ABL Healthcare Member News & Industry Trendletter * June 3, 2021
    Now that we're beginning to launch our In-Person "Reunion" Round Tables (for the fully-vaccinated), please read your invitation closely, so you'll know when your Table will be held exclusively on ZOOM, or if you'll be able to "reunite" In Person - with a ZOOM/Hybrid option. Also, to receive an invitation to a ZOOM Table you would like to attend, please email [email protected] for details.

  • 6/08 - ABL-Health SV & OAK Combined ZOOM Table - Discussion Topic: "Overcoming Challenges" - Featured Guest Speaker: Cheryl Reinking, CNO, El Camino Health on "The Making of a 5-Star Hospital" & "Lessons from El Camino's COVID-19 Pandemic Incident Command Center"

  • 6/09 - ABL-Health SF ZOOM Table - Discussion Topic: "Getting Back to Not-Quite-Normal" - Featured Guest Speaker: Chris Dyer, CEO of PeopleG2 and bestselling author of Remote Work

  • 6/18 - ABL-Health LA REUNION ROUND Table - Discussion Topic: "Post-COVID Lessons in Negotiation" - Featured Member Presenter: Melissa Hanna, JD, CEO of Mahmee

  • 7/07 - ABL-Health OC REUNION ROUND Table - Discussion Topic: "Medi-Cal's CalAIM Initiative & Its Impact on You" - Featured Member Presenter: Greg Buchert, MD, GSB Health Management Solutions

  • Explore Membership in ABL's Executive Round Tables >>>
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Alvaka Networks Explains How to ID the Ransomware You've Been Hit With

In Identifying the Ransomware You've Been Hit With, Alvaka Networks says that if you've been hit by ransomware, one of the first steps in the recovery process is identifying the type of ransomware that you are dealing with. Alvaka describes a free and effective tool called ID Ransomware, and explains that once the ransomware has been determined and the user knows exactly what they are working against, they can begin to formulate an effective plan to resolve the issue.
And, the recent CompTIA article, 10 Tips to Help Your Cybersecurity Staff Avoid Burnout, includes input from Alvaka. (Oli Thordarson, OC)

Axene Health Partners Offers an Actuarial Perspective on Medicare Direct Contracting

In An Actuarial Guide to Medicare Direct Contracting, Axene Health Partners delves into the Global and Professional Direct Contracting (GPDC) Model, which recently began its first performance year. Effective through 2026, the CMS GPDC Model introduces risk-sharing arrangements with the goal of reducing overall healthcare costs while maintaining or improving efficiency. As many providers wade into risk-sharing arrangements, it's vital to incorporate an actuarial perspective to improve the likelihood of profitability over multiple years. The GPDC Model continues the trend towards increasing providers' "skin in the game," akin to an insurer. Since the latter has relied on actuaries for decades to manage healthcare risk, providers engaged in direct contracting would also benefit from actuarial input. (John Price, SF)

Bayer's Investment Arm Leads Financing of Digital Health Company, Ada Health

Leaps by Bayer, the impact investment arm of Bayer AG, has led a $90 million Series B investment in Berlin-based digital health company Ada Health GmbH. Ada Health has developed a powerful AI-based health assessment and care navigation platform that helps users to understand their symptoms, to identify and differentiate conditions with a high degree of medical accuracy, and to navigate safely to the right care, at the right time.
Also, BlueRock Therapeutics, a wholly-owned and independently operated subsidiary of Bayer AG, and Senti Biosciences have announced a collaboration and option agreement to apply Senti Bio's gene circuit technology to the development of BlueRock's next-generation engineered cell therapies for a potentially broad array of therapeutic areas, including but not limited to neurology, cardiology, and immunology within the field of regenerative medicine. (Rama Penta, SV)

Biospectal Announces Independent Validation Studies & Spotlighted by Global Health Coalition

Biospectal has launched two independent research and validation studies using Biospectal OptiBP. Currently underway in four low-resource countries, the studies center on the routine measurement and monitoring of blood pressure, assessment of hypertension during pregnancy, and enable global field testing and validation of the OptiBP smartphone app and data platform integration with the WHO's Digital Antenatal Care module, following WHO SMART guidelines and built on the WHO Open Smart Register Platform.
Meanwhile, Biospectal OptiBP is featured in a recent article from the Global Health Technologies Coalition - 10 amazing innovations to make motherhood safer. (Eliott Jones, SV)

