Capital BlueCross has signed an agreement with The Leapfrog Group, a national nonprofit organization focused on health care quality and safety, that will establish a regional hospital recognition program to help employers and consumers in central Pennsylvania and the Lehigh Valley make more informed health care decisions. [Read more…]
DinnerTime Signs Agreement with Johns Hopkins HealthCare
DinnerTime has signed an agreement with Johns Hopkins HealthCare to provide Johns Hopkins Employer Health Programs (EHP) members with free access to DinnerTime’s personalized meal planning and sale-smart shopping service. As of January 1, 2016, Johns Hopkins EHP members can sign up for DinnerTime free-of-charge when using their EHP membership number and referral code as part of their EHP benefits package. [Read more…]
WellCare Fourth Quarter and Full-Year 2015 Results
WellCare Health Plans, Inc. (NYSE: WCG) announced that it will release its financial results for the fourth quarter and full year of 2015 on Tuesday, February 9, 2016, at approximately 6:30 a.m. Eastern time. The company will also host a conference call at 9:30 a.m. Eastern time that morning to discuss its financial results. [Read more…]
Blue Cross Members With Advanced Illnesses Will Receive Enhanced Benefits
Blue Cross Blue Shield of Massachusetts (Blue Cross) has announced the launch of a comprehensive program aimed at improving quality-of-life for individuals and families facing advanced illnesses and the end of life. [Read more…]
HealthWell Foundation Opens New Medicare Access Fund to Provide Financial Assistance to Renal Cell Carcinoma Patients
The HealthWell Foundation®, an independent non-profit that provides a financial lifeline for inadequately insured Americans, has announced it has opened a new fund to provide financial assistance to Medicare patients suffering from renal cell carcinoma (RCC). Through the fund, HealthWell will provide grants up to $10,000 to assist RCC patients with copayments and premiums. Patients who are on Medicare and have annual household incomes up to 500% of the federal poverty level are eligible for the fund.
According to the National Kidney Foundation, RCC is the most common type of kidney cancer in adults. About 30 percent of people who are diagnosed with RCC develop advanced (metastatic) disease, in which the cancer spreads to other parts of the body— most often the bones or lungs. Kidney cancer is usually treated with a combination of nephrectomy (surgical removal of all or part of the kidney), radiation therapy, immunotherapy, chemotherapy and hormone therapy. Kidney cancer can often be cured if found and treated before it has spread.
Senior Health Insurance of Pennsylvania Enters Into Reinsurance Transaction with Teachers Protective Mutual
Senior Health Insurance Company of Pennsylvania (SHIP) has announced that it has executed a reinsurance transaction with Teachers Protective Mutual, a mutual insurance company, for SHIP to reinsure all of Teacher’s long-term care business.
Founded in 1912, Teachers Protective Mutual offers a variety of insurance coverage including accident, health, life and disability. The company offered individual long-term care products from 1992-2005 to residents in Ohio, Pennsylvania and Virginia.
As part of the transaction, SHIP will initially provide 100 percent coinsurance of the block of long-term care policies Teachers Protective Mutual holds, and will seek to assume the Teachers policies into SHIP in 2016. The transaction has obtained all required regulatory approvals necessary to proceed.
WellStar brings transparency to patient records
WellStar Health System is deploying an innovative solution to improve the patient experience while providing better patient care. WellStar’s electronic medical record patient portal, WellStar MyChart, will provide patients with round-the-clock access to their providers’ notes in addition to instructions, next steps, medication lists and test results from outpatient medical visits. WellStar is the first Georgia-based health system to offer this service to its patients. [Read more…]
hCentive Expands Partnerships With Insurance Carriers and Benefits Administrators
hCentive, the leader in health insurance exchange solutions, announced recently that the company has added new health and ancillary insurance carriers and benefits administrators to its WebInsure Benefits marketplace. WebInsure Benefits is a single cloud-based platform for brokers to efficiently manage their employer group and individual business and simplify administration. The platform provides employers control to shop, enroll and manage health insurance, ancillary benefits, and consumer-directed accounts while delivering an intuitive online experience for consumers.
WellCare Honors High-Performing Physicians in New York
WellCare Health Plans, Inc. (NYSE: WCG), a leading provider of managed care services for government-sponsored health care programs, announced recently that it honored its high-performing network physicians in New York by making them the first inductees into WellCare of New York’s new All-Star Quality Team.
WellCare of New York launched the All-Star Quality Team to recognize the instrumental role that physician providers play in helping its members live better, healthier lives. The 25 physicians selected demonstrated excellence in caring for members per federal metrics called Health Care Effectiveness Data and Information Set® (HEDIS) and were recognized for their HEDIS 2015 results. These measures gauge how effectively WellCare manages its members’ chronic diseases, such as asthma and rheumatoid arthritis, and ensures that members receive preventive care, such as immunizations and health screenings.
WellCare now ranks fourth highest out of 16 plans in providing quality care for Medicaid recipients in New York. The ranking is based on health care quality metrics, member and provider satisfaction, and regulatory compliance measurements as determined by New York’s Office of Health Insurance Programs.
PIA Hails Passage of Policyholder Protection Act
The National Association of Professional Insurance Agents (PIA) has hailed passage of the Policyholder Protection Act. The measure was included in the omnibus appropriations agreement that was passed 316-113 in the House and 65-33 in the Senate on December 18.
The Policyholder Protection Act prohibits federal regulators from using assets designated to pay out insurance claims to “prop up” an affiliated bank. [Read more…]
32 Hospitals Settling Medicare Fraud Allegations Due to Whistleblower
Thirty-two hospitals in 15 states agreed to pay more than $28 million to settle a whistleblower lawsuit brought by Phillips & Cohen LLP alleging that the hospitals overcharged Medicare for a type of back surgery known as kyphoplasty. [Read more…]
WellCare of Iowa to Contest State Official’s Decision to Overturn Medicaid Contract Award
WellCare of Iowa, a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), announced today that the company will aggressively contest the order issued by Janet Phipps, director of Iowa’s Department of Administrative Services, which overturned the state’s original decision to award a Medicaid contract to WellCare of Iowa.
“This decision does not accurately reflect the facts, the integrity of Iowa’s procurement process or Iowa law,” said Lauralie Rubel, state president, WellCare of Iowa. “WellCare intends to use every avenue available within the legal system to correct this erroneous outcome. We will immediately seek an injunction that maintains the status quo to allow WellCare of Iowa to continue its participation in the program while this matter is appealed in a court of law.”
PROCEPT BioRobotics Closes $42 Million in New Funding
PROCEPT BioRobotics, a privately held medical device company based in Silicon Valley, announced today the closing of $42 million in a venture round of equity financing led by Novo A/S. New investor CPMG, Inc. and existing investors also participated in the round.
PROCEPT’s AquaBeam System combines image guidance and robotics to deliver Aquablation, a novel minimally invasive waterjet ablation therapy that enables targeted, controlled, and heat-free removal of tissue for the treatment of lower urinary tract symptoms.
PROCEPT will use the proceeds from the financing for a limited commercial launch of AquaBeam in targeted international markets and to conduct the WATER study (Waterjet Ablation Therapy for Endoscopic Resection of prostate tissue), a randomized blinded controlled clinical trial. PROCEPT has received conditional approval from the FDA for an investigational device exemption trial in the United States to evaluate the safety and effectiveness of Aquablation.
Hemp Health Inc. Helps Marijuana Users Get Sober Quickly
Hemp Health Inc., maker of cannabidiol (CBD) products, today introduced THC Buzzkill, a patent-pending CBD supplement that counteracts the ‘high’ of marijuana. Sold as an oral spray, THC Buzzkill absorbs into the bloodstream rapidly and lessens the psychoactive effects of THC using all-natural ingredients. THC Buzzkill is the first supplement designed for marijuana users who need to sober up quickly.
THC Buzzkill’s primary ingredients come from high-CBD, low-THC cannabis. Kosher, vegan and non-GMO, the cannabis is sourced from sustainable farms in Germany, Denmark and other European countries. THC Buzzkill is legal all 50 states and 42 countries.
THC Buzzkill pilot users report that the tincture lessens the effects of marijuana within 15 minutes. The supplement does not remove chemical traces of THC from the human body, and it does not make it safe for the marijuana user to drive an automobile or operate machinery. Taking THC Buzzkill prior to consuming marijuana will not block the effects.
THC Buzzkill is sold in a 1 ounce or 2 ounce bottle. Users can expect roughly 40 applications per ounce. The supplement will be sold online at www.hemphealthinc.com and at marijuana dispensaries, smoke shops and health stores nationwide. In states that permit recreational marijuana use, residents can expect to find THC Buzzkill at convenience stores and gas stations.
To learn more about THC Buzzkill, visit https://hemphealthinc.com
BIO-Europe® 2015 in Munich to take place November 2-4, 2015
The twenty-first annual BIO-Europe® international life science partnering conference will be held in Munich, Germany, November 2–4, 2015. Organized by EBD Group, the event is co-hosted by BioM Biotech Cluster Development, the Bavarian Ministry of Economic Affairs and Media, Energy and Technology, and Cluster Biotechnology Bavaria.
Bavaria is an ideal location because it is home to a broad spectrum of high-capacity industries including life sciences and is a leading business region in Europe. There are 270 life science companies in the Munich biotech cluster, characterized by innovative small and medium-sized biotech companies and a focus on new therapeutics and diagnostics, “omics”-technologies, personalized medicine and biomarker research.
BIO-Europe is Europe’s largest partnering conference serving the global biotechnology industry and is facilitated by EBD Group’s partneringONE®, the gold standard one-to-one networking solution for the life sciences.
Moleculera Labs Receives Grant from OCAST
Moleculera Labs today announced the receipt of a two-year, $300,000 matching grant from the Oklahoma Center for the Advancement of Science and Technology (OCAST). This grant supports the development and clinical validation of new diagnostic testing panels to identify autoantibodies directed against neuronal antigens in patients experiencing neuropsychiatric disorders such as depression, bipolar disorder and schizophrenia. Such panels are intended to assist physicians in identifying the subset of patients whose symptoms may actually be caused by underlying treatable infection-triggered autoimmune and inflammatory responses.
Research by Madeleine Cunningham, Ph.D., Moleculera’s co-founder and Chief Scientific Officer, and her collaborators has led to development of the Cunningham Panel™, which measures relevant anti-neuronal antibodies and neuronal cell-activating antibodies circulating in the patient’s blood, as well as the activity of a key enzyme in the brain involved in the up-regulation of many neurotransmitters including dopamine. This test panel aids physicians in identifying individuals with PANDAS or PANS, thus enabling those children to receive appropriate anti-infective and/or immunological treatment that often results in a dramatic reduction or resolution of symptoms, without resorting to symptomatic control with neuropsychiatric drugs alone.
Equifax Achieves Milestone in Helping Employers Manage the Affordable Care Act
Equifax Workforce Solutions, a leader in human resource, analytics and verification services, and a business unit of Equifax Inc. (NYSE: EFX), has achieved a major milestone in Affordable Care Act (ACA) management for employers. The company’s ACA Management Platform, a software application that automates ACA administrative tasks and helps employers reduce their potential for penalties, is now used to manage compliance for over 10 million employees.
The Equifax ACA Management Platform, which has been recognized as a leading technology by Human Resource Executive® Magazine, Ventana Research, and the Brandon Hall Group, has seen the adoption rate for ACA-related services grow exponentially since the final versions of Internal Revenue Service (IRS) reporting forms 1094 and 1095 were released. These forms, which require detailed monthly information regarding the coverage offered and provided to employees and their dependents, will be used by the IRS to assess fines under both the individual and the employer mandate.
In addition to releasing the IRS Reporting module to automate the preparation and fulfillment of forms 1095 and 1094, the company recently released additional features, including the Appeals Management module that streamlines the process of storing and responding to subsidy notifications from the exchanges.
Following the Supreme Court’s ruling on King v. Burwell, in favor of Burwell, the government has taken another step in the longevity of the ACA and its impact on employers. The much anticipated decision upheld the legality of Premium Tax Credits, or subsidies, for health insurance provided under the federal Marketplace. Because subsidies trigger penalties for employers, this decision had the potential to significantly impact the Pay or Play mandate. To help employers understand the impact of the Court’s ruling and the next steps they should take in the ACA compliance journey, Equifax is hosting a webinar on July 7, 2015.
Physicians Discuss Role of Medicare Over 50 Years of Care
On July 30, 1965, Lyndon B. Johnson signed Medicare as well as Medicaid into law. The following year, slightly more than 19 million older Americans had Medicare coverage.
Since then, Medicare has grown, and today covers more than 54 million Americans. And, since its inaugural year, a number of changes have been made including the addition of outpatient prescription drug benefits in 2003 when George W. Bush signed the Medicare Modernization Act into law.
However, even with changes over the years, one thing has remained a constant – enabling qualifying Americans easier access to physician care.
To recognize 50 years of providing Medicare coverage, Pennsylvania’s medical associations offer their thoughts on what Medicare has meant to the delivery of health care. [Read more…]
Medical Tourism Association® Joins Forces to Launch Asia-Pacific 2015 Global Healthcare Congress
The Medical Tourism Association® and Beijing Great-Idea Business Resources Company Ltd. have partnered to hold the World Medical Tourism and Global Healthcare Congress Asia-Pacific 2015, Nov. 14-16, 2015, in Guilin, China.
Renée-Marie Stephano, President of the Medical Tourism Association®, said the multi-year event will also include a five-day, three-city B2B and B2G trade mission with top Chinese executives. To register, go to www.asiamedicaltourismcongress.com/
Asia-Pacific will also be a major focus — including several sessions dedicated to health and wellness in the region — at the World Medical Tourism and Global Healthcare Congress, Sept. 27-30, 2015, in Orlando, Fla.
