This message was sent to ##Email## To advertise in this publication please click here March 9, 2021 .ACCOUNTABLE CARE ORGANIZATIONS CMS to review geographic direct contracting payment model Becker's Hospital Review CMS is reviewing the Geographic Direct Contracting Model, a voluntary payment model that aims to test if a geographic-based approach to care delivery can improve health outcomes and lower costs for Medicare beneficiaries. According to an update on CMS' website, the agency said the "Geographic Direct Contracting Model is currently under review and CMS looks forward to sharing additional information when available." READ MORE Study: Bundling can cut health care costs by 11% BenefitsPRO Employers can cut their health-care expenses by paying top medical providers a flat rate for a bundle of related services while offering incentives to the patients who use them, a study suggests. The study, published in the journal Health Affairs, found that employers using a flat-rate approach run by Carrum Health saved about 11% overall on procedures including joint replacements, spinal fusions and bariatric surgeries. The average prices when people used Carrum providers were between 6% to 41% lower compared with other providers. READ MORE .MANAGED HEALTHCARE NEWS Biden administration moves to stop Medicaid work requirements Managed Healthcare Executive The Trump administration didn’t get very far with healthcare reform; the ACA was neither repealed nor replaced. But former CMS Administrator Seema Verma made a run at revamping Medicaid by using Section 1115 waivers to add working requirements. Now the Biden administration is taking steps to stop the requirements before they get started. READ MORE  SPONSORED CONTENT Promoted by Moss Adams LLP Tips to Help Your Health Care Organization Combat Coronavirus Complications 4 Ways Lean Health Care Helps Hospitals Confront Sepsis and Other Safety Concerns Keep Physician Compensation Contracts in Compliance to Avoid Stark Law Violations (January 2019) On demand webcast: Patient Safety Awareness Week: Improve Patient Safety with Lean, featuring PeaceHealth Keys to effective remote patient monitoring in the COVID-19 pandemic Managed Healthcare Executive COVID-19 has impacted our health system in some very clear ways and in ways that we are only beginning to predict the longer term impacts. It has led to exhausted clinicians, delayed care or treatment for patients with non-COVID-19 health issues, and many more stresses on our health ecosystem. READ MORE  PRODUCT SHOWCASE Population Health Designed by Clinicians TCS is the leading provider of software designed to support health plans, TPAs, ACOs, and other risk-bearing organizations. LEARN MORE .GENOMICS & BIOTECH Genomic surveillance can help identify how SARS-CoV-2 spreads in care homes News-Medical.Net Care homes are at high risk of experiencing outbreaks of COVID-19, the disease caused by SARS-CoV-2. Older people and those affected by heart disease, respiratory disease and type 2 diabetes — all of which increase with age — are at greatest risk of severe disease and even death, making the care home population especially vulnerable. READ MORE  PRODUCT SHOWCASE Looking for Affordable Evidence-Based Guidelines? Apollo delivers evidence-based guidelines in an easy to use format, available 24/7 from any internet-connected device. No software download required. ­­Streamline utilization reviews and lower your costs today. Click here to begin your risk-free trial, or call to learn more! 888.276.5563 LEARN MORE Exploring the intersection of genomic data and AI in health care HealthITAnalytics Personalization is something most people have come to appreciate – if not expect – in everyday, consumer-driven experiences. From recommended movies and shows based on what you’ve watched, to playlists tailored to your specific taste, it seems nearly every industry has tapped into the power of targeted products and services. READ MORE A small sensor can be used for rapid detection of RNA and DNA News-Medical.Net In less than a second, a small sensor used in brain chemistry research can detect the key molecules that provide the genetic instructions for life, RNA, and DNA, a new study from American University shows. The AU researchers believe a sensor is a useful tool for scientists engaged in clinical research to measure DNA metabolism, and that the sensor could be a quick way for lab clinicians to distinguish 'healthy' from 'sick' samples and determine if a pathogen is fungal, bacterial, or viral, before conducting further analysis. READ MORE  FEATURED ARTICLE   Tolmar