Most hospitals would likely benefit from third-party liability insurance coverage, says ERI

Healthcare Finance | January 25, 2019

Most hospitals would likely benefit from third-party liability insurance coverage, says ERI
Citing dramatically increased costs and concurrent drops in insurance reimbursement, an article published by Emergency Recovery Inc. in its Rev Cycle Quarterly publication laid out a case for most U.S. hospitals to secure third party liability coverage, or TPL, describing what Celler Organization and Celler Law founder Bobbie Celler called the "genesis of a perfect financial storm." TPL reimbursements can recoup as much as 100 percent of charges levied, if handled correctly. And they pay double commercial rates and more than triple governmental plan rates. It's an alternate reimbursement stream that would seem to be a bulwark against bankruptcy and financial ruin.

Spotlight

The U.S. is the largest health-care spender in the world, but that doesn't actually translate into better health outcomes for Americans. Dr. Clay Johnston, Dean of the Dell Medical School at The University of Texas at Austin, explains why.


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FUTURE OF HEALTHCARE

Virtua Health and Medtronic Share Plans to Reimagine Traditional Health Care Models

Virtua Health | December 16, 2021

Virtua Health and Medtronic plc announce a five-year partnership focused on improving delivery of quality care for residents of South Jersey, particularly those who reside in underserved communities or face systemic barriers to care. Medtronic LABS, an independent impact-focused organization funded by Medtronic plc, will simultaneously launch a separate pilot collaboration with the Cherry Hill Free Clinic and Virtua to address care and food access for people with chronic conditions – the first U.S.-based initiative for Medtronic LABS. "I truly believe technology is the path forward to improving human welfare," said Geoff Martha, Chairman and CEO of Medtronic. "This new partnership and collaboration demonstrate the opportunity to use technology to tackle health challenges in a localized, grassroots way. By taking a data-informed approach, we can help improve access and outcomes for patients with chronic conditions in southern New Jersey." "This partnership presents a significant opportunity to accelerate health equity and better outcomes for individuals and families in our community. Together, we will apply the latest research and innovation to the fundamentals of community-based care, allowing us to identify and empower those who need support to achieve the best-possible quality of life." Dennis W. Pullin, FACHE, president and CEO of Virtua Health The scope of the partnership includes the following projects and will expand over time. Heart Health: Medtronic plc and Virtua Health will develop a program to optimize care for hospital patients diagnosed with heart failure, with a focus on slowing the progression of the disease and enhancing the experience of both patient and provider. By employing Medtronic's data-driven, decision-support tools, Virtua clinicians will provide ongoing resources post-hospitalization, minimizing the likelihood of readmission and creating sustainable, enriching solutions for the individual. Outpatient Care Continuity: The partnership will also optimize patient care in high-value outpatient settings, including ambulatory surgery centers. Additionally, Medtronic plc and Virtua will expand Virtua's hospital at home program, which is due to launch officially in early 2022 and aims to reduce the resource-strain on the health system while allowing eligible patients to heal from the comfort of home. Medtronic LABS' collaboration intends to address population health in the following ways: Community Health and the Cherry Hill Free Clinic: Community health workers and clinicians at the Cherry Hill Free Clinic will utilize Medtronic LABS' digital health platform, extending their reach through mobile tools and point-of-care diagnostics. Those identified as having (or being at risk for) chronic illnesses, such as Type 2 diabetes or hypertension, will then connect to the Cherry Hill Free Clinic for follow-up care. Over time, the platform will become more sophisticated and specific as the data accumulates and reveals localized trends and challenges. Food Access: Medtronic