The Health Care Blog – Page 293 – Everything you always wanted to know about the Health Care system. But were afraid to ask.

Above the Fold

Steal From the Poor. Give to the Rich. Rinse. Repeat. The Tax Bill and Health Care Part II..

Dec 15, 2017• 11

By STEVEN FINDLAY

“We’re going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit. Frankly it’s the health-care entitlements that are the big drivers of our debt…that’s really where the problem lies, fiscally speaking.”

— Paul Ryan, Dec. 6, 2017 on a talk radio show.

Amazing. You have to give Ryan credit for consistency and a kind of brutal Republican honesty. Within weeks of pushing a huge tax cut for corporations and the wealthy, he’s basically saying Republicans plan to pay for that by making cuts to Social Security, Medicare and Medicaid.

Ryan’s “Roadmap for America” laid it all out in 2008: privatize Social Security, transform Medicare into a premium support plan, and block grant Medicaid.

Of course, Ryan is correct about these programs from a “fiscally-speaking” point of view. The three do make up the lion’s share of the federal budget and their current rate of growth is unsustainable. Come 2035 and beyond they would start to gobble up almost the whole federal budget. The three programs will comprise about 50 percent of the $4.1 trillion federal budget in 2018.

And here’s a whooping number for you: Social Security, Medicare and Medicaid will cost the government $28 trillion through 2027.

But let’s be very clear about what is happening now that could set a dangerous precedent for the future. The Republican-led House and Senate, with the support of the Trump administration, have passed tax reform bills that primarily cut taxes for corporations and people making over $150,000 a year.

Applying Psychology to the Challenge of Internal Health Adoption

Dec 14, 2017• 2

By AMELIA EDWARDS

Adoption of technology in the healthcare field has been happening at an incredibly slow pace. This is a fact that few would disagree with. The market is saturated with health tech companies that are vying to be the next big unicorn in the field, but long sales cycles and simple underestimations of what is needed for HIPAA and FDA approval has led to the demise of many of these projects. The ones that do receive enough series funding to produce finessed products for health systems and pharmaceutical companies however soon realize that the battle against time is not over.

Simply getting into a health system is not enough. Once a contract is finally ironed out and the software is exchanged, the next uphill battle against the slow-pace of internal adoption is mounted. Not only is a speedy adoption important for hospitals to demonstrate that their purchases and investments were appropriate, but it is also key for founders who hope to demonstrate that their product works. Nothing is worse than the painfully slow adoption internally of a piece of technology. One bad experience has the potential to tarnish an organization’s appetite for future tech ventures.

The Boys From Silicon Valley

Dec 14, 2017• 12

By MARGALIT GUR-ARIE

A few weeks ago one man, named @jack, decided that millions of people will be allowed to use up to 280 characters when expressing themselves on Jack’s public square platform. One man decides how many letters each and every one of us, including the “leader of the free world”, can use when we talk to each other. Just like that. Nobody seemed the least bit perturbed by this notion. Another dude, named Mark, decided to ask people for nude pictures of themselves, so he can better protect them from the bad guys. We shrugged that off too. Then, in a most embarrassing exercise in public humiliation, our democratically elected representatives begged three slick lawyers representing these platforms to effectively regulate what people can say or see on “their” platforms.

So here we are, in the land of the free and the home of the brave, where Jack and Mark decide what you can or cannot say, and what you can or cannot hear or see. This, my friend, is the power of “platforms”. In the old days, it used to be that he who pays the piper calls the tune. In the artificially intelligent technology age there are no pipers. He who owns the pipe makes it play whatever the hell he wants it to play. And as Sean Parker, a Facebook founder, elegantly put it, “God only knows what it’s doing to our children’s brains”. Perhaps God knows, but he is certainly not the only one who knows, because these platforms are built with the explicit intent to get people addicted to and dependent on the platform.

