Health Care Rounds

In this episode, John reviews what happened in the world of health care this past week, specifically the results of a study published on March 11 in the JAMA Internal Medicine on Home Health and how it can provide a significant amount of savings when compared to other discharge locations. Home health care agencies save Medicare millions of dollars compared with skilled nursing facilities, despite higher readmission rates, according to the study. Researchers used Medicare claims data from 2010 through 2016 to compare the results of more than 17 million hospitalizations, where 39% were discharged to home health and 61% to skilled nursing. This massive study—17 million cases over a seven-year period—demonstrates the enormous potential value home health care can bring to Medicare and other payers. 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 glo

Welcome to Season 2 of Health Care Rounds. In this episode, John Marchica speaks with Scott Hylla, Director of Health Systems and Managed Markets with Sunovion Pharmaceuticals. Scott and John discuss the state of pharma-IDN partnerships, pharma attitudes toward ACOs, and the future of industry-provider relations. Key questions include: How does pharma align with integrated health systems (IDNs), and what are IDNs looking for in a partnership? Should pharma partner with ACOs, and if so, why? What are the key trends in health care delivery that drive pharma toward higher-level partnerships? Speaker Bios Scott Hylla is the Director of Health Systems for Sunovion Pharmaceuticals Inc. He has served in various roles spanning a 28 year career in the pharmaceutical industry, most recently in leading the Sunovion Health Systems team in the development and execution of collaborative strategies in the transformational IDN marketplace. Scott has a BS in Biology from St. John’s University and an MBA in Healthcare Manag

In this episode, John takes a look back on the year of 2018 and gives you his top five health care stories of the year, as well as a few honorable mentions and a few of the worst health policy ideas. 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 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

In this episode, John gives his insight on recent developments on one of this year’s trending healthcare topics, pharmacy benefit managers (PBM) and pharmaceutical rebates. CVS announced that it is launching a new pharmacy benefits plan that returns 100 percent of drug rebates to its clients. In a statement, CVS said its new Guaranteed Net Cost pricing model “more closely aligns PBM incentives with plan sponsors’ objectives” by offering more predictability and transparency. 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 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satel

In this episode, John walks us through the recent flurry of mergers and acquisitions that are coming to a close and only recently announced at the end of 2018. The biggest news is that CVS Health completed its acquisition of Aetna last Wednesday in a deal that valued Aetna at $212 per share, or approximately $70 billion, not including debt. 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 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

In this episode, John discusses our take specifically on the news of the results from the Johns Hopkins care management program, Johns Hopkins Community Health Partnership. A Johns Hopkins community intervention is associated with reductions in admissions, readmissions and emergency department visits, netting $113.3 million in savings, according to new research in JAMA Network Open. 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 2010 as Darwin Advisory Partners, LLC and is headquartered in Scottsdale, Ariz. with a satellite office in Princeton, N.J.

Have a festive Thanksgiving from all of us at Health Care Rounds Podcast! We will be back next week with a new episode, the Season 1 closing, so stay tuned for our take on the first season of Health Care Rounds. In the meantime, enjoy your week!

In this episode, John discusses our take on health care news surrounding the midterm elections and how this will affect health care going forward. At the end of October, Senate Majority Leader Mitch McConnell, R-Ky., told Reuters that if given the chance—that is, if Republicans remained in control of both chambers of Congress—we could expect another attempted repeal of Obamacare. But this last week, referring to an ACA repeal, McConnell told reporters, “I think it’s pretty obvious, the Democratic House is not going to be interested in that,” adding that he was willing to work on health policy issues on a bipartisan basis. 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 equ

John is taking the helm this week to share his experience presenting at a conference last week, and the lessons he learned from two days of sessions. We will return to our regular format next week. The conference, exl’s 12th Partnering with ACOs and IDNs Summit, included about 100 people, mostly represented by pharma, ACOs and health systems. The first part of his presentation covered what we learned from our annual ACO Executive survey, which includes what are their most pressing problems. The second part delved into the partnering, or lack thereof, of pharma companies with ACOs. 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 compan

Hoping all of our listeners had a wonderful and safe Halloween! In this episode, John discusses our take on health care news in the last week of October. He covers President Trump’s proposed change on how Medicare pays for certain drugs, based on an international pricing index of drugs. HHS Secretary Alex Azar referenced a report his agency recently completed—which compared U.S. prices for 27 drugs with prices for the same drugs in 16 other countries—tweeting that “Among these drugs, on average, the US pays 180% more than the international price.” HHS said the rule would include most of the drugs in Medicare Part B, which covers injectables and many specialty medications. 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 compa

John discusses our take on health care news in the second half of October. He covers how CVS and Aetna have made a big step towards completing their merger, as well as a new proposed rule by CMS regarding transparency of pricing in drug advertisements. The U.S. Department of Justice (DOJ) has cleared the way for the $69 billion merger between CVS Health and Aetna Inc., with the stipulation that Aetna divests its Medicare Part D individual prescription drug plan business. CMS proposed a rule requiring prescription drug manufacturers to post the wholesale acquisition cost (WAC) of Medicare- and Medicaid-approved drugs in direct-to-consumer television advertising. 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 we

In this episode, John Marchica speaks with Mr. Ramon Soto, Northwell Health’s Chief Marketing and Communications Officer. Mr. Soto came to what was formerly known as the North Shore-Long Island Jewish Health System after several years of unsuccessful deliberations on how to rebrand the system. In the interview, he touches upon how marketing is much more than “what looks good” and how to use market analytics as a driver to a more consumer-centric health system. Here are some of the interview highlights: The thought behind Northwell Health’s recent rebranding strategy How Northwell Health uses marketing analytics to understand customer needs Using storytelling to stand out in the highly competitive market of New York Speaker Bios Ramon Soto is a skilled marketing executive with deep healthcare and financial services experience. Ramon is the senior vice president, chief marketing and communications officer for Northwell Health. He is responsible for the development and execution of Northwell’s brand strategy,

