ABL Healthcare Member News & Industry Trendletter * September 7, 2022
  • 9/07 - Orange County ZOOM Table - Discussion Topic: "How COVID Expedited AI in Healthcare" - Featured Member Presenter: Ed Buckley, CEO of Select Data

  • 9/13 - Silicon Valley ZOOM Table - Discussion Topic: "Lessons Learned Investing in the Future of Healthcare" - Featured Member Presenter: George Carpenter, President of CGI Biomed Investments

  • 9/15 - Bay Area IN-PERSON Table (at Cal State East Bay, downtown Oakland) - Discussion Topic: "When $10 Million Isn't Enough" - Featured Member Presenter: Debbie Toth, President and CEO of Choice in Aging

  • 9/16 - Los Angeles ZOOM Table - Discussion Topic: "The Employer's Role in Developing Workers' 'Brain Skills'" - Featured Member Presenter: Mark Heinemeyer, CEO of PRODEO, LLC

  • 9/20 9-11 a.m. - "AFTER THE SALE" ABL MEMBERSHIP-WIDE ZOOM EVENT, featuring...
Bob Richardson, Sumit Mahendru & Thomas Leffler
This Event's three Featured Members were able to reap the benefits (and a few thorns) that accompanied their "SOLD" signs. Hear firsthand the stories about their "Roads to the Exit," Post-Exit Realities - including what's worked better (and worse) than expected, and what they'd do differently next time. Bring your questions - because our speakers are bound to have plenty of answers!
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Biospectal CEO Shares 4 Ways Tech Can Help Manage Healthcare Data

Eliott Jones, CEO of Biospectal, wrote an article for Forbes - Consumers Are Awash In Healthcare Data - Here Are Four Ways Technology Can Help Manage It, in which he discusses making it easy to use apps and input data; focusing on essentials; designing better apps and interfaces; and ensuring privacy.
AND, in this video post, Eliott and Professor Patrick Schoettker, MD, discuss how Biospectal's OptiBP can help physicians and individuals manage their hypertension and live longer and healthier lives. (Eliott Jones, SV)

Greg Buchert, MD, Judges Pitch Competition for Life Science Startups

Greg Buchert, MD, of GSB Health Management Solutions, recently represented MEDA Angels and Tech Coast Angels Orange County as a judge in the "Pitch. Launch. Grow. 2022 Demo Day," Orange County's annual pitch competition for life science startups, sponsored by University Lab Partners. Six finalists, from a field of 30 applicants, vied for the award; Entelexo Biotherapeutics was the winner. (Greg Buchert, MD, OC)

Change Healthcare Provides Info on Transparency in Coverage Final Rule, Electronic Prescribing for Controlled Substances Mandate, & More

Change Healthcare has published an infographic on the Transparency in Coverage Final Rule, as well as an article and interactive map on Electronic Prescribing for Controlled Substances Mandates.
ALSO, read a recent article from Change Healthcare - The Power of Data and Working Together to Solve Health Crisis.
MEANWHILE, Change Healthcare announced that they have maintained their HEDIS and NCQA certification in 2022 with their quality rules processing engine, which helps payers ensure compliance.
PLUS, Change scored 100/100 on the Disability Equality Index by Disability:IN. (Marcia Augsburger, JD, Bay Area)

Choice in Aging Heralds Upcoming Bedford Block Party on Sept. 24 + "Dishing with Debbie"

Choice in Aging (CiA)'s 5th Annual Bedford Block Party will take place Saturday, September 24. Entitled "Bocce, Booze, and Blues," the event will include a "fun-filled bocce tourney at an historic Antioch estate, rockin' out to the awesome Frankie G, fresh and delicious local Mexican cuisine, great company, and libations," with "generous community members and elected officials attending." An accompanying online auction will run from September 19-26.
MEANWHILE, click here to watch recent episodes of CiA's Dishing with Debbie, including discussions with Caitlin Sly, Executive Director of Meals on Wheels Diablo Region; Susun Kim, Executive Director of the Contra Costa Family Justice Center; Tracee Stacy, PEAS Education Outreach Specialist; and Elizabeth Zirker, a Managing Attorney with Disability Rights California. (Debbie Toth, Bay Area)

Cigna Grows ACA Marketplace Presence

Cigna is expanding the reach of its ACA Marketplace exchange plans: during the upcoming Open Enrollment Period, which begins in November, Cigna Health Plans will be available on the individual exchange in three new states - Texas, Indiana, and South Carolina - as well as in additional counties in Georgia, Mississippi, and North Carolina. With this expansion (pending final regulatory approvals) Cigna will offer individual and family plans on the individual exchanges in 363 counties spanning 16 states. (Chris De Rosa, OC)

