FUTURE OF HEALTHCARE
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.
Elevance Health, Inc | June 20, 2022
As Anthem, Inc. moves closer to rebranding to Elevance Health, Inc. later this month, the company announced the launch of healthcare services brand Carelon and health plan brand Wellpoint to join the company’s family of brands that includes Anthem Blue Cross and Blue Shield. The move will optimize and streamline the company’s brand portfolio, reduce complexities, and further underscore its evolution to deliver solutions beyond traditional health insurance, simplify the healthcare experience, and advance health beyond healthcare.
“An important part of being a lifetime, trusted health partner is grounded in our ability to ensure consumers have access to services that will meet their whole health needs across their entire healthcare journey. The addition of our new brands to our family of companies will bring together services and products within their respective brands that further integrate our business and health expertise across the industry to solve complex challenges and improve consumers lives.”
Gail K. Boudreaux, President and CEO Anthem, Inc
Blending a powerful suite of solutions to solve complex healthcare challenges
Bringing together decades of experience, the company introduces its new healthcare services brand Carelon to consolidate the company’s existing broad portfolio of capabilities and services businesses under one brand to address the most complex healthcare challenges and support clients and consumers across the entire healthcare continuum. Derived from the word ‘care’ and suffix ‘lon’ meaning full and complete, the name Carelon stands for the importance of providing full and complete care. Carelon will serve one in three people in the U.S.
With services ranging from research to integrated whole person care delivery, pharmacy, behavioral health to digital platform and technology services, Carelon will build better care for people and enhance efficiencies systemwide. Through partnerships across healthcare, Carelon will improve outcomes and reduce total cost of care through digitally enabled solutions to improve whole person health.
The company expects to fully transition its capabilities and services under the Carelon brand over the next two years. This change further helps to streamline the end-to-end experiences for providers, clients and consumers.
“Carelon makes connected care possible for everyone by putting people at the center of what we do and delivering the right balance of care, technology, data-driven insights and expertise to solve complex challenges and help consumers lead healthier lives,” said Pete Haytaian, Executive Vice President of Anthem, and President of Carelon. “Bringing together these solutions will help deliver our strategy, drive growth, and exceed expectations for care providers, consumers, and our other partners.”
Launching a brand focused on improving the health of individuals and communities at all stages of life.
The company will also launch the Wellpoint brand to unify its Medicare, Medicaid, and commercial health plans in select markets, simplifying interactions that consumers have with these health plans. Wellpoint’s suite of products and services are designed for consumers at any stage of life seeking to make the right care decisions and will offer access to simple, supportive health solutions that will help foster independence, confidence, and whole person health for consumers.
The company plans to make this transition over the next few years. This change will not impact the company’s affiliated Anthem Blue Cross and Blue Shield and Anthem Blue Cross health plans.
“Unifying many of our non-Blue Medicare, Medicaid, and commercial health plans under one brand helps consumers, care providers, and the healthcare industry better understand how our organization works together to deliver our distinct set of products and services that address the health and wellbeing of those we serve,” added Boudreaux. “Our Wellpoint health plans will continue to address consumer needs at a personal level, removing barriers and creating more meaningful connections across a lifetime of milestones and experiences.”
This step in the company’s rebranding is a continuation of its bold and ambitious purpose to improve the health of humanity by serving people across their entire health journey; connecting them to care, support and resources; and simplifying every step of the healthcare journey to make health more equitable and accessible.
On June 28, Anthem will become Elevance Health and will commemorate its official rebranding by ringing the opening bell at the New York Stock Exchange (NYSE). Shares of the company’s common stock will begin trading under the new ticker symbol ELV as of that morning.
About Anthem, Inc.
Anthem, which will become Elevance Health on June 28, 2022, is a leading health company dedicated to improving lives and communities, and making healthcare simpler. Through its affiliated companies, Anthem serves approximately 118 million people, including nearly 47 million within its family of health plans. Delivering health beyond healthcare, Anthem is expanding from being a partner in health benefits to a lifetime, trusted health partner.
FUTURE OF HEALTHCARE
Virta Health | June 07, 2022
Virta Health, the leader in type 2 diabetes reversal, revealed preliminary five-year results from its landmark clinical trial at the American Diabetes Association 82nd Scientific Sessions. Presenting four unique abstracts, Virta highlighted myriad, lasting health improvements for people with type 2 diabetes and prediabetes, including blood sugar control, clinically-significant weight loss, reduced inflammation, and improvements in other markers of cardiometabolic health.
