How UPMC Coordinates Compounding Social Determinants of Health

HealthPayerIntelligence | January 29, 2020

Payers can no longer ignore the social determinants of health that impact its member’s lives. Countless studies have linked housing, food insecurity, transportation, and access to care to negative health outcomes. Yet tackling each of these issues can be a challenge for payers as these risk factors are outside of its traditional responsibilities and benefits packages.   For over a decade, the University of Pittsburgh Medical Center (UPMC) Health Plan has been implementing various initiatives across the organization to address member’s social determinants of health. One of its most successful programs, the Cultivating Health for Success, partnered with a local housing and urban development vendor to coordinate a team-based approach that integrates permanent housing and intensive case management for individuals experiencing homelessness. In the first five years of the program, UPMC showed a savings of over $6,384 for each of the 51 members it was able to house.

Spotlight

Ensuring accurate patient identification is critically important to healthcare organizations, yet it has been one of their more challenging goals. The implications of patient misidentification are tremendous, creating a ripple effect of unintended clinical and financial consequences across the entire healthcare system. In late 2017, Health Leaders Media and PSQH conducted a 12 question survey on patient identification to gain industry insight from top hospitals and health systems around the country. With 100 responses from C-level executives, practicing clinicians, and department directors, the results indicated a high priority that positively matching a patient to their records was a top priority heading into 2018.


Other News
HEALTH TECHNOLOGY

Alcon Strengthens Leadership in IOL Innovation with Launch of Clareon Portfolio in the U.S.

