program for infants and toddlers with developmental delays at its Sojourner Truth Center site. Meanwhile, on April 22, Felton's San Francisco Suicide Prevention division will present Laughs for Life 2020, an annual fundraiser whose proceeds will support a 24/7 hotline and community programs that empower individuals to cope in times of crisis. The gala will include a cocktail reception, silent auction, seated dinner, awards, and a comedy show. (Al Gilbert, Bay Area)

Health Coach Institute Announces Upcoming "Live" Event

Health Coach Institute (HCI) will present HCI Live, April 30 to May 2, in Charlotte, North Carolina, a three-day transformational event for health and wellness coaches and practitioners. Speakers, including HCI CEO Eric Neuner, will discuss the hottest industry trends as well as emerging, lucrative coaching opportunities, and will demonstrate new coaching sequences and techniques to create deeper transformation for clients. (Eric Neuner, Bay Area)

Kaiser Permanente Study Finds Improved Outcomes After Portal & Phone App Use

Diabetes patients who used the Kaiser Permanente (KP) patient portal and mobile phone app improved their diabetes management outcomes, according to a recent report from KP scientists. The large study, involving 111,000+ patients, was unique in assessing the relationship between the use of online tools and medication adherence and blood glucose levels. Meanwhile, KP health plan members in California who request healthcare services are able to get their care quicker than most, according to a recent report from the state's Department of Managed Health Care. Among health plans that provide care statewide, KP is the highest rated in all measurement categories. (Walt Meyers, Bay Area)

King & Spalding to Present 'California Healthcare Fraud & Abuse Executive Forum' on March 12

On March 12, King & Spalding (K&S) will present California Healthcare Fraud & Abuse Executive Forum, in Santa Monica. The event will focus on the latest developments impacting senior in-house counsel and compliance officers, and will feature leading speakers, including former Deputy Attorney General Sally Yates, on a wide range of cutting-edge healthcare fraud and abuse issues, plus topical sessions. Meanwhile, The Daily Journal (Calif.) has named two 2019 trial wins by K&S partners and teams to its 2019 Top Verdicts list, which highlights "the largest and most significant verdicts and appellate reversals" in the state. In one of the wins, K&S secured a complete defense verdict on behalf of its client Prime Healthcare, a 45-hospital system, and its affiliates against the California Department of Insurance and a relator in a major Insurance Frauds Prevention Act trial in Los Angeles County Superior Court. In another trial win, K&S successfully defended Johnson & Johnson in a L.A. Superior Court lawsuit in which a plaintiff alleged the company's talcum powder products caused her mesothelioma. Also, on March 16, in Atlanta, K&S will present its 29th Annual Health Law & Policy Forum. (Marcia Augsburger, JD, Bay Area, & Travis Jackson, JD)

KMD Architects Achieves Milestones at Hollywood Presbyterian & Ilsan Global Life Center

Construction has topped out at CHA Hollywood Presbyterian Medical Center's new inpatient tower, the signature element of the hospital's $400-million upgrade. The five-story building, designed by KMD Architects, will house an expanded ED, a neonatal ICU, and additional private patient rooms. Completion is scheduled for 2021. Meanwhile, another KMD-designed facility will celebrate its grand opening on April 3 - the CHA Ilsan Global Life Center, near Seoul, South Korea, a mixed-use healthcare facility for OB/GYN patients and post-maternity care. (Rob Matthew, Bay Area)

Mazzetti's Sextant Foundation to Reimagine the OR at Workshop

On March 26-27, Mazzetti's Sextant Foundation and AORN will hold Reimagining the OR: Pre-op, Intra-op, and Phase 1 & 2 Recovery Workshop, in Anaheim. The program, supported by the Facility Guidelines Institute, uses elements of Human-Centered Design (empathy, define, ideate, prototype, test) and process improvement techniques to reimagine OR spaces. (Walt Vernon, JD, Bay Area)

