Payer Roundup—Maine's new governor rejects state’s planned Medicaid work requirements

FierceHealthcare | January 24, 2019

Newly instated Maine Gov. Janet Mills has rejected work requirements in the state’s Medicaid program, which were requested by her predecessor and approved by the Centers for Medicare & Medicaid Services. The waiver request submitted by former Gov. Paul LePage was approved on Dec. 21 shortly before he left office. Mills sent a letter to CMS saying that Maine would not implement the changes approved in the waiver and would instead offer job training and other supports to enrollees in its MaineCare program. The state’s Acting Commissioner of Health and Human Services Jeanne Lambrew noted that Maine is facing a workforce shortage, which could be exacerbated if people lose access to crucial care, such as coverage for mental healthcare or substance abuse treatment.

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FUTURE OF HEALTHCARE

Skylight Health Announces Series A Preferred Stock Cash Dividend

Skylight Health Group | December 14, 2022

Skylight Health Group Inc. a healthcare platform combining technology and analytics focused on transitioning patients into value based care to drive better health outcomes and experiences in the United States, announced that its Board of Directors has authorized, and the Company has declared, a dividend on its 9.25% Series A Cumulative Redeemable Perpetual Preferred Shares for the month of January 2023. The Series A Preferred Shares trade under the “SLHGP” stock ticker symbol. In accordance with the terms of the Series A Preferred Shares, the Series A dividend will be payable in cash in the amount of $0.1927 per share on January 20, 2023 to the shareholders of record of the Series A Preferred Stock as of the dividend record date of December 30, 2022. The Company also wishes to update details of the Company’s previously announced shares for debt on September 15 and 16, 2022. The Company will settle a total of $438,400 in debt by issuing an aggregate of 626,286 common shares to the creditors at a deemed price of $0.70 per common share, in satisfaction of the debt. About Skylight Health Group Skylight Health Group is a healthcare services and technology company, working to positively impact patient health outcomes. The Company operates a US multi-state primary care health network comprised of physical practices providing a range of services from primary care, sub-specialty, allied health, and laboratory/diagnostic testing. The Company is focused on helping small and independent practices shift from a traditional fee-for-service model to value-based care (“VBC”) through tools including proprietary technology, data analytics and infrastructure. In an FFS model, payors (commercial and government insurers) reimburse on an encounter-based approach. This puts a focus on the volume of patients per day. In a VBC model, the providers offer care that is aimed at keeping patients healthy and minimizing unnecessary health expenditures that are not proven to maintain the patient’s well-being. This places emphasis on quality over volume. VBC will lead to improved patient outcomes, reduced cost of delivery and drive stronger financial performance from existing practices.

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HEALTH TECHNOLOGY

Philips advances AI-powered diagnostic systems and transformative workflow solutions at RSNA 2022