Alcon | March 07, 2022

Alcon the global leader in eye care dedicated to helping people see brilliantly, announced the launch of the Clareon®family of intraocular lenses (IOLs) in the U.S. Utilizing Alcon’s most advanced IOL material, Clareon can deliver consistent visual outcomes and exceptional clarity that lasts.°,1-7The Clareon clarity is born out of a glistening-free§IOL material that has among the lowest levels of haze and subsurface nanoglistenings compared to leading competitor IOLs.†,*,1-3 “We are proud to offer our latest IOL technology in the U.S. and other countries across the globe. At Alcon, we are consistently pushing the boundaries to deliver transformational innovation to cataract surgeons and their patients. Clareon is the result of robust R&D efforts at every level—inventive material science, advanced manufacturing techniques and novel delivery systems—to deliver exceptional, long-lasting clarity.” Ian Bell, President, Global Business & Innovation, Alcon The Clareon portfolio leverages many of the same design characteristics and optics as Alcon’s leading IOLs to help deliver the outcomes surgeons expect.8,9Clareon offers sharp, crisp vision with a proprietary edge designed to help reduce glare and posterior capsular opacification.7The lens’ unique and proven STABLEFORCE®Haptics provide superior axial and rotational stability.*,β,8-14Clareon has been extensively researched, with inclusion in 30 published studies worldwide. Clareon Monofocal and Clareon Toric IOLs have already been implanted in more than one million eyes across more than 70 countries.15 Clareon IOLs are inserted using the next-generation, reusable Clareon Monarch®IVDelivery System, which provides precise and controlled implantation and that was designed specifically for the new Clareon material.15,16Clareon Monofocal is also available in the next-generation automated, single-use delivery system, AutonoMe™. “As one of the investigators for the Clareon pivotal trial, I was immediately impressed with the clarity of the new IOL material, delivery system and the consistent refractive outcomes,” said Dr. Samuel H. Lee, MD, Ophthalmologist, Sacramento, CA.** “Today, the clarity of Clareon persists four years later in my trial patients, with the optic performance that I expect from Alcon IOLs, as well as continued high patient satisfaction.” Clareon Monofocal, Clareon PanOptix®, Clareon PanOptix Toric, Clareon Vivity®and Clareon Vivity Toric IOLs are now available in the U.S. Clareon PanOptix offers patients the possibility of 20/20 vision at distance (far), intermediate (at arm’s length) and near (up close), with continuous vision of 20/25 or better.¥,14,17Clareon Vivity is a non-diffractive extended depth of focus lens with wavefront-shaping X-WAVE™ technology, delivering monofocal-quality distance with excellent intermediate and functional near vision and with a monofocal visual disturbance profile.13,18 Clareon Toric will be available in the U.S. later this year. Alcon will be rolling out the Clareon family of IOLs in international markets throughout 2022 and 2023. There are more than 28 million cataract surgeries performed each year in the world. With the aging population and increased life expectancies, these surgeries are expected to increase 3-4% per year for the next 30 years, leading to an estimated 60 million global cataract surgeries annually by 2045.19 About Cataracts A cataract is a cloudy area in the natural lens of the eye that affects vision. As a cataract develops, the eye's lens gradually becomes hard and cloudy, allowing less light to pass through, which makes it more difficult to see. The vast majority of cataracts result from normal aging, but radiation exposure, taking steroids, diabetes and eye trauma can accelerate their development. Cataracts are the most common age-related eye condition and the leading cause of preventable blindness.20Cataracts are treated by removing the eye's cloudy natural lens and surgically replacing it with an IOL. More than 92% of cataract surgeries are considered successful, and patients typically can return to their normal routines within 24 hours.21 About Clareon IOLs and Delivery Systems The family of Clareon intraocular lenses (IOLs) includes the Clareon Aspheric Hydrophobic Acrylic and Clareon Aspheric Toric IOLs, the Clareon PanOptix Trifocal Hydrophobic IOL, Clareon PanOptix Toric, Clareon Vivity Extended Vision Hydrophobic Posterior Chamber IOL and Clareon Vivity Toric IOLs. Each of these IOLs is indicated for visual correction of aphakia in adult patients following cataract surgery. In addition, the Clareon Toric IOLs are indicated to correct pre-existing corneal astigmatism at the time of cataract surgery. The Clareon PanOptix lens mitigates the effects of presbyopia by providing improved intermediate and near visual acuity while maintaining comparable distance visual acuity with a reduced need for eyeglasses, compared to a monofocal IOL. The Clareon Vivity lens mitigates the effects of presbyopia by providing an extended depth of focus. Compared to an aspheric monofocal IOL, the lens provides improved intermediate and near visual acuity while maintaining comparable distance visual acuity. All of these IOLs are intended for placement in the capsular bag. Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting any IOL in a patient with any of the conditions described in the Directions for Use that accompany each IOL. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon, informing them of possible risks and benefits associated with these IOLs. Reference the Directions for Use labelling for each IOL for a complete listing of indications, warnings and precautions. About Alcon Alcon helps people see brilliantly. As the global leader in eye care with a heritage spanning over 75 years, we offer the broadest portfolio of products to enhance sight and improve people’s lives. Our Surgical and Vision Care products touch the lives of more than 260 million people in over 140 countries each year living with conditions like cataracts, glaucoma, retinal diseases and refractive errors. Our more than 24,000 associates are enhancing the quality of life through innovative products, partnerships with Eye Care Professionals and programs that advance access to quality eye care.