Choice in Aging to Co-Host Session on Designing County's Master Plan for Aging

On the morning of June 24, Choice in Aging and the Contra Costa Advisory Council on Aging will host a session to look at the state of California's blueprint for a Master Plan for Aging, and is encouraging participation by all of those interested in creating a community where all members can age with dignity in the setting of their choice.
Meanwhile, watch recent episodes of "Dishing with Debbie" here, a video series in which CEO Debbie Toth speaks with guests on relevant topics. (Debbie Toth, OAK)

Cigna & Oscar Health Serve Arizona; New Grant Program Addresses Social Determinants of Health

Cigna and Oscar Health recently announced that Cigna Administered by Oscar small group health insurance will be available to Arizona employers across numerous counties starting July 1, 2021.
Meanwhile, the Cigna Foundation has begun accepting applications for its new Education and Workforce Development grant program, which is part of an ongoing focus to address social determinants of health and eliminate health disparities to achieve greater health outcomes overall. (Chris De Rosa, OC)

Competitive Health Encourages Employers to Add Health Advocacy Services to Benefits Offerings

In The Importance of Health Advocacy in the Benefits Marketplace, Competitive Health describes the value of employers adding health advocacy services to their employee benefits offerings, including finding the highest quality and lowest cost healthcare options within a network, resulting in lower out-of-pocket costs and better medical outcomes, leading to healthier, happier employees and lower overall healthcare costs. Health advocates can answer insurance questions, explain and coordinate care options, provide guidance through healthcare concerns, as well as review medical bills, resolve errors, and arrange for better discounts or payment arrangements. (Kim Darling, OC)

Covered California's Enrollment Surges Following American Rescue Plan

Recent data from Covered California shows a surge in enrollment as tens of thousands of consumers signed up for healthcare coverage to benefit from the lower premiums now available through the American Rescue Plan. 76,000+ people have signed up for coverage since Covered California launched a special-enrollment period - more than 2.5 times as many as those that enrolled during the same time period in 2019. The American Rescue Plan provides new and expanded financial help to people who receive their health insurance through an Affordable Care Act Marketplace. (Kathy Keeshen, JD, SF)

El Camino Health Among Top 15% of U.S. Hospitals for Outstanding Patient Experience

El Camino Health has achieved the Healthgrades 2021 Outstanding Patient Experience Award - placing it among the top 15% of hospitals nationwide for patient experience. Healthgrades evaluated 3,297 hospitals that submitted at least 100 patient experience surveys to CMS. Of those hospitals evaluated, 417 hospitals outperformed their peers - based on their patients' responses - to achieve this award.
Also, El Camino earned an 'A' in the spring 2021 Leapfrog Hospital Safety Grade program at its Mountain View hospital, recognizing its continued commitment to providing safe, high-quality care to patients. (Cecile Currier, SV)

HumanGood Completes Redevelopment Project in San Luis Obispo

Judson Terrace Homes, a HumanGood affordable housing community, with 107 apartments located in San Luis Obispo, recently celebrated the completion of a major redevelopment project, which brought upgraded interiors, necessary renovations, and improved amenities. Thanks to rental subsidies acquired by HumanGood's Beacon Development Group, residents are able to continue to afford their homes. Watch this video to see the transformation. (Tara McGuinness, OAK)

Kaiser Permanente CEO Acclaimed for Positive Impact on Diversity, Equity & Inclusion

The CEO Forum Group has released its list of "10 CEOs Transforming Healthcare in America," which includes Kaiser Permanente's Greg Adams, who was chosen for his positive impact on "diversity, equity and inclusion." Each of the 10 CEOs profiled was assigned a category defining their value to the healthcare ecosystem. ABL Member Marcos Vasconcelos, Executive Director, Strategic Market Planning at Kaiser Permanente Health Plan, co-leads this important Equity, Diversity and Inclusion work for the Plan. (Marcos Vasconcelos, OAK)

King & Spalding Declared a Top Law Firm in the U.S.