Elemeno Health Lauded by SJF Ventures Following $7 Million Investment

SJF Ventures recently described their $7 million Series A investment round in Elemeno Health this way: Elemeno has built a "playbook in your pocket" for nurses, which helps them enhance patient care and execute their day-to-day tasks more efficiently. The "playbook" has been associated with increased nurse satisfaction and a decrease in turnover by up to 50%. Improved consistency of care has resulted in decreased medical errors and hospital-acquired conditions by up to 75%.
MEANWHILE, Elemeno has published its recent presentation slides to the American Organization for Nursing Leadership - Empowering Nurses with the Cloud to Improve Engagement, Onboarding, and Cost. (Arup Roy-Burman, MD, Bay Area)

FOMAT Launches Clinical Research Ambulance to Reach Underserved Communities

FOMAT Medical Research has unveiled its new Ambulance of Research, with which FOMAT will engage in innovative ways to conduct hybrid clinical trials, while reaching underserved communities. The company aims to inform the community about the risks involved in various health conditions, educate them on the early steps one can take to prevent serious health problems from developing, and offer free diagnostic tests if appropriate. FOMAT's Ambulance of Research currently offers services for fatty liver scans, COVID-19 tests, immunizations, physical exams, and more.
MEANWHILE, two of FOMAT's clinical research sites were recently named Top 10 Enrollers for a major study on Chronic Pancreatitis; one site was recognized at the top enroller for the entire study.
ALSO, FOMAT was recognized for their incredible contributions towards the largest pediatric mRNA vaccine trial conducted to date. (Nick Focil, LA)

HumanGood Awarded $12 Million from Department of Treasury

HumanGood and Beacon Development Group were selected from a pool of 146 applications as the recipient of a 2021 Capital Magnet Fund (CMF) Award, securing the highest award amount of $12 million. Together with HumanGood's receipt of a $5 million 2020 CMF award, this brings a total of $17 million in funding for affordable housing development efforts. HumanGood and Beacon anticipate disbursing and completing projects with the award funding by September of 2027. (Tara McGuinness, Bay Area)

Illumination Foundation Co-CEO Discusses Using Health-Related Data to Improve Care for Homeless

In its article - Using Health-Related Data to Improve Care for People Experiencing Homelessness: Perspectives from Illumination Foundation - The Better Care Playbook recently spoke with Pooja Bhalla, Co-CEO of Illumination Foundation (IF), and Ashish Abraham, MD, President and Co-Founder of Foresight Health Solutions, and a consultant to IF, to learn about IF's approach to data analytics and how it can inform other organizations looking to improve care for people experiencing homelessness.
ALSO, read Pooja's recent blog post - Framing a Discussion About Health Equity. (Pooja Bhalla, OC)

Kaiser Permanente Plans Inland Empire Expansion + Finds Fewer Hospitalizations for Home-Based Cardiac Rehab Patients

In Southern California's Inland Empire, Kaiser Permanente (KP) is expanding Riverside Medical Center and making upgrades to patient rooms, increasing the hospital's beds from 226 to 298, the Press-Enterprise reported, in a project expected to be finished in the first quarter of 2027. KP is also expanding Moreno Valley Medical Center by 93,000 square feet, expected to be completed in the third quarter of 2023, and building medical offices in Murrieta and Wildomar, CA.
ALSO, a KP study recently published in JAMA Network Open found that patients who participated in in-home cardiac rehabilitation had fewer hospitalizations over 12 months than patients who participated in center-based cardiac rehabilitation. (Marcos Vasconcelos, Bay Area)

Mazzetti Shares What Healthcare Orgs Need to Know About Inflation Reduction Act

In What Healthcare Organizations Need to Know About the Inflation Reduction Act to Leverage Financial Incentives, Mazzetti shares that its Sustainability Team, in collaboration with the company's financial partners, has dissected this bill in its entirety and identified the areas that apply directly to the healthcare sector. It is their hope that by informing clients, that the healthcare industry will proceed with implementing clean energy production strategies, EV charging and electric-fleet conversion, and decarbonization strategies to lower their operational footprints for the future, and therefore further lower the impact that climate change has on human health.
ALSO, in Help Wanted - Healthcare Biomeds and Electricians, Mazzetti CEO Walt Vernon writes about Mazzetti's Sextant Foundation, which aims to help develop sustainable energy and water systems in healthcare settings in low-resourced places around the world. Walt shares that these projects rely on skilled volunteers, particularly electricians, and currently biomedical engineers. He says, "If you are this kind of person, or if you know people, please be in touch. You can make a big difference; you can save lives." (Walt Vernon, JD, Bay Area)

MedWand Solutions Now Commercially Available + Featured in Industry Journals

Following its recent 510(k) clearance from the FDA, MedWand Solutions announced that its MedWand device and VirtualCare ecosystem are commercially available to enable clinical exams with its comprehensive care solutions. Available kits include MedWand Evaluation, MedWand Mobile Clinic, and MedWand Remote Clinic.
MEANWHILE, MedWand has been featured in several recent articles, including: Telemedicine is Transforming with Access to NEW, Cutting-Edge Comprehensive Care Solutions by American Telemedicine Association; MedWand's devices for improved telehealth nab FDA's approval by Health Geniuses; and New Virtual Resources Aim to Promote Telehealth, Enhance Access by mHealth Intelligence. (Bob Rose, OC)

