THE ELECTION

• California Voters Reject New Rules for Dialysis Clinics

COVID IN THE NEWS (STILL)

• Artificial Intelligence Technology Detects COVID-19 Through Cough Sounds
• CMS: Medicare & Most Private Health Plans Must Cover COVID-19 Vaccines Without Cost-Sharing Requirements
• CMS Expands List of Medicare Telehealth Services Payable During COVID

OTHER HOT NEWS

• Teladoc Finalizes Blockbuster Deal with Livongo in Less than 3 Months
• New Law Creates 988 Hotline for Mental Health Emergencies

GOVERNMENT PAYMENT & PRICING TRANSPARENCY UPDATES

• CMS Finalizes Transformative Medicare Payment Changes to Incentivize Dialysis in the Home
• CMS Finalizes Home Health Payment Rule for 2021: 4 Takeaways
• CMS Completes Price Transparency Initiative

NEW CALIFORNIA REGULATIONS

• New California Law Expands Supplemental Paid Sick Leave Requirements

Anthem Blue Cross recently opened two Anthem Neighborhood Stores in Los Angeles-area Koreatown and Alhambra for virtual and by-appointment, in-person services, as well as expanded its Anthem Assist program, which consists of associates who can help consumers in English, Spanish, Chinese, Korean, or Vietnamese. Also, Anthem has introduced Blue Connection, a new health plan option designed to meet the needs of San Francisco Bay Area businesses and their employees. An Exclusive Provider Organization, Blue Connection includes direct access to 3,500+ high-quality doctors and healthcare professionals, including 2,500+ behavioral health providers. For employers, Blue Connection offers up to 25 percent savings compared to Anthem’s standard PPO. (David Pryor, MD, LA)

In Competition Between “Blues” Health Plans and a Recent Antitrust Settlement, Axene Health Partners discusses how the recently proposed settlement of an antitrust suit against BCBSA will affect the Blues plans going forward. And, in Cost Disparities in Employer-Sponsored Health Insurance, Axene notes that rising premiums hinder employers’ ability to pay higher salaries and reduce employees’ take-home pay, and suggests some solutions. (John Price, SF)

Scientific Reports in Nature has published the breakthrough results of Biospectal’s in-depth research conducted at the University of Lausanne, Switzerland’s CHUV hospital. Focusing on optical blood pressure sensing using only the fingertip on a smartphone camera, the study demonstrated that Biospectal’s OptiBP software has achieved equivalency with traditional blood pressure cuff performance and the ISO 81060-2 standard, representing a revolution in how we measure and manage high blood pressure. Biospectal’s OptiBP smartphone app and connected data platform enable clinical grade blood pressure management at the point of patient without any bulky extra device. (Eliott Jones, SV)

On election day, Choice in Aging (CiA) spearheaded the successful effort to set up mobile voting units across Contra Costa County to ensure elders living in congregate facilities had their right to vote met. [See Mimi's blog above for more info.] Meanwhile, throughout October, CiA hosted a video series of “Dishing with Debbie” on the topic of Caregiving. Episodes are available on-demand: PART 1: Dishing with Congressman Mark DeSaulnier on His Experience as a Caregiver. PART 2: Navigating the Caregiving Experience with Lorna Van Ackeren of Hillendale Home Care. PART 3: The Caregiving Workforce & Its Impact on the Healthcare System with Donna Benton, Ph.D., of USC. PART 4: Caregiving Pre-Pandemic Vs. Now & Resources Available with Jo McCord of Family Caregiver Alliance. (Debbie Toth, OAK)

Covered California for Small Business unveiled the health plan choices and rates for small-business employers and their employees for the upcoming 2021 plan year. The statewide weighted average rate change will be 1.5% - the lowest annual increase in the program’s seven-year history, and significantly lower than national projected increases for larger employers. Also, CoveredCA’s annual open-enrollment period officially began November 1, with premiums remaining relatively unchanged for many as the Exchange announced a record-low rate change of 0.5%. Further, some consumers will have more competition in their markets as two carriers announced expanded coverage in Imperial, Inyo, Kern, Mono, Orange, and San Mateo counties. (Kathy Keeshen, JD, SF)

The Angels + Entrepreneurs Network named Arup Roy-Burman, MD, CEO of Elemeno Health, as its October Entrepreneur of the Month, noting his background as the former Medical Director of the Pediatric ICU at UCSF, where he designed the Elemeno prototype. Elemeno’s team-based platform is a virtual coach, delivering custom bite-sized training and communications to the fingertips of healthcare workers - driving practice and consistency at the front lines, reducing costs, increasing safety, and improving outcomes. (Arup Roy-Burman, MD, OAK)