LABS will also support Virtua's Eat Well food access programs, specifically the Food Farmacies located inside Virtua Mount Holly Hospital and the Virtua Health & Wellness Center – Camden. Medtronic LABS and Virtua will identify those at risk for food insecurity – due to financial circumstances or limited health literacy – and connect them to free food, nutrition education, and social-work services. "I am honored that Medtronic LABS and Virtua recognize the essential services we provide at the Cherry Hill Free Clinic, and that they are combining their resources and expertise toward enhancing continuity of care for existing and prospective patients," said Jubril Oyeyemi, MD, founder and chief medical officer of the Cherry Hill Free Clinic. "The CDC estimates that 20 percent of Camden County residents do not have health insurance. By creating pathways to care, we build healthier communities." "Medtronic LABS has trained more than 2,000 health workers and provided screenings to more than a million people worldwide. To date, we have focused our efforts on communities in Kenya, Ghana, India, and the Philippines, which is why we are thrilled to partner with Virtua Health on our first U.S.-based endeavor," said Ruchika Singhal, vice president of Medtronic LABS. "In time, this collaboration will create scalable, replicable improvements to the care-delivery model while advancing health and wellness on an individual level." About the Partners Medtronic: Bold thinking. Bolder actions. We are Medtronic. Medtronic plc, headquartered in Dublin, Ireland, is the leading global healthcare technology company that boldly attacks the most challenging health problems facing humanity by searching out and finding solutions. Our Mission — to alleviate pain, restore health, and extend life — unites a global team of 90,000+ passionate people across 150 countries. Our technologies and therapies treat 70 health conditions and include cardiac devices, surgical robotics, insulin pumps, surgical tools, patient monitoring systems, and more. Powered by our diverse knowledge, insatiable curiosity, and desire to help all those who need it, we deliver innovative technologies that transform the lives of two people every second, every hour, every day. Expect more from us as we empower insight-driven care, experiences that put people first, and better outcomes for our world. In everything we do, we are engineering the extraordinary. Medtronic LABS is an independent, non-profit structure with multiple entities including an operating foundation, a social business, an in-country non-profit, and for-profit subsidiaries. Medtronic LABS is setting out to design the health system of the future: one that is equitable, tech-enabled, and patient-centered. To date, Medtronic LABS has screened more than 1M patients and improved clinical outcomes for over 35K patients in Kenya, Ghana, India, and the Philippines. Virtua Health is an integrated health care system and the trusted partner for personalized health care and wellness for communities in southern New Jersey. With more than 280 locations and 14,000 colleagues, Virtua provides high-quality care with more than two million annual encounters across the full range of community and tertiary health services – from preventive care to urgent care through specialty services in cancer, women's health, neuroscience, and orthopedics to complex minimally invasive cardiac surgery and organ transplantation. Performing more than 175,000 surgeries at its hospitals and network of ambulatory centers, Virtua is one of the largest providers of surgery in the state. As a not-for-profit leader, Virtua continues to improve social determinants in health and has distributed more than 160,000 pounds of fresh produce in underserved areas to address food insecurity. Virtua is advancing important partnerships into the future to help you be well, get well, and stay well. Cherry Hill Free Clinic (CHFC) is an independent 501(c)(3) with the mission of providing free primary care to the uninsured and under-insured. CHFC is supported by Virtua Health, which provides lab, radiology and, in some cases, specialty care to CHFC patients.

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HEALTH TECHNOLOGY

Texas Children's Hospital And Baylor College of Medicine COVID-19 Vaccine Technology Secures Emergency Use Authorization In India

