Industry Voices 5 things the government should do to clear the path for value based rebate arrangements

Fiercehealthcare | April 24, 2019

In January 2019, the U.S. Department of Health and Human Services (HHS) published a proposed rule that would make sweeping reforms to the safe harbor regulations under the Anti-Kickback Statute (AKS), the federal law that prohibits most payments for referrals of items or services reimbursed by Medicare, Medicaid and other federal healthcare programs.

Spotlight

Idealized Design of Perinatal Care is an innovation project based on the principles of reliability science and the Institute for Healthcare Improvement’s model for applying these principles to improve care. The project builds upon similar processes developed for other clinical arenas in three previous IHI Idealized Design projects.


Other News
FUTURE OF HEALTHCARE

Modivcare Announces Acquisition of Guardian Medical Monitoring

Modivcare Inc. | May 19, 2022

Modivcare Inc. a technology-enabled healthcare services company that provides a platform of integrated supportive care solutions focused on improving patient outcomes, announced the Company’s Remote Patient Monitoring Segment has acquired Guardian Medical Monitoring, LLC from its parent company, Guardian Alarm. Guardian Medical Monitoring is a leading provider of remote patient monitoring solutions to Managed Care Organizations and state Medicaid payors including Personal Emergency Response Systems and medication management. GMM’s RPM platform currently monitors approximately 50,000 aging and chronically ill patients on behalf of their respective payors. “Remote patient monitoring is essential to Modivcare’s mission to connect patients to care through our integrated supportive care platform. Our comprehensive remote patient monitoring offering allows patients to safely age in their homes with technology-enabled connectivity to care which increases patient engagement and reduces costs. We are excited to accelerate the growth of Modivcare’s RPM Segment with the acquisition of GMM, and we are excited to welcome the GMM team to Modivcare.” Daniel E. Greenleaf, Modivcare’s President and Chief Executive Officer Jason Anderson, President, Modivcare Home added, “Guardian Medical Monitoring is a complementary acquisition for Modivcare’s RPM Segment, strengthening our customer relationships and expanding our service footprint across key states. Additionally, this acquisition provides an opportunity to expand our E3 engagement platform across a larger base of members and payors. Modivcare’s E3 platform helps our partners reduce gaps in care and address social determinants of health by engaging, educating, and empowering members using our proprietary platform.” About Modivcare Modivcare Inc. is a technology-enabled healthcare services company that provides a platform of integrated supportive care solutions for public and private payors and their patients. Our value-based solutions address the social determinants of health (SDoH), enable greater access to care, reduce costs, and improve outcomes. We are a leading provider of non-emergency medical transportation, personal care and remote patient monitoring.

Read More

HEALTH TECHNOLOGY

Brainlab Announces the Majority Acquisition of medPhoton

Brainlab | May 13, 2022

Brainlab, a digital medical technology company, announced today the majority acquisition of medPhoton GmbH, a Salzburg, Austria-based company, that develops and manufactures robotic imaging solutions for image guided radiation therapy and surgery. Over the last years, medPhoton has maintained a close partnership with Brainlab in the field of intraoperative imaging. This collaboration resulted in the market launch of the mobile imaging robot, Loop-X®, in 2020. Brainlab strategically invested in medPhoton, co-funded the development of Loop-X and became the exclusive distributor of the mobile imaging robot in the field of surgery. "Through the completion of this majority acquisition, we want to build on the previous success of Loop-X and decisively shape the future of intraoperative imaging. In this way, we can combine and align the entrepreneurial pursuits and innovative potential of both companies. Our united goal is to expand the market position of Loop-X as a 3D imaging device for surgery so that doctors can gain access to cutting edge equipment for patient treatment." Stefan Vilsmeier, President and CEO of Brainlab Loop-X mobile imaging robot is central to the Brainlab robotics portfolio and already part of everyday clinical practice in numerous hospitals worldwide. Loop-X sets new standards in surgery with automated imaging steps and robotic assistance. With the support of Loop-X, surgeons and staff gain flexibility and freedom of movement during surgery through access to high resolution 2D and 3D imaging. The independent movement of the imaging components and collimation capabilities allow non-isocentric imaging. Structures can be covered that are much larger—for example, the pelvis—but, patient tailored imaging now also covers much smaller areas—reducing the radiation volume to where it is needed. Beyond diagnostic imaging, this intelligent robot can capture partial information, “digitizing” anatomical intraoperative changes in order to update a “digital model” of the patient previously generated by aggregating pre-operative images. Heinz Deutschmann, CEO of medPhoton, looks forward to the expansion of the strategic partnership: "From the very beginning, Brainlab believed in the strength of our innovation, creativity and drive in the field of radiotherapy. Through our partnership, Brainlab provided us with significant support as we established our presence in the surgical device market and developed our production capabilities. Moving forward, we will continue to advance the production of Loop-X as well as coordinate research and development efforts to build next-generation systems with the objective of exploring new medical applications to improve surgical procedures and therapies. The majority acquisition by Brainlab is therefore the next logical step for us to achieve our most important goal: to advance research and development work at the highest level and expand the production of best-in-class medical technology to provide efficient therapies with optimal safety for patients." medPhoton will continue to operate as an independent research and development company within the Brainlab Group. Together, Brainlab and medPhoton will explore additional areas of application for the technology including radiotherapy, such as brachytherapy, particle therapy and intraoperative radiation therapy. Both companies will also further expand the capabilities at the medPhoton site in Salzburg, Austria. About Brainlab Brainlab is a digital medical technology pioneer founded in 1989 and headquartered in Munich. The company employs more than 2000 people in 25 locations around the globe. Brainlab serves physicians, medical professionals and their patients in over 6000 hospitals in 121 countries. Brainlab creates software-driven medical solutions that digitize, automate and optimize clinical workflows for neurosurgery, spine, trauma, craniomaxillofacial (CMF), general and vascular surgery as well as radiotherapy and radiosurgery. Core products center around surgical navigation, radiotherapy, digital operating room integration, and information and knowledge exchange. The Brainlab open framework operating system will allow third parties to develop medical applications to further advance the field of spatial computing and mixed reality. Brainlab is dedicated to creating an impact in healthcare. The company connects opportunities from emerging digital technologies to transform healthcare at scale and help improve the lives of patients worldwide. About medPhoton medPhoton develops and manufactures CE marked and FDA cleared medical devices for image guided procedures in surgery and radiation therapy, with a strong focus on particle therapy. Advanced product development centers on innovative, universal solutions for robotic, navigated applications in surgery, interventional radiology, brachytherapy and intraoperative radiation therapy (IORT). The company’s core competencies and patented solutions with X-ray-based imaging chains and algorithms are being customized for system integrators in B2B partnerships worldwide.

