Medicare rules increase out-of-pocket costs of multiple sclerosis drugs

Healthcare Finance | February 07, 2019

Medicare patients with multiple sclerosis face skyrocketing out-of-pocket costs for therapies due to complicated insurance rules that force them to pick up an increasing share of the cost, according to new research. Despite recent efforts to constrain escalating costs, researchers with OHSU and the OHSU/Oregon State University College of Pharmacy in Portland, Oregon found trends in insurance coverage that restrict access and saddle patients with increasing patient costs. The conclusion: Medicare beneficiaries without low-income subsidies can expect to spend $6,894 a year out of pocket for treatment of MS. The authors call the market "dysfunctional," lacking the typical incentives of most other consumer products. There are few incentives for companies to not raise prices because higher prices benefit those in the drug distribution channel, including drug companies.

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HEALTH TECHNOLOGY

VBA Partners With Healthcare Bluebook to Provide Enhanced Reporting of Quality Data for Physicians and Hospitals

Healthcare Bluebook and VBA | September 09, 2022

VBA, a leading-edge healthcare technology company, has teamed up with Healthcare Bluebook to incorporate Quantros quality scores for over half a million physicians and hospitals into its VBAnalytics reporting solution. This move is just one of many exciting enhancements around quality-based care reporting planned in 2022 to make VBAnalytics the premier population health and business insight solution for healthcare payers. VBAnalytics already provides robust analysis and reporting of healthcare utilization and costs and offers insight to help payers make the necessary changes to ensure their health plans are performing effectively. “As the healthcare industry continues to strive for transparency in both cost and quality, the Quantros quality data is essential for our clients to remain competitive. Being able to benchmark their results against millions of healthcare claims from all regions of the country provides invaluable insight to manage their plan performance.” Michael Clayton, President and CEO of VBA With VBAnalytics Value-Based Care Reporting, powered by Quantros, health plans can easily combine cost and quality data to determine which providers are performing the best under their value-based care arrangements. Equipped with this information, payers can make adjustments to their provider networks to ensure that patients have access to the best providers. The Quantros quality scores include important measures of physician and hospital performance including patient safety, complications from a procedure or hospitalization, mortality, and hospital readmissions. Data is combined among multiple providers to create an episode of care, which allows for a more comprehensive view of the patient’s experience. VBA has also integrated Healthcare Bluebook’s online shopping tool within its VBAGateway member portal to make it simple for members to access cost and quality information they need with just a few clicks. “When consumers are equipped with accurate information on cost and quality, everybody wins,” said Clayton. “As consumers become more educated about their healthcare decisions, it will lead to more thoughtful choices that can have a positive ripple effect throughout the healthcare system.” Providing consumers with better information also helps to reduce the overall cost of healthcare for employers, who cover a significant portion of the healthcare costs for their employees. About VBA VBA is a leading-edge healthcare technology company providing comprehensive solutions to the insurance industry. Uniquely delivered on a secure, cloud-based platform, VBA provides a suite of technology solutions for benefits administration, user experience, customer support, business insight and more. About Healthcare Bluebook Healthcare Bluebook's purpose is to protect consumers and companies nationwide from overpriced, low-quality healthcare. Since 2007, Healthcare Bluebook has helped millions of people by making it easy for them to find high-quality care at a Fair Price™.