Chambers USA has recognized King & Spalding (K&S) as one of the top law firms in the U.S. in its annual guide. Among practice rankings, Healthcare and Life Sciences were specifically noted.
Meanwhile, K&S urges you to save the date for its 14th Annual Medical Device Summit on September 9-10. (Marcia Augsburger, JD, SF, & Travis Jackson, JD)

LigoLab Case Study Demonstrates How to Effectively Execute a Plan & Scale Lab Ops

In How ECPC is Leveraging LigoLab LIS to Streamline Pathology Workflows and Expand Laboratory Operations, LigoLab details how its laboratory information system became the centerpiece of change for Eastern Connecticut Pathology Consultants. (Suren Avunjian, LA)

Mahmee Chosen for 2021 "Launch With GS" Entrepreneur Cohort

Mahmee is among the 15 companies selected by Goldman Sachs Group to participate in the 2021 Launch With GS Entrepreneur Cohort. The six-week virtual experience will provide high-touch access and resources to a select group of U.S.-based Black and Latinx founders to fast-track their companies' growth and build relationships with investors and industry experts. The participating companies were chosen from hundreds of applicants across the U.S. (Melissa Hanna, JD, LA)

Nelson Hardiman Provides Insight on Covid Vaccines & Workplace Mandates

In Covid-19 Update: Employer's Dilemma - to Mandate or Not Mandate Covid Vaccines in the Workplace?, Nelson Hardiman (NH) discusses if vaccinations can or should be mandatory in the workplace, alternatives to vaccine mandates, reasonable accommodation for employees, and more.
And, Harry Nelson was recently interviewed by CNBC regarding loosening entry requirements for vaccinated international travelers. (Harry Nelson, JD, LA)

On Lok Provides On-Demand Access to Master Plan for Aging Event

The Bay Area Senior Health Policy Coalition, co-led by On Lok and the Center for Elders' Independence, recently hosted a virtual Master Plan for Aging event, in which topics discussed included affordable aging, caregiving that works, health reimagined, and housing for all ages and stages. Click here to watch recordings of the event, divided into sessions. (Grace Li, SF)

PreceptorLink Spotlighted in Industry Blog

PreceptorLink is recommended in 5 Must-Have Tips on How to Secure a Preceptor, a recent blog post written to help nurse practitioner students meet the requirements of their programs. An excerpt: "paying for a preceptor takes all of the leg work out the equation. You are basically hiring an agency to help place you with a preceptor and all you have to worry about is studying. One such agency that stands out is PreceptorLink . . . nurse practitioner owned and operated." (Lynn McComas, DNP, ANP-C, OC)

PreludeDx Wins "Best Breast Cancer Precision Treatment Solution" Award

Global Health & Pharma (GHP) has awarded DCISionRT, from PreludeDx, as the "Best Breast Cancer Precision Treatment Solution" in GHP's Healthcare & Pharmaceutical Awards. GHP's award research is centered around an in-depth evaluation of skills and services, including significant innovations, commitment to excellence, longevity, diversification, sustained or continued growth, feedback from patients and customers, and more.
Meanwhile, DCISionRT is acclaimed in Delivering the Promise of Precision Medicine for Women with DCIS, on HealthTech HotSpot, which is dedicated to the advancement of technological innovations that help transform healthcare. (Dan Forche, OC)

Providence Digital Innovation Group Examines the Move to True Digi-Healthcare

Providence Digital Innovation Group (DIG) has published several short videos, called Community-Inspired Digital Health Conversations, on the topics of health information, access, and behavioral health.
Also, the recent MedTech Intelligence article, The Transformation to True Digital Healthcare, was co-authored by DIG's Chief Digital Strategy Officer and other industry leaders. (Marcee Chmait, LA)

Royal Ambulance Unveils Mural Honoring Frontline Workers

Royal Ambulance recently unveiled its new mural - entitled "Where Heroes Get Their Capes," in recognition of all of the effort put forth by frontline workers throughout the pandemic, celebrating the real-life heroes whose selflessness, courage, and commitment exemplify what EMS is all about. Assemblymember Bill Quirk of Hayward, Alameda Health CEO James Jackson, and other community health leaders joined the celebration, along with Royal's team of frontline EMTs and nurses. Click here to see a larger photo of the mural. (Steve Grau, SV)

