ABL Healthcare Member News & Industry Trendletter * January 10, 2023

>>> Robin Raff is Founder, CEO and Chief Strategist of Pulse Healthcare Marketing, Inc., a rapidly growing healthcare marketing firm where she has launched and grown multiple new healthcare brands using data-driven multi-channel strategies. Robin works with her clients to develop impactful marketing strategy and then oversees her team's flawless execution of creative, media, and data analytics. With 30+ years of marketing experience on both the ad agency and client side working with many world-class brands, Robin brings an entrepreneurial orientation, an unrelenting passion for client service and a laser focus on her clients' ROI. She is sought after for her deep understanding of the complexities and opportunities within the healthcare landscape and in data-driven demand generation marketing. Previously, Robin was Director of Medicare Marketing at Kaiser Permanente for five years, where she led the $40 million national data-driven multi-media Medicare campaigns across their seven regions. She introduced new marketing channels, enhanced marketing processes and reduced costs by making organizational changes that resulted in a $2 million cost savings in year one. She and her team exceeded Medicare enrollment goals every year for five years. Other healthcare clients served by Robin include: Providence, Banner Health, OneBody, Blue Shield of California, UnitedHealthcare, AliveCor, Oticon Hearing, GE Financial Assurance LTC, California Department of Health Services, HeartMath, Essilor, Resolution Health (acquired by Wellpoint), Group Health, and DestinationRx.com. Robin has rejoined the Bay Area Round Table.

  • 1/10 - Silicon Valley ZOOM Table - "Healthcare's Major Trends for 2023: Which will have the greatest impact on you & why?" - Featuring Dave Berkus, iMediSync

  • 1/19 - Bay Area In-Person & ZOOM Table - "Applying IDEO's 'Design Thinking' Approach to Healthcare Services" - Featuring Dennis Boyle, IDEO Health & Wellness

  • 1/20 - Los Angeles In-Person & ZOOM Table - "Touring the Nation's Largest & Most Sophisticated Transplant Donor Recovery Center" - Featuring Tom Mone, OneLegacy

  • 2/01 - Orange County ZOOM Table - "Creating the nation's first Addiction Research Institute" - Featuring Gene Barduson

  • Explore Membership in ABL's Executive Round Tables >>>
Click on Headlines to Read Articles
Biospectal Acclaimed in Recent Industry Journals

Biospectal is included in a recent CB Insights article - The Digital Health 150: The most promising digital health companies of 2022 - which unveils a list of 150 of the top private companies transforming healthcare with digital technology. AND, Startup Reporter's recent article - Startup Discovery at Frontiers Health 2022 - spotlights Biospectal's participation in the recent Frontiers Health event. (Eliott Jones, SV)

Choice in Aging Highlighted in New York Times & San Francisco Chronicle

Choice in Aging (CiA) and its CEO Debbie Toth are featured in a recent New York Times article, As Covid Deaths Climb, Even Seniors Skip Latest Booster. Debbie shares that CiA has been leading the charge in getting seniors vaccinated, but they are frustrated with the lack of outreach and support from the federal government and philanthropic partners for the bivalent booster.
AND, CiA and Debbie are included in the San Francisco Chronicle article - As Covid stages another winter comeback, many Californians don't appear to care.
MEANWHILE, CiA has been named as 2022's Best Non-Profit Organization in Pleasant Hill by the Pleasant Hill Award Program, PLUS will hold its - already sold out - 48th Annual Crab Feed on the evening of February 24, in Walnut Creek. (Debbie Toth, Bay Area)

Cigna Shares Healthcare Trends & Predictions for 2023

Recent articles from Cigna include 4 Healthcare Trends for 2023 and How They Will Impact U.S. Employers (1. Heightened Focus on the Vitality and Well-Being of Employees; 2. A Strategic Effort To Keep Drugs Affordable; 3. Digital and Virtual Health Is Here To Stay; and 4. Working To Fix Our Fragmented Healthcare System) AND 14 Predictions on What the Future of Healthcare Will Look Like.
ALSO, Cigna has been named an industry leader in corporate sustainability for the sixth consecutive year on the Dow Jones Sustainability Indices. (Chris DeRosa, OC)

