Sarah Cannon/HCA at #ASCO18

Sarah Cannon announced that it will present its latest cancer research insights through more than 85 presentations at the American Society of Clinical Oncology’s (ASCO®) Annual Meeting. Hosted in Chicago, from June 1-5, 2018, the ASCO® Annual Meeting is bringing together global oncology leaders to discuss “Delivering Discoveries: Expanding The Reach of Precision Medicine.” Sarah Cannon experts will participate in a number of presentations and educational sessions focused on personalized medicine and targeted investigational therapies that are transforming the current and future state of cancer treatments.

“Sarah Cannon’s 25-year history has been highlighted by leading in a number of innovative areas of clinical research,” said Howard A. “Skip” Burris, III, MD, President of Clinical Operations and Chief Medical Officer at Sarah Cannon. Dr. Burris will also serve as the ASCO® President for the 2019-2020 term. “From novel antibodies to targeted biologics, and now advancements in the field of cellular therapies, we are bringing cutting-edge treatments to patients closer to home.”

As part of ASCO®’s Meeting focus, Sarah Cannon’s leaders will participate in the following highlighted sessions:

• A presentation with Dr. Burris, who will discuss “Most Patients Should Be Tested” in the education session “Point/Counterpoint: Next Generation Sequencing – Is It Right for Every Patient?” which will take place on June 1 from 1:20-1:40pm in S102.
• A “Best of ASCO®” clinical science symposium titled “A Phase 1 Study of LOXO-292, A Potent And Highly Selective RET Inhibitor, In Patients With RET-Altered Cancers” featuring Sarah Cannon co-authors Todd Bauer, MD, and Melissa Johnson, MD, as part of the session “Tumor Genomics: Finding The Target, Hitting The Target” on June 2 from 8-9:30am in Hall D1.
• A poster presentation by Stephanie Graff, MD, titled “Implementation of Breast Cancer Pathway For Genetic Counseling And Testing In Multi-State Health System” as part of the session “Health Services Research, Clinical Informatics, and Quality of Care,” on June 2 from 1:15-4:45pm in 6521 Hall A.
• A poster presentation by Holli Dilks, PhD, and Andrew McKenzie, PhD, titled “Identifying And Interpreting Actionable Molecular Alterations From Next-Generation Sequencing Results In The Community: A Sarah Cannon Molecular Cancer Conference” on June 2 from 1:15-4:45pm in 6601 Hall A.
• A poster session by David Moore, MD, titled “Routine Use of A Modest Next Generation Sequencing Panel Provides Additional Clinically Useful Data Beyond Single Gene Testing In Non-Small Cell Lung Cancer And Is Fit For Purpose As A Clinical Assay: Collated Data From A Single Molecular Diagnostic Laboratory” on June 3 from 8-11:30am in 8540 Hall A.

Additionally, Sarah Cannon investigators are presenting noteworthy studies and insights at ASCO® with the following presentations:

• Dr. Burris’ poster session on “Maintenance Of Health-Related Quality Of Life In Elderly Patients Treated With Ribociclib + Letrozole In MONALEESA-2” taking place on June 2 from 8-11:30am in 1041 Hall A.
• A poster session by Erika Hamilton, MD, titled “Results from a Phase I Study of Andecaliximab In Combination With Paclitaxel In Patients With Previously Untreated Metastatic Breast Cancer,” on June 2 from 8-11:30am in 1032 Hall A. Dr. Hamilton will also highlight research on “Phase 1 Dose Escalation Of XMT-1522, A Novel HER2-Targeting Antibody-Drug Conjugate, In Patients With HER2-Expressing Breast, Lung And Gastric Tumors” in a poster session on June 4 from 8-11:30am in 2546 Hall A.

