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late-breaking news from your medical association Fall 2016
local Merger Talks Between Dignity and Colorado-Based Catholic Health Intiatives
biotech/IT (continued) biotech/IT (continued)
Very preliminary merger talks between Dignity and Colorado-Based Catholic Health Initiatives could create a $28 billion behemoth with more than 500 hospitals and other clinical sites. Dignity has 39 hospitals, of which four hospitals are in the greater Bay Area: St. Mary’s Medical Center and Saint Francis Memorial Hospital in San Francisco, Redwood City’s Sequoia Hospital, and Dominican Hospital in Santa Cruz. The San Francisco-based system boasts 9,000 affiliated doctors and 62,000 employees. CHI runs 103 hospitals in 18 states, none of them in Dignity Health’s California, Arizona and Nevada areas.
Verily Life Sciences Continues its Research of Patients with Parkinson Disease Verily Life Sciences Continues its Research of Patients with Parkinson Disease
Verily Life Sciences, Radboud University in the Netherlands, and ParkinsonNet have launched a study of 650 Parkinson’s disease patients two years to Netherlands, look more closely at the diseasehave and its origins.a Verily, a subsidiary Verily Life Sciences, Radboudover University in the and ParkinsonNet launched study of 650 of Alphabet,disease will contribute The study include molecular Parkinson’s patientsadvance over tworesearch years totools look and moreanalytic closelymethods. at the disease and itswill origins. Verily, a subsidiary analyses, advanced brain imaging andresearch wearable devices for capturing and measuring wide rangemolecular of data in of Alphabet, will contribute advance tools and analytic methods. The study awill include patients’ such as vital signs. Verily, is ondevices the Google/Alphabet campus but is in the process ofdata moving analyses, homes, advanced brain imaging and wearable for capturing and measuring a wide range of in to SSF. patients’ homes, such as vital signs. Verily, is on the Google/Alphabet campus but is in the process of moving to SSF.
state CA Pharmacists Can Now Prescribe Birth Control, But Hard to Find Ones That Do
Color Genomics Has Raised $45 Million from Bono and Others Color Genomics Has Raised $45 Million from Bono and Others
For many women in California a law enacted in 2013 allows them to get birth control by going to a pharmacy without a doctor’s prescription and pick up hormonal contraception, including pills and patches. However, so far it is a struggle to find pharmacists who will give out the medicines.
The startup, Color Genomics, based in Burlingame, sells genetic tests to detect cancer risks. The company recently announced reduced-cost genetic through thesells BRCA Foundation. addition to Bono, investors also The startup,aColor Genomics, basedtest in Burlingame, genetic tests toIndetect cancer risks. its The company recently include PayPal cofounder Max Levchin, Yahoo cofounder Jerry Yang, and Eventbrite CEO Julia Hartz. The company announced a reduced-cost genetic test through the BRCA Foundation. In addition to Bono, its investors also analyzes 19 genes, including the BRCA1 Yahoo and RCA2 genes, through a simple saliva test. The gene mutations the include PayPal cofounder Max Levchin, cofounder Jerry Yang, and Eventbrite CEO Julia Hartz. The company test seeks19togenes, find are connected an inherited predisposition to breast and ovarian Themutations test typically analyzes including the to BRCA1 and RCA2 genes, through a simple saliva test.cancer. The gene the costs $249to but theare BRCA Foundation lowers that price to $50. test seeks find connected to anpartnership inherited predisposition to breast and ovarian cancer. The test typically costs $249 but the BRCA Foundation partnership lowers that price to $50.
Cigarette Tax Fight Is More a Battle of Equals This Time Around In previous failed attempts, proponents weren’t able to match the powerful tobacco industry, but this year the campaign to pass Proposition 56 raised $100 million compared to the tobacco industry who raised $71 million. The proposition, which was approved by the voters on November 8th will add a $2 per pack tax on cigarettes. In 2006 and 2012 R J Reynolds and Philip Morris successfully knocked down tobacco tax hikes at the ballot box. This year the proponents did a lot more to match the industry’s dollars. A study reported last week found that nearly one-third of all cancer deaths can be attributed to smoking.
