Health Care Rounds

If you're like most people, you probably don't know the first thing about perioperative medicine. We didn't either, until John sat down with Dr. Zeev Kain, the founder and president of the American College of Perioperative Medicine. We learned that this emerging field of medicine holds a lot of promise for improving surgical outcomes, lowering costs, and increasing patient satisfaction.

It’s the question on everyone’s mind — at least those in health care — what’s wrong with our health care system and how do we fix it? This week, John sits down with Dr. Robert Pearl, host of the popular health care podcast, Fixing Healthcare, for a fascinating discussion. Dr. Pearl was formerly CEO of Permanente Medical Group, one of the largest physician practices in the U.S. and which consistently ranks in the top 10 programs for clinical quality by the National Committee for Quality Assurance (NCQA).

This week, we close out Season 2 of Health Care Rounds with Dr. Andy Lazris. A board-certified internist, Dr. Lazris’ private practice, Columbia, Md.-based Personal Physician Care, is dedicated to providing individualized and comprehensive care for its patients. We found Dr. Lazris on YouTube where he’s better known as the Running Doc Unhinged. Listen today and learn about common sense medical practice reforms and why aging patients need to be cared for differently — and better — than they are today.

Other briefs include:Stryker signed a definitive agreement to acquire Wright Medical Group.Amgen will pay $2.7 billion for a 20.5% ownership stake in BeiGene, a research-based, oncology-focused biotech company headquartered in Beijing.The University of Louisville announced that it has completed the acquisition of KentuckyOne Health’s Louisville-area assets from CommonSpirit Health.HealthPartners is closing its mail order and all 30 retail pharmacy locations, and will lay off 300 workers.Dr. Philip Ozuah will become Montefiore Medicine’s new CEO.Dr. Stephen Hahn has been nominated as the FDA’s new commissioner.Several updates from CMS. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, p

Other briefs include:Insurers will receive $1.59 billion in unpaid subsidies if the federal government follows through on a judge’s order.California’s attorney general put the kibosh on the Adventist-St. Joseph merger.UPMC has begun building a network of hospitals in China.Fifteen drug companies settled an Illinois Medicaid fraud suit for $242 million.An Oregon insurer has filed an antitrust lawsuit against three health systems.Thomas Zenty, the CEO of Cleveland-based University Hospitals for almost 18 years, will retire in January 2021. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 2010 as Darwin Advisory Partne

This week on Health Care Rounds, Darwin Research Group CEO John Marchica sits down with Naomi Fried, Ph.D., founder and CEO of Health Innovation Strategies. Dr. Fried brings a wealth of experience in understanding how companies affect change, from her tenure as vice president of innovation and external partnerships at Biogen to heading up innovation and technology efforts at Kaiser Permanente.

In this week’s Our Take, we’re covering the latest events in Biogen, involving their second life for aducanumab. To sign up for the weekly email brief, click here. Other briefs include:California releases its first report on drug pricing, in an effort to improve transparency.Bristol-Myers Squibb-Pfizer Alliance is collaborating with Fitbit for atrial fibrillation detection.Amazon is partnering with City of Hope to provide cancer support services to U.S. Amazon employees and their families.Hackensack Meridian Health and Englewood Health have signed a definitive merger agreement.RWJBarnabas Health has signed a non-binding letter of intent to acquire Trinitas Regional Medical Center and its affiliates.Drug distributors McKesson, AmerisourceBergen, and Cardinal Health are discussing an agreement with state and local authorities to settle thousands of opioid-related lawsuits for $18 billion. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights t

In this week’s Our Take, we’re covering the latest events in the Sutter Health antitrust trial. To sign up for the weekly email brief, click here. Other briefs include: California releases its first report on drug pricing, in an effort to improve transparency.Bristol-Myers Squibb-Pfizer Alliance is collaborating with Fitbit for atrial fibrillation detection.Amazon is partnering with City of Hope to provide cancer support services to U.S. Amazon employees and their families.Hackensack Meridian Health and Englewood Health have signed a definitive merger agreement.RWJBarnabas Health has signed a non-binding letter of intent to acquire Trinitas Regional Medical Center and its affiliates.Drug distributors McKesson, AmerisourceBergen, and Cardinal Health are discussing an agreement with state and local authorities to settle thousands of opioid-related lawsuits for $18 billion. About Darwin Research Group  Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care

Everyone says that they are a high-performing organization, but which ones really are? Which health care organizations have proven to deliver better outcomes at lower costs? This week, John sits down with the dynamic Brian Klepper, Ph.D., executive vice president of The Valuation Institute. Brian offers examples of unusually high-performing health care organizations and the secrets to their success.