• A poster session with Kent Shih, MD, on “Dianhydrogalactitol In Bevacizumab-Refractory GBM: Further Analysis Of A Phase 1-2 Trial,” on June 2 from 1:15-4:45pm in 2061 Hall A.
• A poster discussion by Dr. Bauer titled “A Phase 1 Study of MDM2 Inhibitor DS-3032b In Patients With Well/De-Differentiated Liposarcoma, Solid Tumors And Lymphomas” on June 2 from 3-4:15pm in S404.
• A poster session by Dr. Johnson on “First In Human Phase 1/2a Study of PEN-221 Somatostatin Analog (SSA)-DM1 Conjugate For Patients With Advanced Neuroendocrine Tumor Or Small Cell Lung Cancer: Phase 1 Results” on June 3 from 8-11:30am in 4097 Hall A. Dr. Johnson will also present a poster on “A Phase I, Open-Label, Multicenter Dose Escalation Study To Assess The Safety, Tolerability, And Pharmacokinetics Of AZD2811 Nanoparticle In Patients With Advanced Solid Tumors” on June 4 from 8-11:30am in 2592 Hall A.
• An education session with David Spigel, MD, on “Reimbursement And Payment Of Multiplex Testing In The United States” taking place on June 3 from10:15-10:30am in S100a.
• An education session with Dr. Graff on “How Close Is Too Close: Navigating Difficult Situations” as part of the session titled, “When Cancer Hits Close to Home: Treating Colleagues and Loved Ones” on June 4 from 8:30-8:45am in S504.

• A poster session by Judy Wang, MD, titled “Interim Results From A Phase 1 Trial Of SL-801, A Novel XPO-1 Inhibitor, In Patients With Advanced Solid Tumors” on June 4 from 8-11:30am in 2560 Hall A.
• A poster session by Manish Patel, MD, titled “A Phase 1b Dose-Escalation Study Of Prexasertib, A Checkpoint Kinase 1 (CHK1) Inhibitor, In Combination With Cisplatin In Patients With Advanced Cancer” on June 4 from 8-11:30am in 2579 Hall A.
• A poster session by Kathleen Moore, MD, on “Phase 1/2 Open-Label, Multiple Ascending Dose Trial of AGEN2034, An Anti-PD-1 Monoclonal Antibody, In Advanced Solid Malignancies: Results Of Dose Escalation” on June 4 from 8-11:30am in 3086 Hall A.

For a full listing of all presentations authored by Sarah Cannon investigators, visit sarahcannon.com/asco.

Additional Sarah Cannon leaders are co-authors on research presented at the conference, including:

Bertrand Marquess Anz, Raid Aljumaily, MD, Hendrik-Tobias Arkenau, MD, PhD, FRCP, Edward Arrowsmith, MD, Johanna Bendell, MD, Jesus Berdeja, MD, Brook Blackmore, Simon Chowdhury, MA, MRCP, PhD, Mick Correll, Brooke Daniel, MD, Davey Daniel, MD, William Bruce Donnellan, MD, Crystal Dugger, James Essell, MD, Gerald Falchook, MD, MS, Gustavo Fonseca, MD, FACP, Ian Flinn, MD, PhD, Troy Gifford, Lowell Hart, MD, Derek Weldon Holland, MD, Suzanne Jones, PharmD, Darrell Johnson, MD, Sylvia Lynne Krueger, MD, Dax Kurbegov, MD, Andrew Mackenzie, PhD, Michael Maris, MD, Jeffrey Matous, MD, Carmen Murias, MD, Benjamin Rolland Nadeau, MD, Michael Stipanov, MD, DK Strickland, MD, An Tran, MD, Kimberly Tucker, and Denise Yardley, MD.

The researchers represent Sarah Cannon’s global network of strategic sites:

Colorado Blood Cancer Institute, Sarah Cannon Research Institute at Florida Cancer Specialists, Sarah Cannon Research Institute at HCA Midwest Health (Kansas City), Sarah Cannon Research Institute at HealthONE (Denver), Sarah Cannon Research Institute at Tennessee Oncology, , Sarah Cannon Research Institute – United Kingdom, and The Stephenson Cancer Center at the University of Oklahoma

About Sarah Cannon Research Institute

Sarah Cannon Research Institute is the research arm of HCA Healthcare’s global cancer institute, Sarah Cannon. For 25 years, the organization has focused on advancing therapies for patients and has become one of the world’s leading clinical research organizations conducting community-based clinical trials throughout the United States and United Kingdom. Sarah Cannon’s network of strategic sites includes more than 275 physicians who engage in research. The organization has led more than 300 first-in-man clinical trials since its inception in 1993, and has been a clinical trial leader in the majority of approved cancer therapies over the last 10 years. Additionally, Sarah Cannon offers management, regulatory, and other research support services for drug development and industry sponsors as well as strategic investigator sites through its contract research organization (CRO), Sarah Cannon Development Innovations. For more information, visit sarahcannon.com.