HumanGood Secures Financing for New Affordable Housing Communities

HumanGood in partnership with Sunnyvale Life, Inc. has secured financing for a new affordable housing community in Morgan Hill, California. It will be a 3-story apartment building consisting of 83 large one-bedroom units serving low-income and special needs seniors.
AND, HumanGood has secured financing for a new affordable housing community in the Port Richmond neighborhood of Philadelphia, Pennsylvania. A 4-story building will consist of 47 one-bedroom units serving low-income seniors 62+ years; 29 units will be supported by Project Based Vouchers available by the Philadelphia Housing Authority, and five units will be reserved for formerly homeless persons. (Tara McGuinness, Bay Area)

Illumination Foundation Receives Grant + Pooja Bhalla to Discuss CalAIM in February

Tarsadia Foundation has awarded Illumination Foundation (IF) a $500,000 grant to provide housing and healthcare for those experiencing homelessness. Tarsadia Foundation is a global family foundation that since its inception has set out to break cycles of poverty, create opportunities for others less fortunate, and partner with others to create sustainable change. They are committed to serving organizations like Illumination Foundation who are unleashing human potential and helping communities thrive.
MEANWHILE, Pooja Bhalla, Co-CEO of IF, will be a presenter on February 16 at the 2023 Open Minds Performance Management Institute, in a session entitled, "Preparing For CalAIM: Success & Sustainability - The Data-Driven Path Forward." (Pooja Bhalla, DNP, OC)

LigoLab's CEO Discusses Changing Times & Eroding Margins + Lab Industry's Staffing Shortages

Suren Avunjian, CEO of LigoLab, recently co-presented a webinar - Changing Times and Eroding Margins: RCM Solutions - now available to watch on-demand. Topics included a range from the current laboratory testing landscape to embracing automation as a strategy geared towards maintaining successful fiscal growth within the diagnostic market. The discussion offers an opportunity to understand the difficulties associated with revenue cycle management and practical technology-based solutions.
MEANWHILE, in a recent TechTimes article - How LigoLab is Helping Medical Labs Battle Staffing Shortages - Suren explains how technology, and specifically a lab's LIS, can help fight the industry's current shortage of qualified personnel. (Suren Avunjian, LA)

MedWand Teams with AT&T, HP and Oracle to Launch the Urban-Rural Healthcare Alliance

MedWand's idea for the Alliance, announced at CES last week, is to increase access to care by sharing resources through telemedicine. Essentially, it's a hub-and-spoke platform that can connect urban medical centers with multiple rural or underserved urban communities. At CES, MedWand's 2500-square-foot booth, transported attendees to different physical locations via interactive telemedicine pods, live remote exams, educational presentations, and more. (Bob Rose, OC)

Mission Hospice & Home Care to Celebrate 44th Anniversary

Mission Hospice & Home Care will hold its 44th anniversary celebration on Sunday afternoon, January 29, at Peninsula Golf & Country Club in San Mateo. This is the first time in three years Mission has been able to hold the celebration. (Dolores Miller, SV)

Nelson Hardiman Discusses New Law Regarding Physicians & CMS Open Payments Database

Nelson Hardiman has published A Priority Regulatory Update: Physicians to Provide Mandatory Notice to Patients About Payments Received From Manufacturers of Drugs or Medical Equipment, which discusses that as of January 1, 2023, physicians and surgeons licensed by the Medical Board of California and Osteopathic Medical Board of California will be required to notify their patients of the opportunity to publicly search payments made by drug and medical device companies to physicians, physician assistants, advanced practice nurses, and teaching hospitals through the CMS Open Payments database. (Harry Nelson, JD, LA)

