ABL Healthcare Member News & Industry Trendletter * May 9, 2024

>>> Vinit Joshi, DDS, is CEO of Global Implant Dentistry (GID), which is dedicated to providing expert family implant dentistry services that enhance oral health, brighten smiles, and boost confidence. GID's expert team works with precision and care to place just four implants - the cutting-edge All-On-4 dental implant technique - which is an advanced and much faster process. Having developed unique skills, techniques, and processes in implant dentistry, Vinit is also actively involved in training other medical professionals in his innovative surgical techniques, including the digital integration of surgery, utilizing CT scans and 3D milling and printing technologies.
          As Vinit and his team train more dentists in their state-of-the-art approach, he aims to expand GID, in a hub-and-spoke fashion, with Global delivering their unique products that will enable the dentists and other medical professionals to get the best results for their clients as they use their All-On-4 and other specialized implant services. Additionally, Vinit has worked with the UCLA craniofacial team and used his expertise to aid sleep apnea and TMJ patients by improving airway space. Vinit has joined the LA Healthcare Round Table.

  • 5/01 - Orange County ZOOM Table - Discussion Topic: "How Change Healthcare Could Change Healthcare" - Featuring Sara Shanti, Partner at Sheppard Mullin

  • 5/16 - Bay Area ZOOM Table - Discussion Topic: "Welcome Habitat Health: California's Newest PACE Program" - Featuring Simon Widdowson, Senior Director of Business Development for Kaiser Permanente

  • 5/17 - Los Angeles ZOOM Table - Discussion Topic: "Praia Health: Bringing Digital Transformation to the Healthcare Marketplace" - Featuring Marcee Chmait, Head of Digital Partnerships & Business Development at Providence Digital Innovations Group

  • Explore Membership in ABL's Executive Round Tables >>>

Medicare Advantage on the 50 Yard Line, by David Saÿen

Recently, former Louisiana governor, Bobby Jindal, published an opinion piece in The Wall Street Journal titled "Biden Sabotages Medicare Advantage." With the program nearing 50% penetration, he frets about the annual payment adjustment being too stingy. Just a few days later the same paper trumpeted, "Health Giant's Earnings Lift Stocks for Sector." Despite the fiasco caused by the hack of Change Healthcare, a UnitedHealth Group company, revenue climbed 8.6%, beating analysts' estimates. Apparently shoddy work by health insurers isn't a problem like it is for airplane manufacturers.
            Medicare Advantage is a private program where the federal government pays an age- and health-adjusted premium for beneficiaries opting for private plans. It is lauded by conservatives as beneficial for consumers. It's sort of like vouchers for public schools, block grants for Medicaid, and cutting Social Security. Always in fashion for some. While it may benefit investors and health insurance companies, it's not always advantageous for all seniors and disabled folks in Medicare.
            Medicare has a punishing calendar for the folks at CMS. Every year there are changes, and there is an annual rule updating payment for each program area: hospitals, physicians, and health plans in particular. Jindal's concerns stem from changes outlined in the April 4, 2024, MA rule. The complexities of Medicare payment are beyond the scope of this blog, but the upshot is that the rule trims the base payment by 0.16%, the program changes overall are expected to yield a 3.7% increase in payments to plan. These changes aim to improve access to behavioral health providers, enhance transparency regarding supplemental benefits, introduce standards for special supplemental benefits for chronically ill individuals, and refine star ratings for plan evaluations. Additionally, there's a focus on ensuring equitable utilization management practices, emphasizing health equity expertise.
            Despite Jindal's apprehensions about payment updates, the regulatory changes seem positive overall. While some plans may exit certain markets, as is common, Medicare Advantage appears set for another successful year. (BA)

David Saÿen is the former Regional Administrator at CMS,
the Centers for Medicare and Medicaid Services, and is currently the
President of the Board of Trustees at the Alameda Health System

Click on Headlines to Read Articles

Click on Headlines to Read Articles
Anthem (David Pryor, MD) Collaborates with Shatterproof to Improve Care for People with Substance Use Disorders