The World Medical Tourism & Global Healthcare Congress attracts some 3,000 key stakeholders – hospital administrators, doctors and clinicians, employers, government policy makers, insurance executives, facilitators, and hospitality and tourism interests – from across the globe to share their experiences and identify and solve issues that bear significantly on the industry. Participants, sponsors and invited speakers can keep abreast of Congress updates or register at www.MedicalTourismCongress.com
Aetna Publishes Favorable Coverage Policy for ThyGenX
PDI, Inc. (NASDAQ: PDII) subsidiary Interpace Diagnostics announced that effective June 2015, ThyGenX™,i the company’s genetic mutation panel, has been approved by Aetna for assessing fine needle aspiration (FNA) samples from indeterminate thyroid nodules. Aetna’s coverage decision now means that ThyGenX is considered medically necessary. Aetna covers 46 million lives and its positive coverage decision brings the total number of lives covered for ThyGenX to more than 100 million.
Approximately 15-30% of the 525,000 thyroid FNA’s performed on an annual basis are indeterminate based on standard cytological evaluation, and thus are candidates for ThyGenX. ThyGenX has been validated in a prospective, clinical study involving over 600 patients and has a specificity rate of 89%.ii
Guidelines from the National Comprehensive Cancer Network (NCCN) indicate that molecular diagnostic approaches may be useful in the evaluation of thyroid FNA samples that are indeterminate to assist in patient management, including identifying patients who are appropriate candidates for surgery and those for whom surveillance is appropriate.
GuideWell and Alignment Healthcare Create Strategic Medicare Advantage Partnership
GuideWell Mutual Holding Corporation (GuideWell) has entered into a strategic partnership with Alignment Healthcare, LLC (Alignment Healthcare), a population health management company with technology-enabled clinical integration at its core. The new relationship is intended to improve clinical outcomes for Medicare Advantage members in Florida and positively impact overall health care costs.
Together, GuideWell and Alignment Healthcare will create senior-focused clinics in regions of Florida and feature an innovative, technology-enabled, patient-centered model of care, designed to reduce hospitalizations and improve clinical outcomes for medically needy elderly patients.
Utilizing proprietary technology, teams of physicians trained to manage the unique care needs of the most vulnerable patients in the community, will work in partnership with nurse practitioners, physician assistants, and nurse care managers. They will act as advocates and care navigators for their patients, and manage the delivery of health care across multiple disciplines and treatment settings in coordination with primary care physicians.
To further serve the aging population in Florida, GuideWell has acquired BeHealthy America, Inc., a Florida-based Medicare Advantage Health Maintenance Organization (HMO). This acquisition further complements the Medicare Advantage offerings currently available through GuideWell’s health insurance businesses. The new HMO product will combine an attractive benefits design with Alignment Healthcare’s unique care delivery model, providing a more comprehensive level of care for a growing segment of Florida’s Medicare Advantage customer base.
CMS Changes Will Bridge Old and New Models of Chronic Care Management
The prevalence of chronic conditions presents one of the greatest risks to the U.S in terms of population health and well-being. However, many serious conditions such as hypertension or hyperlipidemia can be successfully managed if the patient follows a clearly documented treatment plan. To that end, changes to the chronic care management model by the Centers for Medicare and Medicaid Services (CMS) offers an out-of-the-box approach to improve the outcomes for patients with two or more chronic conditions. Medical practitioners can bill non-face-to-face communications with Medicare beneficiaries, reducing the need for costly direct evaluations when a simple instruction may be all that is needed.
Recent analysis from Frost & Sullivan, CMS Changes in Chronic Care Management: Is it Really a Bridge to Value-based Care?(http://www.frost.com/q294859662), finds that despite a list of cons, the potential merits of this program demonstrate value. Even though it falls short of the new payment taxonomy and true telehealth, this approach to chronic care management is a transitional phase, beginning in the old world of Medicare while possessing the potential to evolve with changing demands.
EHE International Certifies Prime Healthcare As Partner
EHE International, the recognized leader in preventive medicine and annual physical exams, today announced that the Prime Healthcare, Avon, CT office has been named an EHE-certified preventive care center. Through Prime Healthcare, Avon, EHE members in the Avon region now have greater access to its preventive care program to help them proactively maintain their health.
“EHE is proud to add Prime Healthcare in Avon to its growing private provider network. Prime Healthcare is eager to contribute to the wellness of its local community,” said Deborah McKeever, president of EHE International. “EHE members will benefit from the expertise and experience of Prime Healthcare’s doctors who have met our high professional and practice standards earning them the ‘EHE Certified’ status.”
“EHE’s continued expansion in the Avon area and across the United States is a sign that more and more employers are realizing the benefits of standardized clinical protocols in preventive health and annual exams,” added McKeever. “It is well-recognized that a focus on prevention helps control future healthcare costs, improves productivity and allows employees to proactively manage their own health. EHE has a century of experience in caring for employers’ greatest asset, its employees.”
If you would like to learn more about EHE International’s physician network, please contact:
Director, Provider Markets
Office: (212) 332-3025
Mobile: (203) 507-5609
Fax: (212) 332-1170
Email: [email protected]
HCI3 Relationships Strengthen U.S. Health Care Payment Reform Infrastructure and Process
To expedite payment reform across the U.S., the non-profit Health Care Incentives Improvement Institute (HCI3) has partnered with key stakeholders to support the transformation to a health care system based on quality and affordability. HCI3 partners include health plans, providers and purchasers who are actively working toward payment reform implementations, and technology and consulting firms offering services to support these efforts.
Organizations working with HCI3 to implement evidence-based incentive and payment reform programs include:
Blue Cross and Blue Shield of North Carolina
Community Health Choice
Horizon Healthcare Services, Inc.
McKinsey & Co
xG Health Solutions™
SameDay Funding Will Disrupt Traditional Healthcare Reimbursement Model
MTBC (NASDAQ: MTBC), a leading provider of fully-integrated, web-based healthcare IT and revenue cycle management solutions has commenced beta testing of MTBC SameDay Funding™ (MTBC SDF™), which will ensure that healthcare providers receive advanced insurance reimbursement as patient encounters are completed and claims submitted.
MTBC SDF, which is now in beta testing, leverages MTBC’s proprietary data sets and algorithms to estimate its participating clients’ claim level insurance reimbursements. Once these pre-adjudication estimations are made, MTBC will advance funds to its clients, in the amount of the anticipated reimbursement, and then recoup the advanced funds as the respective payer completes the adjudication and payment process.
Maternity Care Issue Between Highmark and UPMC Resolved
Governor Tom Wolf has announced that Highmark will continue to cover pregnancy and related care at Magee-Womens Hospital of UPMC in 2015, despite it no longer being in their network of providers. Coverage for these services will be at in-network rates.
“Any woman who became pregnant and sought treatment in 2014 and has Highmark insurance will have in-network access to Magee-Womens Hospital in 2015,” said Governor Tom Wolf. “The needs of patients must always come first and I am pleased that we have reached a swift and necessary resolution in this matter.”
Under Governor Tom Wolf’s administration, the Pennsylvania Department of Insurance and the Pennsylvania Department of Health will work diligently to continue to enforce the consent decree between Highmark and UPMC.
“We are pleased that expectant mothers will continue to receive the access to the care they need,” said Acting Insurance Commissioner Teresa Miller. “Ensuring greater access to care and transparency for Western Pennsylvania patients is a top priority for this administration.”
The resolution on maternity care:
Considers pregnant women in continuity of care if treatment began prior to Dec. 31, 2014.
Covers patients who have retained Highmark insurance coverage, either individually or though group plans.
Information for health-care consumers with questions on Highmark and UPMC is available at www.StayInformed.pa.gov.
AMCP Welcomes 21st Century Cures Provisions Addressing Drug Abuse, Fraud in Medicare Part D
The Academy of Managed Care Pharmacy (AMCP) applauds two crucial provisions in draft legislation issued this week by the House Energy and Commerce Committee that combat the abuse of controlled substances and payment fraud in the Medicare Part D prescription drug benefit program.
AMCP Chief Executive Officer Edith A. Rosato, RPh, IOM issued the following statement:
The Academy is pleased the Committee’s bill includes Sec. 4281, which calls for creating safe pharmacy networks in Part D to prevent the abuse and diversion of controlled substances, and Sec. 4282, which authorizes Part D plans to suspend payment of claims to pharmacies suspected of a credible allegation of fraud.
While we are still analyzing these provisions in detail, we are gratified to see they are part of the larger discussion on improving patient health and ensuring the integrity of our health care system. These are issues that AMCP has taken the lead on for years. In the coming weeks, we will be offering lawmakers on the Committee in-depth recommendations on how these proposals might be modified to have the biggest positive impact.
The nearly 400-page draft bill, which stems from the Committee’s bipartisan 21st Century Cures initiative last year, aims to accelerate discovery, development and delivery of new drugs and therapies. It also includes reforms of various health care programs such as Medicare Part D. The Committee said it hopes to present legislation to President Obama by the end of the year.
The Academy has developed detailed positions on both Part D topics.
On controlled substances, AMCP’s position includes amending current law to allow Part D prescription drug plans and Medicare Advantage prescription drug plans to limit patients with a history of abuse to a single prescriber and/or pharmacy (or chain of pharmacies), similar to what already occurs in the private market and the Medicaid program..
On anti-fraud, AMCP’s position includes amending current law to allow health plans to withhold payments to pharmacies that are suspected of fraud in the program. This solution would allow plans to combat suspected fraud before payments are made, instead of attempting to recover the payments after the fact, which is often a difficult, if not impossible, task.
Centene’s Florida Subsidiary Awarded Commendable Accreditation Rating From NCQA
Centene Corporation (NYSE: CNC) today announced that its wholly-owned Florida subsidiary, Sunshine Health, was elevated to Commendable Accreditation by the National Committee for Quality Assurance (NCQA) for its Medical Managed Assistance and Child Welfare programs. NCQA evaluates how well a health plan manages all parts of its delivery system – physicians, hospitals, other providers, and administrative services in order to continuously improve the quality of care and services provided to its members.
Sunshine Health serves 400,000 Medicaid members under its Managed Medical Assistance and Child Welfare programs statewide.
NCQA is a private, nonprofit organization dedicated to improving health care quality. NCQA accredits and certifies a wide range of health care organizations. It also recognizes clinicians and practices in key areas of performance. NCQA is committed to providing health care quality information for consumers, purchasers, health care providers and researchers.
Aon Hewitt Shows Continued Cost Savings for Companies and Individuals Participating in the Aon Active Health Exchange
Aon Hewitt, the global talent, retirement and health solutions business of Aon plc (NYSE: AON), has announced that employers and individuals participating in the Aon Active Health Exchange are seeing notable reductions in health care spend for the third straight year.
More than 600,000 employees and their dependents enrolled in health benefits through the Aon Active Health Exchange for the 2014 calendar year. All of the 18 companies that participated in 2014 are returning to the Aon Active Health Exchange in 2015. Across those companies, rates for medical coverage increased an average of 5.3 percent. This is lower than the industry average and includes costs associated with the Affordable Care Act. According to Aon Hewitt’s estimates and several other organizations,1 average health care cost increases in 2015 for large U.S. employers with self-insured arrangements are projected to be between 6.52 percent to 8.0 percent3 before employers make changes in deductibles and copays. Based on employer and employee feedback, plan designs in the Aon Active Health Exchange for 2015 will once again remain unchanged.
Companies participating in the Aon Active Health Exchange also reduced their overall health care cost for medical coverage by more than $750 per employee compared to their expected 2014 spending. These numbers factored in the savings delivered through the exchange model, the impact of employee choices to buy less rich coverage and the impact of employees who chose to purchase richer—and often more expensive—medical plans. Average health care costs were $8,342 per employee, down from $9,098 per employee. These savings were shared with employees through reduced payroll contributions, as well as through offering a range of more affordable health care coverage options.
Capital BlueCross, Health Care Improvement Foundation develop collaborative with area health care systems to improve patient care
Thousands of Pennsylvanians receive medical services every day from local health care systems. Each of these facilities has its own physicians and practitioners with their own specialized knowledge gained from their own experience providing care. But what if they came together to compare notes? What if they shared what they know about what works best for patients? What if, cooperatively, they focused on improving specific categories of care?
That is exactly the purpose of a new collaborative brought together by Capital BlueCross and the Health Care Improvement Foundation (HCIF). A first-of-its-kind for the central Pennsylvania and Lehigh Valley regions, the collaborative is focusing on improving health care safety, outcomes, and the overall patient experience by zeroing in on one important health initiative at a time.
The first area of focus that the collaborative’s health care system participants have agreed to work on with Capital BlueCross and HCIF is palliative care.
The aim of the collaborative is to advance the care and support of patients with advanced illness and their families across the region. Over the course of the collaborative, organizations will work together to improve the awareness and use of POLST (Pennsylvania Orders for Life Sustaining Treatment) by promoting advanced care planning conversations between health care providers and patients with advanced illness and their families, fostering shared decision-making about individualized goals of care, and ensuring the implementation of individualized health care goals across care settings.
A Regional Palliative Care Steering Committee is being formed to provide input into collaborative goals, metrics, and the curriculum for an in-person conference this fall. The committee will continue to work together to ensure that program activities best support participating organizations and that patient outcomes are met and sustained.
Success of the initiative will be monitored and measured by the Pennsylvania Health Care Quality Alliance. The Pennsylvania Health Care Quality Alliance is a non-profit that seeks to improve the quality of patient health through alliances between hospitals, physicians, health plans and other stakeholders who are dedicated to promoting responsible public reporting of health care information. More information can be found at www.pahealthcarequality.org.
New White Paper on Important Role of Post-Acute Care (PAC) Provider within an ACO
Managed Health Care Associates, Inc. (MHA), a leading health care services and technology company focused on the alternate site health care provider marketplace, today announced the release of a new white paper titled, “The Right Care for the Right Cost: Post-Acute and the Triple Aim”. This paper is a collaborative effort between the MHA ACO Network and Leavitt Partners, a leading health care intelligence business, and focuses on the important role of the Post-Acute Care (PAC) Provider within an Accountable Care Organization (ACO).
Through detailed financial analyses and case study presentation, the work highlights the following:
— Type of services that ACOs should include within the post-acute spectrum
— How healthcare reform is impacting post-acute care payments and providers
— In what manner PAC partnerships support the ACO mission of better care, lower cost and overall increased health outcomes.
The paper also offers insight from specific case studies into the ACO-PAC Engagement Spectrum, which varies from minimal commitment to a fully integrated care continuum and how positive outcomes can help ACOs report on required CMS Quality Measures and reduce all cause and diagnosis specific Hospital Readmission Rates.