Texas Children Hospital | December 29, 2021

Texas Children's Hospital and Baylor College of Medicine announced today that CORBEVAX™, a protein sub-unit COVID-19 Vaccine, whose technology was created and engineered at its Center for Vaccine Development (CVD), has received Emergency Use Authorization (EUA) approval from the Drugs Controller General ofIndia(DCGI)to launch inIndiawith other underserved countries to follow. Dubbed "The World's COVID-19 Vaccine", it uses a traditional recombinant protein-based technology that will enable its production at large scales making it widely accessible to inoculate the global population. The initial construct and production process of the vaccine antigen was developed at Texas Children's Hospital CVD, led by co-directors Drs. Maria Elena Bottazzi and Peter Hotez and in-licensed from BCM Ventures, Baylor College of Medicine's integrated commercialization team, to Hyderabad-based vaccine and pharmaceutical company Biological E. Limited (BE). CORBEVAX™ after completing two Phase III clinical trials involving more than 3000 subjects was found to be safe, well tolerated and immunogenic: CORBEVAX™ demonstrated superior immune response in comparison with COVISHIELD™ vaccine when assessed for Neutralizing Antibody (nAb) Geometric Mean Titers (GMT) against the Ancestral-Wuhan strain and the globally dominant Delta variant. CORBEVAX™ vaccination also generated significant Th1 skewed cellular immune response. CORBEVAX™ nAb GMT against Ancestral-Wuhan strain is indicative of vaccine effectiveness of >90% for prevention of symptomatic infections based on the Correlates of Protection assessment performed during Moderna and Astra-Zeneca vaccine Phase III studies. CORBEVAX™ nAb GMT against the Delta strain indicates a vaccine effectiveness of >80 percent for the prevention of symptomatic infections based on published studies. While none of the subjects who took CORBEVAX™ or COVISHIELD™ had serious adverse events, CORBEVAX™ had 50 percent fewer adverse events than COVISHIELD™. In the continuous monitoring of phase II studies, CORBEVAX™ showed high persistence of immune response as indicated by <30% drop in nAb GMT till 6 months second dose as compared to >80% drop observed with majority of the vaccines. "Protein-based vaccines have been widely used to prevent many other diseases, have proven safety records, and use economies of scale to achieve low-cost scalability across the world," said Dr. Maria Elena Bottazzi, Professor and Associate Dean of the National School of Tropical Medicine at Baylor and Co-Director of the Texas Children's Hospital Center for Vaccine Development. "Our decade-long studies advancing coronavirus vaccine prototypes has led to the creation of this vaccine, which will fill the access gap created by the more expensive, newer vaccine technologies and that today are still not able to be quickly scaled for global production." The need for safe, streamlined, low-cost vaccines for middle- to low-income countries is central to the world's fight against the COVID-19 pandemic. Without widespread vaccination of populations in the Global South, additional virus variants will arise, hindering the progress achieved by currently available vaccines in the United States and other Western countries. "This announcement is an important first step in vaccinating the world and halting the pandemic. Our vaccine technology offers a path to address an unfolding humanitarian crisis, namely the vulnerability the low- and middle-income countries face against the delta variant," said Dr. Peter Hotez, Professor and Dean of the National School of Tropical Medicine at Baylor and Co-Director of the Texas Children's Hospital Center for Vaccine Development. "Widespread and global vaccination with our Texas Children's-Baylor-BE vaccine would also forestall the emergence of new variants. We have previously missed that opportunity for the alpha and delta variant. Now is our chance to prevent a new global wave from what might follow." "Over the years, we have worked to make quality vaccines and pharmaceutical products accessible to families around the world. With this as our backdrop, we resolved to develop an affordable