Read More

HEALTH TECHNOLOGY

Softheon Expands to Artificial Intelligence in Care Management for Health Plans through Acquisition of NextHealth Technologies

Softheon | July 01, 2022

Softheon, a leading cloud-based eligibility, enrollment, and billing provider for health plans and government agencies, has acquired NextHealth Technologies, an AI-powered SaaS-based healthcare analytics platform. With the acquisition, Softheon will be better able to help health plans sell and deliver efficient, high-quality care through synergies in the companies' respective products and solutions. Health plans cans save tens or even hundreds of millions of dollars on medical and operational costs through Softheon's growing suite of solutions. The acquisition significantly enhances Softheon's talent density, enhancing go-to-market strategies, engineering processes, and leadership. The overall speed and capability of NextHealth's AI solutions will increase through Softheon's propriety technology. Softheon CEO, Eugene Sayan, will continue to lead the company. Eric Grossman, NextHealth's founder, has become the combined organization's Chief Commercial Officer, supporting Sayan's vision and the company's growth objectives. Sayan shared, "Artificial Intelligence in healthcare is here, and we are seeing the incredible impact it can have on both members and carriers. Our goal has been to make healthcare more affordable, accessible, and plentiful, and we see AI as a clear path forward to bring efficiencies to our carrier partners. This acquisition is a testament to Softheon's commitment to helping health plans tackle some of their biggest challenges, such as population health and the movement toward consumerism in healthcare." NextHealth Technologies, founded in 2013, offers a cloud-based platform that utilizes rigorous methodologies and standardized processes to enable health plan customers to identify impactable populations, measure which clinical initiatives work best for whom, and integrate data-driven decisions into the workflow in real-time to derive the highest ROI from their analytics investments. "We are thrilled to be part of Softheon's continued growth and expansion. This is an incredible opportunity for our respective teams. NextHealth's technical and service staff will continue to build and support cutting-edge applications of AI for carrier member populations with the support and resources of a larger company. We see a bright future for our health plan partners as we bring those tools to bear to deliver significant value and reduced costs." shared Grossman Softheon's purchase of NextHealth is expected to bring economies of scale and operating leverage to the combined company. NextHealth investors, Norwest Venture Partners and TT Capital Partners, will become investors in Softheon and expressed excitement on the prospects of the transaction. "Together, NextHealth and Softheon can provide better care at lower medical and administrative costs while advancing the application of AI in healthcare." said Casper de Clercq, General Partner at Norwest Venture Partners. "The acquisition of NextHealth will enhance Softheon's AI capabilities for health plans," said Ryan Engle, partner at TT Capital Partners, "Member data spanning shopping and enrollment through claims creates opportunities for proprietary methodologies to shape member behavior and create value for plans." Softheon has continued its growth and expansion, having completed more than 20 million enrollments since the inception of the Affordable Care Act, through public and private exchange technology. The acquisition comes after the company introduced its first foray into AI by creating a machine learning algorithm that predicts which members are at risk of letting their insurance coverage lapse, as featured in Bloomberg Law. About Softheon Founded in 2000, Softheon's Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon's solutions serve 8 State agencies and over 90 health plans. Issuers and consumers utilizing Medicaid, Medicare, and the ACA Marketplace benefit from Softheon's innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. About NextHealth Technologies NextHealth Technologies, based in Denver, is an AI-powered analytics platform that rapidly optimizes the effectiveness of health plans' cost, quality, and service enhancement initiatives resulting in significantly reduced costs and improved outcomes. Its cloud-based solution utilizes scientifically rigorous methodologies and standardized processes, enabling and promoting a culture of measurement. The platform is HITRUST-certified, scalable, and is deployed with expert services to ensure client adoption and success. Know what works™ and make it better.