Savi Group Shares How to Streamline Revenue Cycle Management & Maximize Reimbursements

In Streamlining Revenue Cycle Management in 2021, Savi Group reports that technology and automation will play a large role in improving efficiencies and providers will need to adapt quickly.
And, in How Outsourced Medical Billing Maximizes Reimbursements, Savi Group explains how a great outsourcer can maximize a practice's revenues, lower costs, and free up valuable internal resources. (Sumit Mahendru, OC)

SimpleTherapy Offers Relief from Work-From-Home Pain & Stress

Maxis Global Benefits Network has published an article on its website, written by Arpit Khemka, CEO of SimpleTherapy, a Maxis wellness partner. In Helping combat the aches and pains of working from home - Find out how online exercise therapy can help tackle your employees' home-working ailments, Arpit urges everyone to stay moving and declares that exercise is a fundamental aspect of everyone's wellbeing. Even when offices begin to re-open, Arpit says, the trend of remote working might be here to stay, at least in part. But it doesn't require much space to gain all the benefits of an in-home exercise and stretching regime. (Arpit Khemka, SV)

VivaLNK Survey: Nearly Half of All Clinical Research to Adopt Decentralized Clinical Trials

VivaLNK has announced the results of its survey of pharma, biotech, and clinical research professionals on their opinions about the current state of remote patient monitoring (RPM), including: 44% have already adopted RPM for decentralized clinical trials, or have plans to within the next 12 months. 65% noted concerns related to the pandemic as their primary driver for using RPM technology. 94% said that continuous data capture, defined as 24-hours or more, was somewhat or very important to their trials. Heart rate (69%) and blood pressure (57%) were cited as the most important physiological parameters to track for trials. (Jiang Li, Ph.D., SV)

Wipfli's Upcoming Webinars to Cover E/M Changes, Senior Living Organizations, + Mergers & Acquisitions

Upcoming healthcare webinars from Wipfli include:
>> Maximizing Reimbursement under the 2021 Evaluation and Management Code Changes, on June 15.
>> On June 17, Understanding accounts receivables from A-Z: Triple Check and Appeal Process, available to skilled nursing and assisted living organizations.
>> Healthcare mergers and acquisitions, buying and selling what you need to know, on July 20. (Jeff Johnson, John Dao, & Steve Rousso, OAK)

Awarenow is Now Profi; Names Adam Miller Exec Chairman

Profi is the new name for awarenow, reflecting the firm's broader mission to help all professional service providers - solopreneurs and teams - increase their revenue through optimized service delivery, deeper and better client experiences, and activation and automated admin processes. And, the company announced that Adam Miller is now its Executive Chairman, with Alina Trigubenko remaining as Founder and CEO. Whereas awarenow was primarily for coaches and therapists, Profi is laser-focused on streamlining professional service operations from all sectors, including training, accounting, financial services, legal, marketing, HR, wellness, coaching, healthcare and more. (Alina Trigubenko & Adam Miller, ABL-Tech WLA)

Eckert & Ziegler Acquires Majority Stake in Pentixapharm; Secures Deal with Sirtex

Eckert & Ziegler AG (EZ) has acquired a direct majority stake in drug developer Pentixapharm, which is developing a radiopharmaceutical combination product against lymphoma and a number of related tumors. The product will be able to be used both for the diagnosis and the therapy of cancer, and has received the green light for advanced clinical trials from the European Medicines Agency. Meanwhile, EZ and Sirtex Medical recently executed a long-term supply agreement for the use of EZAG's Yttrium-90 in Sirtex SIR-Spheres Y-90 resin microspheres for liver cancer. (Frank Yeager, ABL-Tech SGV)

BCG's Harrison Barnes on: the Big Problem of Worry

In Hypnotists, Worry and Living Your Life Today, Harrison Barnes, of BCG Attorney Search, describes some of his experiences with hypnotism, and shares an insight a hypnotist offered him: almost all of the people who use [a hypnotist] are doing so because of worries that they have; her role was really to help them stop worrying. Harrison found the same basic theme when he looked into The Sedona Method after a colleague raved about it. (Harrison Barnes, JD, ABL-Tech WLA)

