Read the Latest Healthcare Collections News in Pulse

Acainternational | June 11, 2019

The latest edition of Pulse, ACA International’s monthly health care bulletin, is now available online with comprehensive news for health care credit and collections personnel.The June issue features articles on balance billing and how remaining current on state and federal legislative updates may be the best medicine as well a poll on consumers’ financial priorities when it comes to health care costs.
Check out News & Notes for updates on hospital mergers and acquisitions and Data Watch for a report on health expenses and bankruptcy.ACA member agencies have an opportunity to keep their clients up to date on trends affecting the health care industry by ordering them a monthly subscription of Pulse sent directly to their office or email. Each issue is loaded with articles on vital industry topics and noteworthy statistics. Pulse is an excellent opportunity to enhance the service you provide to your clients.

Spotlight

Health Net adds over 6M members & key capabilities in growth products. 1.7M Medicaid members; strengthens leading position in Medicaid. Enhances national leadership position in LTSS. 4 Star Medicare Advantage capability with $3B in revenue and 275k members. Deep experience with Duals and other underserved populations. Attractive Exchange capabilities including 300k members. Brings complementary focus on targeted Exchange population.


Other News
FUTURE OF HEALTHCARE

SpineGuard Announces a New Partnership with Sorbonne, CNRS and Inserm to associate its DSG® Technology With Ultrasound and Serve Surgical Robots