Mission Hospice Workshop Will Focus on Treating Complicated Grief

On March 14, the founder of Columbia University's Center for Complicated Grief, Dr. Katherine Shear, will lead a workshop at Mission Hospice & Home Care - Understanding Complicated Grief - for professionals and community members. For about 10% of bereaved people, the process of adapting to the loss is derailed and acute grief is prolonged, impairing functioning. Dr. Shear will explain how complicated grief can be reliably identified. Research suggests people suffering in this way respond better to targeted complicated grief treatment than other forms of treatment. (Dolores Gomez, Bay Area)

On Lok Looks Forward to Spring Gala

On May 15, On Lok Celebrates! will benefit On Lok's wide-ranging programs for older adults, including healthcare, social activities, wellness and fitness, and nutrition and meal delivery. The evening event will include lively conversation, live entertainment, drinks, and food tastings by Bay Area chefs, set against the spectacular backdrop of downtown San Francisco at the City View at Metreon. (Grace Li, Bay Area)

Select Data Examines AI, Documentation, Coding, PDGM & More

In The Future of Home Health Operations is Fueled by Artificial Intelligence, Select Data discusses how home health agencies are now leveraging AI. Other recent blog posts, available here, include "5 Steps to Improve Documentation & Coding" and "Case for Outsourced Coding." In addition, Select Data provides several on-demand educational videos on: "Preparing Field Clinicians for PDGM;" "Deeper Dive Into PDGM: Comorbidity Adjustments;" and "Building an Effective Plan of Care." (Ed Buckley, Orange County, & Ted Schulte, Los Angeles)

AfterNow Designs UI/UX for Health Tech Startup's Mobile App

In A quick summary of the features designed for TRIPP, Inc., AfterNow describes its recent work on a design project for TRIPP, a health technology startup company developing virtual reality experiences that impact mood and mindfulness. AfterNow designed the UI/UX of TRIPP's mobile app, as well as improving their existing VR user flows. The mobile app helps users keep track of their meditation sessions and mood fluctuations, assists them in hitting their weekly meditation goals, and notifies them when a new experience is available. (Philippe Lewicki, West Los Angeles Technology)

Easy Breathe on: Benefits of Auto CPAP Machines

In What Are the Benefits of an Auto CPAP Machine?, Easy Breathe reports on the types of machines used to treat sleep apnea: fixed-pressure; bi-level; and automatic - which offer a number of benefits the other machines don't. Auto machines are programmed with a sophisticated algorithm that monitors your breathing and auto-titrates the pressure it delivers based on your breathing needs. If your health changes, the machine recalibrates to deliver the optimal pressure without needing another titrating lab study. Auto CPAP machines detect and accommodate all pressures within a default range, minimizing the amount of testing needed to start treatments. (Nick Weiss, West Los Angeles Technology)

Eckert & Ziegler to Open U.S. Production Site for Y-90 & Collaborating on Prostate Cancer Dx

Eckert & Ziegler (EZ) has announced plans to open a radiopharmaceutical production site near Boston. Mirroring the technology of EZ's European plant, it's planned as a first step to produce Yttrium-90, a short-lived radioisotope which is used in oncological applications for the treatment of liver cancer. Once operational, EZ can locally supply of Y-90 to pharma companies and hospitals throughout the world. Also, EZ and Isotopia Molecular Imaging, of Israel, have agreed to jointly develop diagnostic reagents, and intend to colaborate in the early detection of prostate cancer. The production of these reagents shall soon be fully automated through the use of synthesis systems. (Frank Yeager, Monrovia Technology)

PCIHIPAA Makes "Latka 100": Fastest-Growing SaaS Companies in 2019

Out of 3,500 SaaS companies in 2019, PCIHIPAA ranked in Latka 100's Top 5% in terms of annual growth rates. Latka is the leading private community for SaaS CEOs, founders and investors. Cybersecurity and compliance continue to be key areas of concern throughout the healthcare industry, and PCIHIPAA's services are specifically designed for private practices that often rely too heavily on their office manager for solving their security, privacy, and compliance requirements. (Jeff Broudy, West Los Angeles Technology)

PeopleG2's Chris Dyer Shares Leadership Insights in Business Journals

The recent Inc. magazine article, These 10 Leadership Speakers Can Help Transform Your Company Culture, features PeopleG2 CEO Chris Dyer, and spotlights his book, The Power of Company Culture, where Chris identifies seven pillars of cultural success: transparency, positivity, measurement, acknowledgment, uniqueness, listening, and mistakes. Meanwhile, Chris wrote an article for Irish Tech News: Mastering Tough Conversations: The Superpower for Successful Bosses of the Future. (Chris Dyer, Monrovia Technology)