https://bit.ly/2J4nJhL

#ASCO18: 1/2 Novartis treated leukemia ex-patients still in remission after 3 yrs

• ENESTop and ENESTfreedom data evaluate Treatment-free Remission (TFR) rates at 144 weeks among eligible Ph+ CML-CP patients who stopped Tasigna^® 
• Findings further support durability and safety of TFR with Tasigna; nearly all patients who lost TFR regained major molecular response after restarting therapy
• Novartis commitment to seek new solutions in CML continues with update of Phase III trial evaluating asciminib, an investigational BCR-ABL1 inhibitor

New Novartis data from two long-term Treatment-free Remission (TFR) studies in patients with Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) in the chronic phase (CP) will be presented during the 54th Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago. Results from the open-label Phase II trials, ENESTop and ENESTfreedom, show sustained TFR in patients treated with both front-line and second-line Tasigna^® (nilotinib) therapy. The 144-week trials evaluate the potential to maintain molecular response (MR) after stopping therapy in eligible adult patients with Ph+ CML-CP.

“Treatment-free Remission is a new treatment goal in CML,” said François-Xavier Mahon, Cancer Center of Bordeaux, Institut Bergonié and lead investigator of ENESTop. “Clinical studies like ENESTop and ENESTfreedom offer evidence that when a Ph+ CML-CP patient achieves a deep molecular response with Tasigna, along with other eligibility criteria, s/he can attempt TFR and have a nearly 50% chance of remaining treatment-free long-term. These results confirm an exciting opportunity for eligible patients – the opportunity to reduce time on drug for a chronic leukemia.”

Data from ENESTop, presented today in an oral session (Abstract #7003) show that approximately half (48.4%; CI 95%, 39.4%-57.5%) of patients with Ph+ CML-CP who are eligible to stop second-line Tasigna therapy maintained disease remission over a prolonged period of time in the absence of treatment at 144 weeks of follow up, almost 3 years[1]. Patients in this trial took Tasigna following a switch from Glivec^® (imatinib)*. ENESTop data also show that of the patients who restarted Tasigna due to loss of major molecular response (MMR=BCR-ABL/ABL <=0.1% IS), during the study period, nearly all (97.1%) regained MMR and 95.8% regained MR^4.5(BCR-ABL1 IS =< 0.0032%)[1]. Study authors stress that frequent scheduled and compliant monitoring is necessary to assess for loss of response. Results of ENESTop at 144-weeks are consistent with previously reported data at both 96- and 48-weeks.

A second long-term clinical trial, ENESTfreedom, is also part of the ASCO Scientific Program this week. The authors will report on TFR results at 144 weeks in patients who started front-line CML therapy with Tasigna. Results from ENESTfreedom will be shared with ASCO attendees on Monday, June 4 (Abstract #7063). In this trial, researchers found that almost half (46.8%; CI 95%: 39.6%-54.2%) of Ph+ CML-CP patients eligible to stop Tasigna treatment remained in MMR following treatment discontinuation[2].

“Novartis continues to redefine treatment options for Ph+ CML patients,” said Samit Hirawat, MD, Head of Novartis Oncology Global Drug Development. “The importance of achieving deep and sustained responses with Tasigna has been demonstrated in our TFR clinical program, which is the largest among all oncology companies. These long-term trials deliver on our commitment to the patient community to continue to look for more and better solutions for CML.”

An update on the Phase III clinical trial design for Novartis’ investigational BCR-ABL1 inhibitor, asciminib, will also be presented as part of the ASCO Scientific Program (Abstract #TPS7081).

https://bit.ly/2Lj87Up

Employers urge Trump administration to pull back on Obamacare mandate

The employer mandate — the only Obamacare tax Congress did not repeal or delay this year — has business groups urging the Trump administration to pull back from trying to collect as much as $4.3 billion from companies that are now on the hook for assessments.