To address stigma against people with substance use disorders (SUDs) among healthcare professionals, Shatterproof, a national nonprofit dedicated to reversing the addiction health crisis, is teaming up with Anthem Blue Cross to bring additional learning to the healthcare community. The organizations have developed an educational curriculum, "A Provider's Pathway to Supporting Patients with Substance Use Disorder," to help remove stigma as a barrier to people's ability to receive evidence-based SUD treatment. (LA)

Catalight (Susan Armiger) Publishes New Practice Guidelines

Leveraging current research, the recently published Catalight Practice Guidelines outline their treatment hour recommendations and outcome measures for behavioral interventions with Autism Spectrum Disorder and related intellectual and developmental disabilities. The guidelines also address parent-mediated care as an important treatment option for families to consider on their path to wellbeing. (BA)

CGI Biomed Investments' George Carpenter Discusses Evolving Landscape of Entrepreneurship & Investing

In this 37-second video posted by Pegasus Angel Accelerator, George Carpenter shares how it's never been easier to launch a company, but questions if traditional startup investing will remain the norm in 5-10 years. With coding increasingly automated, he envisions a future where a smaller workforce drives a larger number of ventures. George's perspectives underscore the rapid pace of change and how investors may need to adapt by backing intellectual property, code, DAOs, and other emerging vehicles beyond the traditional startup model. (OC)

Cigna (Chris DeRosa) Publishes Research on Youth's Mental Health Crisis Driving Unstainable Costs to Employers

Cigna has released new research that highlights the state of youth mental health and the depth of challenges facing working parents who care for children and young adults with mental health issues. The findings are a call to action for employers to strengthen their approach to parental support and behavioral health care to drive measurable, improved health outcomes. (OC)

Eitan Medical (Roger Massengale) Teams with Master Medical Equipment

Master Medical Equipment is now the premier distributor of Eitan Medical's Sapphire Infusion Pump for the Pre-Acute EMS market. Approved for air and ground transport, Sapphire's small, lightweight and durable design and 2.5% flow accuracy delivers, even under very demanding conditions. (OC)

El Camino Health (Cecile Currier) Finds Many are Unaware of Common Lifestyles that Impact Heart Health

A recent survey by El Camino Health (ECH) finds many people overlook common lifestyle factors that impact their heart health. The survey reveals around three in 10 adults are unaware that alcohol (32%), smoking (27%), and lack of sleep (27%) are linked to heart disease. The survey also found that 68% of adults are unaware that social isolation is linked to heart disease, while 53% know mental wellness is a risk factor. MEANWHILE, Becker's Healthcare has recognized ECH as one of the 150 Top Places to Work in Healthcare. (BA)

FOMAT Medical Research (Nick Focil) Partners with Dr. Than Luu to Enhance Diversity in Clinical Trials

FOMAT Medical Research has entered a collaboration with Dr. Than Luu, directed at pushing the boundaries of healthcare innovation with an emphasis on diversity. This effort intends to capitalize on Dr. Luu's extensive clinical trial experience, particularly in projects aimed at engaging with often overlooked ethnic communities. Adding a new site to FOMAT's network marks an initiative to expand the ethnic inclusivity of clinical research. (LA)

HLTHCard (Mike Epstein) Examines Medicare Prescription Payment Plan Compliance

In Medicare Prescription Payment Plan (M3P) Compliance, Mike Epstein, CEO of HLTHCard, notes that Medicare plans have a long road ahead of them in preparing to administer the M2P plans. One of the biggest obstacles is ensuring that these payment plans are compliant with both US Treasury and Banking regulations and healthcare regulations. Starting January 1, 2025, Medicare beneficiaries will have the option of spreading their out-of-pocket prescription drug costs over the course of their plan year. This is great news for beneficiaries, but Medicare payors have never administered payment plans which opens them up to a world of compliance-related headaches. (LA)

Illumination Foundation (Pooja Bhalla, DNP) Raises Millions to Disrupt Cycle of Homelessness