Pangea Lab & Zymo Research Both Named to OC Register's List of Top Workplaces

Pangea Laboratory and Zymo Research Corporation have each been recognized as one of Orange County's Top Workplaces in 2022 by The Orange County Register. The confidential third-party survey, based solely on anonymously gathered employee feedback, measures 15 culture drivers that are critical to the success of any organization, including alignment, execution, and connection. (Yap Ching Chew, Ph.D., OC)

Parentis Health Provides Insights on Continuity of Care for Seniors + Living Well with Hearing Loss

In Continuity of Care: What Is It and Why Is It Important for Seniors?, Parentis Health shares the health benefits of care continuity and what happens when care is fragmented.
AND, in Living Well with Hearing Loss: Tips for Seniors, Parentis explains why hearing loss could be dangerous for older adults, what causes it, how often they should have their hearing checked, and tips for living well with hearing loss. (Tarek El Nabli, OC)

PreludeDx Presents Positive Data on DCISionRT + Included in Updated Evidence-based Treatment Recommendation

Prelude Corporation (PreludeDx) recently announced study results demonstrating that the company's DCISionRT provides patients with ductal carcinoma in situ (DCIS) superior recurrence risk stratification and radiation therapy benefit prediction compared to commonly used clinicopathologic features. Until now, clinicians have relied upon clinicopathologic features alone, such as nuclear grade (NG), tumor size and age to determine which patients may not need radiation therapy.
ALSO, DCISionRT is newly included as a prognostic factor for an ipsilateral recurrence after first diagnosis of a DCIS in the AGO (Arbeitsgemeinschaft Gynäkologische Onkologie, German Gynecological Oncology Group) Task Force on Diagnosis and Treatment of Breast Cancer. DCISionRT provided information that significantly changed the recommendations to add or omit radiotherapy. (Dan Forche, OC)

Dave Sayen Named to Alameda Health Care District Board

Dave recently shared that he has started a new role as a Director at the City of Alameda, California Health Care District. The District is the steward of the properties on which Alameda Hospital and its associated facilities are operated, including: South Shore Rehabilitation, Park Ridge Rehabilitation, and the Kate Creedon Wound Center. As stewards, the District oversees the collection of the District parcel tax and ensures it is used for the purpose for which it was established, namely, ensuring the provision of acute care services and an emergency department serving the island of Alameda. (Dave Sayen, Bay Area)

Westfax Explains Dangers of Using Text Messaging for Medical Information

In Can You Share HIPAA Information Over Text?, Westfax says that, generally, text messaging is not HIPAA compliant and is not advisable. In fact, HIPAA guidelines call for healthcare providers to inform patients that SMS text messaging is not a secure format. Westfax discusses what to do if patients want to use it anyway to receive medical details. (Barry Clark, OC)

Wipfli Joins Cloud Security Alliance; Acquires ApostleTech; Hailed by Forbes; + Provides Webinars & Articles

Wipfli LLP has joined the Cloud Security Alliance, the world's leading organization dedicated to defining and raising awareness of best practices to help ensure a secure cloud-computing environment.
AND, ApostleTech, a leader in custom customer relationship management implementations, has recently merged into Wipfli.
PLUS, Forbes has named Wipfli to its list of America's Best Tax and Accounting Firms.
MEANWHILE, healthcare-relevant resources from Wipfli include:
>> Webinar on January 17: How FQHCs are using APMs to improve care.
>> Article: 5 important considerations for strategic planning in healthcare organizations.
>> Article: Six digital technology terms every CEO needs to know.
>> eBook: How are you keeping up with changing cyber trends?
>> Article: How human services organizations can prepare for 2023.
(Jeff Johnson, Steve Rousso & John Dao, Bay Area)

ICYMI: The Full-Length Video Recording of ABL's 25th Innovations in Healthcare Awards Event Is Now Available on the Password-Protected "MEMBERS ONLY" Section of the ABL Website, Under "Presentations"

-- There you'll find full-length presentations by Keynoters Dennis Boyle, Partner, Founding Member and Leader of IDEO's Health and Wellness Practice, and Robin Farmanfarmaian, Silicon Valley-based entrepreneur, author, investor and professional speaker,
-- As well as the presentations by ABL's 2022 "Innovator in Healthcare" Awardees: Dean Hovey, CEO of 8B Medical; Eliott Jones, Co-Founder and CEO of Biospectal SA; and Ed Buckley, President and CEO of Select Data Inc.