Funded with cash from sexist pigs and harassers, a startup, whose business model is to help other startups “hook” people on trashy little apps, is calling itself Dopamine Labs. “Dopamine makes your app addictive” is their promise. According to the website, they use AI and neuroscience to deliver jolts of dopamine that “don’t just feel good: they rewire the brain’s habit centers” of users to “boost usage, loyalty, and revenue”. “Your users will crave it. And they’ll crave you”.

See What You Missed At The Tech For Precision Health Summit

Dec 14, 2017

Health 2.0 just wrapped up its inaugural Technology For Precision Health Summit. A collective group of investors, entrepreneurs, and precision health workers gathered for a day of sharing, charged discussion, and live technology demos; all with the goal of pushing hard to advance an industry that is often a matter of live or death.

Some major themes emerged throughout the day including:

>Consumer Fear
>Bridging Data Silos
>Identifying Federal Policies that are either stifling or catalyzing innovation

Check out the full recap here!

OptumCare Can Reach 70 Percent of the US Population

Dec 13, 2017• 2

By TORY WOLFF

Who will be the first to take integrated health care delivery national?

A few years ago, the best bet might have been an established provider with a nationally compelling brand and a growing affiliate federation such as Cleveland Clinic or Mayo. Instead, Optum – just a decade ago three separate services largely focused on serving United’s health benefits business – has entered care delivery and — by a constant stream of acquisitions big and small — built up beachheads in a majority of markets and is – via ongoing big acquisitions, tuck-ins and greenfield expansions – laying the foundations of a national integrated ambulatory system.

Particularly in light of the latest rumors about the role of clinics in driving the value of a potential AET-CVS combination, it is timely to take a look at what Optum has put together, size its geographic reach and discuss some strategic implications.

Job Ad: CEO for Soleforce

Dec 13, 2017

Soleforce, Inc., a new digital health startup based in New York City and incubated out of the Hospital For Special Surgery (HSS), is looking for an energetic and resourceful Chief Executive Officer (or CEO) to join its founding team. Soleforce, Inc. markets the SOLEFORCE™, a patented device that helps patients successfully recover from lower limb injuries. The SOLEFORCE™ allows fractures to heal by ensuring the proper weight distribution on an injured limb and greatly reduces the possibility of damaging hardware, bones, ligaments and tendons post surgery. The SOLEFORCE™ displays how much weight is being applied to an affected limb in real time and outputs sensory notifications that ensure the patient remains at or below prescribed weight-bearing targets. Information from the device is shared with physicians and physical therapists who can use the data to monitor a patient’s progress and customize the care plan. The SOLEFORCE™ addresses a major unmet need in a large market that includes approximately 2 million lower limb injuries per year in the United States alone. The device is FDA-cleared (via Class II 510(k) exemption) and the patent for the underlying sensing technology was issued in early 2017. A pilot clinical study demonstrating safety and efficacy has already been completed, and additional studies are being planned. More information about the opportunity can be found here.

Interested applicants should contact Jean-Luc Neptune at je************@***il.com.

The Implementer’s Dilemma

Dec 12, 2017• 2

By DAVID SHAYWITZ, MD

One word: implementation.

Increasingly, I’m convinced that the underappreciated challenges of implementation describe the ever-expanding gap between the promise of emerging technologies (sensors, AI) and their comparatively limited use in clinical care and pharmaceutical research. (Updated disclosure: I am now a VC, associated with a pharma company; views expressed, as always, are my own.)

Technology Promises Disruption Of Healthcare…

Let’s start with some context. Healthcare, it is universally agreed, is “broken,” and in particular, many of the advances and conveniences we now take for granted in virtually every other domain remain largely aspirational goals, or occasionally pilot initiatives, in medicine.

Healthcare is viewed by many as an ossified enterprise desperately in need of some disruption. As emerging technologies shook up other industries originally viewed as too hide-bound to ever change, there was in many quarters a profound hope that advances like the smart phone or AI, and approaches like agile development and design thinking, could reinvent the way care is delivered, and more generally, help to reconceptualize the way each of us think about health and disease.

Will CVS-Aetna Merger Lead to “Separate But Unequal” Healthcare?

