Search This Blog

Monday, June 24, 2019

BCBS of Minnesota buys joint ownership of hospital’s 20 clinics

Minneapolis-based North Memorial Health and Blue Cross and Blue Shield of Minnesota signed a joint venture agreement to become shared owners of North Memorial’s clinics.
Under the joint venture, announced June 24, BCBS’ parent company, Stella, will purchase a 49 percent ownership in North Memorial’s 20 clinics. North Memorial will retain 51 percent ownership of the joint venture.
The transaction, which will be implemented in 2020, was spearheaded by the physician CEOs of both organizations: BCBS of Minnesota’s Craig Samitt, MD, and North Memorial’s J. Kevin Croston, MD.
“Healthcare costs too much, and it is too often difficult for people to understand and navigate. With this joint venture, we’re removing confusion from the equation,” Dr. Samitt said in a press release. “Blue Cross and North Memorial Health have come together to transform healthcare in Minnesota in a way that no others have, and the winner will be the consumer.”
The business that will run the 20 primary and specialty care clinics will be seperate from both parent organizations. A newly created CEO position and board of directors will manage the clinics. Jennifer Close, president and chief ambulatory officer at North Memorial, will serve as the joint venture’s CEO.
The shared ownership structure aims to lower the overall cost of care by up to 20 percent over five years through value-based payments that focus on wellness, prevention and health outcomes over consumption, according to the organizations.
“Incremental change has been holding the healthcare industry back for too long. The industry is moving too slow, so we are taking bold action to create a transformative solution that is consumer friendly, improves the quality of care and delivers outcomes that are measurably better than others,” Dr. Croston said in a prepared statement. “It is our mission to deliver this change with and for the communities we serve by keeping the healthcare consumer at the center of everything we do.”
Posted by at No comments:

Trump demands transparency on healthcare costs: 7 things to know

President Donald Trump has signed an executive order that aims to lower healthcare costs by improving price transparency.
Seven things to know:
1. The order, signed June 24 at the White House, directs HHS to develop rules requiring hospitals to publish prices “that reflect what people actually pay for services in a way that’s clear, straightforward and accessible to all,” said President Trump.
2. It should also “require healthcare providers and insurers to provide patients with information about the out-of-pocket costs they’ll face before they receive healthcare services,” HHS Secretary Alex Azar said before the order was signed, according to NPR.
3. The overall thought behind the order is that price variation exists among healthcare facilities for the same service, and patients need information to find the cheapest and highest quality care. The administration expects the order to promote competition for health services and lower healthcare costs.
4. President Trump said: “For too long it’s been virtually impossible for Americans to know the real quality and price of healthcare services and the services they receive. As a result, patients face significant obstacles shopping for the best care at the best price, driving up healthcare costs for everyone. With today’s historic action, we are fundamentally changing the nature of the healthcare marketplace. This is bigger than anything we’ve done in this particular realm.”
5. Details about how the rules called for in the order would work remain unclear, but they could prompt healthcare to operate more in a way where patient behavior is driven by quality and price, NPR said.
6. CMS Administrator Seema Verma welcomed the order. Her statement says she is excited to implement reforms “that transform our healthcare system into one that delivers affordable and accessible healthcare and puts American patients first.”
7. However, hospital and health plan lobbyists say that  public disclosure of competitively negotiated, proprietary rates would lead to higher healthcare prices, according to NPR. America’s Health Insurance Plans is arguing the disclosure will reduce competition.
Posted by at No comments:

New therapy promotes vascular repair following stroke

New therapy promotes vascular repair following stroke
Blocking Nogo-A promotes vascular growth (angiogenesis) around the affected brain region and improves the brain’s capacity to regenerate damaged tissue and neural circuits. Credit: Ruslan Rust
Following a stroke, antibodies that inhibit the signaling molecule Nogo-A can help repair blood vessels in the affected brain regions. This also promotes the regaining of motor functions, researchers at the University of Zurich have shown in a mouse model. The study opens up new avenues for treatment.
Each year, around 16,000 people in Switzerland and 15 million people worldwide suffer a stroke. Two thirds of those affected die or remain in permanent need of care due to the brain’s limited capacity to regenerate damaged tissue and neural circuits. At present, despite intensive research efforts only a few medical therapy options are available that reduce the serious consequences after cerebral stroke.
Signaling molecule Nogo-A regulates blood vessel sprouting
A promising new approach to promote the recovery of physiological functions aims to repair the system of vessels in the affected brain regions. The system supplies the injured tissue with oxygen and key nutrients. In people who have suffered a stroke, this repair process is inhibited by a number of mechanisms. A few years ago, the research group of UZH Professor Martin Schwab used a  to, among other things, show that the signaling molecule Nogo-A not only reduces the growth of nerve fibers, but also regulates blood  sprouting in the brain and could thus also inhibit their repair.
Motor function improvement thanks to vascular growth
In a new study with mice, the researchers genetically deactivated the Nogo-A molecule or one of its corresponding receptors, S1PR2. The blood vessels in these mice showed improved regenerative capacity, and they recovered affected better than those of the mice in the control group. These findings were reproduced in a therapeutic approach using anti-Nogo-A antibodies in mice following a stroke, which too led to the re-formation of a robust and functional vascular network around the affected brain regions. “The  of the treated mice showed better recovery and their motor functions were less affected, which we ascribe to vascular regeneration,” says first author and UZH neuroscientist Ruslan Rust.
Nogo-A antibodies already in clinical tests for spinal cord injuries
Previous experimental efforts to enhance vessel growth have almost exclusively focused on vascular growth factor supplementation, an approach that has been shown to be clinically unviable due to  such as increased risk of hemorrhage. “Our findings provide a promising alternative approach to treating  patients,” says Rust, “not least since anti-Nogo-A antibodies are already being used in clinical testing for spinal cord injuries.”
The study is being published in the Proceedings of the National Academy of Sciences.
Explore further
More information: Ruslan Rust el al., “Nogo-A targeted therapy promotes vascular repair and functional recovery following stroke,” PNAS (2019). www.pnas.org/cgi/doi/10.1073/pnas.1905309116
Posted by at No comments:

Certain cells secrete a substance in the brain that protects neurons

USC researchers have discovered a secret sauce in the brain’s vascular system that preserves the neurons needed to keep dementia and other diseases at bay.
The finding, in a mouse model of the human , focuses on specific cells called pericytes and reveals that they play a previously unknown role in brain health. Pericytes secrete a substance that keeps neurons alive, even in the presence of leaky blood vessels that foul brain matter and result in .
The study, which appears today in Nature Neuroscience, helps explain the cascade of problems that lead to neurodegeneration after stroke or , as well as in diseases like Alzheimer’s and Parkinson’s—and suggests a potential strategy for therapy.
“What this paper shows is if you lose these vascular cells, you start losing neurons. The link with neurodegeneration was really not that clear before,” said senior author Berislav Zlokovic, director of the Zilkha Neurogenetic Institute at the Keck School of Medicine of USC.
The discovery comes at a time when scientists are beginning to understand Alzheimer’s disease as the result of multiple processes that begin long before memory loss sets in. Many researchers are shifting their focus from the amyloid plaques that accumulate in the brain later in life toward other targets earlier in the timeline.
Zlokovic, for example, studies the layers of cells that make up blood vessels in the brain. His previous research shows that the more permeable, or leaky, a person’s brain capillaries, the more cognitive disability they have.
For this new experiment in mice, Zlokovic zeroed in on pericytes in the brain’s . Pericytes help regulate blood flow and keep blood vessel walls sealed tight. When researchers artificially removed pericytes, they saw rapid degeneration of the blood-brain barrier, a slowdown of blood flow and the loss of brain cells.
To further understand the role of pericytes, the scientists infused mice with a protein, or , secreted by pericytes in the brain and not found elsewhere in the body. They found that, even with pericyte cells artificially removed, the growth factor protected neurons and the brain cells didn’t die. The results persisted even with constricted .
Because these pericytes are implicated in many diseases—including Huntington’s, Parkinson’s, stroke, brain trauma and —the research offers intriguing possibilities for further investigation.
“This opens up an entirely new view of the possible pathogenesis of Alzheimer’s disease,” Zlokovic said.
Explore further
More information: Sharpening the tools for pericyte research, Nature Neuroscience (2019). DOI: 10.1038/s41593-019-0434-z , https://www.nature.com/articles/s41593-019-0437-9
Posted by at No comments:

Half of U.S. adults should monitor blood pressure at home: study

Some people go to the doctor and find the intake so nerve-wracking their blood pressure spikes. Others find the routine relaxing, as they’re asked to rest for a moment and breathe easy before a blood pressure cuff is wrapped around their arm.
People with borderline hypertension in both categories should confirm the readings by measuring their  pressure outside their health care provider’s office, according to new research published Monday in the American Heart Association journal Hypertension.
Nearly 93 percent of U.S. adults who have high blood pressure when measured in their  and don’t take blood pressure medicine meet the criteria for “white coat hypertension” because their blood pressure is in an acceptable range when re-measured outside a medical setting. Meanwhile, about a third of U.S. adults experience “masked hypertension” because their blood pressure levels measured outside of the doctor’s office are more problematic than measurements at the doctor’s office.
“For some people, a doctor’s office is a place they’re relaxed,” said Paul Muntner, an epidemiologist at the University of Alabama at Birmingham and the study’s senior author. “They are away from job stress, traffic and family issues.”
Others, he said, get anxious they are about to get bad news about their blood pressure – or something worse. Their readings in the doctor’s office cause concern whereas measuring in a more familiar setting would cause less stress.
In either case, the study used the American College of Cardiology and American Heart Association guidelines to determine that as many as 104 million Americans routinely should use a blood pressure machine at home to provide backup for – or a contrast with – the results from their visit to the doctor’s office. People are considered to have high blood pressure if their systolic, or top number, is 130 or higher and their diastolic, or bottom number, is 80 or higher.
Measuring blood pressure outside of a medical setting doesn’t have to be expensive or difficult.
Many pharmacies or  have blood pressure machines customers can use for free. Reliable home versions with an electronic inflatable cuff can be found at local drug stores for less than $50, and Muntner said the device should be one that already has been tested and validated.
Other options, such as ambulatory blood pressure machines, can be more involved. Those provide readings throughout the day and night and can flag hypertension while people are asleep.
But the sheer size of the population the study suggests should be measuring their blood pressure at home could make it a daunting task to achieve, said Dr. Raymond R. Townsend, who was not associated with the study.
“How many people would be well served by out-of-office blood pressure monitoring? My answer would be virtually anybody,” said Townsend, who heads up the high blood pressure program at the Hospital of the University of Pennsylvania in Philadelphia. “I think that’s a little ambitious.”
The study concedes there are barriers to widespread blood pressure monitoring at home: patient compliance, accuracy of the results, out-of-pocket costs of the device and the time needed to instruct patients on how to take their blood .
What is not subject to debate is the importance of controlling hypertension. The consequences of unmanaged  can include heart disease, stroke and organ damage.
And, Muntner said, the study makes a case that there is a benefit to getting more people to check their  on their own.
“For individual patients, hopefully it means people will be more engaged with their own health care and not just when they go to the doctor’s office.”
Explore further
Posted by at No comments:

CityMD and Summit Medical Group to merge

CityMD and Summit Medical Group have signed a definitive agreement to merge, the urgent care chain and independent medical group announced Thursday.
New York City-based CityMD and Berkeley Heights, N.J.-based Summit will be supported by Warburg Pincus, the private-equity firm that acquired a majority stake in CityMD in June 2017.
“Our companies are united by a shared belief that upholding a patient-centered philosophy in today’s environment means providing convenient, on-demand access to outstanding primary care, cutting-edge specialty care and a breadth of ancillary services,” Dr. Jeffrey Le Benger, chairman and CEO of Summit Medical Group, said in prepared remarks.
Founded in 2010 by a group of emergency medicine physicians, CityMD has grown to more than 120 locations across New York, New Jersey and Washington.
Summit has more than 900 physicians at 80-plus locations including comprehensive ambulatory care campuses and a cancer center.
It recently expanded its footprint by acquiring Bend Memorial Clinic, which has 120 doctors in Oregon, to form Summit Medical Group Oregon as well as Arizona Primary Care Physicians and its 51 providers in the Phoenix area to form Summit Medical Group Arizona.
Posted by at No comments:

Your Pet Probably Won’t Give You a Superbug

There was no significant association between people who kept pets with multi-drug resistant organisms in their stool and the people having the organisms in the stool themselves, a researcher said here.
A small study of 32 people found a non-significant link between pet owners who had a pet with multi-drug resistant Enterobacteriaceae in their stool, though these findings did trend towards significance, reported Alexander Page, BA, of Emory University in Atlanta.
However, there was a significant association between pets having multi-drug resistant organisms in their stool if their humans were colonized with those same organisms, Page and co-authors reported in a poster at ASM Microbe.
Page told MedPage Today that all the previous studies up until now that examined this issue were not done in the U.S., and the patient population was much different.
“Most of the time, either the pet or the human had some sort of clinical infection. We’re just looking at healthy people to get a very baseline idea,” he said.
Researchers recruited 32 pet owners who lived with their companion animals (51 dogs or cats) in July 2018, and collected stool samples from people, dogs, and cats at baseline, at 2 months and 6 months. People were an average age of 41; 25 were women and 25 were white. Pets were an average age of 6, and 37 were dogs. Stool was cultured for the presence of multi-drug resistant isolates, and polymerase chain reaction (PCR) testing was done to determine resistance mechanisms, the authors said. A large majority of the identified isolates were Escherichia coli, with a minority of Klebsiella and Enterobacter.
At baseline, four people and two dogs or cats had multi-drug resistant Enterobacteriaceaein their stool. Page pointed to the 12.5% of people colonized with these organisms as “a little bit shocking.”
“Maybe it’s not totally unsuspected, but that’s a bit of a red light going off,” he said, adding that another alarming finding was that most pet owners, especially cat owners, did not take their pets to the veterinarian.
During the study, researchers found that five humans and eight pets had multi-drug resistant Enterobacteriaceae in their stool at one or more study visits. Overall, 13 of 32 households had at least one multi-drug resistant stool isolate in a human or a pet while enrolled in the study. The authors also found that a higher portion of dogs were colonized versus cats.
There was no significant association between people colonized with multi-drug resistant organisms and those with any household antibiotic use or occupational clinical exposure, though those also trended towards significance, Page said.
Next steps in this research will be to do whole-genome sequencing and eventually a microbiome analysis. He said that apart from prophylactic suggestions, their findings should encourage owners to “practice safe snuggling.”
“Pets are family members for most people. You can’t tell people not to snuggle with their pets. Just take your pets to the vet,” Page said.
Hargita and Page disclosed no relevant relationships with industry.
LAST UPDATED 
Posted by at No comments:
Subscribe to: Posts (Atom)