Companies have cried foul about the tack the Internal Revenue Service has taken to collect the assessments, arguing that they weren’t given proper warning or due process and that the administration has violated clear provisions in the Affordable Care Act that outlined how the mandate should be enforced.

A broad coalition that includes the U.S. Chamber of Commerce and the National Retail Association argued in a letter to top officials that the “administration’s enforcement efforts violate the ACA’s express guarantee that employers be given ‘two bites of the apple’ before tax penalties can be assessed.”

They said the “cost, complexity and confusion surrounding compliance with the employer mandate” warrants suspension of the notice letters the IRS continues to send out.

Last fall, the agency began to warn employers via letter that they owed penalties for the 2015 calendar year. The letters continued while GOP-led Congress began to signal they would at least temporarily lift most of the other Obamacare levies such as the Cadillac Tax and health insurance tax. Congress even effectively eliminated the individual mandate penalty as the IRS sent at least 10,000 assessment letters to employers.

The agency estimates that more 30,000 companies owe money, according to testimony this April before the House Oversight and Government Reform Committee.

In one assessment letter obtained by Modern Healthcare last year, the IRS said the company in question needed to pay more than $3.8 million and allowed 30 days to respond with the money owed or evidence that the agency assessed an incorrect penalty.

Companies have been weighing legal action since late last year, and legal consultant Christopher Condeluci ,who has been advising business groups on the issue, said they continue to do so.

Although Congress hasn’t made a move to delay or repeal the employer mandate,House lawmakers last week proposed to delay the health insurance tax again until 2021.

https://bit.ly/2J7mAGe

CMS considers paying for medical device that treats depression

The CMS is considering paying for a type of brain stimulation therapy for Medicare beneficiaries suffering from treatment-resistant depression.

Vagus nerve stimulation (VNS) therapy involves implanting a battery-powered neurostimulator in a patient’s skull to send mild pulses of electrical energy to the brain.

VNS therapy costs up to $30,000 per person in the U.S., according to Inkwood Research, a Boston-based research firm. This includes the cost of the device itself, surgery and other hospital charges.

As many as 5 million people have treatment-resistant depression, according to the National Institute of Mental Health.

The CMS had previously paid for VNS in depression patients starting in 1999. But the agency eliminated the coverage in 2007 due to insufficient evidence showing VNS successfully treated their symptoms.

LivaNova, a medical device company that manufactures a VNS product, sent a formal request for coverage late last year. It cited a March 2017 study published in the American Journal of Psychiatry that showed patients with treatment-resistant depression who were treated with vagus nerve stimulation as well as medication and therapy had better outcomes than those who received just drugs and therapy.

“These patients are in desperate need of treatment options and we believe that the weight of scientific evidence provided in this formal request for reconsideration supports coverage of VNS therapy as a treatment option,” LivaNova officials said in a letter.

The CMS will accept comments on the request until June 29. It plans to issue a proposed decision by November and finalize its decision by next February.

https://bit.ly/2srQ8nI

Rehab hospitals call on CMS to trash payment changes

Rehabilitation hospitals say a proposed change to how the CMS will reimburse them for care could lead to inaccurate payments as new system pulls patient data from a new source.

In the 2019 inpatient rehabilitation proposed pay rule, the CMS proposed to retire the current patient assessment tool that helps categorize the level of care needed by a patient. The CMS used the information since 2002 to help determine IRF’s care reimbursement. But now the agency wants to switch to a new patient assessment tool that’s similar to one in place for other post-acute care settings to create a more uniform evaluation for patients’ care needs. The change will kick in on Oct. 1, 2019 if it’s finalized.

Clinicians use the tool in question to rank the severity of the patients care needs and develop a treatment plan.

The new assessment tool was introduced last year and it’s unclear if it tracks patient needs sensitively enough to determine reimbursement accurately. “The limited analysis CMS has made available to stakeholders is insufficient evidence as to the data’s validity or reliability as a basis for payment purposes,” Richard Kathrins, chair of American Medical Rehabilitation Providers Association’s board of directors, said in a comment letter.

Providers are worried about whether the new tool asks the right questions and helps them evaulate patients as thoroughly as the assessment method they’ve been using for years. The tool is still too new to answer those questions, according to rehab providers.

