Payer Roundup—Democrats pass resolution to defend ACA against lawsuit

FierceHealthcare | January 10, 2019

The House passed a resolution to defend the Affordable Care Act against a lawsuit challenging the healthcare law on Wednesday. It comes as a standalone package days after another House vote passed a similar measure as part of a larger package. Last month, a federal judge struck down Obamacare, siding with attorneys general from Republican states who filed suit challenging the constitutionality of the law. But the judge later clarified the law should remain in place as his ruling makes its way through the appeals process. The latest move by the House is largely seen as a way for Democrats to force Republicans to vote against the law, framing it as a vote against protections for patients with pre-existing conditions.

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This paper discusses the need for innovative IT solutions for better healthcare. It is part of a series of white papers on key aspects affecting the move toward an Enlightened Healthcare Ecosystem. The other two papers focus on Healthcare Challenges and Trends and the Convergence of Healthcare and Pharma.


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HEALTH TECHNOLOGY

Zynx Health Introduces Complimentary Monkeypox Order Set and Care Plan Bundle

Zynx Health | September 20, 2022

Zynx Health announced that it has published new order set and care plan guidelines to aid clinicians in the treatment of patients diagnosed with monkeypox. Created by the Zynx Clinical Team and based on recommendations from World Health Organization and the Centers for Disease Control and Prevention, the content is available as a single, downloadable PDF on the Zynx Health website. Given the public health emergency, this content is being made available at no cost. “As monkeypox cases continue to rise, and with hospitals still facing shortfalls in the wake of the COVID-19 pandemic, our Zynx clinicians have developed and deployed this comprehensive order set and care plan bundle to alleviate the burden of researching the underlying evidence and then building the associated clinical decision support from scratch,” said Chuck Tuchinda, MD, president of Zynx Health. “The monkeypox content on the Zynx site is comprehensive, evidence-based, and ready for use.” The Zynx Clinical Team will continue to update its monkeypox care guidance as new evidence emerges and best-practice recommendations evolve. About Zynx Health Zynx Health, a market leader in providing evidence- and experience-based clinical improvement solutions since 1996 and part of the Hearst Health network, provides healthcare professionals with vital information and processes that guide care decisions and reduce complexity across the entire patient journey in a way that leads to healthier lives for all. Named the “Best in KLAS” Category Leader for Clinical Decision Support – Care Plans and Order Sets in 2021 and 2022, Zynx is a pioneer and market leader in evidence- and experience-based clinical solutions that help health systems improve patient outcomes, financial outcomes, clinical engagement, and technology performance. With Zynx Health, healthcare organizations exceed industry demands for delivering high-quality care at lower costs under value-based reimbursement models. About Hearst Health The mission of Hearst Health is to help guide the most important care moments by delivering vital information into the hands of everyone who touches a person’s health journey. Each year in the U.S., care guidance from Hearst Health reaches 85% of discharged patients, 205 million insured individuals, 103 million home health visits, and 3.2 billion dispensed prescriptions. The Hearst Health network includes FDB Zynx Health, MCG, Homecare Homebase, and MHK. Hearst also holds a minority interest in the precision medicine and oncology analytics company M2Gen.

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HEALTH TECHNOLOGY

Osmind launches integrated virtual visits, expanding care options for in-demand mental health clinicians