Eckert & Ziegler Gets Green Light for Phase III Study with PENTIXAFOR

Eckert & Ziegler subsidiary PENTIXAPHARM GmbH has received a green light from the European Medicines Agency (EMA - which regulates the drug development process to not only one country, but to all members of the European Union) to conduct a phase III registration study in patients suffering from various forms of Non-Hodgkin-Lymphomas. Following several rounds of scientific advice, the EMA Committee for Medicinal Products for Human Use endorsed a study design presented by PENTIXAPHARM's management, which envisions treating up to 500 lymphoma patients with the Gallium-68 based radiotracer PENTIXAFOR in about 30 participating European clinics. (Frank Yeager, ABL-Tech SGV)

GIDEON Informatics on: SARS & Influenza

In the space of a decade, two SARS viruses affected over 625 million people and claimed over 6.5 million lives worldwide. See how SARS-CoV-1 and SARS-CoV-2 compare in GIDEON Informatics' latest blog - SARS (Severe Acute Respiratory Syndrome): A Tale of Two Deadly Viruses.
PLUS, read GIDEON's recent post, All You Need to Know About Influenza (Flu). (Uri Blackman, ABL-Tech WLA)

California Senate's New Health Chair to Prioritize Mental Health and Homelessness

California state Sen. Susan Talamantes Eggman, a Stockton Democrat who was instrumental in passing Gov. Gavin Newsom's signature mental health care legislation last year, has been appointed to lead the Senate's influential health committee, a change that promises a more urgent focus on expanding mental health services and moving homeless people into housing and treatment. The leadership change is expected to coincide with a Democratic health agenda focused on two of the state's thorniest and most intractable issues: homelessness and mental illness. According to federal data, California accounts for 30% of the nation's homeless population, while making up 12% of the U.S. population. (https://californiahealthline.org/news/article/california-senate-susan-talamantes-eggman-new-health-chair-mental-health-homelessness/)

MEANWHILE, the Biden-Harris Administration Announces Plan to Reduce Homelessness 25% by 2025: The administration has released a federal plan for ending homelessness in America called "All In: The Federal Strategic Plan to Prevent and End Homelessness." The plan recommits the federal government to strategies that have been proven to work, like "Housing First" - the model of care that treats housing as the immediate solution to homelessness, but not the only solution. Once housed, many people need support to stay housed - from health care and job training to legal and education assistance. This model works because it treats people with dignity, personalizes their care, and recognizes that - without housing, every other aspect of a person's life suffers. (https://www.hhs.gov/about/news/2022/12/19/biden-harris-administration-announces-plan-to-reduce-homelessness-25-percent-by-2025.html)

NIH Launches Pilot Program for COVID-19 Telehealth Care

The National Institutes of Health (NIH) has announced the launch of a pilot program that will allow people to receive free testing, consultation and treatment for COVID-19 from their homes. The NIH estimated up to 8,000 eligible individuals will participate in the pilot "Home Test to Treat" program. The agency said it is aiming to offer this service to up to 100,000 people in the U.S. over the next year. (https://thehill.com/policy/healthcare/3801129-biden-administration-launches-pilot-program-for-covid-19-telehealth-care/)

Federal Omnibus Bill Includes Relief from Medicare Payment Cuts, Allows for Medicaid Eligibility Assessments, & Extends Telehealth Flexibilities