Blue Cross And Blue Shield Of Texas Transparency Solution Helps Consumers Better Manage Health Care Services
As consumers look for new ways to obtain the best possible care and lower their health care costs, Blue Cross and Blue Shield of Texas (BCBSTX), the largest provider of health benefits in the state, announces the enhanced Provider Finder, an online health care solution developed to enable members to more easily research and select physicians and hospitals, as well as estimate out-of-pocket health care costs. The Provider Finder provides cost estimates for more than 400 common medical procedures, increasing to 1600 by the end of the year.
Provider Finder allows members to search and compare more than 400,000 health professionals and 21,000 facilities nationwide, estimate treatment costs, access clinical quality data and read and write patient reviews. BCBSTX analyzed the use of Provider Finder for approximately 800,000 members and found that members who acted on a Provider Finder recommendation saved on average $900 per procedure.
Recent research indicates that consumers may pay as much as 683 percent more for the same medical procedures, in the same town, depending on the facility they choose.2 For example, the total cost for a knee replacement in the Dallas area could range from $18,801 to $47,324 depending on the facility.3 The Provider Finder offers members a simple, easy to navigate website, to help in selecting the best provider for their needs, based on location, clinical quality and costs. A few unique features include:
— Out-of-pocket costs. Unlike other transparency solutions that rely on estimated costs, the Provider Finder uses an expansive, proprietary database to provide information on out-of-pocket expenses. Out-of-pocket estimates are based on a member’s own health plan benefits including health reimbursement and health savings account balances.
— Unparalleled provider demographic data. The Provider Finder includes a large library of patient reviews of physicians and facilities, as well as photos and information on average wait times and physician training, expertise and awards.
— Extensive Provider Clinical Quality Data. Members can evaluate the quality of care with data from Blue Distinction/Blue Distinction+ Centers, Bridges to Excellence, National Committee for Quality Assurance (NCQA) distinctions and Physician Quality Measurement data.
SpendWell and PaySpan Partner to Enable Innovative Health Care Consumer Experience
SpendWell Health, an online marketplace for health care services, has partnered with PaySpan®, Inc., a leading provider of health care reimbursement and payment automation services. Through the partnership, the SpendWell consumer retail experience of shopping for routine health care services now reaches PaySpan’s network of more than 700,000 health care providers. Together the partnership transforms how people shop for health care, provides financial benefits to providers and promotes a patient experience that is more affordable, administratively efficient and economically sustainable.
SpendWell is leveraging PaySpan’s financial network to reach providers, payers and consumers to create a nationwide online marketplace to give consumers with high-deductible plans a way to shop for quality routine health care services at competitive and fair prices. PaySpan creates new opportunities for providers to expand their business by treating more cash-pay patients with no financial risk.
Through a competitive market search and solution evaluation process, SpendWell selected PaySpan to power its financial reimbursement infrastructure for consumers, health plan members, patients, providers and payers using PaySpan’s Patient Centered Financial Home® commerce framework.
New Affordable Care Act tools and payment models deliver $372 million in savings
The Centers for Medicare & Medicaid Services (CMS) has issued quality and financial performance results showing that Medicare Accountable Care Organizations (ACOs) have improved patient care and produced hundreds of millions of dollars in savings for the program.
In addition to providing more Americans with access to quality, affordable healthcare, the Affordable Care Act encourages doctors, hospitals and other healthcare providers to work together to better coordinate care and keep people healthy rather than treat them when they are sick, which also helps to reduce healthcare costs. ACOs are one example of the innovative ways to improve care and reduce costs. In an ACO, providers who join these groups become eligible to share savings with Medicare when they deliver that care more efficiently.
Kaiser Permanente of the Mid-Atlantic States named top plan in DC, MD, VA
The National Committee for Quality Assurance (NCQA) ranked Kaiser Permanente of the Mid-Atlantic States the #1 health plan in Maryland, Virginia and the District of Columbia. The NCQA Health Insurance Plan Rankings initiative is a comprehensive and independent comparison that assesses 507 health plans nationally.
The data from NCQA’s Private Health Insurance Plan Rankings 2014–2015 shows Kaiser Permanente of the Mid-Atlantic States is among the most successful health plans in the nation, scoring the maximum of 5 out of 5 in Consumer Experience, Prevention, and Treatment; the only plan to achieve 5 out of 5 in all three components in Maryland, Virginia, and the District of Columbia.
The rankings, which look at 240 measures, are based 60% on clinical quality measures, 25% on consumer satisfaction measures, and 15% on Health Plan Accreditation Standards. Overall, Kaiser Permanente, published under the name Kaiser Foundation Health Plan of the Mid-Atlantic States, was ranked #13 out of 507 plans in NCQA’s Private Health Insurance Plan Rankings 2014–2015.
Meridian Health Plan of Iowa Named Top Medicaid Plan
Meridian Health Plan of Iowa is the number one Medicaid HMO in Iowa and is the number 38 Medicaid HMO in the US according to NCQA’s Medicaid Health Insurance Plan Rankings 2014–2015.
Meridian Health Plan of Iowa’s performance in NCQA’s Medicaid Health Insurance Plan Rankings 2014-2015 immediately follows its recent NCQA accreditation status elevation from Accredited to Commendable for achievement in the areas of consumer protection and quality improvement. NCQA Accreditation evaluates how well health plans manage all parts of its delivery system – physicians, hospitals, other providers and administrative services – in order to continuously improve the quality of care and services provided to its members.
Health Plan Accreditation and the Medicaid Health Insurance Plan Rankings 2014–2015 are separate and distinct review processes and recognition. The complete list of NCQA’s Medicaid Health Insurance Plan Rankings 2014–2015 is available online at http://www.ncqa.org.
NHPCO Applauds Passage of the IMPACT Act
This week, the U.S. House of Representatives and Senate passed the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act), legislation which includes hospice integrity provisions that are backed by the hospice community. The National Hospice and Palliative Care Organization (www.nhpco.org) supports this legislation and the additional oversight it will bring to end-of-life care providers.
The IMPACT Act (H.R. 4994) requires more frequent surveys of hospice providers – a measure the hospice community NHPCO has championed for more than a decade. The bill mandates that all Medicare certified hospices be surveyed every three years for at least the next ten years.
A 2007 HHS Office of the Inspector General report found that current survey measures for Medicare-certified hospices was not providing sufficient oversight.
NHPCO has supported this provision since it was originally recommended by MedPAC in 2009.
NHPCO reports that more than 1.5 million dying Americans receive care for the nation’s hospice providers every year.
Contact Corporate Whistleblower Center If You Possess Proof of Healthcare Provider Overbilling Medicare
The Corporate Whistleblower Center is urging physicians, or employees of any type of healthcare company to call them at 866-714-6466, if they possess well documented proof the company is overbilling Medicare out of hundreds of thousands, or millions of dollars each year, because the reward potential for this type of information really can be substantial.
The Corporate Whistleblower Center believes there are thousands of healthcare workers in the United States who have specific information about a healthcare company gouging Medicare out of hundreds of thousands, or millions of dollars each year, and they say nothing, or they do nothing about it. As the Whistleblower Center would like to explain these types of individuals are potentially sitting on a winning lotto ticket, that could be worth hundreds of thousands, or millions of dollars.
In a recent example of the potential rewards for a whistleblower, according to a May 2014 Justice Department press release, Baptist Health System Inc. (Baptist Health), the parent company for a network of affiliated hospitals and medical providers in the Jacksonville, Florida, area, has agreed to pay $2.5 million to settle allegations that its subsidiaries violated the False Claims Act by submitting claims to federal health care programs for medically unnecessary services and drugs. The alleged misconduct involved Medicare, Medicaid, TRICARE and the Federal Employee Health Benefits Program.
This settlement resolves allegations that, from September 2009 to October 2011, two neurologists in the Baptist Health network misdiagnosed patients with various neurological disorders, such as multiple sclerosis, which caused Baptist Health to bill for medically unnecessary services.
The Corporate Whistleblower Center says, “We cannot emphasize enough if any type of healthcare professional has well documented proof a hospital, a medical practice group, a radiology center, a hospice provider, a nursing home, or a skilled nursing facility is overcharging Medicare please call us at 866-714-6466.
Propeller Health Raises $14.5 Million Series B Financing
Propeller Health has raised $14.5 million in Series B financing, led by Safeguard Scientifics (NYSE:SFE) with participation from Series A investor The Social+Capital Partnership. Propeller Health will use the funding to accelerate product development, strategic alliances, client services, sales and marketing.
Asthma and chronic obstructive pulmonary disease (COPD) currently cost payers and patients in the United States over $100 billion annually. By 2020, the Centers for Disease Controls and Prevention estimates that the cost of medical care for adults in the U.S. with COPD alone will increase 53 percent to more than $90 billion.
Propeller is a digital therapeutic designed to help patients and their physicians better understand and control COPD, asthma and other respiratory disease, reducing preventable emergency room visits, hospitalizations and unnecessary suffering. With a novel combination of sensors, mobile apps, analytics and personalized feedback, the system encourages adherence to maintenance therapy and remotely monitors use of rescue medications to predict exacerbations and facilitate early intervention by care teams.
In the last year, Propeller Health doubled its number of commercial programs and added its first contract with an accountable care organization. In addition, the company recently received FDA clearance for a new inhaler sensor and is concluding a 500-person randomized control trial at Dignity Health. Propeller Health also released a version of the app for people with COPD and major updates to its physician dashboards, adherence programs and predictive algorithms.
2014 Recipients of the Leaders in Health Care Scholarships
Transamerica Retirement Solutions, a sponsor of the Institute for Diversity in Health Management (“the Institute”), has announced the recipients of the 2014 Leaders in Health Care Scholarship. This year’s winners, Sheryl Muirhead-McCrae and Tina Huynh, will each receive a $5,000 scholarship toward pursuing an advanced degree in health care administration.
Each year, two deserving first- and second-year students whose field of study is health care administration or a comparable program are recognized. Candidates are also required to demonstrate a commitment to academic excellence and community service. The Institute coordinates the application and candidate selection process on behalf of Transamerica.
Muirhead-McCrae will begin her graduate studies in health care management at Florida International University (FIU) in the fall. She has also worked in the health care field for a number of years and is deeply committed to delivering health care services to underserved communities. Her volunteer work includes coordinating free health fairs aimed at helping women gain access to health services.
Huynh will pursue dual Master of Health Administration and Master of Public Health degrees at the University of Utah. In addition to her academic achievements, she has proven her dedication to community service. Huynh has volunteered for a number of organizations such as AmeriCorps, Big Brothers Big Sisters and the University of Utah Hospital. Ultimately, she plans to become a health care administrator for a non-profit organization.
NetSuite TribeHR Partners With Maxwell Health
NetSuite Inc. (NYSE: N), the industry’s leading provider of cloud-based financials / ERP and omnichannel commerce software suites, today announced a strategic partnership with Maxwell Health that combines Maxwell’s revolutionary cloud solution for employee healthcare and benefits administration with the NetSuite TribeHR human capital management (HCM) platform. Leveraging the combined strengths, the partnership transforms the way companies manage their human assets by ridding them of tedious, time-consuming and error-prone manual processes. With a modern HCM platform, small and medium-sized businesses (SMBs) can now run end-to-end HCM business processes from recruiting, managing and rewarding employees, to facilitating flexible, streamlined healthcare benefits enrollment, administering benefits and promoting workforce wellness – all in the cloud.
The integration of both NetSuite TribeHR and Maxwell Health details:
NetSuite TribeHR is an integrated cloud ERP and HCM software suite for small and mid-sized businesses. It gives SMBs a single cloud solution to run their core business operations as well as a rich, social HR software solution to manage employees. Maxwell Health’s solution simplifies the onboarding and benefits management process and dramatically improves productivity for both HR teams and an organization’s workforce at large. Through the integration, the Maxwell Health solution acts as a benefits enrollment system and serves as the system of record for benefits information and administration, while bi-directional data exchange between the systems ensures that HCM data in NetSuite TribeHR and benefits information in Maxwell Health are always in sync. With modern, attractive user interfaces, NetSuite TribeHR and Maxwell Health align with social and mobile dimensions that extend HCM and benefits administration to HR teams and personnel in an accessible and transparent way, encouraging greater engagement.
The Combined Solution Delivers Unprecedented Features and Benefits Including:
Core HRIS (Human Resource Information System) – Manage essential employee information individually and in aggregate, featuring employee administration, employee profile, employee history, compensation tracking, organizational charts, company directory, employee self-service, manager self-service, employee and recourse document storage, and employee time-off tracking.
Advanced Recruiting – Social applicant tracking system (ATS) with integrations to LinkedIn and Facebook.
Complete Talent Management Solution – 360-degree feedback tools, goal management, performance appraisals, skills tracking, and values and culture tracking.
Social HR for a Social Workforce – Commenting, collaboration, and peer and public recognition tools that span the entire company.
Streamlined Benefits Open Enrollment Process – Remove inefficient and error-prone paperwork typical in open enrollment while handling complex rate structures with best-in-class benefits administration.
Simplified Benefits Shopping – Ecommerce-like benefits shopping experience in an open marketplace of providers.
Mobile Platform for Anywhere, Anytime Access – Mobile platform enables employees to access and use company benefits programs, reach a health care concierge for benefits help, improve health with an in-app fitness tracker, and to collaborate and connect no matter where they are.
Programs and Solutions to Encourage Employees to Stay Healthy – Offering includes a time and money-saving personal health advocate who acts as a liaison within the health care system, and a turnkey wellness program that rewards employees for better health.
New Report Finds Adult Obesity Rates Increased in Six States
Adult obesity rates remained high overall, increased in six states in the past year, and did not decrease in any, according to The State of Obesity: Better Policies for a Healthier America, a report from the Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).
The annual report found that adult obesity rates increased in Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming. Rates of obesity now exceed 35 percent for the first time in two states, are at or above 30 percent in 20 states and are not below 21 percent in any. Mississippi and West Virginia tied for having the highest adult obesity rate in the United States at 35.1 percent, while Colorado had the lowest at 21.3 percent.