California On Track to Reopen Economy on June 15

California is still on track to reopen its economy on June 15, marking an almost full return to normalcy since the onset of the pandemic last year. State officials recently provided some guidance for what this reopening will look like, including an end to capacity restrictions for businesses like retailers, gyms, movie theaters, bars, restaurants, and places of worship, as well as an end to social distancing. Those who are fully vaccinated in California will not need to wear a mask in most settings, save for crowded outdoor and indoor events. Some restrictions will also stay in place for large gatherings, such as concerts, sporting events, meetings and conventions. Vaccine and negative COVID-19 test verifications will be required for indoor events with 5,000+ attendees and will be recommended for outdoor events with 10,000+ people. (Orange County Business Journal, 5/24/21)

Biden Announces International COVID-19 Vaccine Sharing Plan

President Biden plans to allocate 75% of unused COVID-19 vaccines through the U.N.-backed COVAX global vaccine sharing program, the White House announced. The U.S. has said it plans to share 80 million vaccine doses globally by the end of June. The administration says 25% will be kept in reserve for emergencies and for the U.S. to share directly with allies and partners. (https://www.kxly.com/i/biden-announces-international-covid-19-vaccine-sharing-plan/)

States & Companies Are Offering Big Prizes for Those Who Get Vaccinated

What do lotteries, fishing licenses, and college scholarships have in common? They're all part of dozens of innovative freebies being given away for people to get a Covid-19 vaccine, as some states - including Ohio, West Virginia, Minnesota, Arkansas, New York, Delaware, and California - have recently offered big prizes for people to get vaccinated. Now, companies are joining the same effort. Kroger Health's recently announced giveaway will include five $1 million payouts and 50 chances to win free groceries for a year. And at CVS Health, customers who receive a Covid-19 vaccination may choose to enter the #OneStepCloser sweepstakes where prizes include free cruises, tropical vacations, a VIP trip to Super Bowl LVI, and gift cards for date nights. The incentives appear to be working: https://www.cnn.com/2021/05/28/us/covid-vaccine-lottery-incentives-companies/index.html

Employer's Dilemma: Covid Vaccines in the Workplace - to Mandate or Not?

In Covid-19 Update: Employer's Dilemma - to Mandate or Not Mandate Covid Vaccines in the Workplace?, Nelson Hardiman discusses if vaccinations can or should be mandatory in the workplace, alternatives to vaccine mandates, reasonable accommodation for employees, and more.
Meanwhile, the law firm of Siri & Glimstad is stirring up a substantial amount of attention around challenging vaccine mandates, by serving as co-counsel in a vaccine mandate case against the Durham County Sheriff's Office in North Carolina. The firm's argued that mandating shots that only have emergency use authorization is illegal and unenforceable, and have also pointed to the Nuremberg Code when making accusations about violating ethics around human experimentation.

Over Half the Country's Received At Least One Covid Shot

According to the CDC's data tracker that tracks the total number of people in each state who have received at least one COVID-19 shot: As of 6 a.m. May 30, the majority of Americans - 50.5% - had received at least on shot, that's 167,733,972 Americans who got the jab, according to the CDC. California came in at #13 with 56.66% vaccinated with at least one dose - 22,389,100. (https://www.beckershospitalreview.com/public-health/states-ranked-by-percentage-of-population-who-ve-received-at-least-one-covid-19-shot-april-22.html)

The Lab-Leak Theory: And Why It's Now "Plausible"

Suddenly, talk of the Wuhan lab-leak theory seems to be everywhere. President Biden recently called on U.S. intelligence officials to "redouble their efforts" to determine the origin of Covid-19 and figure out whether the virus that causes it accidentally leaked from a Chinese laboratory. Major publications and social media have recently been filled with discussion of the subject. In response, the New York Times has offered an explainer: https://www.nytimes.com/2021/05/27/briefing/lab-leak-theory-covid-origins.html

Covid-19 Won't Push Most Insurers to Raise Premiums, Survey Finds

Key findings from an eHealth survey of 4,700+ consumers and more than two dozen major insurers across the U.S. include: 52% of insurers do not anticipate raising rates due to COVID (39% do anticipate raising rates, but no more than 5%); 54% say COVID vaccines should not be required by law; 60% support expanding Medicare; and 74% want government action on drug costs. (https://news.ehealthinsurance.com/news/ehealth-launches-inaugural-signature-research-report-health-insurance-trends)