Read More

HEALTH TECHNOLOGY

Addison Group Expands Non-Clinical Healthcare Services With Acquisition of Harmony Healthcare

Addison Group | July 11, 2022

Addison Group a national leader in professional services specializing in talent solutions and consulting services, announced the acquisition of Harmony Healthcare a human capital management company providing a diverse range of non-clinical healthcare workforce and consulting solutions nationwide. With healthcare as the third-largest industry in the U.S., this investment comes amid high demands and a continued shortage of non-clinical healthcare workers. Addison and Harmony's combined 28 years of experience in non-clinical healthcare workforce solutions enable health organizations to thrive in an ever-changing environment. The acquisition furthers Addison's position as a national leader in non-clinical healthcare talent resources, recruiting, and consulting services, and Addison's ongoing expansion strategy through organic growth and acquisitions of forward-thinking specialized firms that prioritize client and employee satisfaction. "Addison's consistent growth trajectory is due to our keen understanding of market trends and finding the right solutions for our client's business challenges. As the healthcare industry continues to navigate significant shifts, many organizations are still grappling with talent shortages, cyberattacks, and the rising cost of health services. Our ongoing investment in non-clinical healthcare workforce solutions provides our clients with innovative, accessible, and value-based health system resources. Together with Harmony, we will continue to empower our shared client base with enhanced consultant services within health information technology, reimbursement, and population health." Thomas Moran, CEO of Addison Group "Addison's consultative approach and expansive network of professionals will accelerate our abilities to meet customer demands nationally. Addison's culture focuses on People First, and the vast range of offerings provides our employees and consultants with added career opportunities. We are excited to partner with Addison as we continue our mission to empower healthcare organizations with quality solutions that optimize financial and clinical outcomes while enabling change management required to navigate the rapidly shifting healthcare landscape," said Brandon Martin, President of Harmony Healthcare. Harmony Healthcare will continue to maintain its headquarters in Tampa, Florida. The company's executives and the team will retain their roles with a continued focus on expanding their organization. About Addison Group Addison Group is a leading professional services firm specializing in talent solutions and consulting. Addison Group delivers companies' expertise and talent to achieve and sustain business growth. We offer a full suite of consulting and recruiting capabilities across multiple sectors, including information technology, finance and accounting, non-clinical healthcare, human resources, administrative, and digital marketing. With a growing network of companies, offices across the United States, and deep relationships in regional and local markets, Addison Group is one of the top talent solutions and consulting companies in the US, providing industry-leading expertise with a national reach and a localized touch. Founded in 1999, Addison Group has been repeatedly recognized by the media as one of the fastest-growing private companies in the United States, Forbes' Top 200 America's Best Professional and Specialist Search Firms, America's Best Recruiters and Executive Search Firms, and America's Best Temporary Staffing Firms, SIA Top 100 Staffing Bold Leaders, Inc. Best 100 Places to Work, and Best of Staffing® by ClearlyRated. About Harmony Healthcare Harmony Healthcare, a human capital management company, provides a diverse range of non-clinical staffing and consulting solutions to healthcare organizations nationwide. Harmony Healthcare delivers quality solutions to empower healthcare organization success, enhance clinical and financial outcomes, and enable the transition to value-based healthcare. Harmony Healthcare is a trusted partner to over 300 clients, including 11 of the top 15 largest health systems in the nation, major academic health centers, hospitals, physician practices, payers, 9 of the 15 largest CPA firms, and the federal government. Founded in 2010, Harmony Healthcare is a proud member of several prestigious professional health organizations including ACDIS, HFMA, AHIMA, NCAR, NAHRI, AAHAM, NAHAM, ACHE, AHDI, ACMA, NAHQ, CMSA, and ASHRM.

Read More

Spotlight

Idealized Design of Perinatal Care is an innovation project based on the principles of reliability science and the Institute for Healthcare Improvement’s model for applying these principles to improve care. The project builds upon similar processes developed for other clinical arenas in three previous IHI Idealized Design projects.

Resources