Mission Hospice Announces Fall Gala in October

On October 22, the Mission Hospice Auxiliary will present Diamonds & Denim, its 2022 in-person Fall Gala, which will benefit Mission Hospice & Home Care, helping them serve people regardless of their medical coverage or ability to pay. The event will include dinner, music, auction items, a chance to fund-a-need, and more. (Dolores Miller, SV)

National Healthcare and Housing Advisors Launched by Paul Leon

Longtime public health leader and recognized advocate for the homeless, Paul Leon has recently founded National Healthcare & Housing Advisors (NHHA), a multi-faceted, independent organization which provides a variety of vital services that help clients successfully integrate healthcare and homeless care services delivery across the nation. Areas of expertise include medical respite recuperative care, integrated solutions to address the housing crisis, advanced data analytics, medical billing, and recruitment and workforce equity through nursing. Most recently, Paul was CEO of Illumination Foundation, which he founded in 2008, a healthcare-focused homeless services provider, leading innovative healthcare and housing solutions.
MEANWHILE, Paul was interviewed and profiled in a recent article in Senior Planet from AARP. (Paul Leon, OC)

Nelson Hardiman Delves into the Inflation Reduction Act's Impact on Healthcare

A recent Client Alert from Nelson Hardiman (NH) - A Priority Legislation Update - The Inflation Reduction Act of 2022 & Healthcare - reports on the legislation's ACA extension, expansion of Medicare benefits, drug price negotiation program, and its impact on innovation.
PLUS, Client Alert: A Priority Telehealth Update: Telemedicine Fraud - Enforcement Trends discusses the current seismic shift to telemedicine in a short span of time has also opened the door to new opportunistic forms of fraud and abuse.
ALSO, NH Managing Partner Harry Nelson was recently interviewed on NewsNation Rush Hour regarding the Monkeypox outbreak and whether Americans should be concerned, AND was interviewed on KTLA 5 regarding the rise in fentanyl deaths amid the $650M pharmacy judgment.
MEANWHILE, Harry Nelson is among the six NH attorneys who have been named to Best Lawyers' 2023 Best Lawyers in America List. (Harry Nelson, JD, LA)

Nubratori RX Achieves #988 on INC. 5000 List

Nubratori RX has been named #988 in the latest INC. 5000 list of the fastest-growing companies. It is also #152 in California; #59 in Los Angeles; and #17 in Health Products. This is Robert Nickell's third time as a CEO to reach the INC. 5000/500. (Robert Nickell, Pharm.)

Parentis CEO Tarek El Nabli Nominated for Innovator Award + Pop-in Care Offers "Service Bundles"

Tarek El Nabli, CEO of Parentis Health, is among the Orange County Business Journal's Innovator of the Year Award Nominees. Winners will be announced on September 8th.
ALSO, Pop-in Care, a Parentis Health subsidiary company, has introduced a new pricing structure for its licensed in-home care services catering to individuals with disabilities, the elderly, and those recovering from surgeries or other acute illnesses. Pop-in Care continues to maintain its emphasis on short visits, without minimum hourly or weekly time or visitation requirements. The new pricing structure offers discounts to families who want to pre-purchase a number of hours that can be used over the course of one month from date of purchase. (Tarek El Nabli, OC)

PreludeDx Announces Preferred Provider Agreement with Three Rivers & Galaxy Health

Prelude Corporation (PreludeDx) has signed an agreement with Three Rivers Provider Network, the largest and fastest-growing proprietary provider network in the U.S., under which TRPN's 200+ million members will now have access to PreludeDx's novel DCISionRT test for ductal carcinoma in situ (aka stage zero breast cancer).
AND, PreludeDx has signed an agreement with Galaxy Health Network to provide coverage for DCISionRT to Galaxy's 3.5+ million members and 400,000+ providers. (Dan Forche, OC)

Providence Digital Innovation Group Explains Why Healthcare Needs a Flywheel

In DIG THIS: Why HealthCare Needs a Flywheel, Providence Digital Innovation Group explains that in physics, a flywheel is a mechanical tool used to store rotational energy thereby adding stability and increasing momentum. Just as Jim Collins first popularized the flywheel effect in Good to Great, put in business terms, a flywheel is the mechanism that drives consumers to a platform and keeps them coming back for more and more. While a flywheel is hard to start, once it's started moving, it is difficult to stop. Providence goes on to discuss why healthcare needs flywheel programs. (Marcee Chmait, LA)

