MedPAC debates what form a Medicare without fee-for-service payment might take

MedPAC | April 05, 2019

MedPAC plans to focus heavily on value-based payment in the coming months, and at its meeting Thursday the commissioners weighed what a Medicare without fee-for-service might look like. Eric Rollins, a principal policy analyst for the Medicare Payment Advisory Commission, outlined several scenarios that could unfold if volume-based payments are further phased out or eliminated entirely.  These models are based on what’s worked and what hasn’t today in accountable care organizations (ACOs) and Medicare Advantage (MA), he said. Both programs have challenges that will need to be addressed if they become the foundation for further work on value-based care. For example, the government actually pays slightly more in MA, he said, and ACO savings have been sluggish—though that is showing signs of changing.

Spotlight

The involvement of patients in their care is a top priority for the NHS, highlighted in the NHS Constitution  and the NHS Five Year Forward View. Healthcare providers are encouraged to develop different relationships with patients and communities to help empower them and engage them in their care. This same approach applies to patient safety in healthcare where greater engagement of patients is seen as one of the building blocks for improvement. Indeed, a checklist for safety improvement produced by the Health Foundation in 2015 includes supporting patients, carers and families to play an active role in patient safety.


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HEALTH TECHNOLOGY

Komodo Health Introduces New Scientific Publications Management Software

Komodo Health | May 12, 2022

Komodo Health announced the launch of Komodo Publications Planning, introducing the next generation of publications planning and management applications for Life Sciences. The automated and highly customizable end-to-end software is designed to make it easier to maximize the impact and outcome of scientific publications and medical communications in an accurate, efficient, and compliant manner. With today’s news, Komodo extends the power of its real-world data and technology for Medical Affairs professionals, offering a comprehensive suite of applications to manage all aspects of publications planning, including a more data-driven approach to engaging with healthcare providers. In order to establish scientific integrity aligned to strategic medical objectives, global Medical Affairs teams are responsible for managing complex publication plans within Life Sciences companies, which can include both pipeline and commercial products or therapeutics with overlapping timelines. Multiple stakeholders need to seamlessly collaborate, provide feedback, and share updates with one another throughout the process, from publication concept through planning, and ultimately, publishing. With out-of-the-box connectors to Altmetric, Office 365, Unpaywall, and the ability to seamlessly integrate and optimize existing technology workflows, Komodo Publications Planning provides the tools to address every aspect of planning, execution, and analysis in a consolidated view to bring speed and ease for Medical Affairs teams. The integrated, user-friendly workflow enhances productivity by helping customers reduce time spent managing tasks to allow more time to focus on producing high-quality publications. For example, Pfizer was seeking a way to evolve and digitize how its publications were managed. The company developed a customized tool with Komodo Publications Planning as its foundation, which allowed Pfizer to roll out one cohesive publications management system that could be leveraged by a variety of stakeholders around the globe, creating a more efficient path for collaborating with authors and third-party agencies. With a consolidated view into its medical and scientific publication plans, Pfizer’s global team can automate the planning process, quickly tracking publication milestones and monitoring study progression using real-time alerts. “Working in partnership with Komodo on designing and building a new publications management system has been an exciting and courageous journey. We were able to realize some of the innovative solutions we wanted to incorporate into our system to advance our publications practice,” Catherine Skobe, MPH, Sr. Director, Publications Innovative Solutions Lead at Pfizer “Legacy publications management applications often require long build cycles and offer limited control; Komodo Publications Planning is helping our customers eliminate the need for multiple, disjointed systems, which often cause timely and costly delays for publishing critical clinical advancements,” said Prasad Kanumury (PK), Mavens founder and General Manager at Komodo Health. “The ability to integrate into existing IT infrastructure is helping Medical Affairs teams to more effectively achieve their scientific objectives and produce timely, journal-accepted publications within a single, customizable solution.” Stemming from the 2021 acquisition, Mavens' integration into Komodo has resulted in a number of new opportunities for enterprise impact. The release of Komodo Publications Planning marks the first new application within Komodo’s Medical Affairs Suite. The Medical Affairs Suite offers end-to-end workflow support on everything from optimizing publications, impact reporting, and clinical education to enabling HCPs with disease burden intelligence and advanced analytic solutions to build comprehensive, measurable, and evidence-based strategies. The suite also allows for strategic engagement opportunities through key expert identification within Komodo’s Aperture application, now with Medical Information Cloud integration, to encourage even more timely, compliant, and trackable clinical interactions. The launch of Komodo Publications Planning coincides with the 18th Annual ISMPP Meeting, where experts from Komodo Health and Pfizer presented about the future evolution of the medical publications ecosystem in a session on May 9th. For more information, visit Komodo Health onsite at booth #14. About Komodo Health Komodo Health is a technology platform company creating the new standard for real-world data and analytics by pairing the industry’s most complete view of patient encounters with enterprise software and machine learning that connects the dots between individual patient journeys and large-scale health outcomes. Across Life Sciences, payer, provider, and developers, we help our customers unearth patient-centric insights at scale — marrying clinical data with advanced algorithms and AI-powered software solutions to inform decision making, close gaps in care, address disease burden, and help the enterprise create a more cost-effective, value-driven healthcare system.