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HEALTH TECHNOLOGY

Francisco Partners to Acquire bswift from CVS Health

Francisco Partners | October 04, 2022

Francisco Partners a leading global investment firm that specializes in partnering with technology businesses, announced it has signed a definitive agreement to acquire bswift, a leading provider of benefits technology and services, from CVS Health. Founded in 1996, bswift is a provider of software and services that streamline benefits and human resources administration, offering a cloud-based technology platform with best-in-class service. The company combines its deep expertise and passion for technology innovation with strong customer service and a unique consumer-driven approach. bswift helps its partners and employers simplify administration, manage employee benefits, reduce administrative costs, and connect employees with resources needed to achieve their health ambitions. The company serves millions of employees with a single benefit destination across all life events from hire to retire. bswift will continue to partner with CVS Health and Aetna, a CVS Health company, to provide benefits technology to its employees and client base. “CVS Health and Aetna remain committed to bswift and to the clients, partners and members we support in benefits administration. FP’s deep expertise in technology and proven track record in nurturing and growing technology businesses will enable bswift’s loyal base of employees to continue delivering innovative solutions.” Mark Santos, Vice President, Diversified Commercial Solutions at Aetna Since its launch over 20 years ago, Francisco Partners has invested in over 400 technology companies, making it one of the most active and long-standing investors in the technology industry. Francisco Partners has experience in the healthcare and human capital technology market and its investments have focused on companies that provide the best possible products and service for its customers and partners. Francisco Partners also has extensive experience partnering with corporations to execute divisional carve-outs with transactions such as IBM’s Watson Health business (now Merative) and Discovery Inc.’s Discovery Education business. Justin Chen, Partner at Francisco Partners, said, “We are excited to partner with bswift and help the team continue to grow its robust technology and service offerings across benefits and healthcare. bswift is uniquely positioned as a market leader to help employers navigate the evolving industry trends and opportunities to holistically engage employees through health, wellness and financial benefits.” “We appreciate CVS Health’s work in growing this business and are confident that our partnership will help bswift drive crucial focus in executing on organic and inorganic growth strategies,” said Anders Mikkelsen, Vice President at Francisco Partners. “We look forward to supporting the talented employees and management team.” Financial terms of the transaction have not been disclosed. The acquisition is expected to close in the fourth quarter of 2022, subject to the satisfaction of customary closing conditions. Kirkland & Ellis LLP served as legal advisor and Wells Fargo Securities, LLC served as financial advisor to Francisco Partners. CVS Health engaged Fried, Frank, Harris, Shriver & Jacobson LLP and Dechert LLP as legal counsel and Goldman Sachs as exclusive financial advisor. About Francisco Partners Francisco Partners is a leading global investment firm that specializes in partnering with technology and technology-enabled businesses. Since its launch over 20 years ago, Francisco Partners has invested in over 400 technology companies, making it one of the most active and longstanding investors in the technology industry. With approximately $45 billion in capital raised to date, the firm invests in opportunities where its deep sectoral knowledge and operational expertise can help companies realize their full potential. About bswift bswift helps customers change the way their employees perceive and engage with their benefits through a proven blend of adaptive technology, service excellence, and compassionate service. Their intuitive, personalized enrollment experience inspires confidence and connects employees to the resources they need to achieve their personal ambitions. Partnering with enterprises nationwide and serving millions of employees, bswift offers cloud-based technology and services for online enrollment, interactive decision support, ACA compliance reporting and employee engagement.

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HEALTH TECHNOLOGY

Johnson & Johnson Opens State-of-the-Art Science and Technology Campus in San Francisco Bay Area

Johnson & Johnson | September 21, 2022

Johnson & Johnson opened its San Francisco Bay Campus, a state-of-the-art Research & Development facility in the Bay Area, one of the world’s most established global hubs for innovation and entrepreneurship. The nearly 200,000 square-foot facility will house up to 400 employees, more than doubling the R&D presence of Johnson & Johnson in the Bay Area. The campus bridges key scientific and technological capabilities by co-locating Janssen R&D, Johnson & Johnson Innovation and Johnson & Johnson Technology. It will further integrate the Company into the Bay Area innovation ecosystem to strengthen and increase collaborations with innovators to accelerate growth. “Johnson & Johnson’s expanded presence in the Bay Area affirms our commitment to combining science and technology to deliver transformative healthcare solutions. On this campus, our talented teams will use their diverse experience and expertise to tackle society’s greatest health challenges to create a better future for patients.” Joaquin Duato, Chief Executive Officer, Johnson & Johnson The R&D focus at the new site spans Janssen’s therapeutic areas and key functions, including emerging science and technologies for gene and RNA therapies, novel treatments and approaches for retinal and infectious diseases, and advanced data science, including artificial intelligence and machine learning. Co-locating expertise at the site will enable the expansion of the Company’s world-class discovery engine and industry-leading pipeline. “Our new state-of-the-art science facility in the Bay Area will further strengthen our R&D capabilities and transform how we discover, develop and deliver innovative medicines faster and more efficiently. By integrating drug discovery, data science and digital health, we aim to accelerate the growth of our best-in-class portfolio and deliver better health outcomes for people worldwide,” said James Merson, Ph.D., Site Head, San Francisco Bay Campus and Global Therapeutic Area Head, Infectious Diseases, Janssen Research & Development, LLC. The Johnson & Johnson Innovation Center in California has facilitated investments and collaborations to accelerate early-stage healthcare innovation with academic and industry partners in the Bay Area and greater California ecosystem since 2014. The San Francisco Bay Campus, along with the Company’s JLABS @ South San Francisco, will continue to enable the Company to build strong relationships with entrepreneurs, scientists and investors to support and invest in highly differentiated innovations that extend and improve lives everywhere. Additionally, given the convergence of healthcare and technology in the region, the Company will increase its focus on the Johnson & Johnson Technology organization to enhance its ability to create innovative digital solutions to advance human health. Building on Johnson & Johnson’s long-standing commitment to use its expertise and resources to reduce the environmental footprint of its operations, the Bay Area hub is designed as a high-performance green campus, reinforcing the Company’s pledge to be responsible stewards in creating a healthy, more sustainable future. The aim is for the new site to receive Silver Leadership in Energy & Environmental Design (LEED) certification, the most widely used green building rating system in the world. About Johnson & Johnson At Johnson & Johnson, we believe good health is the foundation of vibrant lives, thriving communities and forward progress. That’s why for more than 135 years, we have aimed to keep people well at every age and every stage of life. Today, as the world’s largest and most broadly-based healthcare company, we are committed to using our reach and size for good. We strive to improve access and affordability, create healthier communities, and put a healthy mind, body and environment within reach of everyone, everywhere. We are blending our heart, science and ingenuity to profoundly change the trajectory of health for humanity. About the Janssen Pharmaceutical Companies of Johnson & Johnson At Janssen, we're creating a future where disease is a thing of the past. We're the Pharmaceutical Companies of Johnson & Johnson, working tirelessly to make that future a reality for patients everywhere by fighting sickness with science, improving access with ingenuity, and healing hopelessness with heart. We focus on areas of medicine where we can make the biggest difference: Cardiovascular, Metabolism & Retina; Immunology; Infectious Diseases & Vaccines; Neuroscience; Oncology; and Pulmonary Hypertension. Learn more at www.janssen.com. Follow us at @JanssenGlobal. Janssen Research & Development, LLC is part of the Janssen Pharmaceutical Companies of Johnson & Johnson. About Johnson & Johnson Innovation Johnson & Johnson Innovation LLC works across the pharmaceutical, medical device and consumer health sectors to accelerate early-stage, transformational solutions by catalyzing the best ideas, wherever they are in the world. We do this by harnessing our deep scientific capabilities coupled with a wide range of tools, including customized deal structures, company creation, incubation and startup services, capital investments and other innovative business models that aim to meet the diverse needs of entrepreneurs, scientists, and emerging companies. Our goal is to help life science and health technology innovations thrive through collaboration and partnership with the global ecosystem, so that together we can change the trajectory of human health. About Johnson & Johnson Technology Johnson & Johnson Technology solves big problems in healthcare through technology and digital innovation. Just as doctors use scalpels, we use data science, algorithms, artificial intelligence, robotics, and other digital solutions to transform patients’ lives. From guiding patients through treatment to accelerating vaccine development to enabling employees to work seamlessly from any location, our digital tools infuse our products with novelty, dexterity, and ease.