Affirms Supply of FENSOLVI® Promoted by TOLMAR Pharmaceuticals, Inc Tolmar Affirms Supply of FENSOLVI® (leuprolide acetate) for Pediatric Patients with Central Precocious Puberty; Company increases U.S. manufacturing capacity of drug to ensure uninterrupted supply amid industry shortage LEARN MORE   .BEHAVIORAL HEALTH Mental health is a matter of public health, too Bloomberg Feb. 6 marked the anniversary of the first known death attributed to COVID-19 in the U.S., and the days that follow will offer reminders that it’s been 12 months since cities started locking down. The mood has shifted considerably since last March: Rates of infection, hospitalization and deaths are falling in many countries; vaccines are getting approved and into arms; and experts suggest there’s reason to be hopeful about the summer. READ MORE PRODUCT SHOWCASE Reducing Overall Costs for Health Plans Ontrak gives health plans the ability to engage small, unaddressed behavioral health populations that can account for almost half of all medical costs—driving millions of dollars in avoidable spending. Our team delivers industry-leading program enrollment and retention, fostering better outcomes for members—and reducing unnecessary costs for plans.   LEARN MORE   Reach Your Prospects Every Week Thousands of industry professionals subscribe to association news briefs, which allows your company to push messaging directly to their inboxes and take advantage of the association's brand affinity. Connect with Highly Defined Buyers and Maximize Your Brand Exposure   LEARN MORE   Survey: HR administrators, employees disagree on mental health coverage MedCity News Since the start of the pandemic, many companies looked for ways to bolster mental health coverage, but there’s still a disconnect between HR administrators and employees, according to a recent survey conducted by mental health startup Lyra Health. About half of benefits leaders said their mental health benefits adequately addressed employees’ needs, according to the survey of 300 HR leaders and 1,000 employees. READ MORE .NAMCP UPDATES Verrica Pharmaceuticals Inc. (“Verrica”) (Nasdaq: VRCA), a dermatology therapeutics company developing medications for skin diseases requiring medical interventions, today announced that its resubmitted New Drug Application (NDA) for VP-102 (cantharidin 0.7% Topical Solution), a proprietary topical therapy for the treatment of molluscum contagiosum (molluscum), has been accepted for filing by the U.S. Food and Drug Administration (FDA). The Prescription Drug User Fee Act (PDUFA) goal date assigned by the FDA for this NDA is June 23, 2021. Click here to view the full press release. Biodesix, Inc. (Nasdaq: BDSX), a leading data-driven diagnostic solutions company with a focus in lung disease, today announced that the company has partnered with Chicago Public Schools (CPS) to provide antigen and Droplet Digital PCR (ddPCR)™ testing for Chicago Public School teachers and staff. The CPS testing program, which launched in January, is a surveillance testing protocol and uses rapid antigen tests to monitor the prevalence of COVID-19 among asymptomatic employees, followed by confirmatory ddPCR testing. Biodesix was one of the earlier laboratories to join in the fight against COVID-19, offering two COVID tests that earned Food and Drug Administration (FDA) Emergency Use Authorization (EUA) during the onset of the pandemic. Please click here to view the entire press release. Home Instead, the leading provider of in-home care for older adults, has launched a new brand identity and campaign to promote the evolving organization. Formerly known as Home Instead Senior Care, the company was founded in 1994 by Paul and Lori Hogan to address a need for personalized care to allow adults to age at home, inspired by Paul’s own grandmother. It has since grown to more than 1,200 independently owned and operated franchises across the globe, which employ 90,000 professional caregivers and deliver more than 80 million hours of care annually. Created in partnership with creative agency Energy BBDO, the brand’s update includes a simplified logo and the removal of the term “senior care” from the official name – Home Instead. The changes are meant to be more inclusive and a reflection of the evolving global language around the way people talk about older adults. The name change also allows the brand to more broadly address helping aging adults meet their needs wherever they are on their care journey. Please click here to view the full press release. Biodesix, Inc., a leading data-driven diagnostic solutions company