Tanner Research CEO to Present Nutrition Science Workshop at New Tanner Facility

On the evening of March 12, John Tanner, Ph.D., CEO of Tanner Research, will present a free Nutrition Science workshop, where John will relay to participants the scientific information they need to avoid heart disease and other leading killers. He will also field questions, and everyone will continue nutrition discussions in small groups. The workshop includes a healthy and tasty meal and choice of a top book on nutrition science. Join John at the new Tanner Research facilities in Duarte. (John Tanner, Ph.D., Monrovia Technology)

"We cannot shut down the world."
Drugmaker Moderna's Coronavirus Vaccine Ready for Human Testing

Moderna said on February 24 that the first batch of its vaccine against the coronavirus is ready for the government to start testing on humans. The therapeutics and vaccines company said it has shipped vials of the medicine, called mRNA-1273, to the National Institute of Allergy and Infectious Diseases (NIAID) in Bethesda, Maryland. The NIAID expects to begin the clinical trial with 20 to 25 healthy subjects by the end of April to evaluate the vaccine's safety and efficacy against infection, The Wall Street Journal reported. That would mark a three-month period between vaccine design and human testing, with first results becoming available as early as July, according to the report. "Going into a Phase One trial within three months of getting the sequence is unquestionably the world indoor record. Nothing has ever gone that fast," said Dr. Anthony Fauci, director of NIAID, according to the WSJ. (Read Article: CBS News, 2/25/20)

And, Gilead Starts Two Late-Stage Studies to Test Drug for Treating Coronavirus

Gilead Sciences Inc said on February 26 that it has started two late-stage studies to test its drug in patients with severe and moderate cases of the illness caused by the coronavirus. The studies will test the experimental antiviral drug, remdesivir, among nearly 1,000 patients at medical centers across Asian countries, as well as in other nations with high numbers of diagnosed cases, the company said. Two dosing durations of remdesivir will be administered intravenously in the late-stage studies following the U.S. FDA's rapid acceptance of remdesivir as a new investigational drug. Gilead is also providing remdesivir to qualified patients with COVID-19 on a compassionate use basis for emergency treatment outside of ongoing clinical studies. (Read Article: New York Times, 2/26/20)

Supreme Court to Again Decide Fate of ACA, Again

The U.S. Supreme Court on Monday said it will hear the case attempting to overturn the Affordable Care Act. The decision means the justices will add the case to their schedule for the next term, which starts in October. A final decision on the fate of the landmark legislation would be rendered sometime next year. The central argument in the lawsuit centers on whether the law is invalid because it no longer contains the financial penalty that was levied against those for not purchasing health insurance coverage. The key legal question is whether the rest of the law could stand without the mandate, or whether the remainder of the law could be severed from it. (Read Article: Healthcare Dive, 3/6/20)

The Basics of 'Medicare for All,' per The New York Times

Now that Bernie Sanders, who introduced the Medicare for All Act in the Senate, is ascending in the presidential nominating contest, it's a good time to take a closer look at what it would mean for the health system, your health insurance and finances, and the federal budget. Here's The New York Times' quick primer, with some suggestions for further reading... (Read New York Times article, 2/25/20)

CMS Issues Proposed Rule to Extend CJR Payment Model & Adds Outpatient Procedures

On February 20, CMS released a proposed rule that would extend the bundled-payment model for joint replacement surgery for an additional three years and broaden its scope to include outpatient procedures. Originally scheduled to expire at the end of 2020, the Proposed Rule would allow CMS to continue the Comprehensive Care for Joint Replacement (CJR) Model from 2021 through 2023. The Proposed Rule seeks to utilize the extension to evaluate the impact of the proposed changes to the payment model. Comments are due by 5 p.m. on April 24, 2020. The Proposed Rule proposes several substantive changes to the CJR Model, notably, proposing to add outpatient total knee and total hip replacements to the definition of "episode." (Read Article: King & Spalding Health Headlines, 2/24/20)

