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...
Aug 12, 2019•9 min•Ep. 65
In today’s Our Take read-in, we discuss several CMS initiatives announced last Monday. The email version of Our Take includes several important links to other final and proposed rules from CMS. To sign up for the weekly email brief, click here. Other briefs include: Pfizer signed a definitive agreement to merge its Upjohn division with Mylan. HHS is working on a plan to allow the legal importation of prescription drugs. CMS denies Utah’s request for partial Medicaid expansion. Cigna and Memorial...
Aug 05, 2019•10 min•Ep. 64
In today’s Our Take read-in, we discuss a bipartisan bill to lower drug prices that cleared a Senate committee. On Thursday, the Senate Finance Committee voted 19-9 to advance a bill proposed by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore., that includes numerous provisions to lower drug prices. The bill, called the Prescription Drug Pricing Reduction Act (PDPRA) of 2019, is likely to undergo considerable changes before it reaches the Senate floor for a full vote — if it gets that far. Ov...
Jul 29, 2019•11 min•Ep. 63
In this week’s episode, John sits with military psychologist Dr. Julie Kinn to talk about the latest behavioral health mobile apps and online resources developed by the Defense Health Agency (DHA). Dr. Kinn discusses how DHA’s technology combats the stigma present around behavioral health issues so that both veterans and civilians are more inclined to seek care. Check out some of their free mobile apps: Virtual Hope Box, Breathe2Relax, and T2 Mood Tracker. For more resources, go to www.health.mi...
Jul 25, 2019•31 min•Ep. 62
In this week’s episode, we focus on Intermountain Healthcare’s announcement that it has formed a “comprehensive health platform company focused on elevating value-based care capabilities.” The new organization, named Castell, will be led by Rajesh Shrestha as president and CEO. Shrestha will continue to serve as vice president and chief operating officer of Community Based Care for Intermountain. Other briefs include: Gilead Sciences’ research and development collaboration with Belgian biopharma...
Jul 22, 2019•11 min•Ep. 61
Last Tuesday, three judges from the federal appeals court in New Orleans heard oral arguments regarding the ruling made last December in Texas v. United States. The district judge overseeing the case ruled that the Affordable Care Act (ACA)’s individual mandate is unconstitutional and, therefore, the entire ACA must be overturned. This week’s Our Take discusses what happened during oral arguments and what’s expected next. Other briefs include: A federal judge has blocked a Trump administration r...
Jul 15, 2019•11 min•Ep. 60
CMS’ Innovation Center has, through federal grants, helped states address specific population health needs. But what happens when entrepreneurs take healthcare improvement seriously, and are able to find innovative ways to align partnerships to effect change? This week, John sits down with Craig Brammer, CEO of The Health Collaborative and President & CEO of the Network for Regional Healthcare Improvement. Craig is an inspirational leader—helping to create change at the national level driven...
Jul 11, 2019•30 min•Ep. 59
In this week’s episode, we focus on the Supreme Court’s decision to hear arguments from health insurers, who claim $12.3 billion in losses after the federal government reneged on payments owed to certain payers under provisions in the Affordable Care Act (ACA). Business leaders, including the Chamber of Commerce, had urged the court to review an appellate court ruling in June 2018 that Health and Human Services is not obligated to make risk corridor payments to insurers. Other briefs include: Ab...
Jul 01, 2019•13 min•Ep. 58
Why are integrated health systems and academic medical centers increasing their focus on international medicine? What lessons can we learn from our colleagues abroad? Find out this week as John sits down with Dr. Heitham Hassoun, vice president and medical director for Cedars-Sinai International Health and Telemedicine. Speaker Bios Heitham Hassoun, MD, a leading international health expert, is vice president and medical director of Cedars-Sinai's Center for International Health and Telemedicine...
Jun 27, 2019•34 min•Ep. 57
In this week’s episode, John shares some of the results from our fifth annual ACO Executive Survey. Results discussed include: ACO priorities 2019 initiatives Operational issues Factors affecting quality and cost Electronic health record interoperability Partnering activity 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 shif...