Osmind | September 16, 2022

Osmind, the public benefit corporation helping clinicians and researchers advance life-saving mental health treatment, announced the launch of integrated Zoom Virtual Visits within its technology platform for mental health clinicians. Now clinicians can access both asynchronous and synchronous digital communication tools, all within the Osmind patient app. Virtual visits extend Osmind’s already integrated experience—between clinicians and patients—and generalist and specialist mental health clinicians, making it easier and safer to meet high patient demand. ”The future of mental health care requires omnichannel care where telehealth plays a role in a larger continuum of treatments. As clinicians, we have a professional obligation to only use telehealth platforms that are HIPAA-compliant. Zoom offers a strong product with powerful user experience over alternatives. We are thrilled to partner to offer their industry-leading solution.” Carlene MacMillan, MD and Vice President of Clinical Innovation at Osmind Osmind’s platform today fosters a therapeutic alliance between researchers, psychiatrists, mental healthcare specialists, and the patients they serve. With this launch, Osmind is expanding treatment options for mental health clinicians treating those vulnerable: people with moderate-to-severe mental health conditions, including patients with treatment-resistant depression and anxiety who may not have the ability to leave their homes to commute, or are geographically restricted from in-person visits. Clinicians and patients stay empowered through progress monitoring and journaling tools. This alliance is strengthened with virtual visits, allowing clinicians to create a virtual visit appointment, share that link with the patient, and launch the virtual visit directly from the Osmind app. With Osmind now a part of Zoom’s ISV Partner Program, clinicians can take advantage of Zoom’s secure, HIPAA-compliant video technology without needing to manage additional vendor overhead or requiring patients to install new technology on their phones or computers. The demand for psychiatric care in the U.S. is only growing. In 2019, 47.7% of adults with a serious mental illness reported an unmet need for mental health services in the previous year, according to the U.S. Department for Health and Human Services. “With the integration of Zoom technology and the Osmind EHR, we are together addressing a significant need in healthcare: clinics can now treat the most at-risk patients securely from where they’re most comfortable with a click of a button, revolutionizing access to care,” said Matt Cipolla, ISV Partner Account Manager, Zoom Video Communications. "We are proud to welcome Osmind into our ISV Partner Program to help transform the mental health landscape.” Clinicians need flexibility in service delivery to meet demand and expand access. Patients save time and money from not needing to commute. Clinicians, patients, and caregivers are additionally frequently already familiar with Zoom, making it seamless for parties to log in to their session. About Osmind Osmind is a San Francisco–based public benefit corporation led by scientists, technologists, and psychiatrists to advance new evidence-generating medicine that helps people living with moderate to severe mental health conditions.

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HEALTH TECHNOLOGY

Stellar Health Announces Expansion of Value-Based Care Initiative for Highmark, Inc.

Stellar Health | October 19, 2022

Stellar Health a healthcare technology company changing the way health insurers and providers activate value-based care arrangements, announced the expansion of their value-based care initiative with Highmark Inc. upon results of its initial program that improved quality and chronic condition management across Highmark's Medicare Advantage and Commercial lines of business. Stellar announced the collaboration in 2021 to help Highmark accelerate new payment models and value-based care for independent practices in Pennsylvania. This initiative, called True Performance Lite, was an extension of Highmark's existing True Performance PCP Suite Program aimed at serving larger providers. The True Performance Lite program used Stellar's unique incentive design that rewards providers and staff for completing granular VBC actions focused on quality improvement, management of chronic conditions, reduced ED and inpatient utilization, and affordability of care for Highmark members. The program saw strong results across VBC metrics compared to 2020: The program also saw high engagement and satisfaction across providers involved in the True Performance Lite program. "I wish all health plans had program, it's the easiest of all platforms by far," said Renee Guistwite, Office Manager from Guistwite Family Practice. Cathy, an Office Manager from Dr. Dana E Bragg MD's office says "This app is really easy. Every part is user-friendly and it doesn't take much time now that we have a workflow going. We are really excited about Stellar!" Stellar's web-based, cloud-native, point-of-care application leverages historical patient information to prompt primary care providers and their care teams of gaps and opportunities relating to patients' healthcare regimens for Highmark members. Stellar Health partners with health insurers to enable providers and their staff to engage in these value-based opportunities through the application with granular action recommendations, ensure success in closing gaps, and pairs each action with a financial incentive for the time it takes to complete it. In 2022, Stellar and Highmark expanded the True Performance Lite program into Pennsylvania, West Virginia, and Delaware supporting over 60+ provider groups across multiple lines of business and are continuing to build on the overall momentum and results in 2023. The companies are continuing to innovate on new ways to engage the Highmark network and drive outsized results through several cost and utilization initiatives as they bring the model to new provider profiles. "Our provider-centric model lends itself to the success we have seen with Highmark over the last year as they lead value-based care delivery in the Mid-Atlantic region. We look forward to expanding with multiple lines of business to allow providers who handle all types of coverage to meaningfully participate in VBC and help deliver better primary care for all patients." Michael Meng, CEO of Stellar Health About Stellar Health Stellar Health is a healthcare technology company focused on enabling success across the value-based care continuum by bridging the incentive gap between providers and payors. The Stellar solution is the first point-of-care, cloud-based platform that helps primary care providers continually engage with their patients by providing them real-time information and tangible action-based incentives for improving quality of care. With Stellar, providers can achieve a range of VBC goals, like improving quality scores and optimizing the patient care journey through transitions of care and high-value referrals, all with the objective of improving patient health.

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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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Spotlight

This paper discusses the need for innovative IT solutions for better healthcare. It is part of a series of white papers on key aspects affecting the move toward an Enlightened Healthcare Ecosystem. The other two papers focus on Healthcare Challenges and Trends and the Convergence of Healthcare and Pharma.

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