Humana, NQF argue COVID-19 spotlights need for population health evolution

Humana, NQF | April 22, 2020

The COVID-19 pandemic is putting a spotlight on why it’s critical for population-based models to consider the impacts of patients’ social needs, experts say. William Shrank, M.D., chief medical officer at Humana, and Shantanu Agrawal, M.D., CEO of the National Quality Forum, co-authored an analysis this week that argues social risks should be weighed alongside clinical risks in population-based payment models. Shrank said that the coronavirus pandemic is further highlighting the impact of the social determinants of health, especially as people with social needs are particularly vulnerable. As such, Humana has adapted its population health strategy to meet those concerns, he said.

Spotlight

This memorandum summarizes the Office of the Actuary’s estimates of the financial and coverage effects through 2026 of selected provisions of the “American Health Care Act of 2017” (H.R. 1628), which was passed by the House on May 4, 2017 and which is referred to in this memorandum as the AHCA. Included are the estimated impacts on net Federal expenditures, health insurance coverage, Medicaid enrollment and spending by eligibility group, gross and net premiums and out-of-pocket costs in the individual market, total National Health Expenditures, and the financial status of the Medicare Hospital Insurance (HI) trust fund.


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FUTURE OF HEALTHCARE

Aatru Medical, LLC Completes Acquisition of Key Supplier Exothermix

Aatru Medical | April 28, 2022

Aatru Medical is pleased to announce the acquisition of Exothermix, the inventor and supplier of the unique mode-of-action component in the NPSIMSTM incisional management negative pressure system. Exothermix is an innovation company with patented technology and manufacturing of simple, fast, and safe oxygen scavengers with various uses including on-demand self-heating solutions that serve the medical, military, beauty, and personal care markets with these customized products. “We are very pleased to join the Aatru family. The resulting synergies allow us to not only continue to be a key component supplier to Aatru Medical, but this also allows us to continue to develop and to manufacturer industry-changing products for our existing and future customers.” Daniel Hancock, who will remain as President of Exothermix The full Exothermix management and staff will remain in place in the College Station, TX facility and continue to service existing customers. Aatru Medical President Edward Armstrong noted, “The acquisition brings together two innovative technologies and business cultures, which provides a stronger platform for future growth, through accelerated product development and the seamless integration of our supply chain.” Aatru Medical, LLC is a privately-owned medical device company located in Cleveland, OH. The company’s recently FDA-cleared NPSIMSTM is a pre-assembled, single use solid-state negative pressure system for surgical incision management.

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FUTURE OF HEALTHCARE

Dalrada Accelerates Its National Healthcare Model With Acquisition of Watson Rx Solutions

Dalrada Corporation | June 09, 2022

Dalrada Corporation announced that it had acquired the pharmacy, Watson Rx Solutions, Inc. The move highlights Dalrada’s aggressive growth plans within the healthcare sector and paves the way for a total end-to-end total healthcare solution. Adding the 10-year-old pharmacy to Dalrada Health’s comprehensive model expands the subsidiary’s synergies with potential opportunities across its products and services portfolio and offers another solution to meet patient requirements. Dalrada envisions a comprehensive healthcare solution for all Dalrada Health clients with unique offerings that will now include: a pharmacy to facilitate prescription processing, physicians and clinicians at treatment clinics, expanding into telemedicine, engagement of Dalrada-owned testing facilities and laboratories, and utilization of Company-specific technologies to facilitate immediate growth of the business. “Watson Rx has a long history of providing excellent pharmacy services. This acquisition allows Dalrada to expand its healthcare footprint and continue to build a total health management solution on an already successful turnkey operation. As a result, the Company will be able to successfully address the health needs of even more patients.” CEO and Founder, Brian Bonar Through comprehensive prescription management, education, nursing, and total health management, Watson Rx Solutions' leadership team holds more than six decades of combined experience in various complex pharmacy disease states and retail services, always putting patients first. Dalrada plans on entering the pharmaceutical space with an accelerated strategic plan to leverage the Company’s existing capabilities. Research reveals that the U.S. online and mail-order sales of drugs, health, and beauty aids were valued at 75.5 billion USD in 2020. Additionally, E-commerce pharmaceutical sales and beauty aids increased from 51.7 billion USD the year prior. Online, E-commerce, and mail-order sales increased from around 31 to 38 percent during the same period. Pharmacy and drug store sales reached 300 billion USD in 2020, with over-the-counter (OTC) medication accounting for over 36 billion USD in sales during the same year, the highest-selling year to date for the OTC segment. Dalrada and its subsidiaries provide value by making timely and impactful products and services available within health, technology, and clean energy markets. About Dalrada Dalrada Corporation drives innovation that positively impacts people, businesses, and the planet. With subsidiaries that are firmly positioned in the world’s top three-growing industries of healthcare, clean energy, and technology, Dalrada creates solutions that are sustainable, affordable, and accessible. The company works continually to produce disruptive products and services that accelerate positive change for current and future generations. Dalrada’s global solutions directly address climate change, post-pandemic gaps in the healthcare industry, and technology solutions for a new era of human behavior and interaction, ensuring a bright future for the world around us.

