HCCI: Healthcare spending, service use vary widely across the country

FierceHealthcare | March 12, 2019

In the latest data released from the Health Care Cost Institute’s (HCCI) Healthy Marketplace Index, an analysis of more than 1.8 billion claims shows wide variation when it comes to medical spending and frequency of services depending on the region of the country. The report looks at services between the years 2012 and 2016 and cost per transaction. The results—across 43 states and 112 local areas—reveal that spending varied greatly across metro areas. Results also differed when segmented by inpatient, outpatient and physician services, and when comparing for service utilization. "To us, the most interesting finding was just the extent of variation—not only in how much the same services cost or were used in areas across the country, but also in how price and use compared within metros," Bill Johnson, Ph.D., a senior researcher with HCCI, told FierceHealthcare. "There were plenty of examples where you could find two metro areas where prices were essentially the same. For example Oxnard, California, and New Haven, Connecticut—New Haven used almost 50% more services."

Spotlight

Right now, theres about $400 billion of healthcare construction underway around the world. This includes everything from cutting edge hospitals to groundbreaking research campuses and from telehealth centers to small specialty clinics. Whether you are part of the building team breaking ground on your citys newest medical center or you are helping to renovate a new ward on an existing facility, its an exciting time to be building in this diverse and growing sector.


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FUTURE OF HEALTHCARE

Prenosis Announces Investment from PACE Healthcare Capital, bringing Total Funding to Over $20 million

Prenosis | March 10, 2022

Prenosis, Inc., a precision medicine company,announced a venture investment from PACE Healthcare Capital, an early-stage investment firm committed to improving health outcomes. This investment brings total funding in the company to over$20 million, including partnerships with Foxconn, Roche Diagnostics, the Defense Threat Reduction Agency, and others. Prenosisis leveraging machine learning algorithms trained on deep biological data and broad clinical data to create precise and comprehensive maps of acute disease. Using these maps, Prenosis develops and markets valuable navigational tools to improve patient care by illuminating the optimal treatment pathways for each patient. "This capital will further accelerate our deep biological mapping of acute disease and to further grow the NOSIS™dataset/biobank, which is the largest such dataset/biobank ever created for sepsis," saidBobby Reddy, Jr., CEO and Co-Founder, Prenosis Inc. "Using our mapping technology, we are developing sophisticated methods to define, divide, and conquer diseases. The navigational guidance solutions based on our health state maps will address the critical challenge of sepsis by providing critical and actionable information tailored to each patient's health state." Prenosis is pioneering a revolution in managing acute diseases that have previously eluded conventional methods, starting with sepsis. Sepsis occurs when the immune system reacts abnormally to an infection, setting off a chain of events that leads to tissue damage and organ failure. Sepsis is currently one of the leading causes of mortality in U.S. hospitals, and the WHO estimates that it causes 1 in 5 deaths worldwide1. Prenosis has spent nearly a decade building fit-for-purpose biological and clinical datasets at an unprecedented level to better understand sepsis and other acute care conditions. Using this information, Prenosis has developed patient maps and valuable navigational tools to empower physicians to administer optimal treatment to patients faster. Prenosis' first such tool, the Sepsis ImmunoScoreTM, is a Software-as-a-Medical Device (SaMD) digital diagnostic designed to aid in the risk assessment for progression to sepsis of patients admitted in the emergency department or hospital. Prenosis is currently seeking to obtain FDA clearance for the tool by the end of 2022. The test runs on Prenosis's Immunix™software platform, which interfaces with hospital Electronic Medical Records that hosts multiple products to improve patient care. "Personalized medicine is the next frontier of healthcare. Complex acute diseases, such as sepsis, can only be conquered through a robust understanding of the biological response of each patient's immune system – one patient at a time. Prenosis brings our understanding of the disease patterns to a whole new level and enables physicians to make better decisions faster for their patients. We are excited to partner with Bobby and the whole Prenosis team as they continue to develop their technology and transform the way we understand and provide care for patients with complex acute diseases." Julia Monfrini Peev, Founder and Managing Partner of PACE Healthcare Capital The funding builds on a recent string of strategic partnerships and accolades for Prenosis, including being selected as part of the MedTech Innovator 2021 Showcase, being named the #2 Medtech Startup of 2021 by MDDI, and being asked to present its research at scientific meetings, including the forthcoming 2022 annual meetings for the Society of Critical Care Medicine and the American Thoracic Society. "In addition to support from other investors and partners, PACE Healthcare Capital's involvement is a strong endorsement of our solutions and will help to accelerate our growth as we further expand our proprietary dataset and work towards commercialization of the Immunix™platform later this year," said Reddy. "As we use our technology to map acute disease, we hope to usher in a new age of data-driven treatment and medical discovery." About Prenosis Prenosis is a health tech innovator devoted to ushering in a new era of precision diagnostics in acute care using artificial intelligence. Its Immunix™precision diagnostics platform leverages machine learning algorithms trained on deep biological data and broad clinical data designed to capture and illuminate the complex health states of patients more holistically. Its proprietary NOSISTMdataset is one of the largest and fastest-growing hybrid biomarker-clinical datasets for sepsis care. The Sepsis ImmunoScore™diagnostic on the Immunix™platform has the potential to save thousands of lives and billions of dollars in healthcare spending annually. The Sepsis ImmunoScore™is not yet approved for commercial use in the United States. About PACE Healthcare Capital PACE Healthcare Capitalis an early-stage venture capital firm focused on investing in companies that have developed high-impact solutions to critical healthcare challenges. With decades of combined experience and $1B+ of capital raised and deployed in healthcare, PACE applies institutional-grade investment processes to identify the best entrepreneurs and deploy financial and human capital to help them grow their business.