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FUTURE OF HEALTHCARE

Mental Health Provider Meru Health collaborates with Tech-Savvy Health Insurance Company Evry Health To Deliver Outcomes-Based Mental Healthcare

MERU HEALTH | January 18, 2022

Meru Health, the most comprehensive mental health solution in the market with industry-leading outcomes, and Evry Health, a modern business-to-business health insurance company announced today that they will partner on delivering Meru Health's solution to Evry Health's members in Dallas, Texas starting January 2022. The Meru Health online mental health solution will be embedded as part of Evry Health's tailored wellness plans that come at no cost to the employer or their employees. These specialized, optional wellness solutions provide a wide range of resources, tools and rewards that are different from other health insurance plans, including benefits such as mental health support through Meru Health. Members will be recommended to the program based on pre-screening criteria as well as Evry Health's data analysis. For example, if Evry Health receives a claim for cancer screening and oncologist claims, this is a flag to proactively loop the member into Meru Health's mental health program and support cycles. The partnership will focus on delivering outcomes-based mental healthcare and it rewards members for following their personalized care pathways. A member who completes Meru Health's 12-week Therapy program can get up to $100 reward for doing so. "This is a completely new way of delivering mental healthcare and we are proud to partner with Meru Health to together change how the system works," said Chris Gay, Evry Health CEO. "Focusing on outcomes is the way mental healthcare – and healthcare in general – should be delivered now and in the future. We are confident our members will get the best possible value-based care, and see their mental health improve as they go through the Meru Health program." Incentivizing members to take care of their mental health can lead to major cost savings down the line. According to data from BCBS, people with major depression are on average nearly 30 percent less healthy than those without depression. This decrease in overall health translates into increased costs: a depressed person has $6,390 more healthcare costs than nondepressed people every year. Evry Health incentivizes participants to focus on better mental health through its voluntary wellness plans. Rewards are deposited to an Evry Health Reward Card that members use like any other credit card. Meru Health is focused on delivering the best long- and short-term outcomes in the market. After program completion, 75% of people are in depression or anxiety symptom remission and 85% of people show clinically significant improvement, measured on industry standard PHQ-9 (depression) and GAD-7 (anxiety) scales. The Meru Health Program is one of only digital mental health interventions with published research that shows that these treatment gains last 12 months after the end of treatment. "We could not be more excited to partner Evry Health, who is changing health insurance just like we are transforming mental healthcare. Together we can really deliver patient-centric care that ensures that people prioritize their mental health. Health plans and employers would benefit a lot focusing more on outcomes. The question we should be asking is are people getting better and staying better after the treatment? I believe trailblazers like Evry Health will be a role model in the industry to start focusing more on care outcomes." Kristian Ranta, the CEO of Meru Health About Meru Health Meru Health is setting the new standard in mental healthcare with the most comprehensive online solution that combines licensed therapists and psychiatrists, a smartphone-based treatment program, biofeedback training, anonymous peer support, and habit-changing activities for sleep, nutrition, and more. The company is committed to evidence-based care and has published groundbreaking clinical outcomes with Stanford, Harvard, and UC Davis that show promising clinical effectiveness and lasting results. Meru Health offers a convenient, accessible, side-effect-free mental health treatment option in contrast to the standard of care in the U.S. today. Meru Health partners with major health insurance providers like Cigna, Humana, and Moda Health, as well as leading businesses that want to provide best-in-class mental health care for their employees or members. About Evry Health Headquartered in Dallas, Evry Health is not your standard health plan. We're on a mission to make healthcare affordable, transparent and high quality again by providing expanded benefits at an affordable price, lowering premiums by up to 20%. We're building the health insurance we've always wanted for ourselves, with a high-tech, mobile-first experience focused on helping people live better, healthier lives.