Findings reveal that significant geographic, income, racial, and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans. The report also found that more than one in ten children become obese as early as ages 2 to 5.
Other key findings from The State of Obesity include:
After decades of rising obesity rates among adults, the rate of increase is beginning to slow, but rates remain far too high and disparities persist.
In 2005, the obesity rate increased in every state but one; this past year, only six states experienced an increase. In last year’s report, only one state, Arkansas, experienced an increase in its adult obesity rate.
Obesity rates remain higher among Black and Latino communities than among Whites:
Adult obesity rates for Blacks are at or above 40 percent in 11 states, 35 percent in 29 states and 30 percent in 41 states.
Rates of adult obesity among Latinos exceeded 35 percent in five states and 30 percent in 23 states.
Among Whites, adult obesity rates topped 30 percent in 10 states.
Nine out of the 10 states with the highest obesity rates are in the South.
Baby Boomers (45-to 64-year-olds)* have the highest obesity rates of any age group – topping 35 percent in 17 states and 30 percent in 41 states.
More than 33 percent of adults 18 and older who earn less than $15,000 per year are obese, compared with 25.4 percent who earn at least $50,000 per year.
More than 6 percent of adults are severely** obese; the number of severely obese adults has quadrupled in the past 30 years.
The national childhood obesity rate has leveled off, and rates have declined in some places and among some groups, but disparities persist and severe obesity may be on the rise.
As of 2011-2012:
— Nearly one out of three children and teens ages 2 to 19 is overweight or obese, and national obesity rates among this age group have remained stable for 10 years.
— More than 1 in 10 children become obese between the ages of 2 to 5; and 5 percent of 6- to 11-year-olds are severely obese.
— Racial and ethnic disparities emerge in childhood (ages 2-19): The obesity rates are 22.4 percent among Hispanics, 20.2 percent among Blacks and 14.1 percent among Whites.
— Between 2008 and 2011, 18 states and one U.S. territory experienced a decline in obesity rates among preschoolers from low-income families.
COB Smart Expands Nationwide to Identify Overlap in Health Insurance Benefits
CAQH® today announced that COB Smart™ has launched in all 50 states and the District of Columbia, enabling health plans and providers to identify overlapping insurance coverage nationwide. A CAQH Solution™, COB Smart determines when an individual is covered by more than one insurer and also indicates which insurer should pay first. The solution streamlines coordination of benefits (COB) activities so that healthcare claims can be processed correctly the first time.
Knowing accurate and timely COB information helps eliminate administrative inefficiencies that cost providers and health plans more than $800 million annually, according to CAQH research. COB Smart helps ensure that providers receive accurate payments, health plans reduce claim rework, and patients spend less time on registration forms and questionnaires.
Real-world use of the solution among health plans shows COB Smart to be highly successful in helping process claims accurately the first time by discovering unknown instances of overlapping insurance coverage. One national insurer and early participant of COB Smart concluded that approximately four out of five records identified by COB Smart had not been previously detected as having other insurance in its eligibility system.
CAQH has continued to enhance COB Smart since announcing its initial launch in February. Participating health plans may now access a new COB Smart payer portal to search and immediately identify instances where overlapping coverage exists for their members. This latest feature returns complete information that enables the participating health plan to contact the other insurer also covering the member.
One in Four Americans Have More Medical Debt than Emergency Savings
Twenty Five percent of Americans say they currently have more medical debt than emergency savings, according to a new Bankrate.com (NYSE: RATE) report. This number nearly doubles (44%) among those earning less than $30,000 per year.
Furthermore, people who do not currently have medical debt are concerned about it. Over half of Americans (55%) are worried they will find themselves overwhelmed by medical debt (27% are very worried and 28% are somewhat worried).
The report found that worry levels were the highest among people in their prime earning years, between the ages of 30 and 64.
These results comprise Bankrate.com’s Health Insurance Pulse, a monthly survey that tracks how Americans are feeling about health care and their personal finances. The survey was conducted by Princeton Survey Research Associates International (PSRAI) and can be seen in its entirety here:
Millennium Health To Host And Participate In Events At PAINWeek 2014
Millennium Health, a leading health solutions company, will have a significant presence at PAINWeek® 2014, the nation’s largest annual meeting for frontline clinicians with an interest in pain management. PAINWeek takes place Sept. 2-6 in Las Vegas.
Highlights of Millennium Health events include:
Sponsored Educational Symposium
Millennium Health will lead a symposium titled My Grandma’s Not a Zombie: Medication Monitoring & Pharmacogenetic Testing (PGT) Can Help Clinicians Individualize Safer Opioid Management, which will explore the growing need to improve care coordination for the treatment of pain and anxiety-related conditions in seniors. The symposium will examine the differences in patient medication responses and assess approaches for providing personalized care in cases of difficult-to-manage pain. The session will feature a panel of four nationally recognized pain experts, representing Millennium Health and partners:
Jeffrey Fudin, Pharm.D.
Anita Gupta, D.O., Pharm.D.
Kenneth Kirsh, Ph.D., vice president of research and advocacy, Millennium Health
Steven Passik, Ph.D., vice president of research and advocacy, Millennium Health
My Grandma’s Not a Zombie will be presented on Thursday, Sept. 4, from 12-1:30p.m. PST, Gracia 4, Level 3, at The Cosmopolitan.
Special Interest Session
Dr. Passik also will lead a separate special interest session titled “The Iceberg Cometh,” on the topic of prescription opioids and the stigma surrounding their use.
The Iceberg Cometh will be presented on Thursday, Sept. 4, from 10:50-11:50 a.m. PST at The Cosmopolitan.
Millennium Health, along with the Millennium Research Institute, a nonprofit national research center, and the University of Washington, will be presenting a poster: Value of CYP Genetic Testing for Opioid Therapy: An Exploratory Combined Cross-sectional and Longitudinal Study in a Chronic Pain Cohort.
The poster session will be held on Thursday, Sept. 4, at the Scientific Session and Reception from 6:30-8:30 p.m. PST.
American Academy of Pain Medicine Educational Program
Millennium Health has provided an educational grant to support the American Academy of Pain Medicine’s (AAPM) presentation of four learning modules at PAINWeek. The module topics from the AAPM’s Essential Tools for Treating the Patient in Pain™ curriculum are: the Brain in Pain, Neuropathic Pain, Headache, and Myofascial Pain Syndromes, and will include Strategies for Success with Chronic Opioid Therapy and Myofascial Pain Syndromes for the AAFP Assembly.
Edison Nation Medical and AARC Team Up To Promote Innovation in Respiratory Care
Edison Nation Medical, the premier healthcare innovation marketplace, today announced a partnership with the American Association for Respiratory Care (AARC), the leading professional association of respiratory care specialists. Edison Nation Medical, which brings 12+ years experience working with individuals and small business to commercialize their innovation ideas, will work with AARC to assist the professional association’s community of more than 50,000 respiratory therapists in bringing their product innovation ideas to life.
AARC’s mission is to provide training, encouragement and support to respiratory care professionals. The organization has played a key role in advancing the science of respiratory care and serves as a tireless advocate for respiratory therapists as well as patients, their families and the public.
Edison Nation Medical works directly with people who have ideas or inventions — big or small — for new medical products that can improve the standard of care. The company provides a clear and easy pathway through which anyone — physicians, nurses, respiratory therapists, entrepreneurs, even patients and caregivers — can submit a medical invention or idea for full evaluation and potential commercialization.
Joining Edison Nation Medical is free and inventions submitted through their confidential and secure online portal are reviewed in detail by medical, product development and legal experts. Following the in depth evaluations, these inventions are further invested in and improved upon by Edison Nation Medical’s expert design and engineering teams, as appropriate. The end goal is to commercialize each qualified product idea either by licensing the idea to a medical device manufacturer or by starting a company around the idea and, when successful, Edison Nation Medical shares licensing royalties or revenues with the inventor.
HealthLink Europe Opens North American Medical Warehouse
HealthLink Europe (http://www.healthlinkeurope.com) has expanded its North American operations through its subsidiary HealthLink International, by opening a 100% medical facility, providing warehousing, fulfillment and order to cash services for medical device manufacturers, throughout North America, utilizing our global ERP platform.
Building on the experience we have gained since 1994 serving our customers in Europe with customer service, VAT deferment, fulfillment and logistics services to the medical industry, HealthLink International offers our customers the same platform for growth in the American market.
Establishing a North American warehouse and order to cash operation, enables us to support our existing customer base, as well as provide value added services for medical device companies throughout North America.
HealthLink Europe is 100% medical, ISO 13485 certified, specializing in class II and III devices and their associated regulatory requirements. Acting as an extension of its customers’ business, HealthLink provides Customer Care Services, Financial Services, Warehousing and Logistics, Fulfillment and Value Added Services, IT Support, Authorized Representative services, and more.
Low T Center Acquisition In Little Rock, Arkansas
Low T Center has acquired two new locations in Little Rock and Conway from APEX Men’s Health. Low T Center will bring their unique business model to the region, offering convenient, personalized and monitored testosterone treatment.
Low T Center Little Rock is located at 10700 N Rodney Parham, Suite C11, Little Rock, AR 72212. Little Rock location will be opening today; while the Conway location will open at a later date. Low T Center Conway is located at 2215 E Oak Street, Suite 4, Conway, AR 72032. Dr. Jeremy Warford, M.D. is the Medical Director of both Centers. Hours of operation are Monday through Friday 8:30am to 5:30pm.
Studies indicate testosterone deficiency has been linked to diabetes, metabolic syndrome, obesity, and high blood pressure. Low T Center was designed so men can walk in, take a simple blood test, and know within 45 minutes if they are a candidate for Testosterone Replacement Therapy. Experience shows testosterone injections may lead to improved energy, strength, and libido, as well as decreases in body fat, irritability, and depression.
We Care Insurance Broking Transforms Online Insurance Buying
We Care Insurance Broking Services announced the launch of its online portal http://www.wecareinsurance.in for searching, comparing and buying insurance policy over the web. With an ambitious library of 1000+ products covering 50 insurance companies, this online platform of We Care Insurance Broking, provides personalized, up-to-date and accurate information.
The search results are unbiased and all searches are anonymous. Currently, one can search for health, home, life or motor policies. An average search will display 25 to 40 policies of various companies and with various features.
All industry research and product related information is provided by http://www.policylitmus.com. Policylitmus has introduced scientific rating methodologies to rate insurance companies based on their sales, claims and customer satisfaction parameters.
In an industry which has seen misselling complaints, We Care aims to put all the relevant information in the public domain so that even the least savvy customer can make an informed choice.
Oligonucleotide Synthesis Market Worth $1,712.1 Million by 2019
According to the new research report “Oligonucleotide Synthesis Market by Product & Services (Equipment, Reagent, Primer, Probe, Custom Oligos), End-User (Research, Pharmaceutical & Biotechnology), Application (Diagnostics, PCR, QPCR, Gene Synthesis, NGS, DNA, RNAi) – Global Forecast to 2019″ published by MarketsandMarkets, the global Oligonucleotide Synthesis Market is expected to reach $1,712.1 Million by 2019 from $1,070.7 Million in 2014, growing at a CAGR of 9.8% from 2014 to 2019..
Browse 84 market data tables and 40 figures spread through 185 pages and in-depth TOC on “Oligonucleotide Synthesis Market”
Based on products and services, the market is broadly segmented into equipment, reagents, and synthesized oligonucleotides. Among these segments, the synthesized oligonucleotides market segment is expected to register the highest growth rate during the forecast period, owing to the increasing number of applications of synthesized oligonucleotides in research, diagnostics and therapeutics; and a growing demand for custom oligos.
The market by applications is classified into diagnostics, research, and therapeutics. Research applications are further segmented into PCR, qPCR, sequencing, gene synthesis, and others. The therapeutics market is further segmented into DNA/antisense oligos, RNAi, aptamers, and others. In terms of applications, the research segment commanded the largest share in 2014, while the diagnostics segment is forecasted to be the fastest-growing segment in the Oligonucleotide Synthesis Market. By end users, the market is segmented into academic research institutes, pharmaceutical and biotech firms, and diagnostic labs. Academic research institutes contributed the major market share in 2014; however, diagnostic laboratories are expected to be the fastest-growing end user segment during the forecast period.
Based on geography, the global Oligonucleotide Synthesis Market is segmented into North America, Latin America, Europe, Middle East and Africa, and Asia-Pacific (APAC). North America is expected to account for the largest share of the market in 2014. However, Asia-Pacific is poised to grow at the highest CAGR during the forecast period, owing to increase in research and development activities, rising R&D funding and growing availability of synthesized oligos in the region.
Rising Medical Solutions Named to Inc. 500|5000 List
For the seventh consecutive year, Rising Medical Solutions (Rising) has earned a spot on Inc. magazine’s Inc. 500|5000 list, an exclusive ranking of the nation’s fastest-growing private companies. The honor roll represents the most comprehensive look at a vital component of the economy—America’s independent businesses. Companies such as Microsoft, Zappos, Pandora, Patagonia, Jamba Juice, Under Armour, Oracle, and other notable alumni have been members of the Inc. 500|5000.
The 2014 Inc. 500|5000 is ranked according to percentage of revenue growth when comparing 2010 to 2013. To qualify, companies must have been founded and generating revenue by March 31, 2010. They have to be US-based, privately held, for profit, and independent — not subsidiaries or divisions of other companies — as of December 31, 2013. The minimum revenue required for 2010 is $100,000; the minimum for 2013 is $2 million. Complete results of the Inc. 500|5000 can be found at inc.com.
Inc. 500|5000 companies demonstrate impressive results. Over the last three years, their average growth rate was 516 percent with collective revenue of $211 billion, and 505,000 new jobs generated.
Beyond Rising’s own direct job creation, the company’s financial impact on America’s healthcare system is roughly equivalent to 150,877 years of employment added back to the economy. Considering the country’s healthcare challenges, Rising’s ability to improve patient outcomes, increase efficiencies, and reduce billing waste provides tangible advancements to a system in need.
New Study: MedStar Washington Hospital Center Demonstrates Home Healthcare Produces Big Savings for the Medicare Program
A new study published in the Journal of American Geriatrics Society found that house calls to elderly patients with chronic conditions keep healthcare costs down by reducing the need for expensive emergency room visits. The patients who utilize this care are some of Medicare’s most costly patients with multiple chronic conditions and difficulty managing medication and understanding when preventative care is needed.
