Texas Walmart hosting Beacon mental health clinic

• Beacon Health Options announced it is launching outpatient mental health therapy in retail stores and other locations that the company said will provide “convenience, privacy and accessibility.”
• The company’s Beacon Care Services will opens its first location in a Walmart store in Carrollton, Texas, which is near Dallas.
• Beacon Health Options, which works with employers, health plans and government agencies to provide mental health and addiction services,said the retail locations will help address behavioral healthcare professional shortages.

Retail clinics are starting to become the norm for medical care. Pharmacy chain stores like CVS and Walgreens have clinics for patients to get basic care, such as treatment for cold and flu. With this mental health clinic, Beacon and Walmart are seeking to make behavioral health more convenient.

Each Beacon Care Services location will include at least one clinician who will work with patients on issues such as depression, anxiety, stress and grief.

“We chose a retail setting for the first practice because it offers the convenience of a local neighborhood location that is close by and easy to get to and our evening hours accommodate our patients’ schedules,” Beacon CEO Russell Petrella said in a statement.

More than 10.1 million people live in the area that is facing a provider shortage and only 35% of Texans’ mental health needs are met statewide, according to the company. Beacon’s first step is in Texas, but the company hopes to expand further and is evaluating other locations.

Meanwhile, Walmart has shown an interest in multiple areas of healthcare. The big box retailer announced earlier this year it had hired Sean Slovenski, former vice president of innovation at Humana, to lead its health and wellness division.

Walmart considered buying the payer earlier this year, but nothing formal has come from those rumors, and Walgreens and Humana is the more likely pairing, according to The Wall Street Journal.

Also, Walmart partners directly with hospitals to provide value-based carethrough bundled payments. For instance, Walmart has a Center of Excellence Network that seeks to reduce unnecessary spinal surgeries. The company contracts with 12 high-quality centers around the U.S., including Mayo Clinic, Mercy Hospital Springfield in Missouri, Virginia Mason Medical Center in Washington and Geisinger Medical Center in Pennsylvania, to offer spine surgeries. Walmart covers 100% of procedures, travel to the facilities (including airfare), lodging and expenses at those facilities for the patient and caregiver.

https://www.healthcaredive.com/news/texas-walmart-hosting-beacon-mental-health-clinic/542948/

Open Health blockchain-enabled feature to incentivize patient data sharing

• Mountain View, California-based Open Health Network has launched a new platform feature that lets users earn cash or rewards for uploading personal health data.
• The new feature, called PatientSphere, uses artificial intelligence and blockchain technology to connect researchers and healthcare companies with those seeking subjects for clinical trials or analytics, and monetizes the data they provide.
• Patients can also share their data — which can be uploaded from a range of sources including wearables, EHRs and Google Fit — with their personal physicians and insurance company.

The first layer of the program allows people to compile their health data in a single location and decide who has access and when and where the information can be seen. The middle layer is actually comprised of two layers — a HIPAA-compliant database where the data are stored and patient identity management powered by blockchain. Finally, there is a HIPAA-compliant metadata layer for searching potential trial participants and publishing identified information.

The new blockchain-enabled feature could help users in the push toward interoperability and getting patients to engage more with their data.

Blockchain is seeing more use in healthcare. Providers, payers, companies and medical researchers all see potential for the technology to solve problems ranging from interoperability to supply chain issues and getting people to adopt healthy behaviors.

But numbers are key. The more people who join a blockchain network, the more robust the entire blockchain becomes. One of the biggest challenges for blockchain in healthcare is convincing people to hop on the network, because incentives are not always aligned between different groups of potential participants.

“What blockchain has been able to do is create markets where a market didn’t previously exist,” Noah Zimmerman, director of Mount Sinai’s Center for Biomedical Blockchain Research, told Healthcare Dive earlier this year. “The question is, are there ways to harness that same kind of behavior — getting people involved and incentivized to achieve an important goal — and do that in the healthcare space?”

Other companies are looking to create data marketplaces in healthcare. Mumbai, India-based LTI is working with a large European insurance company on a wellness program that uses blockchain to track healthy behaviors at a corporate and individual level and rewards participants with discounted rates.

And Embleema has developed a patient-driven blockchain network that lets patients securely share their medical records and personal health information and set limits on who can access the data.

https://www.healthcaredive.com/news/open-health-launches-blockchain-enabled-feature-to-incentivize-patient-data/543310/

Amazon partners with life sciences group, adapting its 1-Click tech

• Amazon is partnering with life sciences tech company M3Health ​to bring the tech giant’s IoT 1-Click technology to the healthcare space.
• The thumb-sized device allows pharma and biotech companies to engage physicians and patients who use their products. An early customer is Novartis’ oncology division.
• A potential use case is enabling doctors to click once to order drug samples and twice to request more information about medications. The button could also be used by patients seeking support services, or to track therapy adherence and request refills.