Royal Ambulance Team Members Win Stars of Life Award

The California Ambulance Association recently awarded eight Royal Ambulance team members their highest honor - The Stars of Life Award. The honor recognizes individuals for their heroic actions on the front lines of healthcare and superior performance throughout their careers in EMS. (Steve Grau, SV)

Satellite Healthcare Shares Study Results on Patient Activation Among Hemodialysis Patients

Satellite Healthcare collaborated on a recent study and publication - Patient Activation Among Prevalent Hemodialysis Patients: An Observational Cross-Sectional Study, which details the largest study to date to explore the status of patient activation among in-center hemodialysis patients in the US, finding the majority with low activation. This finding underscores an opportunity to modify management of patients based on their activation levels and to adopt strategies to improve patient activation among this group of highly medicalized patients. (Jeff Goffman, SV, & Bernadette Vincent, Bay Area)

Select Data Provides Insights on Outsourced Coding, Reducing Staff Turnover & OASIS.E

Maxwell Healthcare Associates, a proud partner of Select Data, recently featured a blog post from Select Data: Case for Outsourced Coding - Optimizing coding and CDI with help from industry experts, which explains why home health agencies with optimized coding and clinical documentation improvement practices have fewer problems with audits, faster time to payment, and excellent capture of all possible and appropriate charges.
AND, watch an on-demand replay of a recent webinar from Select Data and Maxwell: Augmented Coding & QA Webinar - Reduce Staff Turnover While Improving Quality of Care, as well as Spotlight On: OASIS.E New and Removed Items - explore items that take effect on January 1, 2023. (Ed Buckley, OC)

WestFax Announces New Integration with PaperCut

WestFax has announced the launch of its new fax integration for PaperCut MF - the first time a third-party fax provider has worked with PaperCut's Developer Relations team to create a custom plug-in for the company's platform. WestFax says that as part of its overall environmental impact effort, they've partnered with Papercut to reduce office paper waste by helping customers convert to a Secure Cloud Fax alternative. (Barry Clark, OC)

Wipfli to Present Webinars on Healthcare & Cybersecurity

Upcoming healthcare-related webinars from Wipfli include:
>> Build a more cyber resilient healthcare organization, on September 20, which will cover the reasons why hospitals, healthcare providers, and health systems have become a favorite target of cybercriminals, and offer practical strategies and tactics to successfully prevent and mitigate cyberattacks.
>> Healthcare Cybersecurity Compliance, on October 18, which will address attendees' questions and provide insights on current and future regulatory landscape impacting healthcare cybersecurity. (Jeff Johnson, John Dao & Steve Rousso, Bay Area)

Eckert & Ziegler Teams with PRECIRIX, NAID/NIH & European Defense Fund

Eckert & Ziegler (EZ) and Belgian biotech company PRECIRIX NV have signed an agreement for the supply of Actinium-225, used as an active substance in cancer treatment. This gives PRECIRIX priority access to EZ's high-purity, non-carrier-added Actinium-225, which is used for the labeling of trial drugs in radionuclide therapy.
AND, EZ affiliate Myelo Therapeutics GmbH announced that the U.S. National Institute of Allergy and Infectious Diseases, part of NIH, extended their contract to advance the development of the new chemical entity Myelo001 to mitigate acute radiation syndrome.
PLUS, Myelo Therapeutics was selected to receive grants from the European Defense Fund worth approximately 17 million Euro for the development of its medical countermeasure against acute radiation syndrome. (Frank Yeager, ABL-Tech SGV)

GIDEON on: Predicting the Future with GIDEON Data + Monkeypox Outbreak

"If you want to study the past then GIDEON is a great place to do so," the company declared recently. "The question is, what would you do with over 750,000 data points, dating back to the 17th Century? A team of researchers answered in an interview: Predicting the Future with GIDEON Data.
MEANWHILE, GIDEON's recent webinar is available to watch on-demand: Imported Diseases: Ongoing Monkeypox Outbreak and Salmonellosis in a Chocolate Egg. (Uri Blackman, ABL-Tech WLA)

Amazon Care is Dead, but the Tech Giant's Healthcare Ambitions Live On

Amazon will shutter Amazon Care, the virtual and in-home health service, by the end of this year. Initially rolled out as an internal healthcare offering for Amazon's employees, today Amazon Care is available to the employees of half a dozen corporate customers. Workers were told the service was shutting down because those customers did not see the value in the service, a source said. (https://www.washingtonpost.com/technology/2022/08/24/amazon-care-telehealth-shutting-down/)
To understand where Amazon is headed next in healthcare, the industry is looking for clues from a different direction: Amazon's acquisitions. Amazon is in the process of acquiring primary care start-up One Medical for $3.9 billion, although regulators said Friday they are taking a closer look at the deal. While the e-commerce giant's exact path into healthcare is unclear, Amazon has shown sustained interest in providing home healthcare for seniors, and selling telehealth and mental health services to employers. (https://www.washingtonpost.com/technology/2022/09/04/amazon-care-health-one-medical/)

