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You Need a Cyber Team

By KIM BELLARD

Maybe you, like me, are an Olympics fan (in my case: Summer Games, track & field).  Most Americans look forward eagerly to the Super Bowl, while the rest of the world (and, increasingly, many in the U.S.) are waiting for the World Cup.  But too few of us are aware that next summer will be the inaugural International Cyber Security Challenge, an esports event that pits teams from multiple countries against each other in cybersecurity skills.  The U.S. is sending a 25 person team.  

So what, you might say?  Well, if you work in healthcare (or any industry, for that matter), or use any kind of digital device, you should care.  Ransomware attacks on healthcare organizations continue to proliferate. The Colonial Pipeline cyberattack this past spring illustrated the weakness of other parts of our critical infrastructure, and we’ve all almost certainly had some of our personal data exposed in data breaches.    

We’re in a war, but it’s not clear that we have the right army, with the right weapons, ready to fight it. Thus the U.S. Cyber Games.

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In “Riding” Abortion, Is Greg Abbott Driving Texas Toward Divestiture?

By MIKE MAGEE

Texas Governor Greg Abbott has been on a tear lately, and his central theme appears to be “revanchism.” Faced with declining demographics, he is retaliating against enemies and newcomers alike, aligning himself with slippery politicians and vigilantes. As they say in Texas, “He’s on a first-name basis with the bottom of the deck”, and the game he’s playing appears to be “South Africa – 1950.”

The formal establishment of apartheid in South Africa occurred in 1948, though racial injustice had been baked in centuries earlier. Violence and intimidation, embedded in legislation supported by a 15% white minority, led to the creation of the African National Congress (ANC) which launched what they called their “Defiance Campaign.” By 1962, their party had been outlawed, and their dynamic leader, Nelson Mandela, was imprisoned.

And yet resistance continued to grow, inside and outside the country. Religious leaders, like Archbishop Desmond Tutu, took to the street, organizing huge, peaceful rallies. In 1976, images of Black children being attacked and killed in Soweto township during a protest spread like wildfire around the world. 176 died and thousands were injured. In response, the United Nations called on its member states to divest and impose economic sanctions. Only 2 leaders did not. (More on that in a moment.)

Minority rule, oppression, vigilantism, and disenfranchisement are eventually losing propositions as Greg Abbott is learning. A majority of 52% now say his state is moving in the wrong direction. The list of grievances is long and continues to grow. Catholic bishops decried his inhumane handling of immigrant families this year. Baptist minister Rev. Frederick Haynes III spotlighted the Republican legislature’s voter suppression law recently suggesting they were “dressing up Jim and Jane Crow in a tuxedo.” Only 39% approve of his handling of the pandemic, and many Texans find the renewed endorsement of “vigilante justice” for unfortunate women and girls seeking abortions to be a disturbing and dystopian new reality. By the way, 1 in 5 Texans lack health insurance, and Texas is one of twelve Republican-led states that continue to refuse federal offers to expand Medicaid coverage of their citizens.

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State-Based Marketplaces 2.0 – Part 1: The Coming Expansion in Access, Affordability, and Value

By ROSEMARIE DAY and DAVID W. JOHNSON,

The Affordable Care Act (ACA) survived its third challenge at the Supreme Court on June 18, 2021, by a 7-2 vote, signaling that Obamacare is here to stay. With a divided Congress and a Biden administration challenged by multiple urgencies, there is little hope for national legislation to address healthcare’s access, cost, and quality deficiencies comprehensively. 

Despite this lack of dramatic progress or sweeping change at the federal level, reformers need not lose hope. Quietly, state-based marketplaces are making health insurance provision more accessible, affordable and effective. 

A Biden Administration’s executive order signed in January 2021, reopened the federal health insurance marketplace to individuals seeking to purchase or modify health insurance policies. The fifteen state-based marketplaces (SBMs) followed suit by enacting their own versions of this special enrollment period.

The Administration’s $1.9 trillion American Rescue Plan, enacted on March 11, 2021, includes a narrow but powerful provision that temporarily grants premium subsidies to higher-income Americans and reduces premium costs for lower-income Americans.  The “Build Back Better Act” currently moving through the House of Representatives would make these subsidies permanent. It would also provide funding for more experimentation with state-based health insurance affordability programs.

These new policies align with measures undertaken by many SBMs during the past eight years to improve the quality, affordability, and marketability of their health insurance offerings. In this decentralized, real-world way, SBMs have operated as experimental policy laboratories to assess programming modifications for stabilizing local markets, expanding consumer choice, increasing access to vital healthcare services, and lowering premiums. 

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Walmart Picks Transcarent: Tullman on First ‘Everyday Low Prices’ Offer for Self-Insured Employers

By JESSICA DaMASSA, WTF HEALTH

Walmart is looking to scale its healthcare business in a brand-new way: setting its sights on self-insured employers. Today the retail giant announced a go-to-market partnership with Transcarent that will make its “everyday low price” prescription drugs and healthcare services available to self-insured employers for the very first time. Transcarent’s Executive Chairman & CEO Glen Tullman drops in to give us the inside story on the deal with Walmart, what it means for the industry, and how it could once-and-for-all ignite the ‘disruption of the payer’ that we’ve been waiting for since JP Morgan, Berkshire Hathaway, and Amazon came together to found Haven.