The house call program at MedStar Washington Hospital Center, led by Dr. Eric DeJonge, Chief of Geriatrics at MedStar Washington Hospital Center, sends primary care doctors into the homes of some of Washington’s sickest patients. Home visits allow for the doctors to see the patient in their element and get a better sense of the patient’s overall health. The study shows that patients who were provided care in the home had 20 percent fewer emergency room visits and saved Medicare $8,477 per patient over a two year period.
The Medicare home health benefit currently serves 3.5 million senior and disabled Americans who, due to their medical condition, are qualified as homebound and receive skilled care in the comfort of their own homes. Unfortunately, due to recent funding cuts to Medicare, 1.3 million of these patients are at risk of losing access to this critically important service.
Starting on January 1, the Centers for Medicare and Medicaid Services (CMS) began implementing a four year, 3.5 percent annual cut to the Medicare home health benefit, that will slash a total of 14 percent from funding. CMS itself conceded this cut will leave “approximately 40 percent” of providers operating at a net loss by 2017.
Buckeye Health Plan Has New Name, New Look
Buckeye Health Plan (Buckeye), formerly known as Buckeye Community Health Plan, today announced a new name and look designed to project the innovative, customer-centered mission and goals of the company.
During the past few years, Buckeye has experienced growth in its member base and has expanded across the State of Ohio. The name change and new brand identity will be phased into marketing materials beginning in September, 2014.
Capital BlueCross Statement of Support – Healthy Pennsylvania
Capital BlueCross has long supported programs that increase access to health care and health coverage for our community. This tradition of service continues through our work with the Children’s Health Insurance Program and most recently with our involvement in Governor Corbett’s proposed Healthy Pennsylvania plan to cover many uninsured individuals.
We were proud to be a selected plan by the Commonwealth of Pennsylvania to potentially serve our community through Healthy PA. With the news today the program has been approved by the U.S. Department of Health and Human Services, we congratulate Governor Corbett and Public Welfare Secretary Mackereth on this important milestone.
Capital BlueCross looks forward to continuing our role to increase access to health care in central Pennsylvania and the Lehigh Valley.
SOURCE Capital BlueCross
AARP Pennsylvania Issues Statement in Response to Approval of Waiver Expanding State Medicaid Program
AARP Pennsylvania released the following statement in response to federal officials today approving a waiver to expand Medicaid for Pennsylvania:
“AARP Pennsylvania is pleased that an agreement has been reached to provide health coverage to more than 500,000 hard-working Pennsylvanians – including 90,000 residents age 50-64 – many of whom are either between jobs or in jobs without health coverage. AARP Pennsylvania was one of many groups encouraging the state over the last two years to close this coverage gap, and we are pleased that so many state residents will not have to wait much longer to get the coverage they need. The final agreement is responsive to many of the concerns AARP Pennsylvania expressed in our comments, but some concerns remain. We look forward to reading the important details of the final agreement and working with state and federal officials as this process moves forward.”
Edison Nation Medical Launches Open Innovation Search to Uncover Innovative Senior Care Products
Edison Nation Medical, the premier healthcare innovation marketplace, today announced a worldwide search for product ideas to improve the health and wellness of the senior population. Promising ideas uncovered through the 6-month search (www.EdisonNationMedical.com/Seniors) will be presented to leading medical device manufacturers and healthcare retailers with whom Edison Nation Medical has partnered to improve the lives of individuals age 65 and older.
The objective of the search is to uncover ideas for products, devices, technologies or apps that improve the quality of life and the ability to maintain independence for seniors. Senior health and wellness products cover a broad spectrum of product categories, including (but not limited to):
— Products that assist with daily living activities
— Health monitors
— Medication management systems
— Products that improve safety and mobility
— Senior-friendly portable products and devices [Read more…]
Nonin Medical Announces FDA Clearance of Nonin Model 3231 USB Pulse Oximeter
Nonin Medical, Inc., the inventor of finger pulse oximetry and a leader in noninvasive medical monitoring, today announced that the Food and Drug Administration (FDA) has cleared the Nonin Model 3231 OEM/eHealth finger pulse oximeter for use in the United States. The finger pulse oximeter plugs into a telemedicine hub or kiosk through a USB connector and measures oxygen saturation and pulse rate in pediatric to adult patients. The Model 3231 received EU certification last year.
The Model 3231 features accuracy advantages, including:
— Nonin’s clinically proven PureSAT® Pulse Oximetry (SpO2) technology, which utilizes intelligent pulse-by-pulse filtering to provide precise oximetry measurements—even in the presence of motion, dark skin tones, low perfusion, rapid SpO2 changes and other challenging conditions. PureSAT automatically adjusts to each patient’s condition to provide fast and reliable readings that clinicians can act on.
— Exclusive Nonin CorrectCheck™ technology, which provides feedback via a digital display if the patient’s finger is not placed correctly in the device. CorrectCheck is helpful since improper finger placement may lead to incorrect readings.
— SmartPoint™ capture, an algorithm developed by Nonin that automatically determines when a high quality measurement is ready to be stored. This helps to ensure that each reading transmitted by the Model 3231 is accurate. [Read more…]
EndoChoice® Bolsters Leadership Team, Hires David Gill as CFO
EndoChoice® today announced David Gill has joined the company as Chief Financial Officer. The company also announced it has been recognized for the fifth consecutive year as one of the fastest growing companies in the U.S. by Inc. Magazine.
The continued rapid growth at EndoChoice has been fueled by the success of the company’s wide range of products and services purposefully designed and built for gastroenterologists. “We are in business to serve the gastroenterology caregiver and this unprecedented growth is recognition that our efforts are appreciated,” said Mark Gilreath, Founder and CEO of EndoChoice. “As a result of our expansion and plans for the future, it became important to have a CFO of David’s tenure and experience to guide us through our next growth opportunities,” Gilreath added.
David Gill has been the CFO of four public companies and led the IPO’s of Interland, CTI and NxStage. He joins the company as sales of the new Fuse® Full Spectrum Endoscopy® system have accelerated. “Although colonoscopy is considered the best tool to fight colon cancer, numerous clinical studies have shown this disease continues to plague populations around the world because not everyone is routinely screened and traditional endoscopes miss up to 40% of pre-cancerous polyps. I am excited to join the EndoChoice team and be part of the revolution Fuse is bringing to gastroenterology care,” said Gill.
Endoscopes are thin flexible tubes with imaging capabilities that doctors use to view the upper and lower GI tracts of their patients. The Fuse system uses three small cameras at the tip of a flexible GI endoscope, as compared with one at the tip of a standard, forward-viewing endoscope. With a wider 330 degree view, physicians using Fuse see nearly twice the surface area and anatomy, including behind and into folds where colon cancer causing polyps often hide. A recent clinical study found that Fuse detected 69% more pre-cancerous polyps versus the standard colonoscope. As a result, informed patients are beginning to ‘insist on Fuse’ for their next colonoscopy.
September is Senior Vaccination Month at CVS/pharmacy and MinuteClinic
In recognition of the increased risks that seniors have of developing health complications from the flu, pneumonia, shingles and other illnesses, CVS/pharmacy® and MinuteClinic® have declared September to be Senior Vaccination Month. Because people’s immune systems weaken as they age, it is important that adults ages 65 years and older stay up to date on their vaccinations. CVS pharmacists and MinuteClinic nurse practitioners and physician assistants will be raising awareness about the importance of vaccinations for their senior patients throughout the month.
All 7,700 CVS/pharmacy locations and all 900 MinuteClinic locations inside select CVS/pharmacy stores can administer vaccinations to patients to help protect them against the flu and other illnesses every day with no appointment needed, including evening and weekends. In addition to flu and pneumonia vaccinations, other shots such as the shingles vaccine are available at CVS/pharmacy and Hepatitis vaccines are available at MinuteClinic.
In addition to the regular flu shot that is recommended by the Centers for Disease Control and Prevention (CDC) for everyone who is at least six months old, all CVS/pharmacy and MinuteClinic locations also offer the Fluzone® High-Dose vaccine for people 65 years and older. Fluzone High-Dose contains four times the antigens as the seasonal flu vaccine and is designed to provide a stronger immune response in people 65 years and older.
A recent consumer survey by CVS/pharmacy showed that three in five adults in the U.S. are not aware of the importance of the high dose flu vaccine in preventing the flu for adults ages 65 and up. The survey also showed that nearly one in three Americans say they have a role in helping an elderly family member or loved one make health care decisions, including whether to get a flu shot.
Texas Children’s Hospital launches immunotherapy study
For children with food allergies, a trace amount of a substance can trigger deadly anaphylaxis within minutes of ingestion – the fear of which can be life altering for many families. To give hope to these patients and their families, researchers at Texas Children’s Hospital and Baylor College of Medicine are embarking on a landmark peanut immunotherapy trial, using a process known as desensitization where patients swallow tiny, increasing amounts of peanut over time. For more information about Texas Children’s Hospital’s Immunology, Allergy and Rheumatology Department, please visit http://texaschildrens.org/Locate/Departments-and-Services/Allergy-and-Immunology/.
The research team, led by Dr. Carla Davis, a specialist in the Pediatric Medicine, Immunology, Allergy and Rheumatology Department at Texas Children’s and assistant professor of pediatrics at Baylor, begin enrolling children with peanut allergies in the trial this month. The study will investigate the ability of peanut allergic children to take peanut flour, the mechanism by which the body develops tolerance, and measure the effect of viral infections. The goal of the trial is to find a standard of care that may lower the risk of severe allergic reactions in patients and eventually cease the allergy completely.
In Europe, a recent oral immunization trail (OIT) showed promise, and in the United States the Consortium for Food Allergy Research and Stanford University are both conducting similar studies. Presently, desensitization is not the standard of care and no study has determined the mechanism by which the body develops a tolerance. Davis and her team plan to monitor how the immunotherapy works and why, as well as develop systems to accurately identify patients who are good candidates for immunotherapy.
BloodCenter of Wisconsin Launches Erythroid Chimerism Test for Monitoring Transplanted Sickle Cell Disease Patients
BloodCenter of Wisconsin’s Diagnostic Laboratories today announced the availability of an innovative Erythroid Chimerism test to monitor erythroid lineage chimerism in patients with sickle cell disease (SCD) following allogeneic bone marrow transplantation. This allows the physician to directly gauge the success of the transplant in these patients and provides physicians with actionable information to guide patient care.
Sickle cell disease is a common and severe autosomal recessive disorder caused by a mutation in the hemoglobin gene. SCD affects approximately 100,000 people in the United States, one in every 300-500 African Americans. In SCD patients with severe clinical symptoms, allogeneic bone marrow transplantation can be used to replace the blood cell producing capacity, potentially curing them of the disease.1
In patients with SCD, several studies have demonstrated that standard chimerism assays do not always reflect chimerism in the erythroid lineage.2,3 Since red cells do not contain DNA, chimerism of the erythroid compartment can be monitored using HbA and HbS transcripts produced from the hemoglobin gene and expressed in red cell progenitors.
BloodCenter’s Diagnostic Laboratories help physicians provide clinical care to patients worldwide, fostering better understanding and treatment options for patients with difficult-to-diagnose diseases. In addition, the laboratories collaborate with other institutions and industry partners to bring new diagnostic testing and treatment options to patient care.
Radiofrequency Identification (RFID) Market in Healthcare is Expected to Reach USD 5.3 Billion Globally by 2020
According to a new market report published by Transparency Market Research “Radiofrequency Identification (RFID) Market (Tags, Readers, Middleware, Printers and Cabinets) – Global Industry Analysis, Size, Share, Growth, Trends and Forecast, 2014 – 2020” the global radiofrequency identification (RFID) market was valued at USD 1.9 billion in 2013 and is expected to grow at a CAGR of 13.9% from 2014 to 2040, to reach an estimated value of USD 5.3 billion in 2020.
Browse the full Radiofrequency Identification (RFID) Market Report: http://www.transparencymarketresearch.com/rfid-in-healthcare.html
Radiofrequency identification (RFID) is a system based on wireless technology which utilizes radio waves for collecting data from a tag attached to an object, for various purposes like automatic identification and tracking of objects. An RFID system mainly comprises tags, which are attached to objects that need to be tracked, readers, which collect radio signals emitted by tag and middleware or software which convert this data into user friendly format. RFID printers and cabinets have made RFID application easier, especially in healthcare sector. RFID printers can print useful information on RFID tags. Printing patient information on patient’s wrist band tags and shipment details on boxes in logistics are currently prominent application areas for RFID printers. RFID cabinets are metal cabinets used for storing blood bags, medical samples, medicines, or documents that need strict monitoring. These RFID enabled cabinets also find application in logistics industry. Advanced RFID cabinets employed in cold chain logistics also maintain a log of temperature, humidity and other vital parameters.
Although healthcare application accounts for a very smaller share of the overall RFID market, rapid growth is expected throughout the forecast period. Increasing scrutiny due to incidences of drug counterfeiting, medical device theft in hospitals, and need for more efficient supply chain management in pharmaceutical companies, hospitals and clinical trial management are other reasons driving the market growth. Barcode technology has been applied in various sectors for record maintenance, asset identification and billing systems. This technology is cost effective and easier to master as compared to RFID. Threat from barcode technology has largely impeded the RFID market growth, especially in middle and low income countries. Economic crises in 2008 have trimmed hospital expenses in European countries. Anticipating gradual recovery in major countries such as United Kingdom and Germany the Europe RFID market will gain momentum in the near future. Smaller hospitals in Asia Pacific and Rest of the World (RoW) perceive RFID as an un-necessary expenditure, as smaller number of medical devices, medical samples, and patients can be managed otherwise. Further, only fewer members of the distribution channel have updated technology from barcode to RFID. Hence integrated record maintaining is not possible unless manufacturers, suppliers, distributors and other dealers accept RFID as prime method for asset tracking. In spite of these hurdles, RFID market in healthcare is expected to grow rapidly with a double digit growth rate owing to obvious advantages of automation, effective asset tracking and proven cost advantage in the long run.