Cybersecurity Attacks Cost Healthcare Systems More than Any Other Sector

Healthcare providers face a tsunami of cybersecurity threats and they are inflicting significant damage. The FBI reported that 40+ million patient records were compromised by hackers in 2021. That means compromises have more than tripled since 2018. Worse yet, the average cost of a healthcare security breach is by far the highest among all sectors. According to IBM, that per-incident cost rose a startling 29.5% from $7.13 million in 2020 to $9.23 million in 2021. No other sector's per-incident costs come close. In fact, the sector with the second highest per-incident costs - financial services - actually saw its per-incident cost decrease from $5.85 million to $5.72 million. (https://www.changehealthcare.com/insights/healthcare-it-consulting-services-protect-against-cybersecurity-threats)

Analysts See Value-Based Care Expanding as Pressure to Reduce Costs Grow

In a recent Wall Street Journal article - Profit From America's Healthcare Bloat, analysts including Ryan Daniels at William Blair see value-based care expanding in the coming decade as pressure to reduce healthcare costs grows. The changes might gradually help turn the tide on healthcare costs, but for medical providers they are a big headache. Realigning a large medical practice to a new business model can be cumbersome. Doctors go to school to treat patients, not to deal with revamping their actuarial models or upgrading their IT systems. Some groups wind up partnering, or selling themselves to a larger business like UnitedHealth Group Inc.'s Optum, which can help move providers to value-based care. Others who choose to remain independent are turning to companies like Privia or Agilon, which focuses on the Medicare population. (https://www.wsj.com/articles/profit-from-americas-healthcare-bloat-11662300000?mod=hp_lista_pos4)

BUT, Value-Based Care Still Small Fraction of Medical Revenue, MGMA Finds

A new report from the Medical Group Management Association found that value-based care only accounts for a small portion of medical revenue in most specialties. Data from the survey found that revenue from value-based contracts accounted for 6.74% of total medical revenue in primary care specialties, 5.54% in surgical specialties, and 14.74% in nonsurgical specialties. Across all practices, the median revenue amount from value-based contracts was $30,922 per provider. The survey also provided key benchmarks for quality measures, based on covered lives attributed under value-based contracts. Median quality measure performance was 3% for hospital admission rate, 11% for 30-day readmission rate, 27% for emergency department utilization rate, and 1% for 30-day postoperative infection rate. (https://www.healthcarefinancenews.com/news/value-based-care-still-small-fraction-medical-revenue-mgma-finds)

What Does "Quiet Quitting" Look Like at Hospitals?

The trend of "quiet quitting" has recently gained traction on social media, referring to a phenomenon in which workers reduce their enthusiasm at work and stick to the minimum expectations of their role. Some professionals, including Generation Z workers, have embraced the concept as an increased form of work-life balance, and others see it as a lesser-version of actually quitting. According to Jeremy Sadlier, executive director of the American Society for Healthcare Human Resources Administration, it is greatly concerning that the effects of quiet quitting in healthcare have a direct connection to patient care, quality and safety. An April Gallup poll found that 34% of U.S. employees were actively engaged at work in 2021, compared to only 32% this year. Healthcare professionals saw the largest dip in engagement, with their engagement scores dropping nine points year over year. (https://www.beckershospitalreview.com/workforce/what-does-quiet-quitting-look-like-at-hospitals.html)

MEANWHILE, 1 in 10 Office Leases About to Expire, Forcing Some Companies to Decide if Workers Should Return to Offices

About 243 million square feet worth of office leases - approximately 11% of the country's total leased office space - is set to expire across the country this year, a 40% increase from 2018 and the highest since property manager JLL began tracking the data in 2015. This year won't be an outlier, either, the volume of lease expirations is projected to exceed 200 million square feet annually through 2025. At the same time, office occupancy - according to the weekly occupancy report from Kastle Systems, which monitors card swipes in office buildings - is still in the 40% range in some of the biggest markets in the country. Given the slow pace of Return to Office, leaders will have to figure out how many employees they want back In the office full-time, and how many can stay home or work hybrid [as they renegotiate their leases]. (https://www.kornferry.com/insights/this-week-in-leadership/return-to-office-the-moment-of-truth)

Getting More Exercise than Guidelines Suggest May Further Lower Death Risk

New research recently published in the American Heart Association journal Circulation found that doubling to quadrupling the minimum amount of weekly physical activity recommended for U.S. adults may substantially lower the risk of dying from cardiovascular disease and other causes. The study found people who followed the minimum guidelines for moderate or vigorous long-term, leisure physical activity lowered their risk of dying from any cause by as much as 21%. But adults who exercised two to four times the minimum might lower their mortality risk by as much as 31%. (https://www.heart.org/en/news/2022/07/25/getting-more-exercise-than-guidelines-suggest-may-further-lower-death-risk)

