Tufts Health Plan, Harvard Pilgrim Health Care Intend to Merge

Managed Healthcare Executive | September 04, 2019

Harvard Pilgrim Health Care and Tufts Health Plan, both based in Massachusetts, intend to combine their nonprofit organizations into a new entity, which will become one of New England’s largest nonprofit health services organizations. The yet unnamed organization will provide health coverage in all segments of the market regardless of a person’s age, income, life circumstance or health status, according to a press release from Harvard Pilgrim Health Care. The new organization will serve close to 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island, offering employer-sponsored plans; Medicare and Medicaid plans; Qualified Health Plans; and plans for those who are dually eligible for Medicare and Medicaid. Through the combination of two strong organizations with a commitment to nonprofit health care in New England, we will be able to provide even greater value to consumers, as well as improve access to care throughout the region,” said Joyce Murphy, chair of the board for Harvard Pilgrim Health Care.

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It’s more than just knowing what to eat. “Dietitians have to go through a rigorous process of getting matched to a dietitian internship, which is accredited, and then also to take the national registry exam,” explained Noel Konken, a clinical dietitian with Lee Health. Education and knowledge dietitians use to educate patients both in and out of the hospital.


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FUTURE OF HEALTHCARE

Trillium Community Health Plan Successfully Resolves Corrective Action Plan with OHA

Trillium Community Health Plan | June 03, 2022

Trillium Community Health Plan is pleased to announce it has successfully closed the Tri-County Expansion Corrective Action Plan (CAP) with Oregon Health Authority effective June 1, 2022. As a result of this process, Trillium has implemented many practices that have further strengthened the plan's ability to coordinate high-quality healthcare and services, with a special focus on increasing access to care and addressing social determinants of health for Oregon Health Plan members in Clackamas, Multnomah, and Washington counties. In September 2020, OHA issued a CAP for Trillium's Medicaid plan as a condition of expansion into the Tri-County service area. OHA asked Trillium to focus on specific improvements to its network, health equity and language access, community engagement, and intensive care coordination. Leveraging the extensive expertise of its many work groups, committees, and community partnerships, including the Network Adequacy Collaborative and Health Equity Strategy Committee, and with contributions from tribal liaisons, traditional health worker liaisons, and the development of the Community Advisory Council, Trillium has addressed and resolved all CAP requirements. Today, Trillium serves more than 28,000 members in the Tri-County area. Through the CAP, the health plan made several improvements to enhance access to care and services for all members, including The creation of a fully compliant and engaged Community Advisory Council, made up largely of Trillium members representing diverse demographics and lived experience; New partnerships with the regional health equity coalition, tribal organizations, and community-based groups, which further support Trillium members with access to culturally sensitive healthcare, food insecurity, and other investments A robust behavioral health provider network to meet the needs of members; The Network Adequacy Collaborative to ensure all network related issues, including health equity, are identified and addressed promptly; and, A renewed internal committee structure to align plan efforts and center equity on strategic planning. "Trillium is committed to providing equitable, culturally sensitive, integrated care for all of our members in Oregon. We want to thank OHA for their continued partnership throughout this process, which has allowed us to enhance our systems, processes, and partnerships, improving our ability to identify local needs, remove barriers to care, develop service innovations, and collaborate across organizations to enact lasting change within our communities." Justin Lyman, Interim President and CEO of Trillium Trillium extends its appreciation to OHA for its partnership throughout this process. About Trillium Community Health Plan Trillium Community Health Plan serves Oregon Health Plan members through the CCO model, which began in 2012. Trillium is a recognized leader for outstanding coordination of care. It was first awarded a contract with the state of Oregon to help manage care for the Oregon Health Plan in 1999. Trillium partners with an extensive group of providers to improve care and access to services for OHP members.