The House of Representatives and Senate recently passed an omnibus spending bill that funds the Federal government through Fiscal Year 2023 and contains various provisions affecting healthcare providers. Among other things, the bill ameliorates planned Medicare provider cuts. The legislation also allows states to resume Medicaid eligibility determinations and extends telehealth flexibilities first authorized under the COVID-19 public health emergency. (https://www.kslaw.com/news-and-insights/health-headlines-december-27-2022)

ALSO, Becker's Hospital Review shared eight healthcare- and hospital-specific notes out of the 4,155-page bill: https://www.beckershospitalreview.com/finance/congress-last-minute-1-7-trillion-omnibus-package-8-healthcare-takeaways.html

HHS Offers States Flexibility to Better Address Medicaid Enrollees' Needs

HHS, through CMS, has released guidance on an opportunity for states to address health-related social needs for people with Medicaid coverage through the use of "in lieu of services and settings" in Medicaid managed care. This option will help states offer alternative benefits that take aim at a range of unmet health-related social needs, such as housing instability and food insecurity, to help enrollees maintain their coverage and to improve their health outcomes. (https://www.hhs.gov/about/news/2023/01/04/hhs-offers-states-flexibility-to-better-address-medicaid-enrollees-needs.html)

Meanwhile, the GAO Releases Report & Recommendations to CMS to Address Risks Posed by Provider Enrollment Waivers & Flexibilities Implemented as Part of COVID-19 Response

On December 19, 2022, the U.S. Government Accountability Office released a report titled, "Medicare: CMS Needs to Address Risks Posed by Provider Enrollment Waivers and Flexibilities." The report summarizes GAO's analysis of the 47 waivers and flexibilities that CMS issued to sustain Medicare's provider workforce and ensure that Medicare beneficiaries had access to care during the COVID-19 pandemic. In its report, GAO makes several recommendations to CMS to address the risks posed by the waivers and flexibilities. More info: https://www.kslaw.com/news-and-insights/health-headlines-december-27-2022

CMS Proposes Rule to Require Certain Health Plans to Electronically Share Data with Providers Regarding Prior Authorization Requests

CMS has published a proposed rule requiring certain Medicare, Medicaid, Children's Health Insurance Program, and Qualified Health Plan fee-for-service and managed care plans to share electronic health data directly with hospitals and other providers. The stated goals of the Proposed Rule are to implement an electronic prior authorization process, shorten the time frames for certain payers to respond to prior authorization requests, and establish policies to make the prior authorization process more efficient. (https://www.kslaw.com/news-and-insights/health-headlines-december-12-2022)

U.S. Healthcare-Spending Growth Slowed in 2021 - to Just $4.3 Trillion, Federal Report Finds

Growth in U.S. healthcare spending slowed to 2.7% in 2021 after a 2020 surge in federal outlays on the pandemic, according to a recent report from CMS, which said national healthcare spending grew in 2021 to $4.3 trillion. Overall health spending had risen by 10.3% in 2020, and the more moderate increase in 2021 was largely driven by a drop off in federal spending related to Covid-19. In fact, federal health spending fell 3.5% in 2021 to $1.46 trillion after surging almost 37% in 2020. At the same time, there was an uptick in spending on insurance coverage and healthcare services in 2021. (https://www.wsj.com/articles/u-s-healthcare-spending-growth-slowed-in-2021-federal-report-finds-11671046871?mod=lead_feature_below_a_pos1)

Drug Prices Reach New High - in the Millions

Since August, U.S. or European health regulators have approved four new products intended as one-time treatments for rare genetic diseases that carry list prices of at least $2 million a patient. The price tags mark a new high for medicines, which drugmakers were once reluctant to charge more than six figures for but whose prices have been heading upward. The companies say the cost reflects the drugs' potential to help patients in a single dose, but paying for it could challenge patients and health insurers. Most of the multimillion-dollar treatments are gene therapies, a groundbreaking type of treatment that involves injecting a functional gene into a person to correct a faulty, disease-causing one. (https://www.wsj.com/articles/drug-prices-reach-new-highin-the-millions-11671990099?mod=hp_lead_pos6)