In this week’s Our Take, we’re covering the proposed rules to ease restrictions imposed by Stark Law, anti-kickback statute. To sign up for the weekly email brief, click here. Other briefs include:Dartmouth-Hitchcock Health and GraniteOne Health signed an agreement to merge.Walmart is testing new health benefits to help employees receive appropriate care.ICER pulled a draft evidence report it released in late September on three new rheumatoid arthritis drugs.UPS is set to expand its drone delivery service to hospital campuses nationwide.Civica Rx’s first drug has been administered to patients.Dr. Patrick Conway has stepped down as CEO of Blue Cross Blue Shield of North Carolina. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device c

In this week’s Our Take, we’re covering the latest results from the Medicare Shared Savings Program ACO data, just released last week. To sign up for the weekly email brief, click here. Other briefs include:Dartmouth-Hitchcock Health and GraniteOne Health signed an agreement to merge.Walmart is testing new health benefits to help employees receive appropriate care.ICER pulled a draft evidence report it released in late September on three new rheumatoid arthritis drugs.UPS is set to expand its drone delivery service to hospital campuses nationwide.Civica Rx’s first drug has been administered to patients.Dr. Patrick Conway has stepped down as CEO of Blue Cross Blue Shield of North Carolina. About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medica

In this week’s Our Take, we’re covering the antitrust trial for Sutter Health, and implications for future health system mergers. To sign up for the weekly email brief, click here.Other briefs include:Lafayette General Health to merge with Ochsner Health System.CMS finalized a rule for implementing Medicaid DSH payment cuts.Connecticut is working to create the state’s first network of Centers of Excellence.Amazon is piloting a virtual health clinic called Amazon Care.RWJBarnabas Health and St. Luke’s University Health Network signed a three-year clinical affiliation agreement.CVS is launching a new pharmacy solution designed to give patients quicker access to specialty drugs.About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device compa

Several weeks ago we reported on Capital Rx, a new PBM with a “clearinghouse model” designed to eliminate spread pricing and price variability — and promote greater transparency. This week, John sits down with A.J. Loiacono, a veteran entrepreneur and CEO of Capital Rx. Listen in and learn about what’s wrong with pharmaceutical pricing and how A.J. intends to fix it.Speaker BiosA.J. Loiacono, CEO, Capital RxA.J. is a successful entrepreneur, with 20 years of experience in pharmacy benefits and software development. As the CEO of Capital Rx, his mission is to change the way pharmacy benefits are priced and administrated in the US. Prior to Capital Rx, A.J. was a co-founder of Truveris, where he served for eight years as CEO, Chief Innovation Officer, and Board Member, leading the company to record growth (Deloitte FAST 500 and Crain’s Fast50). Prior to Truveris, A.J. co-founded SMS Partners, a joint venture with Realogy (RLGY), and in 2010 exited the partnership with a buyout. In his first venture, A.J. starte

In today’s Our Take read-in, we discuss hospital market concentrations and their association with DOJ investigations and inpatient prices. To sign up for the weekly email brief, click here. Other briefs include: Novo Nordisk announced that Rybelsus has been approved by the FDA for the treatment of type 2 diabetes. NUW Medicine, MultiCare Health System, and LifePoint Health have partnered to form a clinically integrated network known as Embright. Sanofi and Abbott are collaborating to integrate their diabetes-related technologies. Blue Shield of California is testing rideQ, a ride-share program launched by the Blue Cross Blue Shield Institute last year, in the Sacramento area. Tennessee has proposed switching its Medicaid funding to a block grant. About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s clie

In today’s Our Take read-in, we review value-based payment models in oncology. If this is your field, this episode is one you don’t want to miss.  To sign up for the weekly email brief, click here.Other briefs include:Capital Rx, a startup pharmacy benefit manager, launches its Clearinghouse Model.The owners of Purdue Pharma, maker of OxyContin, tentatively agreed to pay $3 billion to settle opioid-related lawsuits.Cigna introduced a new program to make expensive gene therapies more accessible. 370 health care organizations signed a letter to Congress in support of bipartisan legislation to reform prior authorization requirements.Insurers will owe a record $1.3 billion in medical loss ratio rebates this year.Several executive moves.About Darwin Research GroupDarwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes f