This move could be one way for Amazon to work its way into healthcare supply chains. While PillPack, certain medical devices products and digital health apps are more consumer-facing, this shows Amazon is also targeting the lucrative market of healthcare professionals.

Providers are enthusiastic about Big Data’s potential to improve patient care, but interoperability remains a barrier to widespread use of predictive analytics and other health IT advances. Amazon has signaled its intent to tackle these barriers with a number of moves, including its acquisition of online pharmacy PillPack this summer.

Also, The Wall Street Journal recently reported that Amazon is selling software that scans patient medical records for hints that can help doctors and hospitals fine-tune patient treatments while reining in costs.

The company’s Amazon Web Services division also recently expanded its catalog of HIPAA-eligible AI services, which could help ease physician burnout due to increasing administrative burdens. Amazon Translate, Amazon Comprehend and Amazon Transcribe join Amazon Polly, Amazon SageMaker and Amazon Rekognition in AWS’ HIPAA-eligible portfolio.

Amazon Business, the company’s B2B purchasing unit, sees a supply chain opportunity in today’s healthcare environment of rising operating expenses, falling admissions and increasing pressure to cut costs.

Amazon’s strategy includes marketplace disruption, streamlined ordering and use of analytics to coordinate activities among disparate purchasing groups.

“Maybe you’ll have the hospital maintenance department in one group, and then the care providers like nurses and doctors in another group, and then the supply chain purchasing department in another group,” Chris Holt, global healthcare leader at Amazon, told Healthcare Dive in July. “To all of those different employees, we provide analytics on what each different group is doing, what kind of spend categories they’re buying in, how that’s trending over time [and] insights into the price and cost-effectiveness of what they’re buying.”

https://www.healthcaredive.com/news/amazon-partners-with-life-sciences-group-adapting-its-1-click-tech/543314/

How will data drive CVS-Aetna merger?

After the $70 billion megamerger between the pharmacy chain and insurance giant, focus has shifted to what impact the data will mean for the new company’s strategy in the years to come.

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KEY TAKEAWAYS

Opportunities abound for CVS-Aetna after the $70 billion merger according to industry insiders.

However, concerns about making actionable items out of the data and protecting consumer privacy remain as obstacles.

The CVS-Aetna megamerger that officially closedWednesday morning is slated to have a transformative effect on the healthcare industry as the pharmacy chain and health insurer unite.

Through a vertical integration without significant precedence in healthcare, CVS and Aetna have the opportunity to use their increased scale to pursue several innovative business strategies going forward. Many industry players are interested in what the newly merged company could accomplish to further assist consumers at multiple points along the healthcare experience.

However, the combination of two separate healthcare populations has also raised questions about potential issues surrounding consumer privacy and how effectively CVS and Aetna will utilize the data.

John Sculley, former CEO of Apple and current CMO of RxAdvance, a cloud-based pharmacy benefit manager told HealthLeaders that the deal is a great accomplishment for CVS CEO Larry Merlo as the healthcare industry pivots from a hierarchical structure to focusing primarily on consumer needs.

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“The big opportunity with data is how do we move from an industry that has always been siloed to an industry that wants to have data flows across the entire system of care,” Sculley said.

Sculley says that Merlo’s plan to reformat CVS’ stores away from selling products and emphasizing the delivery of healthcare to services based on health, such as nutrition or social determinants, is an innovative move. He also believes that the CVS-Aetna merger will open the doors for widespread M&A activity across the healthcare sphere in addition to the potential mergers on the table currently.

Bill Fox, global chief strategy officer of Healthcare and Life Sciences at MarkLogic, an enterprise database company, told HealthLeaders that the entire merger will rely on what the new company does with its data operations.

“A lot of the assumption around this that it will be good for patients is built around leveraging that data,” Fox said. “The question is, will they do the right things from a technology and IT standpoint to get that data integrated into an operational data hub where they can appropriate, timely action on this new information that they have to improve outcomes.”

Fox cautioned that many mergers are undone by inaction on integrating data between the companies, which is an obstacle CVS and Aetna will have to overcome to ensure the deal is a success.

Sloan Gaon, CEO of PulsePoint, told HealthLeaders that data does not transform industries, but rather how healthcare companies analyze and utilize their data for actionable items is what transforms industries like healthcare.

Gaon said Aetna and CVS are likely to drive down prices for consumers and increase shareholder value but remained skeptical about whether the deal would improve patient care quality. He also expressed concern about how CVS and Aetna will ensure consumer data remains private and secure from potential hacks or misuse outside the organization.