“Too little is known about the accuracy, consistency and clinical efficacy of the new clinical data and information that CMS is proposing to utilize,” Mark Tarr, president and CEO of Encompass Health, one of the largest providers of rehab hospital services in the nation said in a comment letter. “These clinical data and information have not been sufficiently studied, understood or validated to determine payment or patient care implications for rehabilitation hospital services.”

The Kentucky Hospital Association suggested the CMS should study and evaluate the accuracy and reliability of the new data source as well as its implications before changing the reimbursement model.

Jane Snecinski, president of consultancy Post-Acute Advisors, said these providers have a valid reason to be concerned.

“The dangers of moving from a validated system to one that doesn’t have that history may put providers at risk,” Snecinski said. “With limited validation and no piloting of a new system, how can the risk be evaluated?”

https://bit.ly/2kJD5tJ

Reigniting the physicians arms race, insurers are buying practices

In the turf war between hospitals and health insurers over physician practices, hospitals are winning by a long shot. But they’d be ill advised to get too comfortable.

A slew of recent activity shows that insurers are clawing their way back, whether by outright purchases of medical practices or targeting outpatient facilities that employ doctors.

UnitedHealth Group has long led the charge to buy medical practices, absorbing several a year into its OptumCare subsidiary. National insurers Centene Corp., Humana and, most recently, Anthem have also gotten into the game.

Why are insurers more engaged? Most see owning physician practices as a way to control spending. Others are defending their influence and revenue stream from rampant hospital-physician practice consolidation. Some, such as St. Louis-based Centene, are buying medical groups out of necessity to expand healthcare access to plan members.

“It’s the provider that’s in the catbird seat. From the payer side it’s definitely a defense mechanism to have more of a relationship with the patient,” said Sheila Talton, CEO of Gray Matter Analytics, a firm that uses data to help providers and payers reduce costs.

The uptick in deals is also part of a broader movement of health insurers seeking to better align with physician groups—particularly primary-care doctors—to closely manage patient care and improve quality and outcomes.

“Payers want to invest in making sure we have best access to primary care and management for our members with physician groups that are closely aligned with us contractually or through ownership,” said Denise Hanna, co-chair of law firm Locke Lord’s healthcare group. “The hope is that it makes it easier to implement best practices in primary care.”

UnitedHealth’s Optum in December 2017 agreed to buy dialysis provider DaVita’s medical group for $4.9 billion. The medical group employs more than 750 primary-care physicians directly or through associated groups, but contracts with thousands more.

The same month, Humana and two private equity firms announced they would buy post-acute provider Kindred Healthcare for $4.1 billion. For $800 million, Humana gets a 40% stake in the company’s home health, hospice and community-care division, which employs physicians and includes 40,000 caregivers who serve approximately 130,000 patients daily. The same trio in April moved to buy hospice operator Curo Health Services for $1.4 billion to combine with Kindred’s home division.

Humana also acquired Orlando, Fla.-based Family Physicians Group, which owns 22 clinics serving Medicare Advantage and Medicaid patients, in April for $190 million. Humana is moving its health clinics and doctor practices in Florida and Texas under a new brand called Conviva.

Medicaid managed-care insurer Centene Corp. in March said it was buying Community Medical Group, a primary-care provider in Florida with around 200 doctors serving 70,000 patients. And in May, Indianapolis-based insurer Anthem got into the game when it announced a deal to buy Aspire Health, a non-hospice palliative-care company that employs about 700 people, including physicians and other clinicians.

Despite the seemingly high pace of activity, relatively few physicians are employed by health plans. The American Medical Association found about 2% of all physicians in 2016 were employed directly by a health insurer or worked in a practice that was owned by one. The American Academy of Family Physicians also said the number of its members employed by a health insurer has remained steady in recent years at 2%.

Since insurers still lag in the total number of employed physicians, most experts don’t see the strategy as a threat to hospitals, which are buying practices at a much faster clip, acquiring 5,000 independent practices between July 2015 and July 2016, according to a study by the consulting firm Avalere Health and the Physicians Advocacy Institute. The number of doctors employed by hospitals grew by 14,000, or 11%, over the same time period, the study found.