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FUTURE OF HEALTHCARE

GTCR Announces Partnership with Kelly McCrann to Form Avryo Healthcare

GTCR | April 22, 2022

GTCR, a leading private equity firm, announced that it has entered into a Leaders Strategy™ partnership with Kelly McCrann to form Avryo Health Services, LLC. Based in San Diego, CA, Avryo Healthcare will seek to acquire companies and assets in the multi-site healthcare services industry as part of a strategy to build a market-leading company, with a focus on utilizing new technologies and operating strategies to enhance patient access and experiences. GTCR, the firm that pioneered The Leaders Strategy™ - finding and partnering with management leaders in core domains to identify, acquire and build market-leading companies through transformational acquisitions and organic growth - will invest in Avryo Healthcare from its Strategic Growth Fund, a private equity fund with $2.0 billion of limited partner capital commitments. Mr. McCrann is serving as Executive Chairman of Avryo Healthcare and will make a substantial investment alongside GTCR. Mr. McCrann has over 30 years of experience in the healthcare services industry. Prior to partnering with GTCR, Mr. McCrann most recently served as Chief Executive Officer of EyeCare Partners, the largest vertically-integrated medical vision services provider in the US. He became CEO of EyeCare Partners in 2016 and significantly grew the company via acquisition and organic growth into the largest business in the industry before completing a successful sale of the company in 2019. Prior to leading EyeCare Partners, Mr. McCrann spent more than 25 years in senior leadership roles across healthcare provider services and payor businesses, including within dental, behavioral health, ambulatory infusion and kidney dialysis. "We are excited to partner with Kelly to build a leading company in the healthcare services industry," said Sean Cunningham, Managing Director and Co-Head of Healthcare at GTCR. "Kelly has an exceptional track record in the multi-site healthcare services space with experience across specialties, including dental and behavioral health, and a history of driving organic, de novo and M&A growth. Kelly's background, industry expertise and strategic vision make him an ideal partner as GTCR commits to build a platform in this attractive industry." "I am thrilled to partner with GTCR to build Avryo Healthcare into a market-leading company in the multi-site healthcare services space. GTCR has deep domain expertise in healthcare, a substantial track record of creatively building platforms in this space, and a long history of backing experienced CEOs and Executive Chairs. With our partnership, Avryo Healthcare is well-positioned to create a compelling platform in healthcare provider services." Mr. McCrann "GTCR's formation of Avryo Healthcare with Kelly is another excellent example of The Leaders Strategy™ and builds on our history of successful investments in multi-site healthcare services and the broader healthcare industry," added John Kos, Managing Director at GTCR. "We are excited to create this multi-site healthcare services platform behind Kelly and are actively looking for companies and assets in the sector, including founder-led and sponsor-backed companies." About GTCR Founded in 1980, GTCR is a leading private equity firm focused on investing in growth companies in the Business & Consumer Services, Financial Services & Technology, Healthcare and Technology, Media & Telecommunications industries. The Chicago-based firm pioneered The Leaders Strategy™ - finding and partnering with management leaders in core domains to identify, acquire and build market-leading companies through transformational acquisitions and organic growth. Since its inception, GTCR has invested more than $20 billion in over 250 companies. For more information, please visit www.gtcr.com. Follow us on LinkedIn. About Avryo Healthcare Avryo Healthcare was formed in April 2022 as a partnership between Kelly McCrann and GTCR. Avryo Healthcare's mission is to build a leading company in the multi-site healthcare provider services industry with a focus on building a company that utilizes new technologies and operating strategies to enhance patient access and experiences. For more information about Avryo Healthcare, please contact (212) 835-7042.