Transcarent and Glen are hell-bent on re-making the healthcare payment model by eliminating as many middlemen as possible, reshaping the health and care experience along the way. So, what does this partnership with Walmart mean for that mission and for Transcarent? Is this “THE Deal” we’ll look back on as the one that catapulted Transcarent into a new phase of growth? Remember when Glen’s last company, Livongo, shot into the stratosphere after its deal with CVS Health? I ask Glen if he’s running the same play in a much bigger game and finally concede: Transcarent is NOT a healthcare navigator!

#Healthin2Point00, Episode 235 | Walgreens Health + VillageMD & CareCentrix, plus more deals

Today on Health in 2 Point 00, Noom launches a mental health offering, Noom Mood, Headspace partners with Waze to offer meditation while you drive, and we have one for the Press Release Hall of Fame where Dario Health announces a major partnership with a major national health plan— but doesn’t say who it is. We have some massive deals on Episode 235: Walgreens launches Walgreens Health, acquires a controlling stake of VillageMD, AND acquires a majority stake of CareCentrix; Intelerad acquires Ambra Health for $250 million; Mindbody acquires ClassPass; and Sprinter Health gets $33 million – even though their business model makes no sense. —Matthew Holt

#Healthin2Point00, Episode 234 | An M&A and shedloads more money!

Today on Health in 2 Point 00, the word is SHEDLOAD. On Episode 235, Jess and I talk about the scoop on an M&A and shedloads more money in today’s health tech funding climate. First up, Lark gets $100 million, bringing its total to $185 million. How much more money can we throw at a chronic condition management platform? Next, Scottish remote patient monitoring company Current Health gets acquired by Best Buy. TrialSpark raises $156 million, working on developing drugs via their clinical trials software, Twin Health raises $140 million to run clinical trials in silico in “digital twins,” and virtual care GI company Oshi Health gets $23 million. —Matthew Holt

Get Ready for Deepfakes

By KIM BELLARD

The Tom Cruise TikTok deepfakes last spring didn’t spur me into writing about deepfakes, not even when Justin Bieber fell so hard for them that he challenged the deepfake to a fight.  When 60 Minutes covered the topic last night though, I figured I’d best get to it before I missed this particular wave.

We’re already living in an era of unprecedented misinformation/disinformation, as we’ve seen repeatedly with COVID-19 (e.g., hydroxychloroquine, ivermectin, anti-vaxxers), but deepfakes should alert us that we haven’t seen anything yet.  

ICYMI, here’s the 60 Minutes story:

The trick behind deepfakes is a type of deep learning called “generative adversarial network” (GAN), which basically means neural networks compete on which can generate the most realistic media (e.g., audio or video).  They can be trying to replicate a real person, or creating entirely fictitious people.  The more they iterate, the most realistic the output gets.  

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#Healthin2Point00, Episode 233 | Another $2B in deals, including Devoted’s whopping valuation

Today on Health in 2 Point 00, we’re thinking about changing our name to Health in 2 Billion 00. Devoted Health confirmed its $11 billion valuation, bumping it to $12 billion after you count the additional $1.2 billion coming in. Now onto the other 2 billion in deals, BetterUp raises $300 million in a Series C, bringing their total to $569.8 million for performance coaching and resilience training. Honor is growing fast – it raises $370 million ($300M of that is debt), bringing their total to $625M. Elemy, formerly called Sprout, raises $219 million, for children’s behavioral health. Finally, MindMaze raises $125 million, bringing their total to $235 million, working on gamifying digital neurotherapeutics. —Matthew Holt

Medicine is a Moving Missile, Aiming for a Dangerous, Elusive Target

By HANS DUVEFELT

(Desperate times called for desperate measures.)

In the tech world, we have come to expect our devices to become outdated and obsolete very quickly. The biggest tech companies in the world didn’t even exist a few years ago. Bitcoin, a virtual currency which at least I can’t wrap my head around, seems to be more attractive than gold.

I get the sense most people embrace or at least accept the speed of change in tech.

But medical advances that occur rapidly are frightening to many people. Vaccine hesitancy, for example, involves concerns and characterizations like “unproven” and “guinea pigs”.

But can we as a society strive for and reward rapid progress in one area and reject it in another, especially if we feel threatened by outside forces or phenomena – be that a virus, climate change or the collapse of our economy’s infrastructure like supply chains and raw materials.

Tech has its own momentum, more driven by profit motives than altruistism or a desire just to make peoples lives better. Medicine clearly has profit as a driving force, but also a goal of improving life for people. Curing or mitigating disease must rank higher than making life more convenient.

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#Healthin2Point00, Episode 232 | Cue Health goes public + funding for Stellar, eVisit, & Neuroglee

Today on Health in 2 Point 00, Jess and I are at UCSF – we’ll be providing color commentary for the UCSF Health Awards, so tune in tonight for that. On Episode 232, Jess asks me about more deals including Stellar Health raising $60 million, Cue Health going public (and stealing the HLTH ticket), and eVisit raising $45 million for its telehealth solution. Finally, Neuroglee raises $10 million in an Alzheimer’s play. —Matthew Holt

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