with a focus in lung disease, today announced publication of an analysis of the company’s Nodify XL2® lung nodule test. The test supports clinical decision-making for suspicious nodules by more accurately identifying patients with a very low risk of malignancy and shifting those patients into surveillance, thereby minimizing invasive procedures on those with benign nodules. Please click here to view the full press release. LivaNova PLC, a market-leading medical technology and innovation company, today announced the publication of a new study in the International Journal of Bipolar Disorders that showed adding Vagus Nerve Stimulation Therapy (VNS Therapy®) to treatment as usual (TAU) significantly improves outcomes in patients with treatment-resistant bipolar depression (TRBD). The study examined patients from a five-year prospective registry and found 63% of TRBD patients treated with adjunctive VNS Therapy in addition to TAU had a significant reduction in depressive symptoms, as measured by a 50% or greater reduction in the Montgomery–Åsberg Depression Rating Scale (MADRS), compared with 39% of patients in the TAU alone group. Click here to view the entire press release. Click here to view the entire press release. Additionally, LivaNova PLC announced a publication in Contemporary Clinical Trials, which details the design for “A Prospective, Multi-center, Randomized Controlled Blinded Trial Demonstrating the Safety and Effectiveness of VNS Therapy® System as Adjunctive Therapy Versus a No Stimulation Control in Subjects With Treatment-Resistant Depression” or the RECOVER clinical study. RECOVER is currently under way as part of a Coverage with Evidence Development framework of the U.S. Centers for Medicare & Medicaid Services’ (CMS) National Coverage Determination process. Click here to view the entire press release. In late 2018, the National Association of Managed Care Physicians (NAMCP) decided to create the Value Based Care Council (VBCC). The VBCC mission supports empowering medical directors with information and resources to assist them in making value based decisions that support achieving the Triple AIM of improved outcomes and the patient experience while reducing overall costs. The goal is to improve the integration of cost, quality, and access in the clinical decision making process so as to enhance the effectiveness and efficiency of extracting value from the associated spend in order to optimize outcomes. Pursuant to the above, and in response to an unmet need in the marketplace, the VBCC developed a short form in order to enhance the effectiveness and efficiency with which value propositions can be shared between industry and the medical leadership of various payers throughout the country. This same short form provides a concise and consistent manner with which value propositions can be shared and provides the ability to align expectations prior to actually conducting conversations or having a meeting regarding a product or service. The Product Value Proposition Customer Engagement Short Form can be found on the NAMCP website (www.namcp.org) in the Value Based Care Council subsection of the Councils tab, under tools and resources. Please contact Will Williams at wwilliams@namcp.org with questions or for additional information. Jazz Pharmaceuticals is excited to announce the approval of ZEPZELCA™ (lurbinectedin) for the treatment of adult patients with metastatic small cell lung cancer (SCLC) with disease progression on or after platinum-based chemotherapy. ZEPZELCA is a second-line therapy that has been studied in both platinum-sensitive and -resistant SCLC patients. Please click here for more information. Takeda Pharmaceuticals is part of, "The Fight Is In Us", an initiative to maximize the individual and societal benefit of COVID-19 plasma. The campaign will focus on recruiting COVID-19 survivors to donate their plasma at licensed blood and plasma donor centers. If you’ve recovered from #COVID19, your immune system has antibodies that could be used as a treatment. See if you can help others by donating plasma www.TheFightIsInUs.org. #TheFightIsInUS The antibodies that helped you or someone you know fight off COVID-19 may be able to help others. Visit www.TheFightIsInUs.org to see if you qualify to donate plasma. #TheFightIsInUs You are a survivor, now you could be a hero. Plasma from recovered #COVID19 patients could play a key role in creating a potential therapy for coronavirus. Learn how you can donate at www.TheFightIsInUs.org #TheFightIsInUs Biodesix, Inc., a leading diagnostic company in lung disease, recently