uBiome Announces New DNA-Sequencing Microbiome Screening Test uBiome Announces New DNA-Sequencing Microbiome Screening Test
SF-based uBiome, which makes a direct-to-consumer microbial genomic testing kit, has closed on a $22 million Series B funding funding will help the company deploy their new testing kit, closed SmartGut, at-home SF-based uBiome,round. whichThe makes a direct-to-consumer microbial genomic testing kit, has on aan $22 million collection kit, which aimsThe to give individuals doctors access to anew comprehensive screeningan test to weed Series B funding round. funding will helpand thetheir company deploy their testing kit, SmartGut, at-home out important microorganisms that could beand causing distress. The test requires thescreening user to swab a tiny collection kit, which aims to give individuals theirhealth doctors access to a comprehensive test to weed amount of fecalmicroorganisms matter with a cotton swab, is sent directly to the lab forthe sequencing. Once the out important that could bewhich causing health distress. TheuBiome test requires user to swab a tiny results back,matter users will beagiven actionable information about to their microbiome to share withOnce theirthe doctors. amountare of fecal with cotton swab, which is sent directly thegut uBiome lab for sequencing. Over the past four years, the company has collected tens of thousands of gut sample with their basic, $89 testing kits. results are back, users will be given actionable information about their gut microbiome to share with their doctors. Over the past four years, the company has collected tens of thousands of gut sample with their basic, $89 testing kits.
California’s Covered California Competitive Individual Health Insurance Market Consumer Costs by Metal Tiers: Platinum Gold Silver Bronze
PeerWell Picks up $2.1M for Surgery Preparation App PeerWell Picks up $2.1M for Surgery Preparation App
SF-based PeerWell, founded in 2015, makes a mobile app to help patients prepare physically and mentally for surgeryPeerWell, to recoverfounded faster. in The start-up justa picked seed funding in physically a round ledand by mentally XSeed SF-based 2015, makes mobile up app$2.1M to helpinpatients prepare Capital. Thetoapp delivers patients lessons that are proven to improve the results surgery for surgery recover faster. The customized start-up justdaily picked up $2.1M in seed funding in a round led by of XSeed and speed-up recovery. aspect of the program patients with real people undergoing a joint Capital. The app deliversOne patients customized daily pairs lessons that are proven to improve the results of surgery replacement the same One time.aspect The pairing support and arereal at the heartundergoing of the app. a joint and speed-upatrecovery. of the program pairsmentorship patients with people replacement at the same time. The pairing support and mentorship are at the heart of the app. 4 4
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Premium Cost 90% 80% 70% 60%
Out of Pocket Costs 10% 20% 30% 40%
State (continued)
medicare Six Takeaways from MACRA Final Rule
Who is Eligible for Premium Assistance in CA: Single
The final rule offers flexibilities provided in the first transition year and may continue into 2018; during the first year of MIPS (Merit Based Incentive Payment System), providers will not be evaluated on cost or resource use; despite flexibilities allowed under the final rule, it is in providers’ best interest to participate as much as possible during the transition year (and not just for the practice); quality measure benchmarks will be published this year; vendors need to prepare as well; and small group providers and solo physicians could get squeezed out.
Family of Four
Eligible for Premium Assistance
$16,400 to $47,000
$33,540 to $97,200
Eligible for Reduced Cost Sharing
$16,400 to $29,700
$33,540 to $60,750
End-of-Life Care Stats Of 2.6 million total deaths in the U.S. in 2014, 2.1 million were Medicare beneficiaries. Although Medicare spent significantly more on care for people at the end of life who died in 2014 ($34,529 pp) than for other beneficiaries that year ($9,121 pp) the share of total Medicare spending for people at the end of life decreased from 18.6 percent to 13.5 percent between 2000 and 2014. Hospice use among Medicare beneficiaries at the end of life increased between 2000 and 2014 to nearly half (46% of all beneficiaries. Medicare spending on hospice also increased during that period from $2.3 billion to $10.4 billion. Unfortunately surveys show that more than 7 in 10 people aged 65 years and older have not discussed end-of-life care with a physician, and that 4 in 10 have not documented their end-of-life care wishes. Even though Medicare reimburses physicians for patient visits to discuss end-of-life care, 68 percent of physicians report that they have not received training for such discussions. ........would you attend programs if SMCMA offered them??