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FUTURE OF HEALTHCARE

Ensemble Health Partners, in Partnership with Caduceus Capital Partners, Leads Series A Round for Janus Health

Ensemble Health Partners | December 15, 2021

Ensemble Health Partners, in partnership with Caduceus Capital Partners, led the $8 million Series A capital raise for Janus Health, a revenue cycle automation and decision support platform. Billions of dollars are left uncollected annually by healthcare providers due to poor methods and inconsistent human decision making in the revenue cycle process. Janus Health studies end-user behavior within the revenue cycle and uses advanced AI to determine the optimal path for each workflow. Janus then automates processes and end-to-end workflows using its scalable platform and delivers real-time predictive recommendations to guide human worker performance. “I invest in people first. I’ve known Brendan for a long time, and he has assembled an incredible team who are experts in the field. We see a lot of technology fads in healthcare, but I am always most concerned with delivering value and creating a meaningful impact for our clients and associates. As someone deeply entrenched in the revenue cycle world, I see tremendous potential for Janus to deliver on both fronts.” Judson Ivy, Founder, President and CEO, Ensemble Health Partners “Several factors, including labor shortages, shrinking reimbursements and more stable IT environments, are creating a ripe opportunity to transform the revenue cycle with artificial intelligence and automation,” said Brendan Downing, co-founder and CEO of Janus Health. “Janus Health offers a timely service that can have a significant impact for health systems struggling with these rising costs-to-collect and reimbursement challenges.” Health systems continue to struggle with a workforce shortage and lack of resources. A recent McKinsey & Company study showed that $180 billion could be saved in healthcare administration and finance costs with automated technology. Many health systems do not currently have revenue cycle automation, but plan to implement this technology in the next year. With Janus Health, managers and executives receive actionable insights into people, productivity and practices, allowing them to optimally allocate and manage resources. “The revenue cycle in healthcare is notoriously challenging. Billing and collections are especially complicated when you consider the various payors and parties involved in a transaction,” said Dave Vreeland, senior managing partner at Caduceus Capital Partners. “This area is one of the most labor-intensive in healthcare, and there is a huge opportunity for Janus to make a difference in the industry.” Jim Gaffney, EVP, strategy and corporate development at Ensemble Health Partners and Sue Tyler, venture partner at Caduceus Capital Partners will serve on the Janus Health board of directors. About Ensemble Health Partners Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. The company offers end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country. About Caduceus Capital Partners, LLC Caduceus Capital Partners is a venture capital and private equity company focused on early-stage digital health investments. The Caduceus Capital Partners investment model actively supports portfolio companies from the first check to the exit phase with operational expertise and network access to potential customers and partners. About Janus Health Technologies Janus Health is leapfrogging the automation solutions of today by developing the only end-to-end process improvement platform that studies a revenue cycle operation to determine the optimal path of each workflow and rapidly builds intelligent automation and decision support with a single-click.

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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

This memorandum summarizes the Office of the Actuary’s estimates of the financial and coverage effects through 2026 of selected provisions of the “American Health Care Act of 2017” (H.R. 1628), which was passed by the House on May 4, 2017 and which is referred to in this memorandum as the AHCA. Included are the estimated impacts on net Federal expenditures, health insurance coverage, Medicaid enrollment and spending by eligibility group, gross and net premiums and out-of-pocket costs in the individual market, total National Health Expenditures, and the financial status of the Medicare Hospital Insurance (HI) trust fund.

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