FDA Approves Alzheimer's Drug for Mild, Early-Stage Disease

U.S. health officials have approved a closely watched Alzheimer's drug that modestly slows the brain-robbing disease, albeit with potential safety risks that patients and their doctors will have to carefully weigh. The drug, Leqembi, is the first that's been convincingly shown to slow the decline in memory and thinking that defines Alzheimer's by targeting the disease's underlying biology. The FDA approved it for patients with Alzheimer's, specifically those with mild or early-stage disease. The drug will cost about $26,500 for a typical year's worth of treatment. Eisai said the price reflects the drug's benefit in terms of improved quality of life, reduced burdens for caregivers and other factors. The company pegged its value at over $37,000 per year, but said it priced it lower to reduce costs for patients and insurers. However, the Institute for Clinical and Economic Review, a nonprofit that analyzes drug prices based on their benefit. in a draft report, found that the drug would be cost effective for patients at a price ranging from $8,500 to $20,600 per year. (https://www.modernhealthcare.com/government/fda/legmgi-alzheimer%27s-drug-eisai-biogen) (https://www.wsj.com/articles/new-alzheimers-drug-approved-by-fda-promises-to-slow-disease-11673032312?mod=hp_lead_pos3)

In Response, Blues Plans Launch Synergie to Cut Costs for the Priciest Drugs

Elevance Health (fka Anthem) and a coalition of other Blue Cross and Blue Shield carriers have launched Synergie Medication Collective, an independent company the plans see as a novel solution to costly physician-administered drugs. Nearly every Blue Cross and Blue Shield insurer invested undisclosed sums in the new venture. That makes Synergie one of the largest Blues collaborations in history. These companies cover nearly 100 million members and aim to use their collective muscle to extract better deals and standardized contracts from pharmaceutical companies and the providers that administer drugs, said Synergie CEO Jarrod Henshaw. Drug manufacturers now make most of their profits by developing high-cost treatments intended for small patient populations. Specialty medicines represented the majority of the $407 billion spent on the pharmaceuticals in the U.S. in 2021 - 55%, up from 28% a decade before - according to the data from the IQVIA Institute. Synergie stops short of being a full medical benefit manager because it does not provide utilization management services such as prior authorization or focus on site-of-service delivery by encouraging home visits, Henshaw said; rather it will operate under a transparent, pass-through model, where it hands over cost savings to participating insurers. (https://www.modernhealthcare.com/insurance/blue-cross-synergie-medication-collective-specialty-drug-gene-therapies)

Moderna Signs $35 Million Deal with Cancer Drug Developer CytomX

Moderna Inc. announced a $35 million licensing deal with cancer-focused drug developer CytomX Therapeutics to work on messenger RNA-based therapies for a wide range of diseases. The news comes a month after an experimental cancer vaccine from Moderna based on mRNA technology was shown to work against a type of skin cancer. The companies will work together to discover experimental therapies and Moderna will be responsible for human trials and commercial activities of products. (https://www.reuters.com/business/healthcare-pharmaceuticals/moderna-cytomx-announce-mrna-collaboration-2023-01-05/)

Drug Companies Join Medical Psychedelic Movement - But Without the High

Drug developers are designing new psychedelic compounds to treat depression and other mental-health conditions but skip the trip. Mind-bending psychedelics including MDMA (aka "ecstasy"), "magic mushrooms" and LSD are being studied as potential treatments for depression, post-traumatic stress disorder and addiction. Dozens of companies and academic laboratories are also making changes to the structure of those drugs, or designing similar compounds, to take advantage of their therapeutic properties without the high. (https://www.wsj.com/articles/drug-companies-join-medical-psychedelic-movementbut-without-the-high-11671319811?mod=hp_lista_pos3)