These transformative health outcomes coincided with medication reduction or elimination for many trial patients, including Jane Ann Dimitt.
For over two decades, Jane Ann was prescribed increasing levels of medications as her blood sugar and weight continued to climb. By the time she joined Virta in 2015, her A1c had reached 11.4%; the next step was insulin. Through Virta’s treatment, Jane Ann lowered her blood sugar to 5.5% (below even the prediabetes threshold) and lost over 50 pounds, while drastically reducing her reliance on medications. She also saw improved mobility, decreased inflammation and neuropathy, and now has the energy to play with her grandchildren—all without needing the insulin doctors said was imminent.
The outcomes of Jane Ann and Virta’s other trial patients contradict the belief that progression of diabetes—and a lifetime of increasing medications—is inevitable. One-fifth of Virta patients completing five years of treatment saw full remission. One-third of patients achieved A1c below 6.5% without any diabetes medications, or only requiring Metformin. Notably, inflammatory markers, triglycerides, and HDL cholesterol all improved significantly.
These outcomes, in conjunction with previous research demonstrating improvements in cardiovascular disease risk factors, depression symptoms, sleep, and knee pain, establish the promise of Virta’s approach to impact a wide range of conditions amid America’s metabolic disease epidemic. In the U.S., costs are rising as patient outcomes continue to worsen, including surges in amputations, hyperglycemic events, and diabetes-related deaths during the COVID-19 pandemic.
Meanwhile, getting patients to stick with an intervention remains a significant challenge in diabetes therapy. Rates of medication adherence—that is, whether patients take their medications as prescribed—fall as low as 34% over the first three years for those starting insulin. For the National Diabetes Prevention Program, considered the gold standard in lifestyle interventions, only 13% of patients were retained at one year.
In contrast, in Virta’s trial nearly 50% of participants with type 2 diabetes were retained at five years. Of those who continued past year two, 72% remained for an additional three years to year five. For Kim Shepherd, who lost 55 pounds, eliminated 10 different medications, reversed her diabetes, and even saw her GERD (acid reflux) and plantar fasciitis disappear, the reasons to stick with the treatment are clear.
“Diabetes runs in my family, and I know that this disease can rob you of your whole life; it can take your eyes, your feet, and your kidneys. I have 4 kids and 9 grandkids to keep up with. I’ve learned to love hiking and biking. Nothing is worth losing all of that and going back to how I was before.”
Additional key outcomes demonstrating the success of Virta’s approach at five years include
Sustained blood sugar control. Virta patients experienced persistent improvements in blood sugar on average, while requiring significantly fewer medications.
Medication deprescription. Half of patients prescribed insulin at the start of the trial no longer needed it at five years. Across all diabetes drugs, prescriptions were reduced by nearly 50%.
Weight loss. Average weight among Virta participants decreased by 7.6%, exceeding the 5% benchmark for clinically significant weight loss by more than 50%.
Broad improvement in cardiometabolic health. In addition to improvements in triglycerides, HDL cholesterol, and markers of inflammation, patients even showed encouraging signs in reversing the progression of chronic kidney disease.
“Virta’s patients are helping redefine what long-term success can look like in type 2 diabetes care. The patient outcomes set a new standard for real-world applications of diabetes treatment."
Dr. Alan Moses, former Senior Vice President and Global Chief Medical Officer of Novo Nordisk, and Virta advisor
Trial participants with prediabetes also saw meaningful improvements, with progression rates far below what has been demonstrated in other studies. Further, Virta patients sustained 6% weight loss over five years, exceeding the clinically-significant benchmark for diabetes prevention and far surpassing the 2% weight loss observed in the NIH Diabetes Prevention Program lifestyle intervention.
The study is also notable for its longevity. Five-year published results are extremely rare in digital health, where most studies follow populations for no more than a year, and usually significantly less. For many Virta patients, the five-year clinical trial has facilitated a lasting lifestyle change, improving not only traditional markers of health but overall mood, quality of life, and outlook on the future.
Says patient Denise Lamb, who has maintained diabetes reversal alongside a nearly 70 pound weight loss, “My journey has been phenomenal. The Virta program has not only helped me achieve healthy blood glucose, but also attain a far better weight, normal blood pressure, and better understanding of my body. Virta’s lifestyle changed my lifestyle!”