New Omicron Boosters Now Available; MEANWHILE, Paxlovid Far More Effective in Seniors Than in People Under 65, Study Finds

The U.S. authorized the first major makeover of the Covid-19 vaccines last week in an effort to stem an expected tide of infections and hospitalizations this fall. But it's unclear how much protection the new booster shots will provide. The FDA and the CDC cleared the shots without any data from clinical trials that are testing the reformulated doses in humans. The new boosters, authorized for people ages 12+, target the highly contagious and immune-evasive omicron BA.5 subvariant that has caused a wave of breakthrough infections over the summer. The shots also target the original strain of the virus that first emerged in Wuhan, China, in 2019. The nation's top health officials acted with urgency this summer to ensure the new boosters would roll out in time for the fall, worried that the waning effectiveness of the old vaccines is creating an opening for omicron to cause another wave of hospitalizations this winter. (https://www.cnbc.com/2022/09/03/covid-19-omicron-shots-available-but-their-effectiveness-is-unclear-.html)
MEANWHILE, Paxlovid Is Far More Effective in Seniors Than in People Under 65, Study Finds: Taking the antiviral treatment Paxlovid can reduce a person's chances of getting seriously ill from COVID-19. But while seniors tend to get impressive protection from the pills, younger people derive little benefit, finds new research. People who were 65 or older had a 73% lower chance of being hospitalized for COVID-19 and about a 79% lower chance of dying of the disease, compared to people in the same age group who did not take Paxlovid. But people ages 40 to 64 experienced no statistically significant drop in the risk of hospitalization or death. (https://time.com/6208336/paxlovid-effective-older-adults/)

California Announces: $694M to Create 2,500+ New Homeless Housing Units Statewide + $47M for Seniors & Adults with Disabilities

California Governor Newsom recently announced the award of $694 million for 35 projects that will create 2,500+ new units in 19 communities throughout the state. In total, California's nation-leading Homekey program has funded more than 200 projects statewide - creating 12,500+ permanent and interim homes for people exiting homelessness. (https://www.gov.ca.gov/2022/08/24/in-los-angeles-governor-newsom-announces-694-million-in-homekey-awards-to-create-more-than-2500-new-homeless-housing-units-statewide/)
ALSO, the California Department of Social Services announced that five organizations were awarded a total of $47 million in grants to create more residential care options for seniors and adults with disabilities, including people at risk of or experiencing homelessness. These grants are the first to be awarded through the new Community Care Expansion - Capital Expansions Grants Program administered by the California Department of Social Services to help address historic gaps in the state's behavioral health and long-term care continuum. (https://www.cdss.ca.gov/Portals/13/Press%20Releases/2022/CDSSNewsRelease-HousingGrants.pdf)

Gov. Newsom Appoints Dr. Diana Ramos as California Surgeon General

Governor Gavin Newsom recently announced the appointment of public health leader Dr. Diana Ramos as California Surgeon General. Dr. Ramos has more than three decades of cross-cutting experience and expertise with a focus on health equity and reproductive health. She currently serves at the California Department of Public Health's Center for Healthy Communities, where she oversees the state's public health and prevention programs. The California Surgeon General is a key spokesperson on public health issues throughout the state and advises the Governor on efforts to address health risks and challenges as effectively and as early as possible. (https://www.gov.ca.gov/2022/08/25/governor-newsom-appoints-dr-diana-ramos-as-california-surgeon-general/)

VA Says It Will Provide Abortions in Some Cases Even in States Where It's Banned

The Department of Veterans Affairs says it will start providing abortions in certain circumstances, even in states where it's illegal or restricted. The new policy came in response to the recent U.S. Supreme Court decision overturning Roe v. Wade, which allowed state governments to decide whether to permit abortions. Since then, a number of states have implemented full bans on the procedure or drastically limited it. Now, the VA says it's stepping in to offer abortions in order to protect the health and lives of veterans in places where they can no longer access such reproductive care. Under a new interim final rule, pregnant veterans and VA beneficiaries will be able to get abortions if their life or health would be in danger if the pregnancy went to term. Patients whose pregnancies were the result of rape or incest will also be eligible for abortions. (https://www.npr.org/2022/09/03/1120965553/the-va-says-it-will-provide-abortions-in-some-cases-even-in-states-where-its-ban)