Illumination Foundation (IF) raised $1.5 million at their recent 11th Annual Chef's Table gala. More than 400 philanthropic individuals, businesses, and community leaders gathered to support IF and their mission to disrupt the cycle of homelessness.
ALSO, IF was one of 26 organizations who together raised more than $1.8 million toward ending homelessness in Orange County, in the "Help Them Home" campaign. (OC)

Kaiser Permanente (Marcos Vasconcelos) Announces that Risant Health Completes Acquisition of Geisinger

Risant Health, which was created by Kaiser Foundation Hospitals in 2023, has completed its acquisition of Geisinger as its first health system dedicated to increasing access to value-based care and coverage. As a result, Risant Health brings Kaiser Permanente (KP)'s integrated care and coverage expertise to Geisinger's experience in advancing value-based care in a model that includes various payers and a broad network of providers, while serving some of the nation's most vulnerable and marginalized communities. Risant Health expects to acquire 4 to 5 additional leading community-based health systems over the next 4 to 5 years.
MEANWHILE, KP has launched its Food Is Medicine Center of Excellence, which further integrates KP's evidence-based food and nutrition interventions into its care model. (BA)

Life Adjustment Team (Cynthia Sampson) Discusses Partial Hospitalization & Intensive Outpatient Programs

In Family Dynamics in PHP: Supporting Loved Ones in the Recovery Process, Life Adjustment Team (LAT) shares that partial hospitalization programs (PHPs) can provide an effective bridge from inpatient treatment to outpatient care, improving recovery rates and reducing relapse rates. LAT also discusses the role of family support in PHPs, provides examples of how families can help and benefit their loved one's recovery, and more.
AND, in Exploring the Effectiveness of Cognitive-Behavioral Therapy in IOP Settings, LAT delves into intensive outpatient programs and their benefits.
MEANWHILE, on May 18, LAT will participate in "Take Action LA," a community event focused on mental health in Culver City. (LA)

Nelson Hardiman (Harry Nelson, JD) Addresses Nation-States, Cyber Attacks & Healthcare Law

In Hacking and Healing: Nation-States, Cyber Attacks, and Healthcare Law, Nelson Hardiman (NH) acknowledges that modern warfare is no longer restricted to physical battlefields and professional military. Some countries have few qualms about using cyberspace to reach well beyond their physical borders to target private enterprise and the civil infrastructure of adversaries. In recent years, one of the most alarming aspects of cyber warfare is the targeted hacking of healthcare platforms, electronic medical records, and genomic databases. Healthcare systems are repositories of vast amounts of sensitive personal data, making them prime targets for nation-state actors who aim to gather intelligence, disrupt infrastructure, or steal trade secrets and new technologies. (LA)

On Lok (Grace Li) Promotes Healthier Living Workshop + Anticipates Gala on May 17

On Lok is promoting its Managing Ongoing Health Conditions with Healthier Living - a six-week workshop developed by Stanford University to help adults manage ongoing health conditions. Workshops are held in a small group setting, with participants meeting once a week for 2.5 hours, learning, sharing, and building bonds
THEN, on May 17, in San Francisco, On Lok will present On Lok Celebrates: The Blueprint of Senior Care, which will bring together over 600 friends, partners, seniors, staff, and volunteers for a magical evening to celebrate and fundraise for On Lok services and programs for seniors in their community. The gala will include food, live entertainment, auction, dessert, and dancing. (BA)

Onward (Steve Grau) Partners with HonorHealth to Remove Transportation Barriers to Care in Arizona

Onward, a leading provider of Door-Through-Door transportation services, has partnered with HonorHealth in Arizona to serve the Greater Phoenix Metro with Companion Rides. The collaboration will help care teams access the most appropriate mode of transportation based on a patient's condition. Onward's platform will coordinate all levels of ground-based healthcare transportation, into one easy ordering tool, enhancing efficiency, and enabling patients to access care promptly. Care teams, who will coordinate patient transportation at all six HonorHealth hospitals and 70+ clinics, will be supported with intuitive scheduling tools, Companion Rides, and a coordinated network of transportation providers. (BA)