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Currently the RFID market is highly fragmented, but is on the way to consolidation, as the market has seen some major acquisitions in the past few years. Notable acquisitions in the RFID market include acquisition of Intermec by Honeywell and Motorola Solutions by Zebra Technologies. Key players profiled in the radiofrequency identification (RFID) market in healthcare report include Alien Technology, Applied Wireless Identifications Group, CAEN RFID, GAO RFID, Inc., Impinj, Intermec, Invengo, Motorola Solutions (now Zebra Technologies), Sato Holdings and STiD.
Browse the full Radiofrequency Identification (RFID) Market Press Release: http://www.transparencymarketresearch.com/pressrelease/rfid-in-healthcare.htm
The global radiofrequency identification (RFID) market in healthcare has been segmented as follows:
Global Radiofrequency Identification (RFID) Market in Healthcare, by RFID Components
Active RFID Tags
Passive RFID Tags
Active RFID Readers
Passive RFID Readers
For Further inquiries, ask here: http://www.transparencymarketresearch.com/sample/sample.php?flag=S&rep_id=413
Global Radiofrequency Identification (RFID) Market in Healthcare, by Application
People Identification and Tracking
Medical Report, Samples and Blood Transfer Tracking
Global Radiofrequency Identification (RFID) Market in Healthcare, by Geography
People Identification and Tracking
Medical Report, Samples and Blood Transfer Tracking
People Identification and Tracking
Medical Report, Samples and Blood Transfer Tracking
People Identification and Tracking
Medical Report, Samples and Blood Transfer Tracking
Rest of the World
People Identification and Tracking
Medical Report, Samples and Blood Transfer Tracking
Browse all Medical Devices Market Reports: http://www.transparencymarketresearch.com/medical-devices-market-reports-6.html
Sunshine Health Offers Comprehensive Medicaid, Long-Term Care, And Child Welfare Services Across Florida
Sunshine Health, a subsidiary of Centene Corporation, completed the final stages of implementation of the Managed Medical Assistance (MMA) program in 9 of 11 regions and the Child Welfare (Foster Care) program statewide on August 1st. Additionally, Sunshine Health’s Long-Term Care (LTC) program celebrates its first anniversary. LTC implementation began a year ago and was complete on March 1st for the 10 regions in Florida served by Sunshine Health.
Today, Sunshine Health is the largest Long-Term Care plan in the Florida, providing services for more than 30,000 nursing home and home and community based members. Sunshine Health is also the only health plan providing Child Welfare services statewide and is serving nearly 400,000 Medicaid members under the Managed Medical Assistance program.
Aon Active Health Exchange Expands Coverage Options
To meet increasing employer demand to have additional benefits delivered via an exchange platform, Aon Hewitt, the global talent, retirement and health solutions business of Aon plc (NYSE: AON) today announced it is expanding the coverage options offered under the Aon Active Health Exchange for 2015.
Participating employers will have the option of offering their employees a wide range of elective benefit plans during this fall’s annual enrollment season. The elective benefits that can be offered on the Aon Active Health Exchange for coverage beginning January 1, 2015, include:
Medicare Admits Problems with Equipment Repairs
According to AAHomecare, the Centers for Medicare & Medicaid Services (CMS) is changing the way it deals with medical equipment repairs.
In response to complaints from patients across the nation, CMS has admitted that patients are having trouble getting equipment repaired and has released new guidance on supplier documentation for durable medical equipment, prosthetics, orthotics and supplies (DMEPOS) repair claims.
“From patient complaints to members of Congress, it has taken many voices to help CMS understand that the current state of medical equipment repair is unacceptable,” said AAHomecare CEO Tom Ryan. “This new guidance is a step in the right direction towards fixing the convoluted and confusing documentation requirements.”
CMS has instructed its Medicare Administrative Durable Medical Equipment Contractors (DME MACs) to only review the necessity of the repair when making a payment determination.
AAHomecare is reviewing the new guidance for its impact on the industry, however upon first review; providers will now be able to repair equipment, such as power wheelchairs, without the burden of finding the original medical necessity documentation from the original provider, many of whom are now out of business. If Medicare paid for the base equipment initially, medical necessity for the base equipment has been established. This guidance for repairs is to be applied to all DMEPOS equipment owned by Medicare beneficiaries as of November 4, 2014.
Specifically, contractors shall only review for continued medical necessity of the item and necessity of the repair. Contractors shall not expend resources to determine if the requirements for the initial provision of the DMEPOS item as/when it was originally ordered were met.
MagMutual Names Mike Beckett as Regional Vice President, Georgia
MagMutual Insurance Company, the Southeast’s policyholder-owned professional liability insurer, has promoted Mike Beckett to regional vice president for Georgia. He will lead the sales and policyholder services across the company’s first and largest market.
Beckett’s appointment extends a strategic focus by MagMutual on regional leadership that:
— improves service at the local level;
— closely aligns sales, claims, underwriting and risk management/patient safety; and
— allows greater presence and influence within Georgia’s medical, legislative legal and regulatory communities.
Beckett brings more than 20 years of malpractice insurance experience to his new role, having worked at MagMutual since 2002 as an account executive, director of retention for Georgia and vice president of premium accounts.
He holds a master’s of business administration from DeVry University and an undergraduate degree from College of Charleston.
HealthPlanOne Receives Marcum Tech Top 40 Award
The Connecticut Technology Council (CTC) and Marcum LLP announced HealthPlanOne has been named to the Marcum Tech Top 40 (TT40) list of fastest growing technology companies in Connecticut for the fifth consecutive year. The recognition is based both on total revenue and revenue growth over the past four years. HealthPlanOne will be honored alongside 39 other companies at an awards ceremony October 2 at the Oakdale Theatre in Wallingford.
2015 Platinum Plans Are Best Buy for Consumers Using Expensive Specialty Drugs
According to HealthPocket, HealthPocket found that among 2015 Obamacare metal plans whose rate filings have been made public, platinum plans incurred the lowest average out-of-pocket costs for the five common specialty drugs used in the study.
Using publicly released 2015 rate filings in 9 states, HealthPocket analyzed health plan costs for five common specialty drugs. Specialty drugs have been a growing concern for consumers given their high costs and shortage of generic alternatives. They treat complex medical conditions, can cost thousands per prescription, and are used for a broad variety of conditions like arthritis, diabetes, and multiple sclerosis.
HealthPocket found that among 2015 Obamacare metal plans whose rate filings have been made public, platinum plans incurred the lowest average out-of-pocket costs for the five common specialty drugs used in the study. The average out-of-pocket specialty drug costs for platinum plans were 64% lower than gold plans, 74% lower than silver plans, and 78% lower than bronze plans. Even though platinum plans have the highest premiums among the four categories of Obamacare health plans, their reduced co-payments and lower caps on annual out-of-pocket costs can translate into lower overall costs for people taking specialty drugs. 2015 Platinum Plans Are Best Buy for Consumers Using Expensive Specialty Drugs
Time Ticking for Man in Need of Non-Embryonic Stem Cell Treatment
Marc Serchia, 56, is waiting on a miracle, and if the doctors are correct he doesn’t have much more time. At the age of 39, Marc suffered a massive heart attack, faced a 5-hour surgery to repair blocked arteries, and died on the surgical table six separate times. Unbelievably, he survived, but with a severely damaged heart. Doctors wouldn’t put him near the top of the heart transplant list because they didn’t think he’d live to find a match. Defying the odds, Marc has lived 17 years by eating healthy, making daily changes, and his sheer will to survive.
The damage to his heart is extensive. A normal, healthy heart has an ejection fraction — how much the heart compresses to circulate oxygenated blood to the body — between 50-70%. In September 2013, Marc’s ejection fraction was 13%, and doctors were — and still are — amazed he is still standing. [Read more…]
2014 and 2015 Best Hospitals, Ranked by US News & World Report
US News & World Report is out with their rankings of the best hospitals according to their own survey. For the first time, the Mayo Clinic in Rochester, Minnesota, claimed the No. 1 spot, followed by Massachusetts General Hospital and Johns Hopkins Hospital. Memorial Sloan Kettering Cancer Center is No. 1 in cancer and the Cleveland Clinic is 1st in cardiology & heart surgery.
The 2014-15 Honor Roll
1. Mayo Clinic, Rochester, Minnesota
2. Massachusetts General Hospital, Boston
3. Johns Hopkins Hospital, Baltimore
4. Cleveland Clinic
5. UCLA Medical Center, Los Angeles
6. New York-Presbyterian University Hospital of Columbia and Cornell, New York
7. Hospitals of the University of Pennsylvania-Penn Presbyterian, Philadelphia
8. UCSF Medical Center, San Francisco
9. Brigham and Women’s Hospital, Boston
10. Northwestern Memorial Hospital, Chicago
11. University of Washington Medical Center, Seattle
12. (tie) Cedars-Sinai Medical Center, Los Angeles
12. (tie) UPMC-University of Pittsburgh Medical Center
14. Duke University Hospital, Durham, North Carolina ?
15. NYU Langone Medical Center, New York
16. Mount Sinai Hospital, New York
17. Barnes-Jewish Hospital/Washington University, St. Louis [Read more…]
Middle East Respiratory Syndrome Case Confirmed in Orlando Florida
The CDC (Centers for Disease Control) is confirming that a man is being treated for Middle East Respiratory Syndrome at Dr. P. Phillips Hospital in Orlando, Florida. This is the second case that has been confirmed in the United States, another case has been confirmed in Indiana.
CDC officials told Click Orlando that the patient was working in a facility in Saudi Arabia that was caring for another MERS patient. Apparently he contracted the disease while caring for another Middle East Respiratory Syndrome patient in Saudi Arabia.
In a USA Today article, “CDC officials cautioned that while the patient felt the symptoms of the MERS virus while traveling from Saudi Arabia, it was not known if the patient was infectious at that time.”
There have been 538 lab-confirmed cases of MERS-CoV worldwide, including 145 deaths attributed to it; the majority of those cases occurred in Saudi Arabia according to the CDC.
Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. More than 30% of these people died.
Image of map showing countries in Arabian Penninsula with and without confirmed MERs as detailed on this page.So far, all the cases have been linked to countries in the Arabian Peninsula. This virus has spread from ill people to others through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spreading in community settings.
Amgen And AstraZeneca Announce Positive Results From Phase 3 Study Of Brodalumab (AMG 827) In Patients With Moderate-to-Severe Plaque Psoriasis
Amgen (NASDAQ: AMGN) and AstraZeneca recently announced that the Phase 3 AMAGINE-1TM study evaluating brodalumab in patients with moderate-to-severe plaque psoriasis met all primary and secondary endpoints for both evaluated doses. Brodalumab is the only investigational treatment in development that binds to the interleukin-17 (IL-17) receptor and inhibits inflammatory signaling by blocking the binding of several IL-17 ligands to the receptor. Primary endpoints were patients achieving at least a 75 percent improvement from baseline in disease severity at week 12, as measured by the Psoriasis Area Severity Index (PASI 75), and patients achieving clear or almost clear skin at week 12 according to the static Physician Global Assessment (sPGA 0 or 1).
A significantly higher proportion of patients treated with brodalumab achieved a PASI 75 response (primary endpoint), as well as PASI 90 and PASI 100 responses at week 12 (secondary endpoints) compared to placebo. Results showed that 83.3 percent of patients in the 210 mg group and 60.3 percent of patients in the 140 mg group achieved PASI 75 responses compared to placebo (2.7 percent). Results also showed that 70.3 percent of patients in the 210 mg group and 42.5 percent of patients in the 140 mg group achieved PASI 90 responses compared to placebo (0.9 percent). Further, 41.9 percent of patients in the 210 mg group and 23.3 percent of patients in the 140 mg group achieved PASI 100 responses compared to placebo (0.5 percent). Of the 661 patients enrolled in this study, 46 percent reported prior biologic use and 28.7 percent weighed more than 100 kilograms (kg) at baseline (mean weight for the study population was 90.8 kg).
A PASI score is a measure of psoriatic plaque redness, scaling and thickness and the extent of involvement in each region of the body. Treatment efficacy is often measured by the reduction of PASI from baseline (i.e., a 75 percent reduction is known as PASI 75, a 90 percent reduction is known as PASI 90 and PASI 100 is total clearance of skin disease).
The most common adverse events that occurred during the placebo-controlled period in the brodalumab group (more than 5 percent of participants) were nasopharyngitis, upper respiratory tract infection and headache. Serious adverse events occurred in 1.8 percent of patients in the 210 mg group and 2.7 percent of patients in the 140 mg group compared to 1.4 percent for placebo during the placebo-controlled period.
Eisai Adds 200 Sales Specialists to Field Force for BELVIQ
Eisai Inc. will add more than 200 new contract sales representatives to its Metabolic Business Unit, bringing the total sales force for BELVIQ® to approximately 600, triple the size from when the FDA-approved prescription therapy for chronic weight management became available in June 2013. This expansion, which becomes effective on July 1, 2014, will allow Eisai to reach approximately 90,000 physicians.
The increase in sales representatives follows Eisai’s recent launch of a national television advertising campaign which encourages those who continue to struggle with their weight to speak to their doctor about the potential of BELVIQ, when combined with diet and increased activity, to help them lose weight and keep it off. (To view the advertisement for BELVIQ, visit http://www.multivu.com/mnr/7161051-eisai-launches-national-television-campaign-belviq-lorcaserin-hcl-civ)
Women’s Health Magazine and ‘The Doctors’ Partner for National Women’s Health Week (#NWHW), May 11-17, 2014
In honor of National Women’s Health Week (May 11-17), Women’s Health Magazine, the fastest-growing international women’s lifestyle and wellness magazine, is teaming up with the Emmy®-winning daytime syndicated series, The Doctors (check local listings), to encourage women across the country to make their health a priority and bring vital information to the masses during this important week.
To promote the week-long initiative, the May issue of Women’s Health, on sale now, features a four-page spread highlighting instant health upgrades with exclusive advice from The Doctors co-hosts Travis Stork, M.D., Rachael Ross, M.D., Ph,D., Jennifer Berman, M.D., Jennifer Ashton, M.D. and Ian Smith, M.D. In the “45 Instant Health Upgrades” article, the experts discuss ways to improve one’s physical and mental health in all aspects of their life, including sexual health, relationships, nutrition, sleep, oral care, stress and fitness.