Pandemic Has Accelerated Changes to All Aspects of Waiting Room, Including Whether to Have One

In the name of efficiency, profits, public health and a better customer experience, healthcare providers around the country are looking at changing every aspect of the waiting-room experience, from the furniture to the fish tank. Now healthcare providers are using technology and redesigning their facilities to change the experience and bring much of it out of the waiting room. (https://www.wsj.com/articles/how-covid-19-is-helping-to-change-the-doctors-waiting-room-11621785601?mod=hp_featst_pos3)

DOJ Charges 14 People in Alleged Covid-Related Healthcare Fraud

Federal prosecutors have charged 14 people - including a medical doctor and owners of laboratories, pharmacies and a home health agency - in multiple Covid-related fraud schemes that allegedly bilked consumers and insurers out of $143 million, the Department of Justice announced. In addition, the Center for Program Integrity at CMS announced it took administrative action against 50+ medical providers for their involvement in healthcare fraud schemes relating to Covid-19. (https://www.cnbc.com/2021/05/26/doj-charges-14-people-in-alleged-health-care-fraud-related-to-covid-19.html)

Google Strikes Deal with HCA to Develop Healthcare Algorithms

Alphabet Inc.'s Google and national hospital chain HCA Healthcare Inc. have struck a deal to develop healthcare algorithms using patient records. HCA would consolidate and store with Google data from digital health records and internet-connected medical devices under the multiyear agreement. Google and HCA engineers will work to develop algorithms to help improve operating efficiency, monitor patients, and guide doctors' decisions. (https://www.wsj.com/articles/google-strikes-deal-with-hospital-chain-to-develop-healthcare-algorithms-11622030401)
In response, New York University medical ethics expert Arthur Kaplan, PhD, said this new collaboration has ignited the need for updates to U.S. privacy laws. "Now we've got electronic medical records, huge volumes of data, and this is like asking a navigation system from a World War I airplane to navigate us up to the space shuttle," he said. (https://www.beckershospitalreview.com/healthcare-information-technology/viewpoint-google-hca-deal-sparks-need-for-update-in-privacy-laws.html)

Mayo Clinic & Kaiser Permanente Invest $100 Million In 'Hospital Care At Home' Venture

The Mayo Clinic and Kaiser Permanente are investing about $100 million into the technology company Medically Home Group to advance a new healthcare delivery model that delivers "advanced care" typically available inside a hospital into patient homes. (https://www.forbes.com/sites/brucejapsen/2021/05/13/mayo-and-kaiser-invest-100-million-in-hospital-care-at-home-venture/amp/)

Walmart to Bring Telehealth Nationwide with Acquisition of MeMD

Walmart Health has entered an agreement to acquire on-demand, multispecialty telehealth provider MeMD. As such, Walmart will begin providing virtual care services for urgent, behavioral and primary care to complement its in-person Walmart Health Centers - allowing it to stay up to pace with Amazon, which recently announced its plans to expand telehealth to nearly 1 million employees by this summer. (https://www.beckershospitalreview.com/telehealth/walmart-health-to-acquire-telehealth-provider-6-details.html)

Ro Acquires Modern Fertility in a $225+ Million Deal

Ro, a digital elective care and telemedicine provider last valued at $5 billion, has acquired Modern Fertility, a reproductive health company. TechCrunch reported that the deal was "north" of $225 million. With the acquisition, Ro said that it is adding fertility testing and reproductive health to its women's health suite of services, a product that has grown 300% last year in revenue. (https://techcrunch.com/2021/05/19/ro-acquires-modern-fertility-in-a-reportedly-225-million-deal/)

Mental Health App Wysa Raises $5.5 Million for "Emotionally Intelligent" AI

Wysa, an AI-powered mental health app, recently closed a Series A funding round of $5.5 million led by Boston's W Health Ventures, the Google Assistant Investment Program, pi Ventures, and Kae Capital. Wysa is largely aimed at people who just want to vent. Most users are there to improve their sleep, anxiety or relationships. (https://techcrunch.com/2021/05/21/mental-health-app-wysa-raises-5-5m-for-emotionally-intelligent-ai/)