PreludeDx (Dan Forche) Presents Positive Data & Publishes Video of a Typical Sample Journey

Prelude Corporation (PreludeDx) recently presented data on the use of DCISionRT to identify a subset of patients with high-risk clinicopathology (CP) who had a low 10-year risk of in-breast recurrence (IBR) and received no significant benefit from radiation therapy (RT). In contrast, patients who had both high risk DCISionRT and high-risk (CP) had high 10-year IBR rates and significant RT benefit, demonstrating the utility of DCISionRT to enable patients and their physicians to make a more informed treatment decision compared to using CP alone.
MEANWHILE, in this 2-minute video, PreludeDx captured a typical sample journey from the physician's office to their lab, where they use DCISionRT to analyze the biology of a patient's tumor and provide a quantified risk score to the physician within 3-5 days of receiving the specimen. (OC)

Providence (Marcee Chmait) Spins Out Praia Health with $20M in Oversubscribed Series A Funding

Praia Health, a newly formed digital health company, recently announced the closing of a $20 million oversubscribed Series A financing led by Frist Cressey Ventures and backed by Providence Ventures, SignalFire, and Epsilon Health Investors. The funding will bolster the platform's ability to revolutionize the delivery of individualized health solutions at scale, enabling digitally driven health system transformation. (LA)

Chris Selecky Shares that ImmunityBio Received FDA Approval for Anktiva

Chris Selecky, an ImmunityBio Board Member, shared that the company received its first U.S. FDA approval for the cancer immunotherapy, Anktiva to challenge Merck's PD-1 inhibitor Keytruda, and Ferring Pharmaceuticals' gene therapy. Biotech entrepreneur Patrick Soon-Shiong's ImmunityBio, developed Anktiva as an interleukin-15 superagonist, alongside the Bacillus Calmette-Guérin (BCG) vaccine to treat patients with BCG-unresponsive, non-muscle-invasive bladder cancer with carcinoma in situ. (OC)

Sheppard Mullin (Linda Igarashi) Ranked Among Largest Healthcare Law Firms + Discusses FTC Vote to Ban Noncompete Agreements

Sheppard Mullin (SM) ranked among the top 10 largest law firms on Modern Healthcare's "2024 Largest Health Care Law Firms" list. This is the firm's 13th consecutive appearance on the list.
ALSO, SM advised UCLA Health in its recent acquisition of HCA Healthcare's West Hills Hospital and Medical Center.
PLUS, read SM's article - FTC Votes to Ban Noncompete Agreements. (OC)

Wipfli (JJ Johnson) Examines How Data is Revolutionizing RCM in Rural Health

In How data is revolutionizing RCM in rural health, Wipfli reports that the healthcare industry's digital revolution has unlocked the vast potential of data analytics, which can play an indispensable role in helping craft a revenue cycle management (RCM) strategy that will keep rural healthcare providers ahead of the curve. Wipfli suggests how providers can leverage their data in improving rural healthcare RCM, so that they can reach new heights in patient care and financial performance.
ALSO, Wipfli has published its Mid-market technology trends report. (BA)

Zymo Research (Yap Chew, PhD) Unveils Novel Sample Collector for Skin Analysis

Zymo Research Corporation announced the launch of the EpiLift Collector, which is designed to streamline the process of sampling skin surfaces with its innovative dual-sided adhesive tip. It represents a significant advancement in skin sample collection technology. (OC)

Alvaka (Oli Thordarson) on: How to Reduce the Risk of Cyber Attacks

In Reduce the Risk of Ransomware & Other Cyber Attacks, Alvaka provides a valuable list of mitigations to reduce your risk, particularly in the era of massive cyberattacks directed at healthcare entities that touch the majority of Americans.
AND, in How Important Is Email Security for Small and Medium Businesses?, Alvaka discusses implementing effective security measures, including employee training, awareness, robust email filtering, secure gateways, regular software updates, patch management, endpoint protection, and backup and recovery planning. (LA)