announced a partnership with Bio-Rad Laboratories, Inc. (NYSE: BIO and BIOb) to bring a COVID-19 Droplet Digital PCR (ddPCR) test to the FDA for an Emergency Use Authorization (EUA) approval to support the escalating need for testing in the U.S. Two studies published this month, ahead of peer review, reported that ddPCR testing showed superior sensitivity and precision for clinical detection of SARS-CoV-2 (the virus that causes COVID-19) compared to existing test methods that are performed using qPCR. Biodesix currently has a focus on lung disease and offers other diagnostic testing for lung cancer utilizing the ddPCR platform.Click here for more information. "Modeling Cost-Effectiveness of On-Demand Treatment for Hereditary Angioedema Attack" was recently published in the Journal of Managed Care Pharmacy's February 2020 issue. Hereditary angioedema (HAE) is a rare disease that causes painful and potentially fatal episodes of swelling (attacks). HAE attacks can be unpredictable and the need to treat sudden attacks promptly and effectively is critical to minimize risk of hospitalization, morbidity, and mortality. A cost-effectiveness model was evaluated that considers evaluation of on-demand medications, healthcare utilization and patient well-being. For access to the publication, please click here. Biodesix, Inc. announced initiation of the next phase of their biomarker development program with Merck KGaA, Darmstadt, Germany and Pfizer Inc. The companies have completed initial discovery and development of a new proteomic test that identifies likely responders to the anti-PD-L1 checkpoint inhibitor (BAVENCIO®) (avelumab). Development efforts will now focus on transferring the test into Biodesix's CLIA lab in Boulder, CO for clinical phase test validation. The new test was developed through retrospective analysis of the circulating proteome of cancer patients treated with the investigational drug candidate, utilizing the proprietary Biodesix Diagnostic Cortex™ artificial intelligence (AI) platform. Click here to read the full press release. The NAMCP Medical Directors Institute recently held the first meeting of its Executive Leadership Council (ELC) at the recent Fall Managed Care Forum. The NAMCP Medical Directors Institute decided in late 2018 to create the Value Based Care Council (VBCC) with a mission to empower medical directors with information and resources to assist them in making value based decisions that support achieving the Triple AIM of improved outcomes and the patient experience while reducing overall costs. Click here to view an overview of the genesis, formation, and work of NAMCP's Value Based Care Council. Please click here to view the press release. LivaNova PLC (NASDAQ:LIVN), a market-leading medical technology and innovation company, today announced the first patient enrolled in "A Prospective, Multi-center, Randomized Controlled Blinded Trial Demonstrating the Safety and Effectiveness of VNS Therapy® System as Adjunctive Therapy Versus a No Stimulation Control in Subjects With Treatment-Resistant Depression" (RECOVER). The study will evaluate Vagus Nerve Stimulation Therapy (VNS Therapy) for Treatment-Resistant Depression (TRD) in accordance with the U.S. Centers for Medicare & Medicaid Services (CMS) National Coverage Determination as part of its Coverage with Evidence Development Program. The first patient was enrolled by Dr. Azfar Malik in St. Louis. Click here to read the full press release. Biodesix, Inc. this week highlighted findings from multiple studies demonstrating the significance and clinical utility of its VeriStrat® blood-based proteomic test as a predictive biomarker for patient survival outcomes and as a diagnostic tool to improve the clinical management of patients with non-small cell lung cancer (NSCLC). This information is vital to implementing optimal treatment strategies for patients and supports disease state monitoring. To date, VeriStrat testing has helped more than 50,000 patients in determining the best treatment for their lung cancer. Click here to see the full press release.   Managed Care eNews Connect with NAMCP Jason Zimmerman, Director of Publishing, Multiview, 469-420-2686 | Download media kit Lauren Cancienne, Content Editor, Multiview | Contribute News NAMCP Medical Directors Institute 4435 Waterfront Drive, Suite 101  |  Glen Allen, VA 23060  804-527-1905  |  Contact Us  |  www.namcp.org Click here to unsubscribe.  Learn how to add us to your safe sender list so our emails get to your inbox. ADVERTISE SUBSCRIBE PAST ISSUES   7701 Las Colinas Ridge, Ste. 800, Irving, TX 75063