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DIGITAL HEALTHCARE

Jumio Accelerates Digital Transformation in Middle East with KYX Platform

Jumio | March 21, 2022

Jumio, the leading provider of AI-powered end-to-end identity orchestration, eKYC and AML solutions, announced the launch of a Middle Eastern solutions portfolio and the appointment of Arshad Sheikh as its first sales leader for the Middle East, Turkey and North Africa region. This expansion builds on Jumio’s long-standing presence in the Middle East and its ongoing commitment to revolutionize banking for a growing number of customers in the region. A recent forecast from the International Data Corporation states that digital transformation efforts in the Middle East, Turkey and Africa are set to top $58 billion in 2025, accounting for 40% of all information communication technology investments made that year. Additionally, McKinsey & Company found that 83% percent of payments practitioners operating in the Middle East and Africa believe digitizing the customer journey is the most important way to remain relevant in an evolving market. With the Jumio KYX Platform, businesses from banking and financial services to government, healthcare and travel sectors can tap into services that accelerate digital transformation without sacrificing security and convenience. The KYX Platform leverages AI, biometrics, machine learning and certified liveness detection to help enterprises rapidly convert customers, stop fraudsters and maintain KYC and AML compliance. The key features and advantages of the platform extend an organization’s ability to monitor customer behavior from the initial point of account creation through the full lifecycle of customer interactions. Based in Dubai, Sheikh will focus on expanding the company’s client base, growing relationships with existing clients and cultivating a sustainable partner network. Sheikh has more than 20 years of sales, business development and cybersecurity experience in the Middle East. Before joining Jumio, Sheikh worked at Carbon Black/VMWare, Barracuda Networks, Informatica, TrendMicro and Mindware. “We are proud to continue growing in the METNA region in order to better serve the needs of our local customers and partners and to expand our global footprint so organizations can truly know their end users, no matter where in the world they are. Most industries in the region have been swept up in the need to digitally transform their businesses. Jumio’s end-to-end orchestration platform, aided by our extensive partner network, will massively simplify the journey and deliver successful business outcomes across all key industry sectors.” Dean Hickman-Smith, Jumio chief revenue officer For a live demonstration of the Jumio KYX Platform, visit Jumio at booth A34 during GISEC Global, which takes place this week in Dubai. About Jumio When identity matters, trust Jumio. Jumio’s mission is to make the internet a safer place by protecting the ecosystems of businesses through a unified, end-to-end identity verification, eKYC and AML platform. The Jumio KYX Platform offers a range of identity proofing and AML services to accurately establish, maintain and reassert trust from account opening to ongoing transaction monitoring. Leveraging advanced technology including AI, biometrics, machine learning, liveness detection and automation, Jumio helps organizations fight fraud and financial crime, onboard good customers faster and meet regulatory compliance including KYC, AML and GDPR. Jumio has carried out more than 500 million verifications spanning over 200 countries and territories from real-time web and mobile transactions. Based in Palo Alto, Jumio operates globally with offices in North America, Latin America, Europe and Asia Pacific and has been the recipient of numerous awards for innovation. Jumio is backed by Centana Growth Partners, Great Hill Partners and Millennium Technology Value Partners.

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HEALTH TECHNOLOGY

Bright Health Group Expands Executive Team as It Drives Performance in Scaled Businesses