Royal Philips | November 28, 2022

Royal Philips a global leader in health technology announced its portfolio of smart diagnostic systems and transformative workflow solutions featured at the Radiological Society of North America annual meeting. Powered by AI, the company will showcase its latest systems and informatics solutions designed for providers to efficiently deliver patient-centric, high-quality imaging services. Overwhelming volume of radiology data compounding staff shortages and burnout Radiology plays a critical role in diagnosing and guiding patients into the right treatment plans. However, with increasing staff shortages and workloads, radiologists and staff continue to struggle to manage and interpret the huge volume of data captured to provide quality care for each patient. In the recent Future Health Index 2022 report commissioned by Philips, 24% of radiology leaders surveyed stated that managing the sheer volume of data available to them is their top data-related issue, with nearly two-thirds (65%) indicating their staff are overwhelmed by data overload. “With 47% of radiologists experiencing burnout [1], our customers are looking for innovations to help reduce their workloads and seamlessly integrate into their day-to-day operations. With smart intelligence built into imaging systems and informatics across the radiology workflow, Philips’ integrated solutions condense large volumes of data into patient-centric actionable insights for earlier and more definitive diagnosis and treatment.” Kees Wesdorp, Chief Business Leader of Precision Diagnosis at Philips AI-powered solutions enhance operational efficiencies and simplify complex workflows Some of the biggest challenges facing radiology leaders today are driven by managing complex, disconnected workflows which can negatively impact patient care, staff experience, outcomes, and cost. Visitors to the Philips booth at RSNA will see how the company’s latest interoperable and vendor-neutral operational solutions and strong portfolio of smart connected imaging systems help streamline and transform the radiology workflow to improve patient and staff experience; advance clinical and diagnostic confidence for better health outcomes; and drive a sustainable, resilient diagnostic infrastructure to help lower the cost of care. Featured at RSNA will be Philips’ AI-enabled technology [2] that automates and accelerates routine and repetitive tasks to generate patient-centric insights from large volumes of data to help improve productivity. Solutions include Philips Imaging Orchestrator – ROCC and Philips Ultrasound Collaboration Live, both pioneering the virtualization of radiology, extending care and collaboration beyond traditional models. Philips Imaging Orchestrator – ROCC, a vendor-neutral, multi-modality, multi-site telepresence solution provides advanced tele-acquisition capabilities and seamlessly connects imaging experts at a command center with technologists at scanning locations across an organization. Philips Ultrasound Collaboration Live tele-ultrasound, available on Philips ultrasound systems – EPIQ Elite and Affiniti – allows teams to securely video stream from their ultrasound system to a PC or mobile device for remote, on-demand access to clinical expertise regardless of location. Philips will also introduce the latest in AI-enabled image interpretation to help prioritize patient worklists based on clinical outcomes and expand diagnostic capabilities with its new Philips Advanced Visualization Workspace, with enhanced features to automate reporting and help drive earlier and more definitive diagnosis. Also featured is Philips Enterprise Performance Analytics – PerformanceBridge – to enhance operational decision-making through a vendor-neutral, real-time data analysis solution to help improve productivity and reduce costs. Smart connected imaging systems advance clinical and diagnostic confidence New at RSNA, Philips’ AI-powered MR SmartSpeed is designed to increase speed, image quality, and productivity and drive diagnostic confidence with improved image resolution via the AI reconstruction algorithm. It utilizes Philips’ state-of-the-art speed engine and an award-winning [3] AI reconstruction technology delivered at the source of the MR signal to ensure no data loss. SmartSpeed joins the company’s expanding portfolio of AI-driven MR solutions which includes AI-based touchless patient sensing, SmartExam, and MR Workspace. Philips will also showcase MR 5300, Philips’ newest BlueSeal Magnet, and industry-first wide bore helium-free operations system design for sustainable imaging at lower site costs without image quality or clinical compromises. Philips will spotlight its award-winning Spectral CT 7500, the company’s latest dual-detector CT system helping radiologists better characterize disease and reduce scan times at the same dose levels as conventional scans. Used in oncology imaging, cardiac imaging, and interventional radiology, the system has demonstrated a 34% reduction in time to diagnosis, a 25% reduction in repeat scans and a 30% reduction in follow-up scans [4]. Philips will also demonstrate its latest innovations in minimally-invasive care with the company’s SmartCT 3D suite of interventional tools including its Azurion 7 C20 with FlexArm Image-Guided Therapy System and Zenition 70 Mobile C-arm with Flat Detector. Philips will also introduce the Ultrasound Compact 5000 Series system and the Philips Lumify Handheld Ultrasound, now featuring pulse wave Doppler for all physicians – from cardiologists and radiologists to emergency care – to quickly assess hemodynamics in cardiac function anytime, anywhere. Also making its first appearance at RSNA is Philips Fluoroscopy 7000 N – ProxiDiagnost N90, combining digital radiography and high-end nearby fluoroscopy to help enhance clinical confidence and improve patient and staff satisfaction. About Royal Philips Royal Philips is a leading health technology company focused on improving people's health and well-being, and enabling better outcomes across the health continuum – from healthy living and prevention, to diagnosis, treatment and home care. Philips leverages advanced technology and deep clinical and consumer insights to deliver integrated solutions. Headquartered in the Netherlands, the company is a leader in diagnostic imaging, image-guided therapy, patient monitoring and health informatics, as well as in consumer health and home care. Philips generated 2021 sales of EUR 17.2 billion and employs approximately 79,000 employees with sales and services in more than 100 countries.

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FUTURE OF HEALTHCARE, MEDICAL DEVICES

Catalyst Solutions Announces Third-Party Administration White Paper Publication

Catalyst Solutions | December 22, 2022

Catalyst Solutions announces the publication of the white paper, Third Party Administration for Healthcare Payers. This white paper reviews the unique needs that self-funded and fully-insured plans might have for Third Party Administration as well as, the services and benefits TPAs provide. As an industry, healthcare continues to experience constant change. The landscape is dynamic, and new challenges are on the horizon. Mergers, acquisitions, and partnerships are occurring at an unprecedented rate - and the government continues to introduce mandates to which the healthcare plan must adhere. These factors continue to add demands on plans that are already facing budgetary and resource constraints. "To manage these challenges healthcare payers are increasingly outsourcing business processes to Third Party Administrators. Just like in organizations, outsourcing allows them to focus on what they do best, which is: improving the healthcare outcomes of their membership." Scott Martin, President of Catalyst Solutions TPAs deliver administrative support to self-funded businesses and fully-insured healthcare plans. Both are increasingly outsourcing day-to-day operational services to a TPA, which is driving significant cost savings and reducing the administrative burden. Catalyst Solutions provides a full suite of TPA services. Its team of fully-trained, US-based employees can deliver the operational and technology functions required by a healthcare plan or self-funded business. Catalyst seeks to maximize the performance of healthcare plans by taking a holistic view of people, process, and technology. "Catalyst engages plans at a strategic level," Scott Martin said, "aligning our outsourcing services to our customer's business goals. We use our industry expertise to anticipate our customers' long-term needs. Our services don't end with outsourcing – we become trusted advisors in helping our customers achieve a better future." About Catalyst Solutions Catalyst Solutions has an extensive history of exclusively serving the payer industry. With 20+ years of deep industry expertise, Catalyst provides outsourced BPO, IT, and consulting services. As a diversity-certified, woman-owned company based in the U.S., our mission is to help insurance payers drive down costs, optimize revenue, and most importantly, improve member healthcare outcomes. We deliver comprehensive and flexible solutions that meet the unique needs of payers, and we are committed to exceeding customer expectations by providing unmatched, white-glove service. We are passionate about making positive and measurable change on behalf of the clients we serve and the communities in which we live.