Dec 11, 2017• 11

By NIRAN AL-AGBA, MD

Last week, pharmacy giant CVS agreed to purchase Aetna this week for an astounding $69 billion dollar sum. The company allegedly plans to reduce health spending by developing an integrated system touted as “a new front door for health care in America.” This merger is actually an acquisition, entailing transfer of ownership. The central aim of an acquisition is to increase market share, expand the scope of services provided, and improve financial stability. CVS hit the jackpot on all three objectives. While Wall Street investors celebrate, many of us knowledgeable in the delivery of healthcare services are wondering who will bear the responsibility for the patients harmed by this experiment?

Aetna has compiled vast amounts of data from 22 million health plan members. CVS provides pharmacy benefits management to nearly 90 million consumers. Together, with 10,000 stores and 1,100-minute clinics already in the CVS network, this acquisition will create a ‘Walmart for Healthcare’. Applying bulk-purchase business strategies to the sale of merchandise is one thing, while providing healthcare services by ‘trial and error’ to human beings is another matter entirely. Bypassing physicians to deliver healthcare by protocol categorically jeopardizes patient safety.

Executives at Aetna-CVS plan to utilize pharmacists and nurses in the evaluation of acute illness and management of chronic disease. If an insurer, drugstore, and pharmacy benefit manager unite as one, it will usher in an era of medical “segregation,” with segregation defined as the isolation or separation of a race, class, or group by enforced or voluntary restriction, by barriers to social intercourse, by separate educational facilities, or by other discriminatory means.

FDA, VCs, Big Ideas, and more at WinterTech

Dec 11, 2017• 1

By HEALTH 2.0

WinterTech is almost one month away, and we’re extremely excited about the final agenda. The 2018 edition of WinterTech will be not only be focusing on the new investment treads in digital health, but will take a in-depth look into the revolution in choice within the consumer landscape and the rapid development of digital therapeutics.

Our jam-packed 1-day conference includes:

Keynote presentation on how to create seamless health care experiences to meet the needs of consumers by Mark Ganz, CEO of Cambia Health.
Panel discussion on the opportunities, roadblocks, and regulations within the field of digital therapeutics by Bakul Patel, Associate Director for Digital Health at the FDA.
Investment Strategies Past and Present: a look into 2017 trends, surprises, and flops. plus predictions for 2018 by VC firms GE Ventures, Canaan, Fifty Years, NEA, and B Capital Group.
Fireside chat between 4 VCs and their CEOs on their relationship and investment models
Access to the Investor Breakfast where start-ups and investors discuss business models and explore portfolios. Start-ups apply here.
Live demos from some of the most innovative companies in the digital healthcare space.

Don’t miss out the hottest digital healthcare event focusing on investment in the space. Register today to take advantage of the early bird rate before prices increase after Friday, December 22nd.

On the Morality of Insurance Premiums

Dec 11, 2017• 17

By ANISH KOKA, MD

As CVS-Aetna merger talks fill the air this Christmas season and experts weigh in on the impact this will have on the economy and consumers alike, I’m sitting at a little desk in a little office contemplating health insurance.

I run a little shop that’s about as far from CVS-Aetna as you can get in the health care space : a solo practice doctor with four full time employees and revenues a little south of $65 billion dollars. I shouldn’t feel too alone. Small businesses account for 99% of US firms and employ almost half of all private sector employees. But knowing my problem is one shared by many provides only partial solace.

Prior to arrival of the ACA, I provided health insurance to everyone through the company. At the time I had 3 full time employees and the insurance broker I worked with got me a quote for $1300 / month. Now, I really didn’t want to be in the providing healthcare business, so when the ACA arrived with its individual market I was happy to facilitate buying health insurance from the exchanges. So initially, I chose to pay for my employees plans on the individual market. I was quickly told by my accountant that paying for my employees insurance in this manner was running afoul of a three letter entity of the federal government called the IRS.

Apparently the individual ACA market premiums were allergic to being deducted in this pre-tax manner. Fine. So I went ahead and paid each employee $6000 per year extra with the understanding that they would use that money to buy health insurance on the individual market.