About Virta Health
Virta Health helps people reverse type 2 diabetes and other chronic conditions. Current approaches manage disease progression through increased medication use and infrequent doctor visits. Virta reverses type 2 diabetes through innovations in technology, nutrition science, and continuous remote care from physicians and behavioral experts. In clinical studies, 94% of patients reduce or eliminate insulin use, and weight-loss exceeds FDA benchmarks by nearly 150%. Virta works with the largest health plans, employers, and government organizations and puts 100% of its fees at risk based on clinical and financial outcomes.
Alegeus and HealthSherpa | July 19, 2022
Alegeus, the market leader in healthcare payment solutions, and HealthSherpa, the leading enrollment platform for individual ACA health coverage, have outpaced the industry in individual coverage health reimbursement arrangements since announcing an integration partnership in the summer of 2020. With updates to their partnership in 2022, both companies are poised to increase their ICHRA enrollments even faster. HealthSherpa, which has seen more than 10X growth in ICHRA pipeline, has enrolled more than three million individuals on its platform in just the last year.
ICHRAs, which were launched at the start of 2020, allow employers to reimburse employees for individual coverage insurance premiums in place of offering them a traditional group-sponsored health plan. ICHRAs can also be used by employees to pay for out-of-pocket healthcare expenses. Organizations administering consumer-directed health benefit programs can set up an ICHRA with Alegeus, and then HealthSherpa helps ICHRA-eligible employees search for and enroll in the best on-exchange and off-exchange individual health plans. This integration bolsters the health reimbursement arrangement (HRA) experience from Alegeus and gives third-party administrators and health plans a strategy for increasing employer and employee participation in health benefit accounts.
“We’re excited about the growing demand our partners have seen for ICHRA since announcing our integration partnership with HealthSherpa,” said Mark Waterstraat, chief customer officer, Alegeus. “Our joint solution is helping employers to deliver quality and cost-effective benefits quickly and efficiently to their employees. While ICHRAs can offer these through employer-defined contribution and better-fit individual coverage plans, they are still new and require a considerable amount of education and awareness. Through this partnership, our efforts are resonating, as evidenced by growing market demand.”
“ICHRAs are a great option for a large and growing number of employers and their employees, and we’ve seen many of our client organizations begin reaping their benefits,” said Ross Honig, president, OCA. “Working with Alegeus and HealthSherpa has allowed OCA to market our ICHRA solution as a “one-stop” product that is seamless and easy to use for brokers, employers, and their employees.”
“Millions of consumers have enrolled in health insurance through HealthSherpa and experienced the increasing appeal of individual coverage. With our new off-exchange options, employers and brokers alike have more options for employees looking to make the transition away from group-sponsored health insurance. ICHRA is changing the dynamic of the relationship between employers and employees on the critical question of health insurance, and we’re thrilled to partner with Alegeus to help employers understand the benefits and communicate them with their employees.”
George Kalogeropolous, CEO, HealthSherpa
Alegeus and HealthSherpa recently presented a webinar, “The (Present and) Future of ICHRAs,” showcasing how to simplify the administration of ICHRA benefits and make it easier for consumers to find the care and coverage that meets their needs.
HealthSherpa builds technology that increases access to health care. We provide end-to-end solutions for consumers, insurance carriers, and agents, delivering a superior ACA marketplace experience to fulfill our mission of connecting people to health coverage under the Affordable Care Act. The HealthSherpa Marketplace, our flagship health insurance enrollment platform, services more than 45,000 agents, 38 carriers, and 9 million consumers.
With more than 25 years of growth and innovation, Alegeus is the market leader in SaaS-based benefit funding and payment solutions. Our highly flexible, white-label platform powers account-based benefit programs such as HSAs, FSAs, HRAs, COBRA, wellness incentives, lifestyle benefits and beyond. We deliver exceptional user experiences and differentiated capabilities that help our partners strengthen their product offerings, operate more efficiently, and unlock their full growth potential. Our partnerships with the industry’s leading health plans, third-party administrators, financial services and benefit solution providers give Alegeus unparalleled reach in the market, with access to more than 100 million commercially insured Americans. And our unique partnership model empowers our clients to achieve outsized results – growing their programs at a rate that is 3-4X the market, and with the highest NPS scores in the industry. We never compete with our clients in the market – we win when they win. Alegeus is headquartered in Waltham, Mass., with operations centers in Orlando and Bangalore, and a large remote workforce.