Bright Health Group | May 18, 2022

Bright Health Group, Inc. the first technology-enabled, Fully Aligned System of Care built for healthcare's consumer retail market,announced the expansion of its leadership team with the addition of Michael Carson as Bright HealthCare Chief Executive Officer and Jeff Cook as NeueHealth Chief Executive Officer. These proven leaders, reporting directly to Bright Health Group CEO Mike Mikan, will focus on leading the Company’s two complementary businesses, as Bright HealthCare has gained scale, and NeueHealth emerges as a differentiated market player. Carson will lead the Bright HealthCare business, which has reached scale, and will focus on driving core operational excellence, innovative consumer product and network solutions and profitable, sustainable growth. Carson brings deep experience across the payer and provider space, along with a passion for integrated and transformative healthcare innovation that drives better healthcare outcomes, experiences, and value. Most recently, Carson served as Chief Executive Officer of CareAbout, a multi-market, value-based primary and multi-specialty care start-up, and as President and Chief Executive Officer of Harvard Pilgrim Health Care, a leading not-for-profit health services company. Previously, Carson held leadership positions at Anthem, AmeriGroup, Blue Cross Blue Shield plans, and ConcertoHealth. Cook will lead NeueHealth, Bright Health Group’s personalized care delivery business, which has emerged as a differentiated market player. He will continue to grow and develop our Integrated Systems of Care. Throughout his career, Cook has consistently led initiatives that are at the forefront of value-based care and consumer-driven healthcare. Previously, Cook served as national Vice President of CVS Health HUBs, CVS’ suite of HUB clinical services. Prior to that, Cook served as the South Central Regional President of CVS Health/Aetna and held various leadership positions at Ascension Health and UnitedHealthcare. “Michael and Jeff both bring strong expertise in their respective domains, and most importantly, have a passion for and expertise in fully aligned, value-based care. As we embark on this next phase of Bright Health Group’s journey, we are excited to have these two phenomenal leaders join our already deep bench of talent within Bright HealthCare and NeueHealth.” Mike Mikan, President and CEO, Bright Health Group Sam Srivastava, current CEO of NeueHealth, will serve as a strategic advisor through the end of May to ensure a smooth transition. Jay Matushak, current Interim CEO of Bright HealthCare, will be returning to his previous role as CFO of Bright HealthCare, while taking on an expanded set of responsibilities. Said Mikan, “We want to thank Sam for his many contributions to Bright Health Group and Jay for stepping up to lead Bright HealthCare in the interim. Jay has done a terrific job progressing Bright HealthCare and we look forward to him partnering with Michael as they continue the build on our platform for change in healthcare.” About Bright Health Group Bright Health Group is the first technology-enabled, Fully Aligned System of Care built for healthcare's consumer retail market. Our differentiated approach aligns care delivery with the financing of care to drive better outcomes, lower costs, and enhance the consumer experience. We have two market-facing businesses: NeueHealth and Bright HealthCare. NeueHealth provides care delivery and value-based enablement services to over 500,000 value-based patients through our owned and affiliated clinics. Bright HealthCare offers Commercial and Medicare health plan products to over 1.1 million consumers across the nation. We believe everyone should have access to personal, affordable, and high-quality healthcare. Our mission is to Make healthcare right. Together.