In conjunction with the May issue feature, The Doctors will include daily segments from May 12-16, during which the show hosts and Women’s Health editors will reveal health and wellness upgrades to showcase more ways to take advantage of National Women’s Health Week.
CSL Opens World-Class, Advanced Manufacturing Facility for Late-Stage Production of Hemophilia Therapies Now in Development
CSL Limited (ASX:CSL), parent company of CSL Behring which is based in King of Prussia, PA, recently opened the CSL Behring Biotechnology Manufacturing Facility in Melbourne, Australia. The new facility, located adjacent to the site’s manufacturing plant for plasma products, is the centerpiece of CSL’s $250 million expansion at its Broadmeadows site and will play an increasingly important role in the company’s global operations, particularly in the late-stage development of new types of hemophilia products. It is one of the largest and most advanced facilities of its kind in the world and will produce novel recombinant therapies on a large scale for international clinical trials. [Read more…]
Study Finds More Than 20 Million Americans Suffer from Blenophobia Fear of Needles
More than 15 million American adults and five million children over the age of five suffer from high discomfort or exhibit needle-phobic behavior when faced with getting a blood draw or injection, according to results from a new study, with the overwhelming majority of those studied – 75 percent adults and 91 percent children – naming “pain” as the component they most feared.
Clinically known as blenophobia, the condition is defined as a fear of needles, and includes the fear of pain felt during injections and blood draws. Pain associated with needle sticks leads directly to fear and anxiety, according to the study. The phobia presents a widespread public health challenge since a patient’s behavior is often influenced by their fears – and in extreme cases – affects their ability to receive necessary medical care.
“Blood tests are one of the most important diagnostic tools modern medicine has at its disposal, but if patients are reluctant, or even actively avoid blood draws, then we need to find ways to alleviate the pain and discomfort or other causes keeping them from getting these procedures,” said Mark Dursztman, M.D., Clinical Assistant Professor of Medicine, Weill Medical College of Cornell University, and Assistant Attending Physician, The New York Presbyterian Hospital, Cornell Campus. “The fear of needles and needle stick pain is a real and significant health problem, one that needs to be addressed.” [Read more…]
Healthcare Companies Set to Present at the 32nd Annual J.P. Morgan Healthcare Conference
There are several companies who will have their representatives present at the 32nd annual J.P. Morgan Healthcare Conference. J.P. Morgan’s 32nd Annual Healthcare Conference will be held January 13-16, 2014 in San Francisco, California.
Endo Health Solutions (Nasdaq: ENDP) announced that Rajiv De Silva, President and Chief Executive Officer, will present a corporate overview at the 32nd Annual J.P. Morgan Healthcare Conference on Monday, January 13, 2014 at 2:00 p.m. Pacific Time.
Express Scripts Holding Company (Nasdaq: ESRX) announced that it will present at the J.P. Morgan Healthcare Conference on January 15, 2014 at 8:00 a.m. Pacific Time (11:00 a.m. Eastern Time) at the Westin St. Francis in San Francisco, CA.
Concord Medical Services Holdings Limited (“Concord Medical” or the “Company”) (NYSE: CCM), a leading specialty hospital management solution provider and operator of the largest network of radiotherapy and diagnostic imaging centers in China and the parent of Chang’an Hospital, announced that the Company will present at the 32nd Annual J.P. Morgan Healthcare Conference, to be held January 13-16, 2014 at the Westin St. Francis Hotel in San Francisco. Management is scheduled to present at 11:30 a.m. local time on Wednesday, January 15, 2014, and is available to meet with institutional investors at the conference.
Haemonetics Corporation (NYSE: HAE) announced that Brian Concannon, President & CEO, will present at the 32nd Annual J.P. Morgan Health Care Conference in San Francisco on Wednesday, January 15, 2014 at 10:00 am Pacific time / 1:00 pm Eastern time.
Mylan Inc. (Nasdaq: MYL), one of the world’s leading generic and specialty pharmaceutical companies, announced that the Company will present at the J.P. Morgan 32nd Annual Healthcare Conference on Tuesday Jan. 14, 2014, in San Francisco.
Boston Scientific Corporation (NYSE: BSX) is scheduled to participate in the 32nd Annual J.P. Morgan Healthcare Conference on Tuesday, January 14, 2014 in San Francisco. Mike Mahoney, president and chief executive officer, will make a presentation about the company beginning at approximately 9:00 a.m. PT. Following the presentation, Dan Brennan, executive vice president and chief financial officer, and Keith Dawkins, M.D., executive vice president and global chief medical officer, will join Mr. Mahoney in a question and answer session.
WebMD Acquires Avado
WebMD Health Corp. (NASDAQ: WBMD), the leading source of health information, has acquired Avado, Inc., a developer of cloud-based patient relationship management (PRM) tools and technologies that enable better communication between consumers and health care professionals.
WebMD’s connectivity platform is enabling physicians that use its Medscape mobile app to securely send health education and instructions on thousands of conditions, procedures and drugs to their patients who use WebMD’s mobile app.
“Avado’s innovative technology and tools will complement, and further accelerate WebMD’s efforts to connect patients with their healthcare providers, which is an important first step toward making connected care a reality,” said Bill Pence, WebMD’s Chief Operating Officer and Chief Technology Officer.
Avado is a StartUp Health Company founded in 2010 by serial entrepreneurs Dave Chase, Bassam Saliba and John Yii. Avado’s investors include The Partnership Fund for New York City and several health tech entrepreneurs and investors. The Avado technology has been tested in physician offices and medical centers and this technology will become an important building block of WebMD’s patient-provider connectivity offering.
Avado’s founders Dave Chase and Bassam Saliba will continue with the company and report to Pence. Chase, Saliba and Avado’s engineering talent will remain based in Seattle, WA, and work closely with WebMD’s New York-based connectivity product team.
InspireMD’s MGuard Stent Shows Lower Mortality Rate in STEMI Patients
InspireMD, Inc. (“InspireMD” or the “Company”) (NYSE MKT: NSPR), a leader in embolic protection stents, recently announced new 12-month results from the MASTER (MGuard for Acute ST Elevation Reperfusion) trial demonstrating that the MGuard outperformed bare metal and drug eluting stents in all-cause mortality in ST segment elevation myocardial infarction (STEMI) patients. Results from the trial were presented at the Transcatheter Cardiovascular Therapeutics (TCT) Conference in San Francisco earlier.
Additionally, the Company will be holding an evening symposium tomorrow, October 30 th, starting at 6:30 pm PT. Dr. Gregg Stone, Dr. Ori Ben-Yehuda and Dr. Jose Henriques will lead the symposium and will be joined by a panel of medical experts.
The MGuard utilizes the Company’s proprietary MicroNet™ technology, which is a circular knitted mesh that wraps around the stent to protect patients from plaque debris flowing downstream upon deployment. This advanced technology allows the MGuard to specifically address the unmet need for STEMI patients, and save the life of those who suffer from heart attacks.
“It is very reassuring to see that the 12-month follow up data is consistent with the acute results presented at TCT last year, especially the data that shows the mortality benefit trend of using this unique technology,” stated Prof. Dariusz Dudek, Physician-in-Chief, 2nd Department of Clinical Cardiology and Cardiovascular Interventions at the University Hospital in Krakow. “These positive results should give clinicians the confidence to use MGuard technology as a first line of defense against distal embolization for their STEMI patients.”
The MASTER trial enrolled a total of 433 patients with STEMI presenting within 12 hours of symptom onset undergoing percutaneous coronary intervention were randomized at 50 sites in 9 countries to the MGuard EPS (n = 217) or commercially available bare metal or drug-eluting stents (n = 216).
Morgan & Morgan Investigating Ariad Pharmaceuticals ARIA
Morgan & Morgan is investigating whether or not Ariad Pharmaceuticals Inc. (“Ariad” or the “Company”) (ARIA) and certain of its officers violated the federal securities laws when making statements to investors regarding its experimental drug Iclusig.
On October 9, 2013, the Company updated the data from its PACE trial of Iclusig and revealed that the drug was shown to cause a higher rate of blood clots and heart-related side effects than previously disclosed. As a result, the FDA placed a hold on new patient enrollment for Iclusig testing, and the Company advised patients currently receiving the drug to lower their dosage.
Following this news, shares of Ariad fell $11.31, almost 66%, to close at $5.83 per share on October 9, 2013.
Health Plan News will post updates to this story if warranted.
ICU Eyewear Sponsors Seva Foundation
ICU Eyewear, a pioneer in sustainable and fashionable eyewear, is now a corporate sponsor of the Seva Foundation in concordance with World Sight Day on Oct. 10 th, 2013. ICU’s support of the Seva Foundation will provide aid to two programs, including the SIPI Program and Seva’s Eye Care Initiative, furthering the Seva Foundation’s mission to eliminate preventable blindness and visual impairment.
As part of the SIPI program domestically, ICU is providing 600 pairs of eyeglasses and sunglasses to impoverished Native American communities in New Mexico. The SIPI, or Southwestern Indian Polytechnic Institute, works with Seva and will train 25 American Indians, most of which are women, to be top tier vision technicians and licensed opticians. This training is at no cost to the participants and benefits the high demand in impoverished American Indian communities in or near the Albuquerque area.
ICU Eyewear, founded by Patricia Kesten in 1997, has become a globally recognized leader in reading eyewear and sunglasses. ICU Eyewear designs have revolutionized the reading glass industry with fun styles, bright colors and unique patterns at affordable prices for the everyday customer.
Latest Innovative Echogenic Catheters to be Showcased at ASA
B. Braun Medical Inc. (B.Braun) will launch Contiplex® C, its revolutionary, one-step, echogenic catheter-over-needle system and unveil Contiplex Echo, its echogenic, styleted catheter, both designed for Continuous Peripheral Nerve Blocks (CPNB) at the American Society of Anesthesiologists (ASA) annual meeting in San Francisco, California, October 12 th-14th. As the market leader in regional anesthesia, B.Braun is committed to providing products and services to meet the changing needs within the acute pain management field.
Contiplex C is an innovative catheter-over-needle system for CPNB and practitioners seeking to transition from single shot to continuous techniques. The catheter tip can be purposely directed to an exact location, without the need to thread. Once the catheter tip is in the desired location, the needle is removed in one easy step, and the catheter is already placed. Its catheter-over-needle design helps reduce leakage because the catheter sits tightly within the puncture site.
Contiplex Echo is a new styleted catheter, featuring flat coil technology to enhance echogenicity. Its rigid body is designed to facilitate controlled threading with the aid of a stylet. Contiplex Echo will be available in both open and closed tip (multi-port) configurations along with the Contiplex Tuohy Ultra needle to provide echogenicity from both needle and catheter during CPNB placement.
Attendees are encouraged to visit B.Braun’s booth #1917 at ASA to experience hands-on demonstrations of these and other exciting regional anesthesia products, infusion pumps, CAPS® pre-filled sterile admixtures, and anesthesia IV administration sets from B.Braun. Visit www.bbraunASA.com for videos and further information.
Akeso Care Management Receives URAC Accreditation for Health Utilization Management
Akeso Care Management®, Inc. (ACM®), announced today that it has been awarded Health Utilization Management Accreditation by URAC, a Washington, DC-based health care accrediting organization that establishes quality standards for the health care industry. [Read more…]
Physicians Practice Releases 2013 Staff Salary Survey
America’s changing healthcare industry is beginning to reshape the non-physician healthcare work force, with certain jobs evaporating while others are blooming, according to results of the 2013 Staff Salary Survey by Physicians Practice , America’s Leading Practice Management Magazine. [Read more…]
GlaxoSmithKline and Liberty Property Trust/Synterra Partners Opens Five Crescent Drive
GlaxoSmithKline is set to open its new double LEED® platinum certified facility in Philadelphia’s Navy Yard Corporate Center this Saturday, ushering in a new era of how people work in Philadelphia.
The 208,000 square foot building at Five Crescent Drive represents an $80 million investment by Liberty Property/Synterra, and an investment of approximately $70 million by GSK. GSK has signed a 15.5-year lease at the building, which includes a four-story central atrium, a monumental stairway, a coffee shop, cafeteria, fitness center, meeting centers and a large multi-purpose room. [Read more…]
Laugh Your Way to Good Health!
Human beings have been laughing for as long as we have been human. In fact, recent evidence suggests that apes and other animals also laugh in their own way. And although humor is experienced across all ages and cultures, scientists are still not in agreement about the root causes of humor and laughter. For more in-depth information about humor and laughter, please check this out: http://en.wikipedia.org/wiki/Humor_(positive_psychology)#Humor_and_Health
Health and laughter
There is widespread agreement among scientists that humor in general, and laughter in particular, are very good for us. In fact, laughter provides a number of very powerful physical and emotional health benefits. [Read more…]
How a 4,000 year old machine can improve your health
Most people think of a treadmill as an exercise device. In reality treadmills were invented over 4,000 years ago and used animal and human power to perform labor intensive tasks like drawing water and grinding grain. For an overview of the history of treadmills: http://en.wikipedia.org/wiki/Treadmill
Strangely enough, treadmills were also used in prisons as punishment. Inmates were made to walk on a large vertical wheel like a paddle wheel. They’d walk in drudgery for up to eight hours per day, which equated to climbing 10,000 vertical feet or more. To learn more: http://www.uh.edu/engines/epi374.htm [Read more…]
MetroHealth System Signs Agreement with Press Ganey
MetroHealth System has signed a multi-year agreement with Press Ganey to provide improvement solutions for its medical center, rehabilitation hospital, outpatient surgery center and network of 16 health centers.
More than 500 primary care and specialty care physicians practice within MetroHealth. Each year, MetroHealth provides nearly one million inpatient and outpatient visits, with revenue of more than $700 million. MetroHealth’s network of health centers incorporates a patient-centered medical home team-care approach to optimize patient outcomes through chronic disease management. The system’s major medical center is a leader in trauma, emergency and critical care; women’s and children’s services, including high-risk obstetrical care and neonatal intensive care; comprehensive medical and surgical subspecialties; heart and vascular care; cancer care; senior health; stroke and rehabilitative health care services.