AcuityMD Raises $7M to Better Track Evolving World of Medical Hardware

A new Boston-based company is helping doctors keep track of the most up-to-date medical devices on the market: AcuityMD, founded in 2019, is an enterprise software company that wants to unlock the often siloed world of medical device data. And to do so, it just landed a $7 million seed round, led by Benchmark. (https://techcrunch.com/2021/05/25/acuitymd-raises-7m-to-better-track-the-evolving-world-of-medical-hardware/)

Biden's $6 Trillion Budget: Takeaways for Healthcare Leaders

President Biden has proposed a $6 trillion budget for fiscal year 2022, which includes funding for healthcare, and Becker's Hospital Review has compiled "Seven healthcare takeaways." They include:
>> No funding or details are described for several healthcare proposals President Biden has outlined in his healthcare platform, including a public option health insurance plan, lower prescription drug costs and lower Medicare eligibility. The budget calls on Congress to "take action" on the proposals, but doesn't provide a financial plan to do so.
>> It includes a $6.5 billion investment to launch the Advanced Research Projects Agency for Health, which would increase federal funding for R&D in healthcare, with an initial focus on diseases such as cancer, diabetes, and Alzheimer's.
>> It includes $8.7 billion in funding for the CDC to "restore capacity at the world's preeminent public health agency and rebuild international capacity to detect, prepare for, and respond to emerging global threats."
>> The spending plan will include increased taxes on corporations and high-income households. (https://www.beckershospitalreview.com/hospital-management-administration/biden-s-6t-budget-7-takeaways-for-healthcare-leaders.html)

Hospitals Get 1st CMS Warning on Price Transparency Failure

CMS has started issuing its first round of warning letters to hospitals not in compliance with the hospital price disclosure rule, which took effect Jan 1., aiming to make hospital pricing information readily available to patients to compare costs and make more informed healthcare decisions. Hospitals will have 90 days to address the findings in the noncompliance letter from CMS. (https://www.beckershospitalreview.com/finance/hospitals-get-1st-cms-warning-for-noncompliance-with-price-transparency-rule.html)

OIG Issues Favorable Advisory Opinions Regarding Medigap Plan and Preferred Hospital Organization Arrangements

The OIG recently posted Advisory Opinions relating to three near-identical arrangements between Medigap plans and Preferred Hospital Organizations (PHOs). The arrangements involve (i) a discount on a policyholder's Medicare Part A deductible, (ii) a policyholder premium credit, and (iii) a monthly administrative fee to the PHOs. The arrangements are designed to incentivize the Medigap plans' respective policyholders to seek inpatient care from a hospital within the applicable PHO network. Although OIG determined that the arrangements would generate prohibited remuneration under the federal Anti-Kickback Statute and the Beneficiary Inducements Civil Monetary Penalties law, OIG concluded that the arrangements pose a sufficiently low risk of fraud and abuse and that OIG would not impose administrative sanctions under those laws in connection with the proposed arrangements. (https://kslawemail.com/128/7926/pages/article-2.asp?sid=2ff9932b-e358-4cf4-9841-c20693388f2e)

Crispr's Next Frontier: Treating Common Conditions

In the next decade, Crispr-Cas9 and other new gene-editing techniques may protect the health of millions of people with a range of conditions, including chronic pain and diabetes. Rather than take drugs for years or even decades, for example, at-risk people might be able to protect themselves with a one-and-done Crispr therapy. (https://www.wsj.com/articles/crisprs-next-frontier-treating-common-conditions-1162022683)

In the War on Cancer, Science Is Winning

A recent opinion piece in The Wall Street Journal shares information from the recent International Vatican Conference, an annual gathering of medical, scientific, and religious experts, at which panelists described progress on many fronts in the battle against cancer. Progress includes:
>> In five years there may be a simple blood test costing less than $500 that can detect 70% of all cancers in the earliest stages.
>> New vaccines against HPV, which causes cervical and throat cancer, are in late-stage trials. Scientists are also testing vaccines for melanoma, leukemia, lung, and renal cancers.
>> Many trials of Crispr therapies in the U.S. now are in phase 2 for leukemia, lymphoma, myeloma and more. In China, Crispr is showing promise against lung cancer. (https://www.wsj.com/articles/in-the-war-on-cancer-science-is-winning-11621881949)

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