And a 2017 AMA study showed that less than half of practicing physicians—47.1%—owned their medical practice in 2016. About 32.8% of physicians were in hospital-owned practices that year, according to the AMA.

Insurers are playing defense by buying doctor groups, some industry experts said. When hospitals buy physician practices, they are able to keep patients in their health systems and protect their revenue. Insurers that buy doctor groups are able to reduce their spending by exerting more control over how those physicians practice medicine, where they refer patients, and what medications they prescribe.

“Health insurers believe this is a defensive strategy to control the premium streams,” said Paul Keckley, industry consultant and managing editor of the Keckley Report. “A doctor and an insurer can substantially ratchet down what’s spent in hospitals.”

But there are other reasons insurers eye physician practices, and they differ from health plan to health plan. Many aren’t buying physician practices for the sake of employing doctors, but to further another goal. Humana’s stake in Kindred’s home health and hospicedivision is likely to help reduce costs for its large Medicare Advantage population of 8.6 million. Analysts have also noted that Aspire Health’s medical providers are unlikely to be Anthem’s motivation for buying the palliative-care operator. Anthem CEO Gail Boudreaux said in a statement that the deal furthers its strategy of providing integrated care to improve outcomes.

Large-scale deals between companies from different parts of the supply chain, including those between CVS Health and Aetna, and Cigna and Express Scripts, also aim for improved care integration.

Centene’s bid for Community Medical Group, which owns 12 primary-care and specialty clinics in Florida, was a strategic move to improve access to care in an area where it was lacking, CEO Michael Neidorff said.

“I don’t have interest in owning a lot of doctors,” Neidorff explained. “I think patients get better care when the vast majority of physicians are independent. However, there are times where we need to ensure our population has access to high-quality care,” and that’s when an acquisition may make sense.

Some doctors who once balked at the idea of working for an insurance company have come around to the idea. Dr. Amir Bacchus, chief medical officer of Henderson, Nev.-based population health management startup P3 Health Group, was sought out by UnitedHealth to help manage a group of employed doctors several years ago when he was a regional chief medical officer at HealthCare Partners of Nevada. He turned them away. HealthCare Partners later was bought by DaVita Medical, which late last year agreed to sell the group to UnitedHealth. 

Bacchus said there are both good and bad examples of managed-care organizations that employ physicians. Organizations like Kaiser Permanente that manage both sides of the healthcare equation have excelled because they treat their physicians like assets and allow them to lead, he said. But there’s a danger in treating physicians like a commodity to leverage against hospitals.

“For places that do things like that, you see high physician burnout because autonomy begins to wane, and then physicians feel like they’re cogs in the wheel,” Bacchus said.

Patient choice could also dwindle in markets where insurers employ most doctors. In Nevada, for instance, Bacchus said UnitedHealth’s Optum and DaVita Medical Group doctors, who must sign strong noncompete contracts, would together treat hundreds of thousands of patients in the state, whose population totals about 3.1 million.

Across the country in Connecticut, some insurers and money management firms have taken to buying just the administrative side of physician practices, including claims processing, billing and technology, and they leave the clinical side of the practice alone to focus on patient care.

Optum in December 2015 bought the administrative and back-end operations piece of ProHealth Physicians. The Connecticut primary-care group with 370 doctors at the time would continue to be physician-owned. That sort of arrangement can be a sweet deal for doctors, said Matthew Katz, president of the Connecticut Medical Society.

“If they have someone else doing the collection and management of the business, they see they’re better off focusing on what they’re good at,” he said, adding that insurers are able to reap profits in such deals by streamlining billing and collecting more revenue. Physician practices, he said, have struggled with heavy debt loads as the number of patients enrolled in high-deductible health plans has grown.

Still, many insurers are looking to collaborate more closely with doctors but aren’t interested in employing them. Dr. Michael Cropp, CEO of Buffalo, N.Y.-based not-for-profit insurer Independent Health, spent much of his career as a family physician practicing at staff model HMOs, including HealthPartners in Minneapolis. He decided the processes developed at staff models could be used in an environment where doctors kept their independence so long as some organization was able help with capital and infrastructure. Independent doctors have more room to try innovative things, he said.