Abortion Pills to Be Available More Widely Under New FDA Rules

The FDA has expanded access to a drug that induces abortion, allowing bricks-and-mortar pharmacies to dispense the pills for the first time. Under the changes the agency issued, any pharmacy can complete and sign a short form to become certified to provide the so-called abortion pill, not just the handful of mail-order pharmacies that were permitted to ship prescriptions during the pandemic. (https://www.wsj.com/articles/abortion-pills-to-be-available-more-widely-under-new-fda-rules-11672789765?mod=hp_lead_pos10)

Headwinds Are Facing Group Medicare Advantage Growth

New York City's struggle to switch more than a quarter-million retired government workers and their dependents from traditional Medicare to private health insurance could set an alarming precedent for employers and insurers banking on the fast-growing group Medicare Advantage program. Cost-conscious employers offering retiree benefits are increasingly adopting such plans as alternatives to existing commercial health plans or traditional Medicare coverage. Membership through group plans represents nearly 20% of the 29.5 million individuals enrolled in Medicare Advantage, and the number of patients enrolled through this kind of coverage more than doubled over the last decade, according to the latest federal data. But public and private employers seeking to join the trend may face pushback from retirees who fear their benefits will be limited. Some former workers have sued their previous employers to block the switch. Federal investigations into Medicare Advantage carriers and the potential for changes to the program this year from CMS could also present hurdles. (https://www.modernhealthcare.com/insurance/group-medicare-advantage-challenges-growth-medicare-lawsuits)

Top 10 Hospital and Payer Trends to Watch in 2023

Per Healthcare Finance News, here are the Top 10 trends from 2022 that are likely to influence hospital and payer decisions in 2023. See the stories at the link to take a closer look at how and why those trends will continue into 2023. Then check back at the link every week through the end of the year for more coverage.
> The end of the public health emergency: What happens next?
> Technology, digital health and automation: Strategies to streamline, reach patients and goals.
> Hospital finances: Cutting expenses, where to save?
> The retail competition: Amazon, CVS, Walgreens, UnitedHealth move into primary care.
> Payers: Meeting the Transparency in Coverage rule that goes into effect January 1, 2023.
> Hospital at home checks the boxes: an aging demographic and a less expensive alternative.
> Medicare Advantage: Who's in, who's out? Telehealth: Fad or future?
> Mergers, acquisitions and partnerships.
> Interoperability for providers and payers.

SCAN Group Merges with Oregon Managed Medicare & Medicaid Nonprofit

Long Beach-based SCAN Group, a senior healthcare nonprofit, and Portland, Oregon-based CareOregon, a managed care nonprofit, have agreed to merge under the new name HealthRight Group. The merger is intended to give both nonprofits more clout in a marketplace for government-funded healthcare programs increasingly dominated by for-profit managed care providers. The deal is expected to close sometime this year.
In addition to its health plans, HealthRight will operate a diversified business unit comprising assets from both organizations including Welcome Health, a geriatric home-based primary care medical group; Housecall Providers, an in-home primary and palliative care provider; MyPlace Health, a joint venture between Scan Health and Boston-based Commonwealth Care Alliance; Healthcare in Action, a medical group for people experiencing homelessness; and HomeBase Medical, a medical group focused on improving chronic disease management and palliative care for Medicare beneficiaries. (https://labusinessjournal.com/healthcare/medical-center/scan-group-merges-with-oregon-managed-medicare-and-medicaid-nonprofit/)

According to the Wall Street Journal, the deal is the latest sign of how government-backed health coverage, including both Medicare and Medicaid, is increasingly the core of the managed-care business and the main engine of its growth. About 70% of Medicaid enrollees are now in managed-care plans, according to the Kaiser Family Foundation. (https://www.wsj.com/articles/nonprofit-health-plans-with-6-8-billion-in-projected-revenue-set-to-combine-11671038354?mod=hp_lista_pos4)