In today’s Our Take read-in, here’s the lead: “A judge ordered Johnson & Johnson to pay $572 million to Oklahoma for creating a ‘public nuisance.’ The state had sought $17.5 billion in a lawsuit against J&J, contending that the company had engaged in misleading marketing and contributed to the opioid epidemic that has claimed the lives of more than 6,000 Oklahomans. J&J plans to appeal, and the company’s shares rose in after-hours trading on the day of the ruling, suggesting that investors believed the outcome could have been much worse.” To sign up for the weekly email brief, click here. Other briefs include: Capital Rx, a startup pharmacy benefit manager, launches its Clearinghouse Model. A federal judge officially approves the merger between CVS Health and Aetna. Michigan-based insurers Priority Health and Total Health Care will merge. Amgen will buy Celgene’s Otezla (apremilast), a psoriasis drug, for $13.4 billion. CMS rejects Idaho’s request for a waiver for Medicaid expansion. Blue Cross

In today’s Our Take read-in, here’s our lead story: Good Neighbor Pharmacy tops the list of chain drugstores in customer satisfaction, according to a new survey by J.D. Power and Associates. The network of independent pharmacies received the highest overall score among brick-and-mortar chain store pharmacies, with a score of 914 out of 1,000 possible points, followed by Health Mart (893), Rite Aid Pharmacy (865), Walgreens (840), and CVS (834). To sign up for the weekly email brief, click here. Note that we’re not uploading a read-in next week due to the Labor Day holiday. Other briefs include: CMS announced that quality star ratings for qualified health plans offered on the Health Insurance Marketplace will be available in 2020. Signify Health and Remedy Partners signed a definitive agreement to merge. SSM Health formed a joint venture with Denver-based Paladina Health to offer direct-to-employer primary care in the St. Louis area. Three new drug approvals for AbbVie, Genentech, and Nabriva Therapeutics. A

This week, Bob Roth returns to Our Take to discuss America’s growing aging population and implications for ignoring what he calls the Aging Crisis. Bob’s passion for caring for the elderly stems from his personal experience with his own mother, which led to the creation of Cypress HomeCare Solutions, the Roth family business. Listen to the elder care issues Bob is calling out—and what we need to do about it. Speaker Bios Bob Roth, Managing Partner, Cypress HomeCare Solutions Bob Roth founded Cypress with his family in 1994 and has been at the helm as Managing Partner since December 2003. Experienced in consumer products, healthcare and software since 1984, Bob is considered an innovator of technologies used to enhance communication and effectively support customers and peers in the health and home care industries. Bob was a finalist for the 2015 Phoenix Business Journal’s prestigious Healthcare Heroes award. In 2013 Cypress was awarded the Better Business Bureau’s Business Ethics Award, the only home care age

In today’s Our Take read-in, we discuss Commercial Accountable Care Organizations, including updates on programs from UnitedHealthcare, Aetna, Cigna, Humana, and Anthem. To sign up for the weekly email brief, click here. Other briefs include: Harvard Pilgrim Health Care and Tufts Health Plan have signed a definitive agreement to merge. Humana files a lawsuit against Mallinckrodt plc. The FDA has approved Pretomanid Tablets, a game changer in the treatment of treatment-resistant tuberculosis. Centene is expanding its health exchange offerings to ten more states. About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and in-depth customer insights to health care executives, with a strategic focus on health care delivery systems and the global shift toward value-based care. Darwin’s client list includes forward-thinking biopharmaceutical and medical device companies, as well as health care providers, private equity, and venture capital firms. The company was founded in 201

In today’s Our Take read-in, “The FDA announced Tuesday that Novartis submitted the drug application for Zolgensma, the company’s novel gene therapy treatment for spinal muscular atrophy, with manipulated data. The FDA said it is assessing the matter and ‘remains confident’ that the gene therapy will continue to be available to patients.” To sign up for the weekly email brief, click here. Other briefs include: Allscripts Healthcare Solutions reached a tentative $145 million settlement agreement with the Department of Justice. CMS has agreed to reimburse any FDA-approved chimeric antigen receptor (CAR) T-cell therapies. SSM Health is introducing an individual health plan in the St. Louis market this fall. Provention Bio’s teplizumab received the FDA’s Breakthrough Therapy Designation. New York City launched NYC Care, a program that offers health care to uninsured residents. CVS has expanded its CarePass program to participating CVS pharmacies throughout the U.S. Walgreens customers can soon get select prescri