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FUTURE OF HEALTHCARE

Omega Healthcare completes acquisition of ApexonHealth and Vasta Global

Omega Healthcare | April 18, 2022

Omega Healthcare, a leading technology-enabled healthcare management solutions provider,announced its acquisition of ApexonHealth, an AI and automation-based revenue cycle management and payor solutions provider, and Vasta Global, a provider of real-world data abstraction and analytics for the oncology market. ApexonHealth leverages its digital solutions to deliver comprehensive technology-enabled services for both providers and payors from revenue cycle management and coding to claims management and advanced analytics. ApexonHealth's cognitive and automation capabilities have significantly reduced manual effort and increased accuracy in claims adjudication strengthening its payor services. ApexonHealth's expertise in the healthcare payor sector will augment Omega's existing payor-focused offerings. Vasta Global provides clinical data management with a focus on the oncology market and provides real-world evidence data curation and analytics, clinical trial support, and cancer registry services for cancer centers. Vasta Global's customers span the entire healthcare ecosystem including providers, pharmaceutical and biotechnology companies, and contract research organizations that provide clinical trial management services. The two acquisitions will complement Omega Healthcare's existing strengths in revenue cycle management and clinical data management for various medical registries including cancer, stroke, and trauma. These acquisitions are part of the strategy to accelerate Omega's journey in scaling its portfolio of AI- and data-analytics- based solutions to help healthcare clients optimize revenue while reducing cost through leveraging of big data and automation technology. With the recently completed acquisition of Reventics, Omega Healthcare will deliver an end-to-end revenue cycle management suite of solutions to healthcare providers, from analytics-driven clinical documentation improvement to platforms for payment data management. The Company will also expand its oncology-focused offering to now include big data capture and reporting to help healthcare providers and pharmaceutical companies leverage complex, longitudinal data to improve cancer treatment. "We are pleased to welcome ApexonHealth and Vasta Global to the Omega family. We've been very impressed by the vision and execution by the two management teams. Bringing together the Omega, ApexonHealth, and Vasta offerings together will unlock significant value to our clients." Anurag Mehta, CEO of Omega Healthcare "I am thrilled about this opportunity to join the Omega platform. Our mission to provide sustainable and scalable solutions to our clients is one that is shared by the Omega Healthcare team. With their broad capabilities, we are excited to offer our clients access to data curation, registry management, and machine learning solutions. Through this alliance, we reinforce our commitment to scientific discovery for patients through accelerated clinical research and real-world data," said Kinjal Vora, CEO of Vasta Global. "We are pleased to welcome ApexonHealth and Vasta Global to the Omega family," commented Harsh Nanda, Managing Director and Head of Technology Private Equity within Goldman Sachs Asset Management. "With the acquisitions of Reventics, ApexonHealth, and Vasta Global, Omega now services more than 350 customers spanning the entire healthcare continuum with the support of robust technology-led solutions and insights. Together, we can help our clients enhance the patient experience while improving operational efficiency and strengthen our position as the partner of choice for the healthcare ecosystem." About Omega Healthcare Founded in 2003, Omega Healthcare helps payors, providers, and pharmaceutical companies eliminate administrative burdens, accelerate cash flow, and reduce health management costs while enhancing patient care. The company streamlines medical billing, coding, and collections processes and provides virtual nursing services, including triage, care continuation, clinical documentation improvement, and re-admittance avoidance. Combining the largest medical coding staff in the world with proprietary technology, analytics, and automation capabilities, Omega Healthcare provides the most comprehensive outsourced solutions in the industry and is ranked among the top revenue cycle management business process services by industry analysts. About ApexonHealth Founded in 1996, ApexonHealth provides healthcare-focused digital solutions that combine the best of cutting-edge technology around machine learning, workflow automation, and business process automation to deliver comprehensive services for both providers and payors from revenue cycle management and coding to claims management and advanced analytics. Having helped 80+ healthcare organizations in 14+ years transform their RCM systems, ApexonHealth is actively involved and supports various healthcare bodies like the American Health Information Management Association (AHIMA), American Academy of Professional Coders (AAPC), and more. About Vasta Global Vasta Global offers solutions for data management, clinical research, bioinformatics consulting, and business process outsourcing. With over a decade of experience in cancer research and medical information management, Vasta Global is committed to providing sustainable and scalable solutions for clinical research and bioinformatics needs. The company's information technology and data management solutions streamline and integrate research and patient care workflows while collecting quality data, achieving research goals, and shaping the clinical practice guidelines of tomorrow. About Goldman Sachs Asset Management Bringing together traditional and alternative investments, Goldman Sachs Asset Management provides clients around the world with a dedicated partnership and focus on long-term performance. As the primary investing area within Goldman Sachs, we deliver investment and advisory services for the world's leading institutions, financial advisors and individuals, drawing from our deeply connected global network and tailored expert insights, across every region and market—overseeing more than $2 trillion in assets under supervision worldwide as of December 31, 2021. Driven by a passion for our clients' performance, we seek to build long-term relationships based on conviction, sustainable outcomes, and shared success over time. About Everstone Capital Partners Everstone is a premier investment group focused on cross-border North America – Asia investments and domestic investments in India and Southeast Asia, with assets of ~US$7 billion across private equity, real estate, credit, climate change and green infrastructure, and venture capital. Everstone has a significant resource base across its seven offices in Singapore, India, New York, Mauritius and UAE, comprising best-of-breed investing, operations and strategic resources with extensive skills and experience.

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Spotlight

Ensuring accurate patient identification is critically important to healthcare organizations, yet it has been one of their more challenging goals. The implications of patient misidentification are tremendous, creating a ripple effect of unintended clinical and financial consequences across the entire healthcare system. In late 2017, Health Leaders Media and PSQH conducted a 12 question survey on patient identification to gain industry insight from top hospitals and health systems around the country. With 100 responses from C-level executives, practicing clinicians, and department directors, the results indicated a high priority that positively matching a patient to their records was a top priority heading into 2018.

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