Nine out of ten consumers receive subsidies.
national ACA Health Insurance Marketplace Calculators The Kaiser Family Foundation has developed a health insurance marketplace calculator updated to include local data on the 2017 ACA rates. With the tool, consumers can generate estimates of their health insurance premiums and government subsidies that are sold in their local area. The estimates are based on household income, family size, ages of family members, and zip code. The calculator also helps consumers determine whether they could be eligible for Medicaid/MediCal.
Biotech/IT
Five Specialty Pharmaceutical Trends
TytoCare Received FDA Clearance for its Digital Stethoscope
These trends are 1) specialty approvals will continue to outpace traditional medications; specialty medications will face more competition; 3) biosimilars are gaining traction; 4) cancer drug development is a key focus area; and 5) orphan drug development will continue to expand.
Israel-based medical device maker TytoCare, founded in 2012, has received FDA 510(k) clearance for its digital stethoscope, joining its other tools for remote medical exams, i.e. a connected otoscope for ear examinations, a high-resolution camera, and a thermometer that uses the forehead to get a reading. The stethoscope pairs with a smartphone and allows users to examine the ears, throat, skin, heart, lungs, and temperature. Data can be captured, stored, and shared via a cloud-based telehealth platform with video conferencing. Examinations can be done in real time or in advance of a telehealth visit. TytoCare is also exploring multiple verticals, including multi-patient environments such as self-service kiosks, retail clinics, or employer offices.
CDC Reports Fewer Get Flu Shots The CDC reports that during the 2015 flu season, the vaccination rate for all Americans was 45.6 percent, a decline of 1.5 percentage points from the previous season. The largest decreases were seen among adults 50 and older. Two new vaccine options in 2016 include one that protects against four strains of the flu and another aimed at those 65-plus that include an adjuvant to increase the shot’s effectiveness by boosting the body’s immune response.
Gilead to Pursue NASH Drug
Employed, Self-Employed Physicians Equally (Dis)Satisfied
Gilead plans to move forward with an experimental drug for fatty-liver disease, or nonalcoholic steatohepatitis, after the compound failed mid-stage studies in two other diseases. The drug called GS-4997 or selonsertib. The drug showed some efficacy against fibroids in separate Phase II trials in people with NASH, pulmonary arterial hypertension and diabetic kidney disease. The company plans to start a Phase III program in pf GS-4997 in NASH.
Deloitte Consulting recently released results from their 2016 Survey of US physicians regarding electronic health records. Some of the key findings include comments from the respondents that 7 out of 10 physicians think that EHRs reduce their productivity; that 3 in 4 physicians believe that EHRs increase costs, outweighing any savings; that 62% want improved interoperability from their EHRs; that 47% of physicians believe that EHRs improve clinical outcomes (however in 2014 the response to this question was 55%); and that 78% of physicians believe that EHRs are useful for analytics and reporting.
SSF-Based Theravance COPD Drug Seeks FDA Approval in 2017 Positive early results from two late-stage studies could push a potential once-a-day treatment for COPD to the FDA in the coming year. The results of these studies, which enrolled 1,250 people, indicate that patients who received the drug revefenacin, or TD-4208, have an easier time breathing after 12 weeks of once-daily dosing.
AARP Launches Caregiver-Focused Website AARP Services, a subsidiary of AARP, has launched a new interactive website designed to address gaps in the caregiving market, from scheduling and telehealth to professional advice. The CareConnection site, currently in beta, aims to be a central hub for caregivers. The idea for the site is based on findings from a report conducted by AARP and the National Alliance for Caregiving, that found that the adoption of digital tools and technologies make caregivng easier, more efficient, and of higher quality. It will also feature a mobile app that matches caregivers with peers, plus a function that enables caregivers to swap their best tips.
Genentech Win with Another Cancer Fighter Tecentriq Tecentriq, already approved in May to treat bladder cancer, scored a second approval as a treatment for patients with metastatic non-small cell lung cancer. This is a first in its class of so-called cancer immunotherapies to win approval. It also adds to the company’s portfolio of lung cancer drugs, including Avastin and Tarceva.
WebMD Saw 70 Million Visitors in its Third Quarter With increasing advertising dollars and more contributions from pharmaceutical companies, as well as a national rollout of their prescription pricing and information app, WebMD is reporting strong third quarter earnings even with a slight decline in page views.
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