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FUTURE OF HEALTHCARE, DIGITAL HEALTHCARE

BioNJ Hosts Its Inaugural Health Equity in Clinical Trials MBA Business Plan Case Competition

BioNJ | December 07, 2022

BioNJ, New Jersey's life sciences trade association, hosted an Inaugural Health Equity in Clinical Trials MBA Business Plan Case Competition on Saturday, December 3, at Rutgers Business School. BioNJ's Business Plan Case Competition, which is part of a broader BioNJ strategic initiative of Health Equity in Clinical Trials, was designed to promote the next generation of diverse clinical trial innovators and identify innovative approaches and successful models that can be used nationally to strengthen diversity in clinical trials and expand health equity. BioNJ believes that health equity in clinical trials is critical to deepening the understanding of the safety and efficacy of medicines in under-represented populations, expanding access to medical innovation for these populations and increasing dialogue and trust among the biopharma industry, communities and healthcare systems. By discovering new approaches, utilizing new technologies and developing new business standards to make trials more accessible, we can work to create more agile, efficient and Patient-centered medical research. Eight teams, competing for more than $20,000 in prize money, were tasked with developing a business plan defining a new solution, application or technology to help address this important and challenging problem. Teams identified one particular type of health disparity on which to frame their proposed solutions and connected with community-based organizations to better understand the real-world barriers that exist for their chosen populations to engage in clinical trials. The disease areas on which the respective teams focused included Alzheimer's, heart failure, multiple sclerosis, diabetes type 1 and type 2, colorectal and cervical cancers, and oncology. "There is an urgent need to bring more diversity to clinical trials in order to better serve Patients and their communities…thereby helping to address health inequities. Only by improving diversity in clinical trials will we be able to deepen our understanding of the safety and efficacy of medicines for all populations. I am extremely proud of our teams. Each of the business plans offered a unique out-of-the-box solution – helping advance our ambition to have no Patient left behind." Amadou Diarra, Ph.D., Senior Vice President, Global Policy, Advocacy & Government Affairs for Bristol Myers Squibb; BioNJ Board Member and Chair of the BioNJ Health Equity in Clinical Trials Initiative Live pitch presentations were made throughout the day to a Panel of Judges comprised of industry experts Naikia Atkinson, Director, U.S. Clinical Trials Diversity and Inclusion, Sanofi Schylr Greggs, Director, Technology Operations, Medidata Sharon Hanlon, Head, Clinical Trial Engagement & Enrollment, Bristol Myers Squibb Maribel Hernandez, Vice President, Clinical Operations & Special Projects, PTC Therapeutics Jack Rosenberg, Manager, Investments and Business Development, TrialSpark Del Smith, Co-Founder & CEO, Acclinate Lolita Smith, Program Manager, Rare Disease Diversity Coalition, Black Women's Health Imperative Matt Walz, CEO, TrialBee "Although ultimately three winning teams were presented with cash prizes, each team has made a difference for Patients by offering new solutions and technologies to better serve Patients, build community trust and address gaps in health care delivery," said Paul Howard, Ph.D., BioNJ Business Case Competition Steering Committee Chair and Senior Director, Public Policy for Amicus Therapeutics. "This is just the start as we work to share these proposals more broadly." A white paper with all of the presentations will be published in April and rolled out during BioNJ's acclaimed BioPartnering Conference – which brings together more than 500 industry professionals from around the globe. The three winning teams will present their plans during the April 18 BioPartnering Conference and all of the students are invited to attend to meet the community. About BioNJ BioNJ is the life sciences trade association for New Jersey, representing close to 400 research-based life sciences organizations and stakeholders across the healthcare ecosystem from the largest biopharmaceutical companies to early stage start-ups for nearly 30 years. Because Patients Can't Wait®, BioNJ is dedicated to ensuring a vibrant ecosystem where Science is Supported, Companies are Created, Drugs are Developed and Patients Have Access to Lifesaving Medicines.

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