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FUTURE OF HEALTHCARE

Trillium Community Health Plan Successfully Resolves Corrective Action Plan with OHA

Trillium Community Health Plan | June 03, 2022

Trillium Community Health Plan is pleased to announce it has successfully closed the Tri-County Expansion Corrective Action Plan (CAP) with Oregon Health Authority effective June 1, 2022. As a result of this process, Trillium has implemented many practices that have further strengthened the plan's ability to coordinate high-quality healthcare and services, with a special focus on increasing access to care and addressing social determinants of health for Oregon Health Plan members in Clackamas, Multnomah, and Washington counties. In September 2020, OHA issued a CAP for Trillium's Medicaid plan as a condition of expansion into the Tri-County service area. OHA asked Trillium to focus on specific improvements to its network, health equity and language access, community engagement, and intensive care coordination. Leveraging the extensive expertise of its many work groups, committees, and community partnerships, including the Network Adequacy Collaborative and Health Equity Strategy Committee, and with contributions from tribal liaisons, traditional health worker liaisons, and the development of the Community Advisory Council, Trillium has addressed and resolved all CAP requirements. Today, Trillium serves more than 28,000 members in the Tri-County area. Through the CAP, the health plan made several improvements to enhance access to care and services for all members, including The creation of a fully compliant and engaged Community Advisory Council, made up largely of Trillium members representing diverse demographics and lived experience; New partnerships with the regional health equity coalition, tribal organizations, and community-based groups, which further support Trillium members with access to culturally sensitive healthcare, food insecurity, and other investments A robust behavioral health provider network to meet the needs of members; The Network Adequacy Collaborative to ensure all network related issues, including health equity, are identified and addressed promptly; and, A renewed internal committee structure to align plan efforts and center equity on strategic planning. "Trillium is committed to providing equitable, culturally sensitive, integrated care for all of our members in Oregon. We want to thank OHA for their continued partnership throughout this process, which has allowed us to enhance our systems, processes, and partnerships, improving our ability to identify local needs, remove barriers to care, develop service innovations, and collaborate across organizations to enact lasting change within our communities." Justin Lyman, Interim President and CEO of Trillium Trillium extends its appreciation to OHA for its partnership throughout this process. About Trillium Community Health Plan Trillium Community Health Plan serves Oregon Health Plan members through the CCO model, which began in 2012. Trillium is a recognized leader for outstanding coordination of care. It was first awarded a contract with the state of Oregon to help manage care for the Oregon Health Plan in 1999. Trillium partners with an extensive group of providers to improve care and access to services for OHP members.

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AI

TapCloud and Maxwell Healthcare Associates Join Forces to Transform Post-Acute Space

TapCloud | January 28, 2022

TapCloud, a technology leader in patient-directed care, will partner with Maxwell Healthcare Associates (MHA), a leading post-acute operational, financial, technological and regulatory consulting firm, to transform the post-acute industry with their innovative patient communication and artificial intelligence (AI) solution. TapCloud's technology uses AI-driven tools to capture symptoms that automatically identify patients in need. The system supplies patients or their caregivers with words to indicate how they're feeling. The word cloud symptom tracker is unique to the patient, their-conditions, their medications and their history as it learns and evolves each time they use it. MHA's reach and influence within the post-acute space is expansive, and their unique ability to connect industry partners with strategic solutions continues as they ally with TapCloud. They integrate result-orientated products and services to post-acute organizations that seek immediate answers for their problems. With MHA's organizational expertise and TapCloud's advanced solution, home health, palliative, and hospice providers will have the necessary tools to improve end-of-life care. "We're very excited about 2022 and the opportunities that it will present us. TapCloud is an extraordinary organization that will enhance the care and communication with patients in the post-acute setting. Our goals at MHA are to equip our customers with tools that will not only enhance the care they provide but expose them to tools that have been vetted through our review process." CEO of Maxwell Healthcare Associates,Jennifer Maxwell President of TapCloud,Jolinda Lambert, shares in the enthusiasm and strongly believes the partnership will blossom into the new year. "Our product's ability to change how care is delivered is transformative. We can't wait to get started with MHA to help shape personalized care." About TapCloud TapCloud is aChicago-based health-tech company founded in 2013. They produce an AI-driven application that provides better insights into a patient's symptoms and automatically identifies patients in need at the right time. About Maxwell Healthcare Associates Maxwell Healthcare Associates boasts an average of 20 years of experience in the post-acute space and has a pulse on what's relevant now in the industry. MHA can work with home health and hospice agencies to strategize, optimize and transform agencies across the nation.