Eckert & Ziegler (Frank Yeager) Gets MDR Certification for Prostate Seeds, Paving Way for Long-Term Supply

Eckert & Ziegler BEBIG GmbH, which focuses on brachytherapy solutions for the treatment of prostate cancer as well as eye and brain tumors, has obtained the MDR certificate for its proprietary prostate seeds from DEKRA Certification B.V. as one of the first companies in its market. This milestone guarantees a high level of patient safety and the long-term availability of the seeds within the EU. The Medical Device Regulation is a European Union directive with the aim of improving the quality of medical devices and increasing patient safety. (LA)

GIDEON Informatics (Uri Blackman) Utilized in Recent Publications

Information and resources from GIDEON Informatics was used in the report Understanding the global water crisis - Reasons behind the Water Crisis and its Potential Health Outcomes, published by the European Journal of Development Studies, and in a book called Polyvagal Power in the Playroom. In the book, GIDEON data was utilized in a chapter entitled "Plagues, Pandemics, and the Polyvagal Theory in the Playroom," which discusses how play therapy helps us understand children's responses to stressful situations and restricted social interactions, such as during plagues and pandemics. (LA)

John Tanner's NuSci to Present Movie "Code Blue" & Dinner on May 16

On the evening of May 16, NuSci Nutrition Science Foundation will present a Movie - "Code Blue" - and Dinner Night. "Code Blue" follows a passionate physician, Dr. Saray Stancic, as she reflects upon her journey from a multiple sclerosis diagnosis to wellness through her own adoption of lifestyle medicine. Dr. Stancic introduces viewers to expert physicians and scientists who are paving the way to make meaningful and necessary change in our healthcare environment, and empowers audiences to stand up and reclaim control of their health. The evening's event, to be held at Tanner Research in Duarte, will include a healthy buffet dinner and dessert. (LA)

Walmart's Closing 51 Clinics & Shuttering Entire Health Division; Optum's Exiting Telehealth

Walmart will close all 51 of its doctor-staffed health clinics as part of an announcement that its Walmart Health initiative is shutting down. The clinics, in Arkansas, Florida, Georgia, Illinois and Texas, had been open just a few years. Walmart also said it is winding down its virtual care option, although Walmart pharmacies and vision centers will not be affected. The announcement is a swift reversal for the retail giant. Just last month, Walmart said it hoped to expand the number of doctor-staffed clinics to 70 by the end of this year. But amid rising costs and competition, the company determined it could not financially justify the effort. (https://www.nbcnews.com/business/business-news/walmart-closing-health-clinics-walmart-health-division-why-rcna149968)
MEANWHILE, Optum's Exiting the Telehealth Business: The announcement that UnitedHealth, which owns Optum, was shutting down Optum Virtual Care came shortly after employees began sharing posts on social media about a massive workforce reduction. Optum launched the telehealth service in 2021. A spokesperson for UnitedHealth Group's health services arm said Optum would continue to provide patients with a "robust network of providers for virtual urgent, primary and specialty care options." (https://www.fiercehealthcare.com/health-tech/how-walmart-and-optum-exiting-telehealth-signals-major-shift-virtual-care-market)

New Hospital Safety Grades: Significant Improvements in Patient Experience & Health Care-Associated Infections

The Leapfrog Group, an independent national nonprofit driving a movement for patient safety, recently released its spring 2024 Hospital Safety Grades, assigning an A, B, C, D, or F to nearly 3,000 general hospitals on how well they prevent medical errors, accidents, and infections. Nationally, patient experience - a set of measures using patient-reported perspectives on hospital care - indicates significant signs of improvement since the fall 2023 Safety Grades, and preventable health care-associated infections show a sustained drop after unprecedented rates during the height of the pandemic. Of the over 30 measures used to generate Hospital Safety Grades, The Leapfrog Group reports on five patient experience measures that have a direct impact on patient safety outcomes: Nurse and Doctor communication, Hospital staff responsiveness, Communication about medicines, and Discharge information. According to Modern Healthcare, a third of nonprofit hospitals received "A" safety grades from the Leapfrog Group, compared with 28% of for-profit and 17% of government-owned facilities. (https://www.leapfroggroup.org/news-events/new-hospital-safety-grades-find-significant-improvements-patient-experience-reports-and) (https://www.modernhealthcare.com/safety-quality-leapfrog-group-grades-spring-2024)