“You’d get the best of both worlds,” Cropp explained. “You’d have a sense of ownership in the practice with the drive to be patient-centered, and room to continue to improve, with the ability to invest in these new models of care.”

Independent Health began collaborating with primary-care physicians to create, back in 2012, a new care and value-based payment model in which doctors were accountable for the whole continuum of care. That initiative led to better care coordination and cost savings. Later, once most primary-care doctors in the area received most of their payments through a value-based care model, Independent Health led efforts to include Buffalo in the CMS’ Comprehensive Primary Care Plus program starting in 2018.

It launched a company called Evolve Practice Partners last year to help local physician practices succeed in that program, which aims to improve patient outcomes and lower costs. “If we don’t have strong practices, we don’t have a product to sell,” Cropp said. “And if we don’t make these investments, who will? They don’t have capital, they don’t have human resources or access to these new ideas without us.”

For-profit insurer Cigna Corp. has also largely opted to take the collaborative route, as employing doctors tends to restrict patient choice, CEO David Cordani said. The Bloomfield, Conn.-based insurer has struck 500 accountable care arrangements under which it rewards physicians for meeting cost and quality targets when managing a group of patients.

“We don’t want to design products that are proprietary to our access points. We think that restricts choice,” Cordani said. “We would prefer to partner and afford broader choice and broader accessibility for the individuals and then partner and enable the physicians, as opposed to try to control them through ownership.”

https://bit.ly/2kKy5Fi

Vegetarian diet reduces heart disease death risk by 40 percent

The latest in a long line of papers on the many health benefits of reducing meat intake concludes that a plant-based diet is great news for your heart.

A new review concludes that plant-based diets improve heart health.

Currently, in the United States, vegetarianism and veganism are steadily becoming more popular.

Touted as a more healthful option, many people are working to reduce their meat intake.

In the past few decades, numerous studies have demonstrated that restricting meat impacts the body in a number of positive ways.

For instance, a plant-based diet has been shown to reduce the risk of obesity, type 2 diabetes, and metabolic syndrome. Vegetarianism and veganism may even protect against certain cancers.

A recent review, now published in the journal Progress in Cardiovascular Disease, focused on the benefits of a plant-based diet on cardiovascular health, specifically.

Plant-based diets and heart health

The researchers — from the Physicians Committee for Responsible Medicine in Washington D.C. — scrutinized reams of recent, relevant studies.

Collating information from a host of clinical trials and observational studies, they found that a plant-based diet was consistently linked with improved measures of heart health.

They concluded, for individuals following a plant-based diet, that:

• Risk of death from cardiovascular disease is reduced by 40 percent.
• Coronary heart disease risk is reduced by 40 percent.
• Blocked arteries are unblocked partially or fully in as many as 91 percent of patients.
• Hypertension risk drops by 34 percent.

Also, total cholesterol and low-density lipoprotein, or “bad,” cholesterol levels are much lower in vegetarians compared with non-vegetarians. Moreover, a plant-based diet was shown to be associated with weight loss.

“A plant-based diet has the power to not only prevent heart diseasebut also manage and sometimes even reverse it — something no drug has ever done.”

Study author Dr. Hana Kahleova, Ph.D.

Dr. Kahleova also notes that more healthful diets and lifestyles lower the risk of heart attack by 81–94 percent, while drugs can only lower this risk by 20–30 percent.

How does vegetarianism protect the heart?

There seem to be many reasons why a plant-based diet is more healthful for the heart than a meat-heavy one. It seems that plants impart some benefits, while meat increases certain risks.

For instance, plants are rich in fiber and phytonutrients, which are known to reduce inflammationand oxidative stress. Also, animal products are often high in fat, cholesterol, heme iron, and environmental pollutants.

However, this is a complex interaction, and there may be many more factors involved that are, as yet, unknown.

Heart disease is responsible for the deaths of more than 600,000 U.S. individuals each year, and it remains the leading cause of death, globally. However, these findings show that if society could be gently nudged toward plant-based diets and away from excessive meat consumption, humanity’s heart health could be substantially improved.

As Dr. Kahleova notes, with more than a dash of positivity, “Heart disease is the world’s leading cause of death. This study proves it doesn’t have to be.”

https://bit.ly/2xycyZH