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HEALTH TECHNOLOGY

Murata Vios Announces Integration with PointClickCare’s EHR Platform

Murata Vios, Inc | June 24, 2022

Murata Vios, Inc., developer of the Vios Monitoring System, is proud to announce the launch of its integration with PointClickCare, the leading cloud‐based software vendor for the senior care market. The integration will allow healthcare facilities to seamlessly integrate vital signs data into residents’ electronic health records for clinical review, helping to eliminate data entry time lags, transcription errors, and improve clinician efficiency. “Real‐time understanding of a resident’s vital signs can help prevent hospital readmissions because care teams can more quickly identify and treat the early signs of clinical deterioration. With the Vios Monitoring System and its Remote Monitoring Services, PointClickCare customers have a better way to capture this data and respond to changes in a resident’s condition. It can also free up clinical time that was previously spent on manually spot‐checking and recording vital signs every few hours.” Amit Patel, CEO of Murata Vios The Vios Monitoring System is a wireless, FDA‐cleared patient monitoring platform designed to improve resident safety and outcomes. The system delivers insights and value to post‐acute care providers by Continuously monitoring vital signs. The Vios Monitoring System measures high‐fidelity 7‐lead ECG, heart rate, oxygen levels, pulse rate, respiratory rate, and posture data. Improving 24/7/365 oversight of changes in resident conditions. With Vios Remote Monitoring Services, a team of cardiac‐trained technicians can alert the on‐site care team to any changes in a resident’s condition, enabling them to quickly respond to resident deterioration that could lead to readmission. Identifying risk of pressure injuries. The Vios Chest Sensor has a built‐in 3‐axis accelerometer that detects and displays the resident’s posture in real‐time. When turn orders are added, the system can determine when a patient is at‐risk of developing a pressure injury so the on‐site care team can address the issue. Additional information regarding the integration can be found on the PointClickCare Marketplace – an online platform that enables customers to easily evaluate authorized third-party technology partners. Partners listed on the PointClickCare Marketplace offer integrated apps and/or services that are designed to be quickly deployed and work seamlessly with providers’ existing workflows. “The PointClickCare Marketplace offers the widest range of integrated solutions available to the market,” says Chris Beekman, Marketplace Director, PointClickCare. “Our partnership with Murata Vios is further testament to our continually growing partner network and ecosystem, and the wealth of possibilities it provides our customers to extend their technology capabilities.” About Murata Vios, Inc. Murata Vios, Inc., a subsidiary of Murata Manufacturing Co., Ltd., developed the Vios Monitoring System (VMS) to improve patient outcomes and reduce costs across the care continuum. Healthcare facilities can use the wireless, FDA‐cleared vital signs monitoring solution on existing IT infrastructure and instantly deploy the VMS to meet the acuity needs of patients across various care settings. Vios Remote Monitoring Services support healthcare teams with real‐time patient event analysis and notifications, helping to maximize patient safety while minimizing the burden on stretched clinical staff. About PointClickCare PointClickCare is a leading healthcare technology platform enabling meaningful collaboration and access to real‐time insights at any stage of a patient’s healthcare journey. PointClickCare’s single platform spans the care continuum, fostering proactive, holistic decision‐making and improved outcomes for all. Over 22,000 long‐term post‐acute care providers, and 1,600 hospitals use PointClickCare today, enabling care collaboration and value‐based care delivery for millions of lives across North America.

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HEALTH TECHNOLOGY

HeartBeam Announces FDA Submission of HeartBeam AIMI™ Product

HeartBeam, Inc. | August 17, 2022

HeartBeam, Inc. a developmental stage digital healthcare company with a proprietary ECG telemedicine technology for heart attack detection, announced it has submitted a 510(k) application to the US Food and Drug Administration for its HeartBeam AIMI™ platform technology for use in diagnosing heart attacks. “The 510(k) submission of our first product, based on our platform technology, is an important milestone toward commercialization and underscores our continued progress toward making the HeartBeam AIMI platform widely available to help Emergency Department physicians correctly and expeditiously diagnose patients with chest pain or other symptoms of a heart attack. I am proud of the HeartBeam team for their commitment to achieving this critical step in bringing the Company’s technology to market. We look forward to working through the FDA review process toward our goal of clearance for the US market.” Branislav Vajdic, PhD, HeartBeam CEO and founder The HeartBeam AIMI platform technology is anticipated to assist health care professionals in identifying patients who present with chest pain to facilitate rapid detection of a heart attack and determine an appropriate treatment regimen. Chest pain is the second most common reason for an emergency department visit with high costs associated with these visits. The goal of HeartBeam’s technology is to offer more accurate heart attack detection to triage patients and expedite treatment. HeartBeam AIMI is software as a medical device with a 510(K) regulatory pathway. The HeartBeam algorithm used in an emergency department setting slots into existing physician workflow, leverages existing 12-lead ECG hardware and provides the attending physician with an instant comparison of the patient’s baseline and symptomatic ECG for their consideration in the patient’s diagnosis. This will allow physicians to quickly determine if a patient needs intervention or can be discharged which helps manage patient flow. Jon Hunt, PhD, HeartBeam Executive Vice President and Chief Business Officer, added, “Our FDA approval process doesn’t require any human or animal trials, so there is good reason to believe that we will receive FDA clearance for a limited market release by end of 2022 and full commercial roll-out in Q1 2023. While the FDA conducts its regulatory review, our team will focus on executing key components of its commercialization plan and subscription revenue model. We continue to engage in positive discussions with strategic institutions, including academic centers, regional healthcare systems and regional community hospital systems that can utilize our products. We look forward to approval and offering our HeartBeam AIMI platform in an expected $500 million total addressable market.” About HeartBeam, Inc. HeartBeam, Inc. is a development stage digital healthcare company with proprietary ECG telemedicine technology that will redefine the way high risk cardiovascular patients are diagnosed in an ambulatory setting at any time and any place. Its breakthrough solution employs a reusable, credit card sized, 3D vector ECG recording device and cloud-based software capable of assisting a physician in diagnosing a wide range of cardiovascular disease. HeartBeam is initially focusing on a huge unmet need of helping diagnose heart attacks in patients outside of a medical institution. No single lead ECG technology can offer this value to patients and their physicians. This underserved market is several times larger than the cardiac arrhythmia detection market based on the prevalence of patients with coronary artery disease at high risk of heart attack.

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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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Spotlight

It’s more than just knowing what to eat. “Dietitians have to go through a rigorous process of getting matched to a dietitian internship, which is accredited, and then also to take the national registry exam,” explained Noel Konken, a clinical dietitian with Lee Health. Education and knowledge dietitians use to educate patients both in and out of the hospital.

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