The Joint Commission Launches Telehealth Accreditation

The Joint Commission announced it is launching a new Telehealth Accreditation Program for eligible hospitals, ambulatory and behavioral healthcare organizations, effective July 1, 2024, which will provide updated, streamlined standards to provide organizations offering telehealth services with the structures and processes necessary to help them deliver safe, high-quality care using a telehealth platform. (https://www.jointcommission.org/resources/news-and-multimedia/news/2024/04/the-joint-commission-launches-telehealth-accreditation/)

AI Drug Discovery Startup Launches with a Massive $1B, Ready to Start Developing Drugs.
MEANWHILE, OpenAI & Moderna Expand Partnership to Offer Moderna's Employees Access to ChatGPT Enterprise.

Biotech investors are making a big bet that similar computational methods to AI could revolutionize drug discovery. Recently, ARCH Venture Partners and Foresite Labs, an affiliate of Foresite Capital, announced that they incubated Xaira Therapeutics and funded the AI biotech with $1 billion. Other investors in the new company include F-Prime, NEA, Sequoia Capital, Lux Capital, Lightspeed Venture Partners, Menlo Ventures, Two Sigma Ventures and SV Angel. Xaira's CEO Marc Tessier-Lavigne, a former Stanford president and chief scientific officer at Genentech, says the company is ready to start developing drugs that were impossible to make without recent breakthroughs in AI. (https://techcrunch.com/2024/04/24/xaira-an-ai-drug-discovery-startup-launches-with-a-massive-1b-says-its-ready-to-start-developing-drugs/) MEANWHILE, OpenAI and Moderna have expanded their partnership to offer Moderna's employees access to ChatGPT Enterprise, a platform that allows customizable GPTs to be developed for a specific purpose, including creating GPTs by beginning a conversation with ChatGPT, then providing extra knowledge on a subject or giving it instructions. Within two months of adopting ChatGPT Enterprise, Moderna said it had 750 GPTs created across the company, every user had 120 conversations through the platform per week on average, and 40% of users created GPTs. (https://www.mobihealthnews.com/news/openai-expands-partnership-moderna-customizable-gpts)

AI-Generated Digital Twins Are Here, and They're Ready to Work

Artificial intelligence is making it possible for companies to replace humans with Digital Twins who can participate in clinical trials. AI systems can take in data on a person's individual characteristics - such as their health profile - then predict how they would be affected by a disease. This AI content, sometimes referred to as a person's digital twin, is already being used for a variety of tasks. For instance, San Francisco-based Unlearn is using AI to generate digital twins of people based on their health data to predict how disease might progress over time for those individuals - aiming to make clinical trials more efficient and effective. (https://www.wsj.com/articles/the-ai-generated-population-is-here-and-theyre-ready-to-work-16f8c764?mod=hp_minor_pos4)

Boston Doctors Discover Ways AI Can Reshape Their Workdays

Artificial intelligence hasn't been the job killer that some predicted, at least not so far. Census data released in March showed that 2.6% of employers reported cutting jobs between July and February in response to the introduction of generative AI - and 2.8% reported adding jobs because of it. But in subtle and not-so-subtle ways, generative AI is already changing how some people work. Large language models like OpenAI's ChatGPT, Google's Gemini and a host of industry- or task-specific software are slowly being embedded into more Americans' daily tasks. In some cases the tools are helping people do their jobs better and faster. In others they are making people do their jobs differently. For example: around 450 doctors at Mass General Brigham - almost 10% of the Massachusetts system's attending physicians - are experimenting with generative-AI programs that listen in on patient visits and update medical records. The programs typically generate notes in minutes, so the provider can review them when the visit is still fresh in their head. (https://www.wsj.com/tech/ai/ai-medicine-law-marketing-jobs-a1821672)

