Summer 2017 by SMCMA

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late-breaking news from your medical association Summer 2017

Local Sutter Helideck This month Mills-Peninsula completed a helideck restoring the ability to rapidly transport critically injured patients to the center via helicopter. The previous iteration of the medial center had a helipad, but was not included in the 2011 rebuild of the hospital. MPMC’s helideck adds to the list of a few Peninsula locations where emergency medical helicopters can land.

Technology

Sutter Health Receives Its Largest Single Donation from Atherton couple Michael and Judith Gaulke have donated $20 million to establish an innovation center at PAMF/San Carlos with the hope of bringing health care ideas to life faster. Both of the donors are cancer survivors. Michael Gaulke stated that the innovation center will improve the delivery of health care and will help pioneer breakthroughs in care delivery in Northern California. Sutter’s Innovation Hatchery tests ideas in 90-day sprints in the system’s hospitals and clinics. Sutter’s Hatchery will focus on projects in primary care, mothers and babies, mental health, compassionate hospitalization, and end-of-life care. Michael serves on the PAMF Community Board of Trustees and the Sutter Health Board. He is a former executive chairman of Exponent, an engineering and scientific consulting firm. In 2012 the couple gave $3.5 million to endow a faculty fund in the electrical engineering department of Oregon State University Foundation. Both graduated from OSU and Judith’s father was a professor of pomology horticulture at the school.

HIV-Fighting Drug will help Prevent Spread of AIDS Virus Regulatory approval of a generic version of an HIV drug may see a drop in price. Teva Pharmaceutical Industries won the FDA’s first approval in 2014 for a generic version of the drug Truvada, developed by Foster City-based Gilead Sciences. The approval is for already infected people with HIV. Teva’s approval covers Truvada’s use in combination with other antiretroviral agents to treat people infected with HIV as well as for pre-exposure prophylaxis, or PrEP, to prevent sexually acquired HIV infections in adults. Note: The patent for Emtricitabine, a key part of Truvada, does not expire until 2021. Propeller Health Has Learned Lessons in its Ten Year Existence Though not a startup, Wisconsin-based Propeller Health, a digital health company which makes connected inhalers and patient- and provider-facing data analytics tools for respiratory disease’s Asthma and COPD, recently made a presentation at a Boston conference about the challenge of developing devices to fit seamlessly into patients’ lives. As an example, the company thought they had designed a battery-operated product that patients would love as the device had to have its battery charged only every 30 days, only to discover that people didn’t charge things on that cadence. After that feedback the company designed a disposable device that lasts a year and a half on a single charge. It was noted that the last thing you want to add is a new burden in people’s lives. The company now focuses more on health outcomes as opposed to trying to push or sell technology for technology’s sake. Today, that original device is not just about reminding patients to take their meds, or helping them understand what their trigger is, but now patients can get a forecast of what might happen tomorrow based on their history.

National Five Factors to Impact Medical Cost Trends in 2018 Price Waterhouse Coopers Health Research Institute (PwC HRI) has identified five factors that it expects will impact medical cost trends in 2018.  Rising general inflation  Slowing of movement to high-deductible health plans  Fewer branded drugs coming off patent  Public and political scrutiny on drug companies  Employers targeting the right people with the right treatment to minimize waste

Genetic Testing Job Perk Salesforce, Visa, and the NBA’s Sacramento Kings all offer group-rate cancer screening to their employees/athletes. Some companies have offered a deal with Color Genomics with the entire cost of Color’s cancer test covered. About 20 percent of employees are taking advantage of these offers. A recent JAMA article takes a critical look at the value of such direct-to-consumer testing. The article suggests that the DTC market grew to $150 million in 2010 and is estimated to reach $350 million by 2020. Also observed was the view that while the tests may have low or negative value for the consuming public, driven by advertisements, genomics-style tactics will likely have explosive growth.

PwC HRI also found that prescription drug costs contribute to nearly 20 percent of all medical costs for employers. Its study identified how a single high-priced drug can have a disproportionate impact, such as in 2015 when the new Hep C drugs helped drive-up Rx spending by 14 percent. New Drug Price Transparency in Nevada A new law in Nevada is setting the strictest rules on drug price transparency in the U.S., which targets rising insulin prices and requires drug makers to disclose their prices, profits, and discounts given to the middlemen who negotiate insurance coverage each year. In California, the legislature is also addressing the issue of bringing pharmaceutical pricing out of the dark.