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HEALTH TECHNOLOGY

AESOP Technology Wins Coveted Place in Mayo Clinic Platform_Accelerate Program to Build Better AI Model for Healthcare

AESOP TECHNOLOGY | August 23, 2022

AESOP Technology announced that they have been accepted into Mayo Clinic Platform Accelerate, a 20-week program that helps early-stage health tech AI startups get market-ready. Participants are selected through a competitive screening process where a panel of Mayo Clinic leaders reviews them from the clinical and operational perspective, led by John Halamka, MD., President of Mayo Clinic Platform. "It's an excellent opportunity for a medical AI startup like us. Data is the fuel from which everything grows into power, and this program provides de-identified patient datasets and tools to help us validate our solutions. This practical experience will help us go even further in developing better products. The fact that we get to be mentored by Mayo Clinic's reputable experts is inspiring." Jeremiah Scholl, the CPO of AESOP Technology 'AESOP', which stands for 'AI-Enhanced Safety of Prescription', is working to make physician data entry easier, faster, and less error-prone using machine learning on 3.2 billion data sets. The company has developed products capable of this. One is RxPrime which detects wrong drug errors by checking if medications match patients' diagnoses, age, and gender. Errors can happen at any stage of the medication-use process, but more than 50% of them occur during the prescribing phase. RxPrime is able to detect potential and unexplained errors in prescriptions and provide optimal recommendations, even for the look-alike-sound-alike medication errors. It offers just-in-time decision support without interfering unnecessarily with the clinical consultation process. The other is AESOP Technology's latest clinical documentation improvement tool, DxPrime, making it easier for doctors to input correct diagnoses into electronic health record systems. This task can be challenging as there are 68,000 different diagnosis codes under the International Classification of Diseases. The ICD codes were designed to support insurance and billing rather than clinical medicine. "Medical professionals are more overwhelmed with their workload after the pandemic. How AI can support them gains more importance," says Jim Long, the CEO of AESOP Technology. "AI is transforming the healthcare industry in a variety of ways, like any other industry. Healthcare has unique challenges, and this program will help us be more grounded." As a participant of the Mayo Clinic Platform_Accelerate, AESOP Technology is glad to expose themselves to real-world applications, which helps cultivate future growth in this rapidly progressing field. As part of the program, Mayo Clinic will take an equity position in the startup. About AESOP Technology AESOP aims to optimize the clinical decision support process with more flexible AI-powered technology to improve patient safety and medical coding quality.

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We are there for you for every generation
We put your needs first and treat you the same way we would treat our own loved ones. Patients who have been coming to us since childhood often return as adults and with children of their own. Our members stay with us because we know how to take care of their medical needs and have the tools and resources to help keep their family healthy today and always

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