SpineGuard | June 08, 2022

pineGuard an innovative company that deploys its DSG sensing technology to secure and streamline the placement of bone implants, announces the launch of a new three-year collaboration program with two labs of Sorbonne University CNRS and Inserm: the ISIR. DSG is based on the local measurement of electrical conductivity of tissues in real time without X-ray imaging, with a sensor located at the tip of the drilling instrument. Its efficacy was proven by more than 90,000 surgeries across the globe and 19 scientific publications. SpineGuard has entered in 2017 a collaboration with ISIR for the application of DSG to surgical robots and the enhancement of their safety, accuracy, and autonomy. SpineGuard and ISIR capitalize on first order outcomes published so far… At the close of a first collaboration phase, SpineGuard announced sub-millimetric accuracy experimental outcomes in bone boundary detection and automatic stop of a vertebral drilling performed by a robot using the DSG technology. These impressive outcomes were presented as they were produced successively at the Hamlyn medical robotics conference in London in May 2019, receiving the first price for best scientific paper, then in plenary session at the SMISS minimally invasive spine surgery (SMISS) in Las Vegas in November 2021, and lastly during the CRAS conference in Naples in April 2022. … and join forces with the LIB laboratory in order to add ultrasound to the project. Encouraged by this success, the research and development teams wish to go even further in surgical robots advancement: the guidance technologies that allow the robot to position itself properly relative to the patient to find the drilling entry point rely today on X-Ray imaging, dangerous for health, in combination with space-consuming optical registration. SpineGuard has long explored the possibility to use ultrasound complementarily to DSG for this preliminary step, before the tool is penetrating bone, and was granted two families of international patents on that topic. The LIB laboratory, who features an international level expertise in the field of ultrasound imaging, answered with enthusiasm the invitation to join the project. SpineGuard, ISIR and LIB thus start a new 3-year collaboration that is expected to produce breakthrough results in the field. “We are happy to launch this partnership that will allow us to go even further in improving surgical robots in orthopedics. This new phase of the project aims at enabling robots to perform bone drilling and cutting, as well as implant placement, in a secured and more autonomous manner in the human skeleton. Our goal is to implement first-class collaboration between French Research and Industry and trigger commercial ventures in the orthopedic field via strategic agreements with industry partners.” Stéphane Bette, co-founder and Deputy CEO of SpineGuard Guillaume Morel, Professor at Sorbonne University and ISIR Director, and Brahim Tamadazte, Researcher at CNRS and member of ISIR, added: “We are delighted to continue the close and dynamic collaboration initiated in 2017 with SpineGuard. The entry of robotics and associated new technologies in operating room is no doubt one of the biggest medical advances of the last twenty years. Robotic approaches often allow the surgical gesture to be less invasive, more accurate, safe and intuitive in numerous surgical procedures. The first outcomes from the previous collaboration gave us more visibility on the clinical added value that a robot with original and effective sensors can bring to Orthopedic Surgery in general and Spine in particular. This new collaboration will be about ultrasonic sensors coupled with robotics. This original and promising association will allow the surgeon to define the entry point and the pedicle screw trajectory accurately and non-invasively, without relying on ionizing or costly preoperative imaging (scanner, MRI). The association of two prestigious labs of Sorbonne University (ISIR and LIB), whose competencies are highly complementary to SpineGuard’s industrial vision constitute a stimulating work environment favorable to innovation. The journey with SpineGuard goes on for three more years with a target of several technologic and scientific innovations to serve patients and care providers.” Quentin Grimal, Professor at Sorbonne University and Manager of the team “Ultrasound and imaging for bone quality characterization” at LIB, concludes: “Using ultrasound to position a surgical tool is particularly relevant. Ultrasounds are danger free and provide real time information about interfaces, bone anatomy, even bone mechanical quality. The use of an ultrasound probe should allow to position the robotic arm in an optimal manner to place pedicle screws. In general, echography does not allow to see beyond the bone surfaces because ultrasounds are strongly reflected at the surface and strongly attenuated when propagating in bone. Low amplitude signals coming from inside bone can however be exploited through specific treatments which are a specialty of our team. Our team, pioneer in ultrasound utilization to probe bone, has introduced several approaches that offer an alternative to X-Rays for characterization of trabecular or cortical bone health. For our team, this partnership with SpineGuard and ISIR is a great fit: it will accelerate methodology and instrument developments for a broader utilization of ultrasound in orthopedic surgery. We are very happy to participate in this innovation rich project.” About SpineGuard® Founded in 2009 in France and the USA by Pierre Jérôme and Stéphane Bette, SpineGuard is an innovative company deploying its proprietary radiation-free real time sensing technology DSG® (Dynamic Surgical Guidance) to secure and streamline the placement of implants in the skeleton. SpineGuard designs, develops and markets medical devices that have been used in over 90,000 surgical procedures worldwide. Nineteen studies published in peer-reviewed scientific journals have demonstrated the multiple benefits DSG® offers to patients, surgeons, surgical staff and hospitals. Building on these strong fundamentals and several strategic partnerships, SpineGuard has expanded the scope of its DSG® technology in innovative applications such as the « smart » pedicle screw, the DSG Connect visualization and registration interface, dental implantology and surgical robotics. DSG® was co-invented by Maurice Bourlion, Ph.D., Ciaran Bolger, M.D., Ph.D., and Alain Vanquaethem, Biomedical Engineer. SpineGuard has engaged in multiple ESG initiatives. About ISIR ISIR is one of the largest French Research institutions in robotics and intelligent systems, reporting mainly to Sorbonne University, CNRS (National Center for Scientific Research) and Inserm (National institute for health and medical research). It regroups more than 50 teaching researchers and permanent researchers and approximately 80 PhD ad post-doc students. ISIR is structured around 6 research teams focused on artificial intelligence and machine learning, mobile robotics, small scale robotics, assistance robotics (physical therapy and mobility support), human-robot interaction and surgical gesture assistance. ISIR has a rich expertise in the design of innovative robotic architectures, simulation and control, clinical validation and transfer of high industrial potential results. Over the last 5 past years, 10 pre-clinical or clinical studies were conducted at ISIR. 8 patents were granted, and 2 start-up companies created. About LIB The Laboratory for biomedical imaging (LIB) is specialized in Fundamental and Applied Research for biomedical morphologic imaging methods, functional and molecular on small animal and human. It reports to Sorbonne University, CNRS and INSERM. It regroups 35 permanent researchers and teaching researchers, of whom half are also hospital practitioners, approximately 10 engineers and technicians and more than 30 PhD students and post-docs. LIB is structured around 6 teams whose focuses correspond to key priorities of 21st century Public Health: cancer, cardiovascular and neurologic diseases, bone quality. LIB develops new diagnostic and treatments methods exploiting various modalities: ultrasound, MRI, CT, SPECT-PET, etc. LIB has a strong commitment to technology transfer. Over the last 5 years, 6 patents were granted, 7 software were filed, and 5 startup companies launched.