“Is the average American willing to trust Aetna and CVS with their private data and information?” Gaon said. “Regulatory constraints may inhibit the sharing of that data in a way that patients have more control going forward than less because of those regulatory constraints.”

https://www.healthleadersmedia.com/finance/how-will-data-drive-cvs-aetna-merger

Verma lambastes ObamaCare, gives states 4 ways to bypass it

The new waiver concepts aim to give states inspiration on how they might construct applications for waivers under the law with new flexibility the Trump administration announced last month.

Centers for Medicare & Medicaid Services Administrator Seema Verma strongly criticized the Affordable Care Act in a speech Thursday and invited states to sidestep provisions of the Obama-era law in four ways, outlining a policy path forward that critics worry could undermine the ACA’s central protections.

The four waiver concepts CMS released Thursday stem from revisions to a guidance document the Trump administration released last month to grant states greater flexibility under the ACA’s Section 1332 waivers, which the administration has renamed State Relief and Empowerment Waivers.

“With this guidance, states will be able to develop innovative approaches that break away from the otherwise inflexible federal approach and increase consumer control and expand choice and competition in their markets,” Verma said.

Some have questioned the legality of the administration’s revised guidance, based on the fact that it avoided formal notice-and-comment rulemaking.

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“There are serious questions about whether the policy articulated in the guidance is a permissible interpretation of the underlying statute, but, at the very least, it is likely invalidfor the agency to attempt to make this policy without a full rulemaking process,” Christen Linke Young, a fellow with the USC-Brooking Schaeffer Initiative for Health Policy, wrote in analysis.

The changes to the guidance reinterpreted key terms in the ACA’s statutory guardrails, which are designed to keep Section 1332 waivers from undermining the law’s intent, as HealthLeaders reported last month.

Verma acknowledged during a call with reporters Thursday that states could propose to use federal subsidies to cover short-term limited-duration plans (which qualify as “coverage” under the guidance’s revised definitions, even though they are not required to offer the full benefits and preexisting condition protections as ACA-compliant plans), but she offered reassurance that CMS would weigh each state’s proposal against the ACA’s guardrails.

“At the end of the day, we’re going to look at the proposal that the state gives us against the four guardrails. So we’d look at it in terms of comprehensiveness, affordability, coverage, and deficit neutrality,” she said.

“We’re particularly interested in looking at the proposals on the impact [on patients] with complex healthcare needs because it has to be affordable for them, has to be comprehensive,” she added. “We’re going to look at the proposals that are delivered to us head-to-toe along those four guardrails.”

4 WAIVER CONCEPTS

There have been eight waivers approved already under Section 1332, representing two types of waivers. Seven states have secured waivers for permission to establish state-run reinsurance program. The eighth, Hawaii, has had a waiver since 2016 that authorizes its Small Business Health Options Program.

Having experienced the waiver application process firsthand, Verma complained that the rules are too stringent, impeding innovation. So the Trump administration loosened the rules and outlined four waiver types as inspiration for state-led proposals:

1. Account-Based Subsidies: States could redirect federal subsidies to accounts consumers manage to cover insurance premiums or other healthcare expenses. “An account-based approach could give beneficiaries more choices and require them to take responsibility for managing their health care spending,” the administration said in a fact sheet. “This approach could also allow a consumer greater ability to select a plan based on the individual’s or their family’s needs, including a higher deductible plan with lower premiums.”
2. State-Specific Premium Assistance:  States could devise novel subsidy programs of their own that uses federal pass-through dollars. “A state may design a subsidy structure that meets the unique needs of its population in order to provide more affordable health care options to a wider range of individuals, attract more young and healthy consumers into their market, or to address structural issues that create perverse incentives, such as the subsidy cliff,” the administration said.
3. Adjusted Plan Options: States could offer financial assistance for consumers to buy plans that don’t meet the definition of a Qualified Health Plan, opening the door to more affordable options that may provide less coverage. “Used in conjunction with the Account-based Subsidy waiver concept, states could provide subsidies in the form of contributions to accounts, allowing individuals to use the funds to purchase coverage that is right for them and use any remaining funds in the account to offset out-of-pocket health care expenses,” the administration said.
4. Risk Stabilization Strategies: States could establish reinsurance programs or high-risk pools. State-run reinsurance programs vary from state to state and have already lowered premiums and improved market stability. “These models include a claims cost-based model, a conditions-based model, and a hybrid conditions and claims cost-based model,” the administration said.

More information is available on the Section 1332 waivers page of the CMS website.

https://www.healthleadersmedia.com/innovation/verma-lambastes-aca-giving-states-4-ways-bypass-it

Early Amazon investor Doerr convinced Bezos will roll out Prime Health

• John Doerr expects Amazon to offer a Prime Health service.
• He says Amazon, Alphabet and Apple all have a role in the future of health care.
• Doerr shared his thoughts this week at the Forbes Healthcare Summit.