and effective COVID-19 vaccine. It has now become a reality. We deeply appreciate Texas Children's Hospital Center for Vaccine Development, Baylor, CEPI, the Bill and Melinda Gates Foundation, and the government of India for their continuous support and cooperation during this journey. The combined efforts & unceasing support demonstrate that we can collectively overcome any challenge". Mahima Datla, Managing Director, Biological E. Limited ABOUT TEXAS CHILDREN'S HOSPITAL Texas Children's Hospital, a not-for-profit health care organization, is committed to creating a healthier future for children and women throughout the global community by leading in patient care, education and research. Consistently ranked as the best children's hospital in Texas, and among the top in the nation, Texas Children's has garnered widespread recognition for its expertise and breakthroughs in pediatric and women's health. The hospital includes the Jan and Dan Duncan Neurological Research Institute; the Feigin Tower for pediatric research; Texas Children's Pavilion for Women, a comprehensive obstetrics/gynecology facility focusing on high-risk births; Texas Children's Hospital West Campus, a community hospital in suburban West Houston; and Texas Children's Hospital The Woodlands, the first hospital devoted to children's care for communities north of Houston. The organization also created Texas Children's HealthPlan, the nation's first HMO for children; has the largest pediatric primary care network in the country, Texas Children's Pediatrics; Texas Children's Urgent Care clinics that specialize in after-hours care tailored specifically for children; and a global health program that's channeling care to children and women all over the world. Texas Children's Global Health program leads efforts that advance health care equity through innovative collaboration in care, education and research for underserved populations globally. Texas Children's Hospital is affiliated with Baylor College of Medicine. ABOUT TEXAS CHILDREN'S HOSPITAL CENTER FOR VACCINE DEVELOPMENT Texas Children's Hospital Center for Vaccine Development is one of the leading vaccine development centers in the world. Established in Washington DC as the Sabin Vaccine Institute Product Development Partnership (PDP) in the year 2000 and after relocating to the Texas Medical Center in 2011, it rebranded as Texas Children's Center for Vaccine Development. For the past two decades it has acquired an international reputation as a non-profit PDP, advancing vaccines for poverty-related neglected tropical diseases (NTDs) and emerging infectious diseases of pandemic importance. In addition, it builds and strengthens capacity for vaccine development locally and with foreign nations and leads global efforts to guide and influence vaccine policy and advocacy through "vaccine diplomacy" as an international bridge for peace and vaccine development capacity. ABOUT BCM VENTURES Baylor College of Medicine Ventures is the commercial engine of the health sciences university, created to support the translation of academic knowledge and intellectual assets for the benefit of society. We do this by engaging university innovators, entrepreneurs and industry to fully develop ideas along their best commercial path. We foster a culture of commercialization and engage with industry to identify market opportunities for collaborative ventures. ABOUT BIOLOGICAL E. LIMITED Biological E. Limited (BE), a Hyderabad-based Pharmaceuticals & Biologics Company founded in 1953, is the first private sector biological products company in India and the first pharmaceutical company in Southern India. BE develops, manufactures and supplies vaccines and therapeutics. BE supplies its vaccines to over 100 countries and its therapeutic products are sold in India and the USA. BE currently has 8 WHO-prequalified vaccines in its portfolio. In recent years, BE has embarked on new initiatives for organisational expansion such as developing generic injectable products for the regulated markets, exploring synthetic biology and metabolic engineering as a means to manufacture APIs sustainably and developing novel vaccines for the global market.