HHS Issues Final Report of Recommendations to Reduce Regulatory & Administrative Burdens Relating to Health IT & EHRs

On February 21, HHS released its final report with its comprehensive strategic plan for reducing regulatory and administrative burdens associated with the use of health IT and EHRs. The report targets technology burdens HHS can address through the rulemaking process and provides recommendations for four main areas: clinical documentation, health IT usability, federal EHR and health IT reporting requirements, and public health reporting. According to HHS, the report "describes examples of EHR related burden, as well as strategies and recommendations that HHS and other stakeholders can use to help clinicians focus their attention on patients rather than paperwork, when they use health IT." Congress mandated the issuance of the report in December 2016 as part of the 21st Century Cures Act. (Read Article: King & Spalding Health Headlines, 2/24/20)

PROPOSAL: End Ban on Medicaid Funding for Institutional Care for Those with Mental Illnesses

According to a Wall Street Journal editorial, hundreds of thousands of Americans with serious mental illness sleep in jails, shelters and prisons on any given night. Fewer than 40,000 are in state psychiatric hospitals. This is largely due to a federal policy, the Institutions for Mental Disease Exclusion, which created a financial incentive for states to kick the mentally ill out of hospitals. Rep. Eddie Bernice Johnson (D., Texas), a former psychiatric nurse, has introduced a series of bills to abolish the IMD Exclusion. Other supporters include Amy Klobuchar, Pete Buttigieg, and President Trump. Despite this bipartisan support, the proposal has stalled in Congress because of "opposition from civil libertarians and mental-health advocates." The IMD Exclusion, part of the 1965 law that established Medicaid, prevents the program from funding care for mentally ill adults while they live in hospitals or even adult homes with more than 16 beds. It was intended to prevent the federal government from taking on care of the mentally ill, which had historically been a state responsibility. Also, at the time, many mistakenly believed that newly developed antipsychotic drugs and community mental-health centers would obviate the need for institutions. The "Opinion" piece's author, D.J. Jaffe, who also wrote Insane Consequences: How the Mental Health Industry Fails the Mentally Ill, believes easing the IMD Exclusion is the most important thing federal government could do to improve care for the seriously mentally ill. (Read Article: Wall Street Journal, 2/18/20)

Insurer-Owned Clinics: New Competitor to Physicians & Hospitals

UnitedHealth Group Inc.'s insurance unit is offering a plan in the Los Angeles area built around doctors who work for its Optum arm, which has acquired a sprawling network of doctor practices, surgery centers, and urgent-care clinics. The company says it is working to offer similar designs in other markets, though they might also involve non-Optum doctors. At Aetna Inc., which was acquired by CVS Health Corp., many insurance plans this year have dropped co-payments for members if they go to the drugstore chain's MinuteClinics. Blue Cross & Blue Shield of Texas launched a plan in January that includes free primary-care visits at clinics it recently opened with a partner company in the Houston and Dallas areas. It priced the coverage 12%-18% below a different product it offers statewide. Generally, plans built around a health insurer's own clinics include smaller networks with more limited choices of doctors and hospitals. That can lower premiums - and the insurers benefit because they keep revenue inside their own holdings rather than paying outside companies for their members' care. This trend creates worries for rival doctor groups and hospital companies that have invested deeply in buying up physician practices, which now increasingly compete against offerings from insurers. (Read Article: Wall Street Journal, 2/23/20)

Consumer Technology Association Develops Healthcare AI Standard

The Consumer Technology Association recently announced the development of what it's calling the first-ever ANSI-accredited standard for the use of artificial intelligence in healthcare. It defines terms such as assistive intelligence, synthetic data, and others related to how AI is used in healthcare. The standard was developed with input from some 50 tech firms large and small. (Read Article: Healthcare IT News, 2/26/20)

Amazon Care Virtual Medical Clinic Now Live for Seattle Employees

Amazon Care, the company's virtual health clinic, is now live for its Seattle employees and their dependents. The app provides virtual medical consultations, as well as a way to schedule a follow-up visit from a health professional to a patient's home or office, and a way to deliver prescriptions to the patient's home, according to the group's website. (Read Article: CNBC, 2/18/20)

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