John Doerr

David Paul Morris | Bloomberg | Getty Images

John Doerr made a fortune for his venture firm through an early investment in Amazon, when it was just an online bookseller. More than two decades later, he’s betting the company is preparing for a big move into health care.

Speaking at the Forbes Healthcare conference this week, Doerr said Amazon is among the best-positioned companies to take information its learned from customers and use it to their benefit. He’s expecting CEO Jeff Bezos to roll out an offering for medical and health products that resembles Amazon Prime, which has over 100 million users.

“Imagine what it’s going to be like when he rolls out Prime Health, which I’m convinced he will,” said Doerr, chairman of Kleiner Perkins, the firm he joined in 1980. Doerr, who also backed companies including Google and Intuit, led Kleiner’s investment in Amazon in 1995 and sat on the e-retailer’s board until 2010.

Doerr didn’t say whether he’d spoken with Bezos about his plans in health care, but the two remain close. As CNBC reported in March, Doerr was involved in helping to find someone to lead the joint health initiative between Amazon, Berkshire Hathaway and J.P. Morgan Chase.

Amazon isn’t the only company that Doerr expects to play a role in pushing health care forward.

Despite Google’s failed efforts with an earlier electronic medical records product called Google Health, Doerr still sees Alphabet as player in the market, and he should know since he’s on the board. Doerr praised Verily, Alphabet’s life sciences unit, as a more promising project, as well as the various artificial intelligence research groups like Google Brain.

He also wouldn’t rule out Microsoft as an enterprise-focused health player, given the software giant’s efforts to get doctors using cloud technology.

Doerr is ultimately hoping that entrepreneurs and tech companies will start to build on top of traditional electronic medical records companies, like Epic and Cerner, rather than replace them altogether.

“This is a theme of mine,” he said.

From ad-tech to health-tech

Doerr said that tech companies can do to health care what Google co-founders Larry Page and Sergey Brin did to advertising, only at a much larger scale and with a much greater impact.

“I met Larry and Sergey in 1999 and they transformed advertising,” Doerr said

TV ads historically were bought and sold over martini lunches on Madison Avenue in New York, and advertisers made their decision based on personal connections. Google’s Ad Words replaced that method by introducing ways to target users and measure and track performance in real time.

“It propelled Google and the online industry to where today, where it’s bigger than online television advertising,” Doerr said.

He cited U.S. online advertising as a $75 billion industry, while health-care spending is $3.5 trillion, or “50 times bigger,” he said.

To tap into health care, technology companies have to get access to data, which remains locked up and stored in formats that computers can’t access or can’t read. Big tech is aggressively working to address that problem. Amazon just released a service to help mine medical records, Alphabet is working with big hospitals to analyze health data to predict serious illness and Apple is looking to bring patient health information to the iPhone.

“My dream is to bring the efficiency of the ad words market to value-based care, to the health care markets,” Doerr said. “It’ll be harder because the data is literally incarcerated.”

https://www.cnbc.com/2018/11/29/john-doerr-convinced-amazon-will-roll-out-prime-health.html?__source=twitter%7Cmain

Bausch Health To Redeem $200M Of 5.625% Senior Notes Due 2021

Bausch Health Companies Inc. (NYSE/TSX: BHC) (“Bausch Health” or the “Company”) announced today that it will redeem $200 millionaggregate principal amount of its outstanding 5.625% Senior Notes due 2021, CUSIP Nos. 91911KAD4, C94143AD3 (the “Notes”) on Dec. 31, 2018. Bausch Health intends to use cash generated from operations to fund the aggregate redemption price for the Notes.

“Reducing our debt remains a priority for Bausch Health as we continue to transform the company, and due to strong recent operational cash flow, we are able to redeem these senior unsecured notes due in 2021,” said Joseph C. Papa, chairman and CEO, Bausch Health.

Bausch Health issued today an irrevocable notice of redemption for the Notes, and a copy was issued to the record holders of such Notes. Payment of the redemption price and surrender of the Notes for redemption will be made through the facilities of the Depository Trust Company in accordance with the applicable procedures of the Depository Trust Company. The name and address of the paying agent are as follows: The Bank of New York Mellon Trust Company, N.A., c/o The Bank of New York Mellon; 111 Sanders Creek Parkway, East Syracuse, N.Y. 13057; Attn: Redemption Unit; Tel: 800-254-2826.

https://www.biospace.com/article/releases/bausch-health-announces-redemption-of-200-million-aggregate-principal-amount-of-its-outstanding-5-625-percent-senior-notes-due-2021/