A recent episode of Elevate Addiction Services’ podcast series interviews its President and Chairman Dan Manson, who is “on a mission to approach addiction more holistically, but also from a scientifically evidence-based approach” - healing the whole person not merely their symptoms. (Dan Manson, SV)

HumanGood announced that 15 of its life plan communities have earned the 2020-21 Best Nursing Home rating by U.S. News and World Report, which evaluated 15,000+ nursing homes. The ratings are based on analysis of publicly available data, including information that is not factored into CMS star ratings. Unlike the star ratings, the U.S. News ratings recognize that patients undergoing relatively short-term rehabilitation have very different needs from those who require longer-term care. (Tara McGuinness, OAK)

Inglewood Imaging Center has completed its MRI department upgrade following a successful $1.7 million capital funding, becoming one of the first sites globally to install this new wide-bore high-channel MRI system, which is 17% more spacious, +/- 50% faster, up to 75% quieter than previous, and customizable with music, lighting, and air flow to help create a more comfortable patient exam experience unparalleled in Southern California. In addition, IIC added features to help improve referring physician practices - for example, in orthopedics, there is a new software feature called MARS (metal artifact reduction software), which was added to help solve metal artifacts for orthopedists with metal implant issues. IIC also bought software for nephrologists (non-contrast “contrast” MRA’s), urologists (multiparametric prostate), neurologists (advanced diffusion, SWI), internists (small parts software), and more. (Brad Schmidt, LA)

Aging Well Solutions has acquired Iris Digital Communities from Irvine Health Foundation, and will establish a presence in Orange County, branded as IrisOC. The technology platform is an outgrowth of IHF’s work in supporting innovations and collaborative initiatives that improve the well-being and lives of older adults and veterans in OC. IHF President Ed Kacic said, “We aim to work with others in order to help Orange County residents optimize their health status, and using various forms of technology is an effective approach to reaching target populations. Building and deploying the Iris platform for OC was a core part of our strategy. The technology enables older adults, their caregivers and the organizations that serve them to engage with and manage Social Determinants of Health at the local level. We are pleased that Aging Well Solutions has acquired the IDC platform and technology.” (Ed Kacic, OC)

Kaiser Permanente has created guidance that can be widely adopted across the healthcare industry - the KP COVID-19 Social Health Playbook - which provides clinical care teams with guidance and tools for screening COVID-19 patients for social needs, connecting them to help, and following up to ensure their needs are met, and to prevent further transmission of the virus. It is publicly available as a free resource for care providers across the industry. Meanwhile, according to the CMS’ 2021 Star Ratings, KP Medicare health plans in California, Colorado, Georgia, Hawaii, the Mid-Atlantic states, and the Northwest received 5 out of 5 stars, CMS’ highest Medicare star rating. This is the 10th consecutive year all KP Medicare health plans have been rated 4.5 stars or higher. (Marcos Vasconcelos, OAK)

Kencor Health recently debuted Ecosystem Integration and Professional Services to provide implementation, professional services, support, and advisory services, to hospitals, clinics, and medical facilities, for system optimization and improved operational performance. The integration and services are focused on complete implementation of EHR/EMR, as well as Kencor’s current modular offerings in its Health Ecosystem: Remote Patient Monitoring, Telehealth, and Virtual Clinical Trials (T3). Meanwhile, Kencor CEO Muthu Krishnan recently served as a panelist at the 2nd Annual Patient Experience and Engagement Summit, on the topic of “Craft the New Normal: What Will Never be the Same Again in the Healthcare Experience?” (Muthu Krishnan, SV)

King & Spalding has again earned top practice and lawyer rankings in Benchmark Litigation’s guides to the top litigation firms in the U.S. and Europe. In its national-level rankings in the Benchmark Litigation United States 2021 guide, K&S ranks in Tier 1 for General Commercial Litigation, International Arbitration, Product Liability and Recall, and White-Collar Crime. Partner Marcia Augsburger is named a “Litigation Star California 2021.”

Meanwhile, on November 10, K&S will hold a webinar - Challenging Payers’ New Specialty Pharmacy Policies That Reduce Payment to Hospitals. And, on Nov. 10-11, it will present the virtual 13th Annual King & Spalding Medical Device Summit. Plus, on Nov. 18, K&S will hold a webinar - COVID-19's Impact on the Senior Care Industry: A Discussion on Crisis Management in the Face of Litigation and Enforcement Activity. (Marcia Augsburger, JD, SF & Travis Jackson, JD)

KMD Architects announced that phase 2 expansions and renovations to the MultiCare Allenmore Emergency Department have been completed and will improve access to care for the Tacoma, WA community. Some services will be shared between the ED and the new crisis stabilization unit recently built as part of the new adjacent 120-bed behavioral health hospital, also designed by KMD. Meanwhile, to assist with COVID-19 measures and work-from-home schedules, KMD has instituted virtual site tours, implemented by Skanska: through VR and 3D cameras mounted on hard hats as construction staff walk through KMD’s CHA Hollywood Presbyterian Medical Center project, architects can keep a careful eye on all components of its construction from their home offices. (Rob Matthew, SF)