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HEALTH TECHNOLOGY

Alegeus and HealthSherpa Experience Significant Momentum for ICHRA

Alegeus and HealthSherpa | July 19, 2022

Alegeus, the market leader in healthcare payment solutions, and HealthSherpa, the leading enrollment platform for individual ACA health coverage, have outpaced the industry in individual coverage health reimbursement arrangements since announcing an integration partnership in the summer of 2020. With updates to their partnership in 2022, both companies are poised to increase their ICHRA enrollments even faster. HealthSherpa, which has seen more than 10X growth in ICHRA pipeline, has enrolled more than three million individuals on its platform in just the last year. ICHRAs, which were launched at the start of 2020, allow employers to reimburse employees for individual coverage insurance premiums in place of offering them a traditional group-sponsored health plan. ICHRAs can also be used by employees to pay for out-of-pocket healthcare expenses. Organizations administering consumer-directed health benefit programs can set up an ICHRA with Alegeus, and then HealthSherpa helps ICHRA-eligible employees search for and enroll in the best on-exchange and off-exchange individual health plans. This integration bolsters the health reimbursement arrangement (HRA) experience from Alegeus and gives third-party administrators and health plans a strategy for increasing employer and employee participation in health benefit accounts. “We’re excited about the growing demand our partners have seen for ICHRA since announcing our integration partnership with HealthSherpa,” said Mark Waterstraat, chief customer officer, Alegeus. “Our joint solution is helping employers to deliver quality and cost-effective benefits quickly and efficiently to their employees. While ICHRAs can offer these through employer-defined contribution and better-fit individual coverage plans, they are still new and require a considerable amount of education and awareness. Through this partnership, our efforts are resonating, as evidenced by growing market demand.” “ICHRAs are a great option for a large and growing number of employers and their employees, and we’ve seen many of our client organizations begin reaping their benefits,” said Ross Honig, president, OCA. “Working with Alegeus and HealthSherpa has allowed OCA to market our ICHRA solution as a “one-stop” product that is seamless and easy to use for brokers, employers, and their employees.” “Millions of consumers have enrolled in health insurance through HealthSherpa and experienced the increasing appeal of individual coverage. With our new off-exchange options, employers and brokers alike have more options for employees looking to make the transition away from group-sponsored health insurance. ICHRA is changing the dynamic of the relationship between employers and employees on the critical question of health insurance, and we’re thrilled to partner with Alegeus to help employers understand the benefits and communicate them with their employees.” George Kalogeropolous, CEO, HealthSherpa Alegeus and HealthSherpa recently presented a webinar, “The (Present and) Future of ICHRAs,” showcasing how to simplify the administration of ICHRA benefits and make it easier for consumers to find the care and coverage that meets their needs. About HealthSherpa HealthSherpa builds technology that increases access to health care. We provide end-to-end solutions for consumers, insurance carriers, and agents, delivering a superior ACA marketplace experience to fulfill our mission of connecting people to health coverage under the Affordable Care Act. The HealthSherpa Marketplace, our flagship health insurance enrollment platform, services more than 45,000 agents, 38 carriers, and 9 million consumers. About Alegeus With more than 25 years of growth and innovation, Alegeus is the market leader in SaaS-based benefit funding and payment solutions. Our highly flexible, white-label platform powers account-based benefit programs such as HSAs, FSAs, HRAs, COBRA, wellness incentives, lifestyle benefits and beyond. We deliver exceptional user experiences and differentiated capabilities that help our partners strengthen their product offerings, operate more efficiently, and unlock their full growth potential. Our partnerships with the industry’s leading health plans, third-party administrators, financial services and benefit solution providers give Alegeus unparalleled reach in the market, with access to more than 100 million commercially insured Americans. And our unique partnership model empowers our clients to achieve outsized results – growing their programs at a rate that is 3-4X the market, and with the highest NPS scores in the industry. We never compete with our clients in the market – we win when they win. Alegeus is headquartered in Waltham, Mass., with operations centers in Orlando and Bangalore, and a large remote workforce.

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HEALTH TECHNOLOGY

Softheon Expands to Artificial Intelligence in Care Management for Health Plans through Acquisition of NextHealth Technologies