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AI

Aidoc partners with Novant Health, providing imaging AI to expedite treatment for patients in the emergency department

Aidoc | January 25, 2022

Aidoc,the leading provider of enterprise-grade AI solutions for medical imaging, announces a partnership with Novant Health, a health network of over 1,800 physicians with 15 medical centers across three states. By incorporating Aidoc's AI platform, which includes seven FDA-cleared solutions for triage and notification of patients with acute medical conditions, Novant Health is taking proactive steps to improve patient outcomes and reduce emergency department (ED) length of stay amid resource constraints inflicted by the Omicron variant. With a dedication to digital transformation for improving workflow efficiencies and patient outcomes, Novant Health is one of the first health networks inNorth Carolinato adopt Aidoc's AI platform. Novant Health has integrated multiple technologies and has been recognized by the College of Healthcare Information Management Executives'(CHIME) "Digital Health Most Wired" program five years in a row for effectively applying "core and advanced technologies into their clinical and business programs to improve health and care in their communities." "When diagnosing and treating critical pathologies like pulmonary emboli and hemorrhagic strokes, every second counts," said Dr. Eric Eskioglu, Executive Vice President Chief Medical and Scientific Officer, Novant Health. "We are thrilled to partner with Aidoc to bring yet another leading-edge AI-technology to Novant Health. For years, we've been committed to harnessing innovative technologies to improve patient safety and outcomes through the Novant Health Institute of Innovation and Artificial Intelligence. With Aidoc's technology, our physicians will be able to more quickly identify and prioritize these patients and provide rapid life-saving treatments." From Aidoc's AI platform, Novant Health will be utilizing the intracranial hemorrhage (brain bleeds), pulmonary embolism (lung blood clots), incidental pulmonary embolism, c-spine fracture, and abdominal free air AI solutions. In one example, a studyconducted by the Yale New-Haven Health System found that Aidoc's intracranial hemorrhage AI solution was able to reduce ED length of stay by approximately one hour. "With rapidly rising numbers of people infected with the highly contagious Omicron variant, we can see the hard impact on hospital emergency room capacities and resources across the U.S. We're proud to partner with a leading, innovative hospital network like Novant Health, which serves a large portion of the population in the three states its facilities are located in. Together, through our AI solutions and their state-of-the-art facilities, we will enable radiologists and related hospital providers to expedite care for tens of thousands of patients, contributing toward a mitigation of the current emergency room situations and setting an example for integrating innovation during turbulent and non-turbulent periods." Elad Walach, CEO and co-founder of Aidoc About Aidoc Aidoc delivers the most comprehensive and widely-used portfolio of AI solutions, supporting providers by flagging patients with suspected acute conditions in real-time, expediting patient treatment and improving quality of care. Aidoc's healthcare AI platform is currently used by thousands of physicians in hospitals and radiology groups worldwide and across multiple care coordination service lines, having analyzed over 10.3 million scans in the past year. About Novant Health Novant Health is an integrated network of physician clinics, outpatient facilities and hospitals that delivers a seamless and convenient healthcare experience to communities inNorth Carolina,South Carolina, andGeorgia. The Novant Health network consists of more than 1,800 physicians and over 35,000 employees who provide care at nearly 800 locations, including 15 hospitals and hundreds of outpatient facilities and physician clinics. In 2021, Novant Health was the highest-ranking healthcare system inNorth Carolinato be included onForbes'Best Employers for Diversity list. Diversity MBA Magazineranked Novant Health first in the nation on its 2021 list of "Best Places for Women & Diverse Managers to Work." In 2020, Novant Health provided more than$1.02 billionin community benefit, including financial assistance and services.

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Spotlight

Right now, theres about $400 billion of healthcare construction underway around the world. This includes everything from cutting edge hospitals to groundbreaking research campuses and from telehealth centers to small specialty clinics. Whether you are part of the building team breaking ground on your citys newest medical center or you are helping to renovate a new ward on an existing facility, its an exciting time to be building in this diverse and growing sector.

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