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Sept. 29, 2020
 
 
 
 
ACCOUNTABLE CARE ORGANIZATIONS
 
 
Stakeholders urge CMS to drop proposed ACO quality changes
HealthLeaders Media
Citing concerns about mandating sweeping new reporting requirements in the middle of a pandemic, some of the nation's largest physician and hospital associations on Sept. 23 asked the federal government to drop changes on how Medicare accountable care organizations are assessed for quality.
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House government funding bill gives providers relief on Medicare advance payments
Fierce Healthcare
The House passed a short-term government funding bill that extends the deadline for providers to start repaying Medicare advance payment loans to the end of the COVID-19 public health emergency. The bill that the House passed late Sept. 22 is a major win for provider groups who worried they could struggle to repay the Medicare loans starting in August. The bill still has to pass through the GOP-controlled Senate.
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MANAGED HEALTHCARE NEWS
 
 
For price transparency, the outlook is murky
Managed Healthcare Executive
Martin Moll, J.D., advises medical practices of all shapes and sizes in his role as founder and advisor at Breakaway Bookkeeping & Advising. When the topic of price transparency comes up, he immediately points out a fundamental problem. “If you talk about price transparency, it actually requires transparency,” he said. “And at the end of the day, that’s the hard part for doctors, because they actually don’t know what things cost.”
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SPONSORED CONTENT
Promoted by Moss Adams LLP
• Tips to Help Your Health Care Organization Combat Coronavirus Complications
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Telehealth, Medicare Advantage top-of-list in 10-year plan for nonprofit health plans
Managed Healthcare Executive
Telehealth gets a strong endorsement in a 10-year plan put out by a group representing many of the country’s blue-ribbon nonprofit health plans. The Alliance of Community Health Plans’ “Health Care 2030: ACHP’s Roadmap to Reform” also calls for support of primary care with access to behavioral health services, heaps praise on Medicare Advantage, and advocates for reforming anti-kickback and Medicaid pricing requirements to encourage value-based contracting.
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GENOMICS & BIOTECH
 
 
Data management in the DNA of new gene therapy plant
Genetic Engineering & Biotechnology News
Officials at Catalent, a CDMO, recently announced plans for a new gene therapy facility, explaining that the $130 million expansion will add five Phase III through commercial-scale manufacturing suites. The plant will make extensive use of automation according to Randy Hendrickson, vp, commercial operations, Catalent Cell & Gene Therapy, who tells GEN the approach is key to managing data at the existing plants on the campus.
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    DNA link behind severe COVID-19 may lead to a new treatment
    Bloomberg
    When two brothers fell critically ill with COVID-19 around the same time in March, their doctors were baffled. Both were young — 29 and 31 years old — and healthy. Yet within days they couldn’t breathe on their own and, tragically, one of them died.
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    Poxviruses have gene to 'blind' host cells’ DNA sensors
    Genetic Engineering & Biotechnology News
    If security signs were posted inside the cell, they wouldn’t display images of video cameras. Instead, they might warn would-be intruders — poxviruses, for instance — of DNA sensors. Unfortunately, such signs wouldn’t deter poxviruses, which brazenly replicate their large genomes in the cytosol while somehow remaining unseen.
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    BEHAVIORAL HEALTH
     
     
    Employers increasing virtual, behavioral health coverage amid pandemic
    AJMC
    Based on findings of the Business Group on Health’s 2021 Large Employers' Health Care Strategy and Plan Design Survey, employers have increased funding in virtual care and behavioral health amid the coronavirus disease 2019 pandemic, said Ellen Kelsay, president and CEO of the Business Group on Health.
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    SPONSOR SPOTLIGHT
     
     
     
     
    Behavioral health providers embracing telehealth during the COVID-19 pandemic
    Healthcare Finance
    Telehealth is increasing in usage and popularity, and this is becoming true for behavioral healthcare providers, who have typically been reticent in adopting virtual care technologies. A recent survey from digital behavioral health company Tridiuum found that 81% of behavioral health providers began using telehealth for the first time in the last six months due to the COVID-19 pandemic.
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    FEATURED ARTICLE
    Decipher Prostate Genomic Classifier validated as a predictive biomarker
    Promoted by Decipher Biosciences
    Decipher predicts overall survival and is the 1st genomic classifier validated in a Phase III, randomized controlled trial in prostate cancer. In RTOG 9601, Decipher identified high-risk patients most likely to benefit from the addition of hormone therapy to salvage radiation. Dan Spratt, MD Associate Professor of Radiation Oncology at University of Michigan gives his perspective on this important development.

    https://youtu.be/VrEBjKQtMYE
    Learn more about the benefits of Decipher Prostate for Healthplans and their members diagnosed with prostate cancer, visit www.decipherbio.com or email at managedcare@decipherbio.com.
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    Scheduling mental health outpatient appointment beneficial following psychiatric discharge
    Healio
    Scheduling a mental health outpatient appointment following psychiatric discharge increased the odds of successful transition from hospital to community-based care, according to study results published in Journal of Clinical Psychiatry.
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    NAMCP UPDATES
     
     

    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.
     
     
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