In LigoLab’s LIS & RCM Operating Platform Supports Pooled Testing, LigoLab reports that there are clear advantages for labs that have a laboratory information system (LIS) that can support a COVID-19 PCR pooled testing strategy for the screening of asymptomatic individuals. Pooled testing, which involves the mixing of multiple specimens together into a batch sample, enables labs to boost testing capacity, improve turnaround times, conserve testing kits and other supplies, and reduce the cost per test. The LigoLab Platform has pooled testing technology built into its clinical module, and supports the tracking of multiple specimens in one well and the retesting of a pooled sample if it comes back positive for the coronavirus. And, in TestDirectly Eliminates the Paper Requisitions That Cause Accessioning Headaches, LigoLab explains that its TestDirectly Direct-to-Consumer Portal is the latest addition to its fully integrated LigoLab LIS & RCM Operating Platform. (Suren Avunjian, LA)

University of California, San Francisco has selected healthcare specialists Mazzetti and global consulting and engineering firm Arup as the lead MEP engineers of record for its new hospital - UCSF Helen Diller Medical Center at Parnassus Heights. Collaborating with architect partners HDR and Herzog & de Meuron to design the “hospital for the future,” Mazzetti and Arup will integrate forward-looking, innovative design, supporting UCSF’s commitment to world-renowned clinical research and training. (Walt Vernon, JD, SF)

Nelson Hardiman Managing Partner Harry Nelson recently appeared on KTLA5 to discuss the National Prescription Drug Take-Back Day and the impact of COVID-19 on addiction and rehabilitation facilities that have had to shut down due to the pandemic. They also discuss the Department of Justice’s $8-billion Purdue Pharma settlement and all the work that is now needed to get people the help they need. In particular, Harry touches on steps the state of California has been taking. Also, Harry presented a webinar with Florida AG Ashley Moody: "Confronting the Overdose Crisis"; watch a replay here. And, Harry takes part in the podcast, Legal Talk Network: The President, COVID 19, and Impact on the American Public. Meanwhile, watch a replay of Nelson Hardiman’s recent webinar: The Collections Continuum - Reimbursement Guide from Treatment to Payment. (Harry Nelson, JD, LA)

On Lok, which has been serving seniors for almost 50 years, has unveiled a new brand identity, which includes a redesigned logo, website, and renaming of its innovative PACE offering from On Lok Lifeways to On Lok PACE. With the new brand identity, On Lok will continue to bridge the spectrum between frail seniors served through On Lok PACE to more active seniors through programs such as those offered by On Lok 30th Street Senior Center. On Lok founded PACE and has remained committed to its innovation, spurring its expansion to 31 states. Expanding initiatives include a pilot with California Pacific Medical Center ACE (Acute Care for the Elderly) Unit at Mission Bernal Campus; a partnership with Openhouse to expand services for LGBTQ seniors; and an evolution from in-person care to virtual care in all aspects of senior care and wellness. (Grace Li, SF)

Prelude Corporation (PreludeDx) recently presented pivotal data at the American Society of Radiation Oncology (ASTRO) 2020 National Meeting, regarding its commercially available test, DCISionRT, and its new genomic signature presently in development for women with invasive breast cancer (IBC). ASTRO Poster #2034 included nearly 1,800 women diagnosed with ductal carcinoma in situ (DCIS) and classified as clinicopathologically low-risk by Radiation Therapy Oncology Group-like criteria for recurrence of DCIS or progression to IBC. PreludeDx’s DCISionRT assay reclassified almost half of these patients to elevated risk, suggesting a group of patients who would be under-treated with surgery alone. More information. (Dan Forche, OC)

In How to Optimize Your Denial Management Process, Savi Group examine ways you can help streamline the claims submission process to reduce denials and make denial management in healthcare more efficient. Click here to read other recent blog posts from Savi, including: “Essential Steps in EHR Implementation;” “Your Ultimate Guide to Claims & Payment Processing;” and “Hard vs Soft Denial in Medical Billing: What’s the Difference?” (Sumit Mahendru, OC)

On November 17, Wipfli will present a webinar - Managing cyber risk: Protecting yourself beyond HIPAA, which will discuss leading practices for what you can do to protect yourself and your healthcare organization. And, on December 15, Wipfli will present a Wipfli Healthcare Connections webinar, that will include Q&A - Leading during challenging times - Attributes to help healthcare leaders succeed. (Jeff Johnson, OAK, & Steve Rousso)