"Plan for Promoting Responsible Use of AI" in Administration of Public Benefits - HHS

HHS has publicly shared its plan for promoting responsible use of artificial intelligence (AI) in automated and algorithmic systems by state, local, tribal, and territorial governments in the administration of public benefits. Recent advances in the availability of powerful AI in automated or algorithmic systems open up significant opportunities to enhance public benefits program administration to better meet the needs of recipients and to improve the efficiency and effectiveness of those programs.
More Information: https://www.hhs.gov/about/news/2024/04/29/hhs-shares-plan-promoting-responsible-use-artificial-intelligence-automated-algorithmic-systems-state-local-tribal-territorial-governments-administration-public-benefits.html

Final Rules Issued on Staffing Standards for Nursing Homes; Access to Medicaid Services; & More

HHS, through CMS, has issued three final rules:

- "Minimum Staffing Standards for Nursing Homes" establishes, for the first time, national minimum staffing requirements for nursing homes to improve the care that residents receive and support workers by ensuring that they have sufficient staff.

- "Ensuring Access to Medicaid Services" creates historic national standards that will allow people enrolled in Medicaid and the Children's Health Insurance Program to better access care when they need it and also strengthens home and community-based services, which millions of older adults and people with disabilities rely upon to live in the community. This final rule will set minimum threshold standards for payments to the direct care workforce, create meaningful engagement with Medicaid consumers, and advance provider rate transparency.

- "Medicaid and Children's Health Insurance Program (CHIP) Managed Care Access, Finance, and Quality" will improve access to care, accountability and transparency for the more than 70% of Medicaid and CHIP beneficiaries who are enrolled in a managed care plan. It will require a limit on how long enrollees have to wait for an appointment and allow people to compare plan performance based on quality and access to providers.

More Information: https://www.hhs.gov/about/news/2024/04/22/biden-harris-administration-takes-historic-action-increase-access-quality-care-support-families-care-workers.html

A New Rule Protects Privacy of Those Seeking Reproductive Healthcare

Patients have a right to privacy when it comes to their medical information, even when they travel to another state for an abortion, IVF, birth control or other types of reproductive health care, federal officials have declared in a new rule. The final rule, called HIPAA Privacy Rule to Support Reproductive Health Care Privacy, prohibits the disclosure of a patient's health information as it relates to reproductive health care, as well as strengthens privacy protections for that patient, their family and their doctors who are providing or facilitating the care. This means that the rule prevents medical records from being used against people for providing or receiving certain types of reproductive health care - even if a patient traveled to another state for that care. (https://www.cnn.com/2024/04/22/health/biden-administration-new-rule-reproductive-health-care-privacy/index.html)

$46.8 Million in Behavioral Health Funding Opportunities Announced by HHS

HHS, through the Substance Abuse and Mental Health Services Administration, announced $46.8 million in notices of funding opportunities to promote youth mental health, grow the behavioral health workforce, improve access to culturally competent behavioral care across the country, and strengthen peer recovery and recovery support.
More Information: https://www.hhs.gov/about/news/2024/05/08/biden-harris-administration-announces-46-8-million-behavioral-health-funding-opportunities-advance-president-bidens-unity-agenda-may-mental-health-awareness-month.html

Policies Finalized to Increase Access to Health Coverage for DACA Recipients

HHS, through CMS, finalized a rule that will expand access to health care for Deferred Action for Childhood Arrivals (DACA) recipients. The rule ensures DACA recipients will no longer be excluded from eligibility to enroll in a Qualified Health Plan through the Affordable Care Act's Health Insurance Marketplace, or for coverage through a Basic Health Program. CMS estimates that this rule could lead to 100,000 previously uninsured DACA recipients enrolling in health coverage. (https://www.hhs.gov/about/news/2024/05/03/hhs-finalizes-policies-increase-access-health-coverage-daca-recipients.html)