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HEALTH TECHNOLOGY

PulsePoint Releases Next Generation Health Media Platform With Advanced Automation And AI

PulsePoint | July 06, 2021

PulsePoint, a technology company revolutionizing health decision-making in real-time, today announced the next generation launch of its digital media buying platform, Life by PulsePoint™. Its enhanced AI and automation simplifies and supercharges the media planning, activation, and optimization processes. Designed for the self-serve programmatic trader, these updates promote efficiencies and surface predictive and in-flight campaign analytics for quick strategic decisioning to yield higher media return on investment. Built upon PulsePoint's extensive data foundation, Genome™, that proactively uses microdata to capture attention when intent is signaled, Life is the leading healthcare end-to-end programmatic platform. Life's automated machine learning and AI allows marketers to quickly create highly-customized segments that classify populations in real-time, and deliver sequential messaging to drive customer actions in the moment and across the health journey. This next generation of the Life platform includes: • Advanced media planning innovations: Life offers an AI-powered forecasting tool used to run simulations to generate predictive performance metrics and intelligent audience insights. This makes it easier for marketers to preview budgets and ideate and adjust tactics to obtain their desired campaign outcomes, all before a single dollar is spent. Each forecast is powered by detailed supply and channel insights, like expected delivery, and campaign performance can be viewed by a variety of dimensions, including creative types, domains/apps, condition categories, healthcare professional specialties, geographies, among others. • Better campaign management with advanced dashboard: An automated and real-time view of line item performance and pacing gives traders a deeper, more granular look into their campaigns, making it easier for them to optimize their spend based on flight delivery and anticipate new incremental opportunities. The dashboard not only surfaces key numbers, but it also includes dynamic performance charts to uncover real-time campaign insights. • Turnkey PMP (private marketplaces) deal builder: Enhanced with turnkey end-to-end functionality, self-serve traders can now enable the deals that they negotiated directly with publishers and/or SSPs through Life's UI, decreasing the time it takes to launch PMPs. "Life was built for the healthcare marketer to simplify and optimize marketing campaigns," said Andrew Stark, CRO of PulsePoint. "Our newest capabilities increase efficiencies through advanced forecasting and real-time performance optimization, enabling more control and enhanced campaign management." Life by PulsePoint provides access to over 110 billion daily impressions across more than 2 million health pages, reaching 1.8M+ opted-in, verified healthcare professionals and over 90% of the online U.S. population. This release is just another step in PulsePoint's journey to deliver personalized messaging at each stage of the health journey using predictive insights built on real-time data. The company was recently acquired by Internet Brands, a KKR portfolio company and owner of WebMD Health Corp. PulsePoint's teams will continue to operate as their own division from their existing hubs in New York, San Francisco, and London. About PulsePoint PulsePoint is a leading technology company that uses real-world data in real-time to optimize campaign performance and revolutionize health decision-making. Leveraging proprietary datasets and methodology, PulsePoint targets healthcare professionals and patients with an unprecedented level of accuracy—delivering unparalleled results to the clients we serve.

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INSURANCE

Exela Expands PCH Global Solution with Leading Healthcare Insurer

Exela Technologies | January 12, 2022

Exela Technologies, Inc. (“Exela”)today announced that it continues to expand its relationship with a leading health insurance organization that spans almost two decades. This customer continues to accelerate deployment of Exela’s PCH Global platform to speed up their digital transformation and improve both the member and provider experience. The latest expansion is valued at $6.2 million of additional contract value revenue. Exela continues to invest in expanding PCH Global’s capabilities to provide a cloud hosted solution with one of the best edit resolutions for healthcare claims. This extension of deployment marks another milestone in the value proposition of the PCH Global platform to digitally connect members, providers and insurance companies to enable clean claims, payment transparency and digital appeals. PCH Global’s cloud network also offers increased scalability, the highest uptime and best business continuity protections. PCH Global has robust data analytics which are continually improving as Exela processes more and more data. Additionally, PCH Global’s improved data analytics can be accessed via a self-service model. “We are proud of our long standing partnership and privileged to be part of customer’s digital transformation journey. Adoption of our PCH Global platform continues to address healthcare industry’s goal to deliver most efficient, cost effective and best healthcare to the members.” Suresh Yannamani, President of Exela About Exela Technologies Exela Technologies is a business process automation (BPA) leader, leveraging a global footprint and proprietary technology to provide digital transformation solutions enhancing quality, productivity, and end-user experience. With decades of experience operating mission-critical processes, Exela serves a growing roster of more than 4,000 customers throughout 50 countries, including over 60% of the Fortune® 100. Utilizing foundational technologies spanning information management, workflow automation, and integrated communications, Exela’s software and services include multi-industry, departmental solution suites addressing finance and accounting, human capital management, and legal management, as well as industry-specific solutions for banking, healthcare, insurance, and the public sector. Through cloud-enabled platforms, built on a configurable stack of automation modules, and over 17,500 employees operating in 23 countries, Exela rapidly deploys integrated technology and operations as an end-to-end digital journey partner.

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Spotlight

The U.S. is the largest health-care spender in the world, but that doesn't actually translate into better health outcomes for Americans. Dr. Clay Johnston, Dean of the Dell Medical School at The University of Texas at Austin, explains why.

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