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.ACCOUNTABLE CARE ORGANIZATIONS
CMS announces a new value-based direct contracting model
RevCycleIntelligence
A new direct contracting model from CMS will test whether a geographic-based approach to value-based care can improve quality of care while reducing costs for Medicaid beneficiaries in a specific region.
The Geographic Direct Contracting Model is a voluntary opportunity for healthcare providers and other entities in a region to coordinate the care of Medicare beneficiaries as Direct Contracting Entities, CMS explained in an announcement Dec. 3.
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Medicaid MCO enrollment continued rising through September 2020
HealthPayerIntelligence
States may need to re-evaluate their Medicaid managed care organization payment rates as trends of increased enrollment and low care utilization continue into fiscal year 2021, according to a Kaiser Family Foundation data note.
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.MANAGED HEALTHCARE NEWS
Government, drug companies gearing up to distribute COVID-19 vaccine
Managed Healthcare Executive
With approval of the Pfizer-BioNTech COVID-19 happening as early as next week, attention is shifting how it and other COVID-19 vaccines will be distributed and administered.
Certainly pharmacists and possibly dentists and optometrists will be playing an important role in administering the COVID-19 vaccine. HHS announced in late October that CVS and Walgreens had agreed to administer COVID-19 vaccines to residents of nursing home and other long-term care facilities.
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Could the pandemic put an end to medical overtreatment?
Managed Healthcare Executive
Several years ago, more than 2,000 physicians indicated in a survey that significant proportion of medical care is unnecessary and ineffectual. Responses to the survey suggests that more than a fifth of overall medical care is unnecessary as is more than a fifth of all prescribed medications. The same is true of nearly a quarter of all tests, the responses suggest, and more than 11% of all procedures. Malpractice, patient demand and the difficulty of accessing medical records were cited as the top reasons for this bloat and waste in our healthcare system.
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.GENOMICS & BIOTECH
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CTU’s new grant provides incoming students enrolling in the RN-BSN degree program 20% off tuition for those who apply and start courses by Jan. 5, 2021.
- Program costs starting at $9,984, with grant savings applied
- Save up to $2,496, with grant applied
- Available to apply from Oct. 1, 2020 – Jan. 5, 2021
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Genomics analysis moves to the next level
Genetic Engineering & Biotechnology News
Science fair projects presenting complicated genomic analyses. Smartphones displaying personal genome sequences. Treatment plans specifying genomic modifications. These are just a few of the “bold predictions” outlined in the new strategic vision developed by the National Human Genome Research Institute.
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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
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Discovery shines light on how cancer cells could protect themselves
Medical Xpress
Sydney researchers have found cancer cells can repair their DNA by using 'cables' in their nucelus. The findings open new possibilities for designing future cancer treatments.
Researchers at Children's Medical Research Institute in Westmead, Sydney, have made an unexpected discovery about cancer cells and how they harness 'cables' in a cell's nucleus to aid DNA repair and replication.
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.BEHAVIORAL HEALTH
Digital tools are revolutionizing mental health care in the US
Harvard Business Review
We have a crisis in mental health care in the U.S. 60% of young people with major depression received no mental health treatment in 2017-2018, and one quarter of adults with mental illness reported an unmet need for treatment. In the U.S., 55% of counties have no psychiatrist, psychologist or social worker, and 70% don’t have a single child psychiatrist. Queues for substance abuse care can be weeks long; 70% of those who needed substance use treatment in 2017 did not receive it.
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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.
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Divorce has a negative impact on physical and mental health, study finds
Insider
An increasing number of divorces this holiday season may be more than unfortunate byproduct of the pandemic. A new study that's the first of its kind found divorce may impact people's physical and mental health as well.
The study, published in Frontiers in Psychology, surveyed 1,900 divorcees in Denmark. The participants filled out questionnaires on the nature of their divorce, their background and their health.
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.NAMCP UPDATES
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| 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.
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| 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.
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| 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.
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| 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.
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| 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
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| 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.
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| "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.
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| 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.
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| 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.
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| 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.
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| 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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