Amazon Debuts Grocery Delivery Program for Prime Members, SNAP Recipients

Amazon has debuted a new grocery delivery program for Prime members across the U.S., as well as a lower-cost option for people who receive Supplemental Nutrition Assistance Program (SNAP) benefits, the official name for the food-stamp program. The cost of unlimited grocery delivery from Whole Foods Market, Amazon Fresh, and other local grocers and specialty retailers is $9.99 a month ($4.99 for SNAP recipients), for orders over $35. The new delivery service is available in more than 3,500 cities and towns across the nation, and includes features such as one-hour delivery windows. (https://www.cbsnews.com/news/amazon-grocery-delivery-prime-snap/?mc_cid=862553a55d&mc_eid=12fad95525)

Oracle's Moving HQ to Nashville to Be Near the Center of the Healthcare Industry

Oracle plans to move its world headquarters to Nashville, Tenn., to be amid a healthcare epicenter, according to co-founder and chair Larry Ellison. "It is the center of the industry we're most concerned about, which is the healthcare industry," Mr. Ellison told former U.S. Sen. Bill Frist, MD, at an April 23 fireside chat at the Oracle Health Summit. "It's the center of our future." Oracle previously said it intended to build a $1.35 billion waterfront campus in the city, which is home to several of the largest health systems - including the largest, HCA Healthcare, which Dr. Frist's family founded - and healthcare companies in the U.S. (https://www.beckershospitalreview.com/ehrs/oracle-moving-hq-to-nashville-to-be-near-healthcare-industry.html)

Cervical Cancer Can Be Eliminated

Doctors are rallying around an audacious goal: eliminating a cancer for the first time. Cervical cancer rates in the U.S. have dropped by more than half since the 1970s. Pap tests enable doctors to purge precancerous cells, and a vaccine approved in 2006 has protected a generation of women against Human PapillomaVirus, a sexually transmitted infection that causes more than 90% of cervical cancers. With this evidence that the disease is preventable, groups that have worked for decades to end polio and malaria are turning to cervical cancer, plotting to take cases down to null. WHO is urging countries to boost vaccination, screening and treatment. Doctors in the U.S. are working on a national plan. Now starts the last mile: targeting stubborn pockets of resistance and inadequate access to care that still result in deaths. (https://www.wsj.com/health/healthcare/cervical-cancer-rates-rising-hpv-vaccination-e57e37b3?mod=hp_lead_pos7)

"Consumers Rule:" Driving Healthcare Growth with a Consumer-Led Strategy

A recent McKinsey & Company article explores the latest trends in consumer healthcare behavior, considers responses, and identifies steps leaders can take to define a consumer-led strategy. Excerpts from interviews with three senior advisers discuss Trend 1: Consumers are spending more on health and wellness but are not satisfied and want more innovation; Trend 2: Consumers trust the healthcare industry with their data, but organizations underuse it; and Trend 3: Consumers are actively shopping and making trade-offs. (https://www.mckinsey.com/industries/healthcare/our-insights/consumers-rule-driving-healthcare-growth-with-a-consumer-led-strategy)

Senior Living Homes Won't Pick Up Fallen Residents, They Call 911 Instead

Lift-assist 911 calls from assisted living and other senior homes have spiked by 30 percent nationwide in recent years to nearly 42,000 calls a year, an analysis of fire department emergency call data by The Washington Post has found. That's nearly three times faster than the increase in overall 911 call volume during the same 2019-2022 period, the data shows. The growth has infuriated first responders who say these kinds of calls - which involve someone who has fallen and is not injured but can't get up - unfairly burden taxpayers and occupy firefighters with non-emergencies that should be handled by staff at facilities that charge residents as much as $7,000 a month. (https://www.washingtonpost.com/business/2024/05/03/assisted-living-homes-senior-falls-911/)

Copyright © 2024 Adaptive Business Leaders Organization. All Rights Reserved.