Summer 2017

National cont.

national

CareKit-based Pediatric Health-Tracking App Boston Children’s Hospital and Duke Health System came together to develop an Apple CareKit-based IOS app called Caremap. The app is designed to help families securely track their children’s health and share that data with members of their ongoing care team. The app can also serve as a detailed repository of critical information for children with complex medical conditions from multiple health problems. One-half a million children in the U.S. fall into the category of those with complex medical needs. Going on vacation can be a particular problem when children end up in an adult emergency room without access to their EHR The app allows families to track across ten daily parameters, and can also add custom metrics that are relevant to their specific health conditions. The idea for Caremap was born a year ago by Docktor and Apple ResearchKit pioneer Dr. Ricky Bloomfield. Bloomfield now works for Apple’s health team, but she was on the forefront of implementing ResearchKit and HealthKit while at Duke. The app comes just a few days after Apple’s update of CareKit, which features Apple’s Cloud Bridge API to make data-sharing between CareKit patient apps and care teams easier. There is also a new tab called Care Contents that allows developers to combine activities for Care Card and Symptom Tracker.

Untangling of Faulty Misfolded Proteins Scientists at the University of Pennsylvania have been trying to engineer Hsp104 (heat shock protein 104) to dissolve protein clumps that are connected to various neurodegenerative diseases. With a high-resolution image the scientists can now see the moving parts of the Hsp104 complex and how they might tune it to optimally attack neurodegenerative disease proteins and pull a misfolded protein out of the clumps. Misfolded proteins that can’t function like they are supposed to are blamed for such disorders as Parkinson’s and Alzheimer’s disease. Scientists have been working for years to unravel the tangles. Now they can see how the Hsp104 works. 2017 Kid Count Data Book The Anne E. Casey Foundation (an organization focused on improving the well-being of American children and building better futures for disadvantaged youth), has released a report, “2017 Kid Count Data Book,” whose findings include the fact that 1) nationally, lowbirth weight babies represented 8.1% of live births in 2015; 2) 34% of childhood deaths were caused by accidents; 3) 19,562 children and youth age’s one to 19 died in the U.S. in 2015; and 4) 5% of children (3.5 million) lacked health insurance in 2015. Also noted was that Massachusetts and Vermont had the lowest uninsurance rate at 1%.

Opioids Could Kill Nearly 500,000 Americans in the Next Ten Years As America faces an acceleration of addiction and overdosing, death from opioids have been rising sharply and drug overdoses already kill more Americans under age 50 than anything else. Public health experts at ten universities forecast the arc of the epidemic over the next decade will be worse.

Senior Health - State Rankings The three top states ranking highest on senior health are Minnesota, Utah and Hawaii. Minnesota’s strengths include a low percentage of seniors who face the threat of hunger, a high percentage who visit a dentist, and most seniors can age in place. On the other end, three states with the least healthiest seniors were Mississippi, Kentucky, and Oklahoma. Mississippi faces challenges in food, insecurity, poverty, and premature death.

Medicare

Buying Health Care for Employees An article in a recent Harvard Business Review addressed “Why GE, Boeing, Lowe’s, and Walmart Are Directly Buying Health Care for Employees.” An interesting article, it discusses Geisinger Health System, who began partnering with Walmart around cardiac surgery in 2012 and joined the Employers Centers of Excellence Network for spinal surgery in 2015. In 2016 Geisinger began providing destination care for bariatric surgery patients. The network provides employees of participating companies with 100 percent coverage for all travel and medical expenses at selected healthcare systems. Patients pay no out-of-pocket costs. The average Lowe’s employee who has joint replacement surgery performed by one of the network centers saves approximately $3,300 in copayments and other fees as compared to those patients who get the same care under traditional insurance.

AMA Support for Smaller Practices Medicare’s new merit-based Incentive Payment System has received support from the AMA as they have developed a program to assist those physicians in smaller practices who have never participated in Medicare reporting programs with basic information on how to avoid a payment penalty in 2019 through minimal reporting in 2017. The AMA has developed a short video accessible on the AMA’s website entitled “One patient, one measure, no penalty: How to avoid a Medicare payment penalty with basic reporting. Go to www.ama-assn.org/qpp-reporting. The website also has a sample CMS-1500 claim form. On the CMS’s website a physician can find a link to the CMS MIPS eligibility tool, and links to other quality measures.

Kaiser Permanente Health Plan Membership Kaiser Permanente Health Plans operate in eleven states, with the largest membership in California (4,136,975 in northern California and 4,396,545 in southern California) followed by Colorado, Georgia, Hawaii, Washington, the Mid-Atlantic states; and the Northwest (Oregon and Washington); for a total Kaiser membership of 11.8 million members as of 3/31/17. There are 21,000 physicians in the system and 38 Kaiser Hospitals.

Summer 2017