Softheon | July 01, 2022

Softheon, a leading cloud-based eligibility, enrollment, and billing provider for health plans and government agencies, has acquired NextHealth Technologies, an AI-powered SaaS-based healthcare analytics platform. With the acquisition, Softheon will be better able to help health plans sell and deliver efficient, high-quality care through synergies in the companies' respective products and solutions. Health plans cans save tens or even hundreds of millions of dollars on medical and operational costs through Softheon's growing suite of solutions. The acquisition significantly enhances Softheon's talent density, enhancing go-to-market strategies, engineering processes, and leadership. The overall speed and capability of NextHealth's AI solutions will increase through Softheon's propriety technology. Softheon CEO, Eugene Sayan, will continue to lead the company. Eric Grossman, NextHealth's founder, has become the combined organization's Chief Commercial Officer, supporting Sayan's vision and the company's growth objectives. Sayan shared, "Artificial Intelligence in healthcare is here, and we are seeing the incredible impact it can have on both members and carriers. Our goal has been to make healthcare more affordable, accessible, and plentiful, and we see AI as a clear path forward to bring efficiencies to our carrier partners. This acquisition is a testament to Softheon's commitment to helping health plans tackle some of their biggest challenges, such as population health and the movement toward consumerism in healthcare." NextHealth Technologies, founded in 2013, offers a cloud-based platform that utilizes rigorous methodologies and standardized processes to enable health plan customers to identify impactable populations, measure which clinical initiatives work best for whom, and integrate data-driven decisions into the workflow in real-time to derive the highest ROI from their analytics investments. "We are thrilled to be part of Softheon's continued growth and expansion. This is an incredible opportunity for our respective teams. NextHealth's technical and service staff will continue to build and support cutting-edge applications of AI for carrier member populations with the support and resources of a larger company. We see a bright future for our health plan partners as we bring those tools to bear to deliver significant value and reduced costs." shared Grossman Softheon's purchase of NextHealth is expected to bring economies of scale and operating leverage to the combined company. NextHealth investors, Norwest Venture Partners and TT Capital Partners, will become investors in Softheon and expressed excitement on the prospects of the transaction. "Together, NextHealth and Softheon can provide better care at lower medical and administrative costs while advancing the application of AI in healthcare." said Casper de Clercq, General Partner at Norwest Venture Partners. "The acquisition of NextHealth will enhance Softheon's AI capabilities for health plans," said Ryan Engle, partner at TT Capital Partners, "Member data spanning shopping and enrollment through claims creates opportunities for proprietary methodologies to shape member behavior and create value for plans." Softheon has continued its growth and expansion, having completed more than 20 million enrollments since the inception of the Affordable Care Act, through public and private exchange technology. The acquisition comes after the company introduced its first foray into AI by creating a machine learning algorithm that predicts which members are at risk of letting their insurance coverage lapse, as featured in Bloomberg Law. About Softheon Founded in 2000, Softheon's Software-as-a-Service (SaaS) and Business Process-as-a-Service (BPaaS) solutions solve complex challenges for health plans and government health agencies. Currently, Softheon's solutions serve 8 State agencies and over 90 health plans. Issuers and consumers utilizing Medicaid, Medicare, and the ACA Marketplace benefit from Softheon's innovative technology that reduces administrative overhead and enhances user-experiences. Softheon is an Agent, Broker, and Merchant of Record that facilitates health insurance enrollment, administration, and renewal. About NextHealth Technologies NextHealth Technologies, based in Denver, is an AI-powered analytics platform that rapidly optimizes the effectiveness of health plans' cost, quality, and service enhancement initiatives resulting in significantly reduced costs and improved outcomes. Its cloud-based solution utilizes scientifically rigorous methodologies and standardized processes, enabling and promoting a culture of measurement. The platform is HITRUST-certified, scalable, and is deployed with expert services to ensure client adoption and success. Know what works™ and make it better.

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FUTURE OF HEALTHCARE

SpinaFX Medical to Exhibit at Society of Interventional Radiology Annual Scientific Meeting

Spinafx medical inc | June 13, 2022

Minimally invasive image-guided therapy company, SpinaFX Medical Inc. announced it will exhibit at the Society of Interventional Radiology (SIR) 2022 Annual Scientific Meeting inBoston, MA,June 11-16, at booth 414. Dr. Alexis Kelekis, medical advisor to SpinaFX, will present the results of a research study on which he was the lead author, recently published inThe Spine Journal, on the effectiveness of intradiscal oxygen-ozone treatment compared to microdiscectomy for contained lumbar disc herniation with radiculopathy. This study has been recognized by SIR as one of the 2022Abstracts of the Year. "We are excited to meet with some of the world's leading interventional radiologists to discuss innovations in minimally invasive, image-guided care and share our recent progress and momentum at SpinaFX. We look forward to Dr. Kelekis' presentation and celebrate the study's findings, which have the potential to benefit both patients and providers by addressing a significant gap in the continuum of care for the millions suffering from back pain." Jeff Cambra, SpinaFX CEO "I am thrilled that Dr. Kelekis will share the findings of our skilled research team at SIR's Annual Scientific Meeting," said Dr.Kieran Murphy, SpinaFX Chief Medical Officer and co-author of the recognized study. "The technology used in this randomized control trial holds great promise for patients struggling with contained herniated lumbar disc pain and it is an honor to have this research recognized by such a prestigious and well-respected organization." Dr. Alexis Kelekis willpresentthe results of his study onWednesday, June 15, at10:40 a.m.during Closing Plenary. As an exhibitor during the meeting onJune 11-16, SpinaFX will offer attendees the opportunity to discuss the study results and their implications with Drs. Kelekis and Murphy, learn more about SpinaFX and its goal to help develop minimally invasive, image-guided treatment options, and provide input on developing technology with the potential to redefine the treatment of contained herniated discs. Visit SIR'swebsiteto learn more about the Annual Scientific Meeting. About SpinaFX Headquartered inOntario, Canada, SpinaFX is a treatment solution and technology company bringing innovative, minimally invasive image-guided treatments to patients with back pain due to contained herniated discs.

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Spotlight

Health Net adds over 6M members & key capabilities in growth products. 1.7M Medicaid members; strengthens leading position in Medicaid. Enhances national leadership position in LTSS. 4 Star Medicare Advantage capability with $3B in revenue and 275k members. Deep experience with Duals and other underserved populations. Attractive Exchange capabilities including 300k members. Brings complementary focus on targeted Exchange population.

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