White House Seeks $47B in Emergency Funding: 2 Healthcare Takeaways

The White House requested $47 billion in emergency funding Sept. 2 to support response efforts for the war in Ukraine, COVID-19, monkeypox and natural disasters. The Biden administration is asking Congress to consider the requests as part of a short-term spending bill to fund the U.S. government after the current spending package expires Sept. 30. Two healthcare takeaways:
>> COVID-19 funding. The White House is requesting $22.4 billion to support ongoing pandemic response activities, including stockpiling tests and accelerating research on next-generation vaccines. The request comes after Congress failed to reach a deal on additional COVID-19 funding this summer, spurring the government to shift funding away from testing and end its program that shipped free rapid tests to Americans. If more funding is not secured, the U.S. government will be forced to forgo buying and distributing free COVID-19 vaccines by January, officials said.
>> Monkeypox funding. The Biden Administration is also seeking $4.5 billion to fund monkeypox response efforts. About $3.9 billion would cover monkeypox vaccines, tests and treatments in the U.S., while $600 million would be used to support global monkeypox efforts. More than 19,000 monkeypox cases had been confirmed in the U.S. as of Sept. 1, according to the CDC. (https://www.beckershospitalreview.com/finance/white-house-seeks-47b-in-emergency-funding-2-healthcare-takeaways.html)

CDC Director Announces Organization Shake-Up Aimed at Speed

The head of nation's top public health agency recently announced a shake-up of the organization, intended to make it more nimble. The planned changes at the Centers for Disease Control and Prevention - CDC leaders call it a "reset" - come amid ongoing criticism of the agency's response to COVID-19, monkeypox, and other public health threats. The changes include internal staffing moves and steps to speed up data releases. (https://www.kxly.com/i/cdc-director-announces-organization-shake-up-aimed-at-speed-2/)

HHS Funds U.S.-Based Production of Smallpox and Monkeypox Vaccine

HHS will provide approximately $11 million to support the first U.S.-based fill and finish manufacturing of JYNNEOS - a vaccine approved to prevent smallpox and monkeypox - at Grand River Aseptic Manufacturing (GRAM) in Grand Rapids, Michigan. The agreement between the Biomedical Advanced Research and Development Authority (BARDA), part of the HHS Administration for Strategic Preparedness and Response (ASPR), and GRAM aids the company in accelerating the fill and finish manufacturing qualification and production in its recently expanded facility. The funding will allow GRAM to purchase additional equipment necessary for JYNNEOS production and recruit and train additional staff to operate the line. With BARDA's support, vaccine production at the facility is expected to be underway later this year, "months ahead of the 9-month schedule typical for this type of work." (https://www.hhs.gov/about/news/2022/08/29/hhs-funds-us-based-production-of-smallpox-and-monkeypox-vaccine.html)

Medicare Shared Savings Program Saved Medicare $1.66 Billion in 2021

CMS announced that the Medicare Shared Savings Program, through its work with Accountable Care Organizations, saved Medicare $1.66 billion in 2021, compared to spending targets, while continuing to deliver high-quality care. This marks the fifth consecutive year the program has generated overall savings and high-quality performance results. Shared Savings Program ACOs are groups of doctors, hospitals, and other healthcare providers who collaborate to give coordinated high-quality care to people with Medicare, focusing on delivering the right care at the right time, while avoiding unnecessary services and medical errors. When an ACO succeeds in both delivering high-quality care and spending healthcare dollars more wisely, the ACO may be eligible to share in the savings it achieves for the Medicare program (also known as performance payments). (https://www.hhs.gov/about/news/2022/08/30/medicare-shared-savings-program-saves-medicare-more-than-1-6-billion-in-2021-and-continues-to-deliver-high-quality-care.html)

Departments Issue Final No Surprises Act Dispute Resolution Rule and Other Guidance

On August 19, the Departments of HHS, Labor, and the Treasury issued a long-awaited Final Rule on the Independent Dispute Resolution (IDR) Process under the No Surprises Act (NSA). The Final Rule modifies the weight given to the information that IDR entities must consider in deciding payor-provider payment disputes under the NSA, it also imposes new requirements for plans and issuers to supply a disclosure when they downcode claims governed by the NSA. Read More: https://kslawemail.com/128/9408/pages/article1.asp?sid=70699854-251c-413c-9ff0-38e5d8f6e1cc

Senator Wyden Launches Inquiry into Medicare Advantage Marketing Practices

On August 23, Senate Finance Committee Chair Ron Wyden (D-Ore.) announced he was launching an inquiry into potentially deceptive marketing tactics by organizations offering Medicare Advantage benefits and Part D prescription drug programs. Senator Wyden's inquiry comes following information from CMS in its final rule earlier this year that marketing complaints more than doubled from 2020 to 2021 and that many of those complaints were related to third-party marketing organizations. Senator Wyden sent letters to 15 state insurance commissioners and state health insurance assistance programs requesting data about Medicare Advantage marketing complaints and other information. (https://kslawemail.com/128/9430/pages/art2.asp?sid=81abdba5-cc11-43e8-82a5-4679f749d4cb)