Meanwhile, Sachin Jain's Top 10 Healthcare Industry Predictions For 2023

In a recent Forbes article, Sachin Jain, President and CEO of SCAN Group and Health Plan, offered some predictions for 2023 - some "pure hunch; others are extensions of trends observed in 2022 that will continue into 2023; and others still are a reflection of my deepest hopes - some of which I hope I will nudge into being by writing it here in this column." In summary they are:
1) Medicare Advantage Will Remain Under A Microscope.
2) A Private Equity and Venture Capital Feeding Frenzy Of A Different Kind.
3) More and More Customer Segmentation.
4) Toxic Positivity Around Value-Based Care Will Abate.
5) Home-Based Care Will Get A Closer Look.
6) Biopharmaceutical Innovation Will Continue to Impress at Prices That Won't.
7) Tech and Retail Will Continue to Inch Into Healthcare Delivery.
8) COVID's Impact Continues.
9) Progress on the True Underlying Causes of Clinician Burnout.
10) Greater Recognition That We Have a Leadership Crisis in American Healthcare

CVS Spends Billions to Expand from a Chain of Drugstores to a Full-Service Healthcare Company

CVS invested $100 million in Carbon Health Inc., a San Francisco-based chain of urgent- and primary-care clinics, according to a recent announcement. Just hours later, Bloomberg News reported that CVS was in negotiations to buy Oak Street Health Inc., a decade-old chain of clinics that service Medicare recipients, for more than $10 billion. (https://www.marketwatch.com/story/cvs-eyes-next-generation-health-clinics-after-amazons-move-for-one-medical-11673313087)

Where Digital Health Funding Could Go in 2023

After a year [2021] of mega-rounds, skyrocketing valuations and a parade of growing digital health startups, the investment landscape looked a lot more tepid in 2022. But there are still plenty of opportunities for startups, especially for companies that can demonstrate their value amid a challenging economic environment, said Dr. Sunny Kumar, partner at GSR Ventures. Kumar sat down with MobiHealthNews to discuss digital health funding and his predictions for 2023. (https://www.mobihealthnews.com/news/qa-where-digital-health-funding-will-go-2023)

How Doctors Treat Their Own Colds and Flus: Squirt Bottles Filled with Saline Solution, Elderberry Tablets & Cans of Chicken Soup

Since Americans are being hit with a barrage of seasonal illnesses right now, the Wall Street Journal asked ear, nose and throat specialists, pediatricians and family doctors about the medicines they take and remedies they swear by when sick. All the doctors said that rest and fluids are key. And everyone said it's important to be up-to-date on flu shots and Covid vaccinations, including boosters. They had more surprising advice too, such as which over-the-counter medications are worth taking, when to stock up on supplies, and how to avoid a potential risk of nasal irrigation. (https://www.wsj.com/articles/when-doctors-get-sick-with-flu-other-viruses-how-to-treat-11671730067?mod=hp_featst_pos3)

Why Human-Animal Hybrid Brains Hold Promise for Neurological Disease

Scientists around the world are implanting tiny blobs of human brain tissue into the brains of rodents, creating hybrid organs called chimeras. In this video, Wall Street Journal's Daniela Hernandez explains how they work and what scientists hope to learn from them: https://www.wsj.com/video/series/daniela-hernandez/why-human-animal-hybrid-brains-hold-promise-for-neurological-disease/C9710C90-FA64-4C9F-A890-3ED5E1970812?mod=hp_featst_pos4

A New Test For Autism Hopes To Help Doctors Diagnose Before Symptoms Show

Researchers have developed a first-of-its-kind test for autism that they say can find markers of risk in a single strand of hair, an innovation that might help clinicians identify it in young children before they miss developmental milestones. The FDA gave LinusBio's test a "breakthrough" designation, which is intended to speed up the regulatory approval process for new technology when there aren't alternatives on the market. The designation does not change approval standards, and the company faces regulatory hurdles before its device could be considered for widespread use in the U.S. (https://www.nbcnews.com/science/science-news/new-test-autism-hopes-help-doctors-diagnose-symptoms-show-rcna61081)

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