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FUTURE OF HEALTHCARE

SandboxAQ and Mount Sinai Health System Collaborate on Data Protection

Sandbox AQ | March 24, 2022

Sandbox AQ, an enterprise SaaS company leveraging quantum tech and AI, announced a collaboration with Mount Sinai Health System to launch Post-Quantum Cryptography solutions, a broad security technology solution to protect patient data against current and future cybersecurity threats. Sandbox has developed SaaS-based enterprise modules that incorporate the latest encryption protocol standards recently ratified by NIST (National Institute of Standards and Technology). Through Sandbox AQ, Mount Sinai Health System will incorporate PQC protocols into its network to provide increased security for millions of customers and their sensitive data. "Our collaboration with Sandbox AQ propels our security and technology strategies forward, enabling us to deliver advanced, secure cutting-edge products to our patients. Protecting patient data against cyber threats is incredibly important to us." Kristin Myers, Executive Vice President and Chief Information Officer at Mount Sinai Health System and Dean for Information Technology at Icahn School of Medicine at Mount Sinai "Quantum technology will quickly render today's RSA-based encryption obsolete, which is why it's imperative that we protect the world's sensitive data now against the next generation of cyberattacks," said Jack D. Hidary, CEO of Sandbox AQ, which officially launched today. "Mount Sinai is one of the first healthcare systems planning to implement PQC protocols into its health network to protect its customers and transform its business. We look forward to collaborating with them on this project." About SandboxAQ Sandbox AQ is an enterprise SaaS company delivering solutions at the nexus of quantum tech and AI. Based in Palo Alto, the inspiration for Sandbox AQ and some of the team originated at Alphabet Inc. in 2016. Sandbox AQ launched as an independent, venture-backed entity in 2022. About Mount Sinai Health System The Mount Sinai Health System is New York City's largest academic medical system, encompassing eight hospitals, a leading medical school, and a vast network of ambulatory practices throughout the greater New York region. We advance medicine and health through unrivaled education and translational research and discovery to deliver care that is the safest, highest-quality, most accessible and equitable, and the best value of any health system in the nation. The Health System includes approximately 7,300 primary and specialty care physicians; 13 free-standing joint-venture centers; more than 410 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island; and more than 30 affiliated community health centers. The Mount Sinai Hospital is ranked in U.S. News & World Report's "Honor Roll" of the top 20 U.S. hospitals and among the top in the nation by specialty: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Urology, and Rehabilitation. Mount Sinai Kravis Children's Hospital is ranked in U.S. News & World Report's "Best Children's Hospitals" among the country's best in four out of 10 pediatric specialties. New York Eye and Ear Infirmary of Mount Sinai is ranked among the Top 20 nationally for ophthalmology. The Icahn School of Medicine at Mount Sinai is one of three medical schools that have earned distinction by multiple indicators: ranked in the top 20 by U.S. News & World Report's "Best Medical Schools," aligned with a U.S. News & World Report "Honor Roll" Hospital, and No. 14 in the nation for National Institutes of Health funding. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and top five globally, and Mount Sinai Morningside as top 20 globally, and "The World's Best Specialized Hospitals" ranks Mount Sinai Heart as No. 1 in New York and No. 4 globally and the Division of Gastroenterology as No. 3 globally, and the Division of Pulmonary Medicine as No. 6 globally.

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Spotlight

The involvement of patients in their care is a top priority for the NHS, highlighted in the NHS Constitution  and the NHS Five Year Forward View. Healthcare providers are encouraged to develop different relationships with patients and communities to help empower them and engage them in their care. This same approach applies to patient safety in healthcare where greater engagement of patients is seen as one of the building blocks for improvement. Indeed, a checklist for safety improvement produced by the Health Foundation in 2015 includes supporting patients, carers and families to play an active role in patient safety.

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