The Administration Proposes to Make Healthcare Enrollment Easier

The Biden-Harris Administration has proposed a new rule to overhaul the enrollment processes (simplify application and verification processes) for Medicaid, the Children's Health Insurance Program, Basic Health Programs (BHPs), and eliminate arbitrary coverage caps for children in CHIP. Currently 88+ million people are enrolled in Medicaid, CHIP and BHPs [which are currently only available in New York and Minnesota]. This rule, if finalized, would standardize commonsense eligibility and enrollment policies, such as limiting renewals to once every 12 months, allowing applicants 30 days to respond to information requests, requiring prepopulated renewal forms, and establishing clear, consistent renewal processes across states.
Medicaid is the single largest health coverage program in the U.S., covering nearly one in four Americans and providing robust benefits with little-to-no out of pocket costs. Medicaid and CHIP provide 51% of our nation's children and youth - 40+ million - access to quality, affordable healthcare. The Administration is proposing to end lifetime benefit limits in CHIP and allow children to enroll in coverage right away by eliminating pre-enrollment waiting periods, consistent with nearly all other health coverage. The proposed rule would also permit states to transfer children's eligibility directly from Medicaid to CHIP when a family's income rises, preventing unnecessary redetermination processes from causing lapses in coverage.
The proposed rule also:
>> Proposes simplifications that would increase enrollment and retention for people age 65+, as well as those who have blindness or a disability.
>> Offers ways to simplify enrollment for Medicare Savings Programs (MSPs), which permit Medicaid to pay Medicare premiums or cost sharing for Medicare beneficiaries with lower incomes. A recent study estimated that only about half of eligible low-income individuals enrolled in Medicare were also enrolled in MSPs. The rule would automatically consider older adults for MSP enrollment when they apply for low-income subsidies to help pay for Part D Medicare coverage. (https://www.cms.gov/newsroom/press-releases/biden-harris-administration-proposes-make-health-care-enrollment-easier-millions-americans)

CMS Eyes State Medicaid Programs as Part of Biden Admin's Plan to Improve Nursing Home Care

CMS recently issued guidance in an informational bulletin that aims to strengthen the correlation between nursing home quality measures and reimbursement. In addition to directing CMS to take nursing home reform actions, the administration plans to improve the quality of care in nursing homes by [partial list]:
>> Seeking a $500,000,000 appropriation to HHS directing the agency to improve its inspection processes and procedures, and develop a database that tracks nursing home operators with known healthcare-related violations to increase transparency in nursing home reporting requirements;
>> Increasing enforcement activity and scrutiny of low performing nursing homes;
>> Recommending that CMS promulgate guidance prohibiting nursing home owners from entering into Medicaid provider agreements if they have a history of owning underperforming or non-compliant facilities and that CMS have the ability to initiate enforcement actions against owners after their nursing home facility closed;
>> Directing CMS to implement the results of its study examining the appropriate minimum staffing requirement for nursing homes. CMS will make this minimum staffing requirement a mandatory requirement for all nursing homes. (https://www.kslaw.com/news-and-insights/health-headlines-august-29-2022)

CMS Issues IPPS and LTCH Final Rule for FY 2023

On August 1, 2022, CMS issued its annual Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System Final Rule for FY 2023. In the Final Rule, CMS updated the IPPS and LTCH payment rates, modified the payment rules for direct graduate medical education to comply with a recent federal court decision, imposed a permanent 5% cap on year-to-year wage index losses, and adopted a new supplemental payment for tribal hospitals and hospitals located in Puerto Rico. (https://kslawemail.com/128/9370/pages/art1.asp?sid=60d2957b-f8ad-445c-8fe5-6e11804c1fb4)

Millions of Americans Will Soon Be Able to Buy Hearing Aids Without a Prescription

Adults with perceived mild to moderate hearing impairment will be able to buy hearing aids directly from stores, pharmacies and online retailers - no prescription or doctor's appointment required - as soon as mid-October. That's thanks to a final rule recently issued by the FDA, following years of campaigning by lawmakers and advocates. It creates a new category of over-the-counter hearing aids, which the Biden administration says will make the devices more accessible and affordable for millions of Americans. (https://www.npr.org/2022/08/16/1117741695/over-the-counter-hearing-aids)

Ending Bad Cholesterol with a Single Injection

More than 200 million people take statins daily to lower their bad cholesterol (LDL). Unfortunately, a majority fail to stick with their daily pills, putting them at risk of heart disease. Verve, a biotech company formed by one of the top heart-disease experts, wants to change that with a single injection that would permanently reduce LDL. It's a treatment based on CRISPR technology. But unlike the traditional Crispr approach, which acts like a pair of scissors to make a cut to the DNA, Verve is employing a new technology known as base editing, which acts more like a pencil and eraser, substituting a single letter of DNA for another. The gene Verve seeks to edit, PCSK9, regulates LDL levels in the body. While the treatment is highly experimental and the chance of failure is high, early results look promising. (https://www.wsj.com/articles/ending-bad-cholesterol-with-a-single-injectionan-opportunity-for-the-brave-11660824001?mod=hp_minor_pos19)

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