John discusses our take on health care news in the first half of October, specifically commenting on the recent movements of multiple significant health systems. University Health Network (UHN) and Vanderbilt Health Affiliated Network (VHAN) announced a partnership for value-based health care that reaches throughout the state of Tennessee. Baylor Scott & White Health (BSW) and Memorial Hermann Health System have signed a letter of intent to merge. In a statement, the organizations said their next step is to complete a due diligence and regulatory review prior to signing a definitive agreement, which is expected to occur in 2019. 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,

What’s it like competing for business as an integrated delivery system—sandwiched eight miles between the University of Maryland Medical System and Johns Hopkins Health System—in a global budget environment within the state of Maryland? Find out this week in John’s conversation with LifeBridge Health CEO Neil Meltzer, a dynamic and inspirational leader serving his community and the stakeholders of LifeBridge with purpose. Interview highlights include: What sets LifeBridge apart from the steep competition in the Baltimore market How LifeBridge hotspots community needs through patient data analysis Where LifeBridge is looking to expand in the future Speaker Bios Neil Meltzer is president and CEO of LifeBridge Health, a position he has held since 2013. Mr. Meltzer joined Sinai Hospital of Baltimore as vice president of operations in 1988, and a decade later became Sinai’s president and chief operating officer. Mr. Meltzer has a background in public health and brings a community-focused approach to every health

John discusses our take on the important health care news that occurred in the second half of September. Our main stories this episode include the creation of OneOncology, a merger of three oncology groups, and a suit on the alleged illegal kickbacks regarding the prescription of Humira. Three large cancer practices have teamed up to create OneOncology. Announced Wednesday, OneOncology includes Tennessee Oncology, New York Cancer & Blood Specialists and Memphis-based West Cancer Center, comprising more than 225 providers and over 60 locations. California Insurance Commissioner Dave Jones filed suit against AbbVie, alleging that the drugmaker gave illegal kickbacks to physicians to prescribe Humira (adalimubab). In court filings, the state alleges that AbbVie “systematically and repeatedly has violated the Insurance Frauds Prevention Act by providing kickbacks to health care providers throughout California.” About Darwin Research Group Darwin Research Group Inc. provides advanced market intelligence and

In this podcast, John Marchica has Dr. Adeel Yang at the table to discuss his newest venture, Medumo. Medumo’s CareTours™ are digital "instructional pathways" that healthcare providers can rapidly customize to guide patients throughout treatments and procedures in the most effective, scalable way possible. Medumo was highlighted at the Connected Health Conference in 2017, looking at “Digital Health Startups Working with Large Health Systems - Lessons Learned.” Here are some of the interview highlights: What is Medumo and how does it help both the patients and their providers? Current key gaps in health care along the patient’s health care journey and how Medumo addresses these through its digital platform. How the Medumo team has managed to succeed in the health start-up world. Speaker Bios Dr. Yang is the co-founder and CEO of Medumo, a PULSE MassChallenge digital health startup offering an intelligent patient navigation platform that creates value for hospitals by improving operational efficienc

John shares a special our take on the trove of changes that occurred in the world of ACOs this past week. In late August, the National Opinion Research Center at the University of Chicago released the results of the first performance year (2016) for CMS’ Next Generation ACO model. Also in late August, CMS released its MSSP ACO public-use data file for 2017, which includes financial performance and quality scores for 472 ACOs, representing nearly 9 million beneficiaries. According to a new study published in The New England Journal of Medicine by Harvard Medical School researchers, physician-group ACOs outperformed hospital-integrated ACOs during the first three years of the MSSP (2013–2015). 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

John shares our take on what happened in health care at the end of August including the NYU at the frontier of offering free tuition to medical students, as well as how a few Republican senators have introduced legislation to protect Affordable Care Act’s provisions for people with pre-existing conditions. The New York University School of Medicine announced that it is now offering free tuition for medical students, becoming the first major medical school in the U.S. to offer tuition-free education. “Our full-tuition scholarships make it possible for aspiring physicians to choose a specialty based on their talent and inclinations to better serve the communities who need it most, and to more easily pursue scientific breakthroughs that improve how we care for patients.” Ten Republican senators have introduced legislation that purports to protect the Affordable Care Act’s provisions for people with pre-existing conditions. The language offering protections would be effected by amending the Health Insurance Port

Happy Labor Day from all of us at Health Care Rounds Podcast! We will be back next week with a new episode. In the meantime, enjoy your week!

In this podcast, John Marchica discusses the intricacies of Canadian health care with his old colleagues, Trafford Crump, PhD and Paul Woods, MD, MS. Canada’s health care system is about 70% federally funded and is experiencing the same health care trends of an aging population and attempts to move towards a value-based care model. Here are some of the interview highlights: How health care is structured in Canada, and its similarities and differences to health care in the U.S. The increasing costs of health care in Canada, and delving into why this is becoming a trend. The reasonings behind looking to the province of Ontario to lead the way to value-based care in Canada. Speaker Bios Trafford Crump, PhD is a health services researcher and assistant professor at the University of Calgary’s Department of Surgery with an interest in patient-centered measures. Dr. Crump's earlier research involved developing the methods for eliciting health care preferences from community-dwelling Medicare beneficiaries in the