Press Ganey and MetroHealth will be able to identify areas of opportunity and implement targeted action plans to enhance the patient experience. MetroHealth is one of the largest, most comprehensive providers in Northeast Ohio, serving the greater Cleveland community for more than 175 years.
ESKADENIA Solutions Successfully Automates Emirates Group Medical Insurance Operations
The Emirates Group comprised of Emirates airline and dnata, which has multiple business interests in the aviation, travel, tourism and leisure industries (Emirates Group), chose ESKADENIA Software Medical Insurance System to run the medical operations of more than 104,000 employees with their dependants.
The Emirates Group chose ESKADENIA’s Medical System due to its powerful claims audit tools and efficient network management that gives full details on the medical providers (Doctors, Pharmacies, Laboratories, and Hospitals) used by the Group.
ESKADENIA’s Medical Insurance System was customized to handle its employees’ medical claims in the most efficient and comprehensive manner. The Emirates employees can access their medical profile online and monitor their benefits, limits and utilization. In addition, they can submit claims directly from the web, request for medical approvals, and appeal for rejected claims.
It is worth to mention that ESKADENIA Medical Insurance system works for both individuals and groups, also it complies with governmental regulations, which makes it an easy to- use tool for the recording and manipulation of insurance policy production, medical networks, claims, policy renewals, and reinsurance operations.
Anthera Pharmaceuticals Announces Proposed Public Offering of Common Stock
Anthera Pharmaceuticals, Inc. (Nasdaq: ANTH) today announced that it intends to offer and sell shares of its common stock in an underwritten public offering. The Company expects to grant the underwriters a 30-day option to purchase up to an additional 15% of the shares of common stock offered in the public offering. The Company intends to use the net proceeds from the offering for general corporate purposes. The offering is subject to market and other conditions, and there can be no assurance as to whether or when the offering may be completed, or as to the actual size or terms of the offering.
Jefferies & Company, Inc. is acting as sole book-running manager in the offering and Leerink Swann LLC is acting as co-manager.
Uroplasty Reports Fiscal Third Quarter 2013 Financial Results
Uroplasty, Inc. (NASDAQ: UPI), a medical device company that develops, manufactures and markets innovative proprietary products to treat voiding dysfunctions, today reported financial results for the third quarter of fiscal 2013 ended December 31, 2012. The Company also announced the completion of a purchase agreement for both Urgent PC and Macroplastique with KP Select, Inc., which provides contract management services for all Kaiser Permanente and affiliated health care facilities.
Fiscal Nine Months 2013 Financial Results
For the nine-month period ended December 31, 2012, sales grew 13% to $16.9 million, reflecting a 25% increase in U.S. sales and an 11% decrease in sales outside the U.S. In the U.S., sales of Urgent PC increased 45% to $8.0 million and Macroplastique sales increased 1% to $4.3 million. At December 31, 2012, cash, cash equivalents and cash investments totaled $15.6 million
KP Select Purchase Agreement and Additional Expanded Coverage
The recently-completed purchase agreement with KP Select, Inc. for sales of Urgent PC and Macroplastique to Kaiser Permanente is a three-year contract and begins on March 1, 2013. Kaiser Permanente provides services to more than nine million members in 10 states through 37 hospitals and 611 medical offices and clinics, though not all locations treat urinary incontinence.
Bankruptcy Court Clears Way For Montefiore Medical Center To Acquire Assets of Westchester Square
The Bankruptcy Court for the Southern District of New York today approved Montefiore Medical Center’s bid to acquire the facilities of New York Westchester Square Medical Center (NYWSMC), a Bronx, N.Y., neighborhood hospital that has operated under Chapter 11 bankruptcy protection for nearly seven years.
The new facility will be renamed Montefiore Westchester Square. The plan is to have a full-service emergency department, an ambulatory surgery center and, over time, comprehensive primary and specialty care services.
Cooper Health System Pays $12.6 Million To Resolve False Claims Lawsuit
A federal lawsuit filed by prominent Delaware Valley cardiologist Nicholas L. DePace, M.D., sparked a multi-year investigation by the United States Department of Justice and the New Jersey Attorney General’s Office that has resulted in New-Jersey based Cooper Health System, and Cooper University Hospital paying $12,600,000 to settle Medicare and Medicaid fraud allegations.
According to Dr. DePace’s Complaint, since 2004, Cooper funneled illegal kickbacks to referring physicians through an advisory board known as the Cooper Heart Institute Advisory Board (“CHIAB”). Cooper established the CHIAB in 2004, with the stated purpose of utilizing prominent New Jersey physicians to advise the Cooper Heart Institute regarding innovative technologies, new management strategies, community needs, and appropriate educational and research initiatives.
In reality, the CHIAB was a sham, in which Cooper paid physicians with high-volume medical practices upwards of $18,500 each to do little more than watch four lectures per year hosted at an elegant banquet facility. These lectures consisted mostly of marketing presentation on cardiac care at Cooper. Additional lectures included generic subjects that were irrelevant to the stated mission of the CHIAB, including a 2008 lecture entitled: “The Healthcare Plans of the Two Presidential Candidates.”
In the spring of 2007, Cooper invited Dr. DePace to join the CHIAB. After attending his first CHIAB lecture, Dr. DePace quickly realized that the CHIAB was a thinly-veiled kickback scheme. Dr. DePace observed that the other CHIAB members were family physicians with high-volume practices. These physicians were all in the position to direct millions of dollars in patient care to Cooper.
Dr. DePace also observed that the CHIAB physicians were paid $18,500 for doing nothing more than sitting and listening to marketing presentations and lectures on irrelevant topics. The physicians did not discuss the lecture topics, and were not required to perform any additional work in exchange for the payments from Cooper.
In exchange for Cooper’s kickback payments, CHIAB physicians referred their patients to the Cooper Heart Institute for expensive in-patient and out-patient cardiac services. At least one CHIAB member admitted to Dr. DePace that, when making referrals, he knew that Cooper, through the CHIAB, “butters his bread.”
The settlement with the United States, and the State of New Jersey, announced today, will require Cooper to pay the United States $10,000,000 and the State of New Jersey $2,600,000. The settlement is one of the largest against a hospital for operating a kickback scheme, and is one of the largest recoveries for the State of New Jersey under its recently passed state False Claims Act. Cooper denies that it is liable for violating federal or state laws.
ACLJ Files 4th Direct Challenge To HHS Mandate
The American Center for Law and Justice (ACLJ), a pro-life legal organization that focuses on constitutional law, today filed its fourth direct challenge to the mandate of the Department of Health and Human Services (HHS) on the basis that the mandate violates the religious beliefs of business owners. The lawsuit was filed today in the U.S. District Court for the District of Columbia and contends that the HHS mandate violates constitutional and statutory rights by requiring two Ohio companies and their owners to purchase health insurance for employees that include coverage for contraception, sterilization and abortion-inducing drugs.
The lawsuit, posted here: http://c0391070.cdn2.cloudfiles.rackspacecloud.com/pdf/complaint-declaratory-injunctive-relief-freshway-v-hhs.pdf, argues that the HHS mandate violates the First Amendment, the Religious Freedom Restoration Act, and the Administrative Procedure Act.
The lawsuit contends the HHS mandate forces the owners to “violate their religious beliefs and moral values” or face crippling fines and penalties. For the two companies combined, the fines and penalties would total nearly $40,000 a day, amounting to $14.4 million annually, which the owners contend will be “ruinous” for their businesses.
UK Treatment Decisions Seriously Flawed
The Quality Adjusted Life Years (QALY) approach to deciding which treatments are available on health services – used by the UK and generating much interest across Europe – is dangerously flawed and should be abandoned, according a European Commission funded research project.
HTA agencies are charged with recommending whether new treatments are publicly funded. NICE uses QALY – an economic theory which mathematically weighs number of life years by quality of life provided by different treatments. Based on this calculation, decisions are made about whether treatments are offered by the National Health Service. In the UK, if the incremental cost per QALY (= cost for one additional year in perfect health) is below £30,000, the treatment is usually made available. Many European countries are currently considering replicating the NICE model.
The research surveyed 1,300 respondents in Belgium, France, Italy and the UK, and is the largest investigation into QALYs ever undertaken.
Botswana Insurance Holdings Limited deploys ESKADENIA’s General and Financial Insurance systems in record time
ESKADENIA Software has successfully deployed its comprehensive package of General Insurance and Financial Insurance Systems at the short-term insurance operation of Botswana Insurance Holdings Limited in short period of time.
ESKADENIA Insurance Management Systems are designed to reduce operational cost, speed up work, maintain historical data and ensure a high level of security at Botswana Insurance Holdings Limited; The systems support real-time integration with the financial modules of ESKADENIA® Business Manager, including the General Ledger, Accounts Payable, Accounts Receivable, and Cash Management Systems to maintain Botswana’s needed financial information and accounts updates.
The ESKADENIA Insurance Software package (General, Financial, Approval System, Notification Engine, Management Information System, & ESKA Insures for Agents & Brokers) provide a collaborative environment for information management across Botswana Insurance Holdings’ departments and allows users to capture up-to-the-minute information whenever required.
The software package also, provides Botswana Insurance‘s users with advanced up-to-date reports and statistics to analyse operational performance and make proper management decisions.
Developed on Microsoft .Net Objected Oriented technology and using Oracle Database, the web-based systems, securely accessed from wherever an Internet service is available, which allows Botswana Insurance Holdings Limited employees to define insurance products, manage production, and run daily insurance transactions in an efficient and simple manner. Through the systems’ location-independent interface, the company can efficiently handle greater volumes of operations and smoothly manage work processes.
John Haenen, the CEO of BIHL Sure! commented that “ESKA® Insures provided us with the best platform for our business, we were impressed by the collaborative way in which ESKADENIA Software handled the deployment of our system – on time, on budget, and faultlessly functional at first switch-on.”
“We are proud to be selected as their technology partner by the largest financial service Group in Botswana – BIHL Sure! and to consolidate our position in the African Insurance market. The systems were deployed in record time indicating our ability to provide advanced and stable products to customers and the market “said Nael Salah, Managing Director of ESKADENIA Software.
About BIHL Sure!
The Company is a wholly-owned subsidiary of the BIHL Group, which is in turn a subsidiary of Sanlam, the largest insurance group in Africa with revenues exceeding US$5 billion. It writes some 38 lines of business in client-definable packages, or on custom designed forms for complex risks. The market in which it operates requires interaction with brokers, tied agents and bulk on-sellers such as banks. Systems are required to cater for all of these channels as well as the emerging direct market that demands access via the internet or smartphone. One of the Company’s leading strategies is to provide high standards of customer care 24/7/365, driven primarily by its electronic platforms. For this reason the relationship with its systems supplier is regarded as strategic and mission critical.
About ESKADENIA Software
ESKADENIA® Software is a CMMI® level 3 certified company that is active in the design, development and deployment of a range of software products in the Telecommunications, Insurance, Enterprise, Education, and Internet application areas. The company is based in Jordan and has sales activities in Europe, the Middle East and Africa; more than 85% of its sales are exported to the global market. ESKADENIA Software is a product and market-oriented organisation that assists enterprises and promotes businesses by use of highly effective IT strategies, solutions and tools. ESKADENIA Software strongly believes that a company’s achievement is based on the success of its Human Resources and the commitment to quality and excellence that each one holds strong to. ESKADENIA endeavours as a team to maintain quality and customer respect, build up perseverance, and foster innovation.
AHCA Sends Letter to Congress Opposing Using Medicaid Provider Taxes to Pay For Stafford Student Loan Subsidy
The American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) today sent a letter to House and Senate leaders urging both chambers to reject a proposal to pay for Stafford student loan subsidies with reductions in the Medicaid provider tax rates, also known as provider assessments.
Last week, House and Senate Republican leaders sent a letter to the President offering reduction in the Medicaid provider assessments as a way to offset the cost of keeping student loan interest rates low. The House of Representatives could vote on the measure as early as June 29.
A copy of the letter is below. [Read more…]
Enterologics Unveils Strategy to Develop Live Biotherapeutics for Gastrointestinal Diseases
Enterologics, Inc., (OTCBB: ELGO.OB) a biotechnology company, is dedicated to the development of live biotherapeutic products for gastrointestinal (GI) disorders that it believes are poorly addressed by current therapies. Key examples include pouchitis, irritable bowel syndrome (IBS), Crohn’s disease, ulcerative colitis and Clostridium difficile infections.
Enterologics intends to license or acquire technology to build a product pipeline based on producing probiotic bacteria in novel, shelf-stable, high potency formulations that are delivered orally. Unlike probiotic bacteria that are sold over-the-counter as dietary supplements or in food products such as yogurt, we intend to develop products to meet the exacting standards necessary to gain FDA approval as prescription drugs and biologics, with demonstrated safety and clinical benefits for specific GI indications. [Read more…]
How to Get Health Insurance Coverage
Buying health insurance coverage is a big decision. It’s complex, it’s costly, and it could have big monetary implications. Similar to a lot of other things, it’s simpler if you break up the job into lesser tasks and find your way out through them.
a) Create a list of solutions you and your household may need.
Take into consideration your gender, age, and family medical record. Are there any ongoing medical conditions? Is There anyone regular medical prescription?
At the lowest, plan to purchase ‘a high insurance deductible health plan’, which is usually termed as ‘catastrophic coverage’. Simply speaking, this coverage provides a reduced premium, and you make payment for most routine costs out of your pocket. If you’ve a critical accident or become severely ill, your insurance plan will activate when you attain your deductible. [Read more…]
Unisys to Provide IT Services to Support Humanitarian Mission of the American Red Cross
Unisys Corporation (NYSE: UIS) today announced that it has received a contract to provide IT managed services to a new client, the American Red Cross, a leading provider of humanitarian services.
The contract has a potential value of approximately $80 million over its initial five-year term. It also has two one-year renewal options.
Under the terms of the contract, Unisys will provide a full range of customer support and data center managed services to support approximately 20,000 Red Cross workers throughout the U.S. and Puerto Rico. The workers are engaged in disaster relief, blood-supply management and other activities critical to the organization’s humanitarian mission. [Read more…]
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