Jun 24, 2019•14 min•Ep. 56
In this week’s episode, John reviews some of the lessons learned from ExL’s 13th Partnering with ACOs & IDNs Summit, which took place in Boston, June 10-11. Briefs include: Anthem signed a definitive agreement to acquire Beacon Health Options. Washington state proposal to pay for hepatitis C drugs using a “subscription” model approved by CMS. Penn Medicine has created a clinical alert app that reduces stays in the intensive care unit. Ascension’s leadership lineup will undergo several change...
Jun 17, 2019•12 min•Ep. 55
This week, John sits down with Brett McClain, chief operating officer for Dignity Health’s St. Joseph’s Hospital and Medical Center, where he recently oversaw the launch of Dignity’s systemwide specialty pharmacy. Brett speaks to the development of the specialty pharmacy through a strategic partnership, how pharma engages with his health system, the Dignity-CHI merger, and more. Speaker Bios Brett McClain is the Chief Operating Officer for Dignity Health’s St. Joseph’s Hospital and Medical Cente...
Jun 13, 2019•33 min•Ep. 54
In this week’s episode, John reviews CVS’ move to expand its HealthHub stores to 1,500 by the end of 2021. HealthHub stores have expanded space for health-related products and larger health clinics with a lab for blood testing and screening. They also have a general wellness room used for yoga classes and educational events. We also have our first subscriber feedback, which addresses John’s editorial from last week on Novartis’ new gene therapy priced at $2.1 million. Briefs include: Supreme Cou...
Jun 10, 2019•10 min•Ep. 53
In this week’s episode, John reviews Novartis’ new gene therapy for spinal muscular atrophy, priced at more than $2.1 million. ICER, a nonprofit research institute that evaluates the cost effectiveness of pharmaceuticals, said Novartis’ price is within the upper bound of the organization’s value-based price benchmark range. Briefs include: A broad bipartisan draft health care legislation package containing dozens of provisions was recently released by the Senate Health Committee. Forcing oncolog...
Jun 03, 2019•11 min•Ep. 52
This week, John sits down with Dr. David Radley, senior scientist for The Commonwealth Fund, and Dr. Trafford Crump, assistant professor at the University of Calgary. Trafford and Dave welcomed John to Dartmouth’s PhD program in health economics and clinical epidemiology back in 2005, and have remained good friends ever since. In this episode, they talk about the politicization of health care, health system performance, what's driving healh care cotsts, patient-reported outcomes, and more. Speak...
May 30, 2019•46 min•Ep. 51
In this week’s episode, John talks about the latest bombshell lawsuit filed by 44 states accusing Teva and other generic drugmakers of price fixing. Other briefs include: A house bill introduced to address surprise medical billing. CMS’ guidance designed to eliminate spread pricing. Advent International to acquire AccentCare. Civica Rx announces first two drugs in production. A hearing is set to review CVS-Aetna merger. About Darwin Research Group Darwin Research Group Inc. provides advanced mar...
May 23, 2019•9 min•Ep. 50
In this week’s episode, John talks EHRs and physician burnout, prescription drug prices in TV ads, and more. Highlights include: Gundersen Health System and Marshfield Clinic talk merger. Bon Secours Mercy Health signs letter of intent to acquire Dublin, Ireland-based Bon Secours Health System. UnitedHealthcare’s new bundled payment program for maternity care. U.S. District Court judge struck down the 340B rate cut. Washington becomes the second state to announce a subscription-based payment mod...
May 16, 2019•17 min•Ep. 49
Analysts and consultants often make predictions about where markets are headed. In this week’s episode, John goes back five years and reviews what he first wrote about accountable care organizations and the value-based care movement. What did he get right? Where was he wrong? What lessons have we learned? Highlights include: What the Affordable Care Act was designed to address. How markets reacted to events related to policy announcements. Harvard Business School’s Clay Christensen and why ACOs ...
May 09, 2019•35 min•Ep. 48
In this week’s episode, John reviews Humana’s new oncology payment model, several important announcements from the Centers for Medicare and Medicaid Services, and more. Highlights include: CMS is offering five new payment models for primary care practices CMS is inviting state Medicaid directors to test new ways to approach dual-eligibles FDA cleared the first medical device to treat attention-deficit/hyperactivity disorder (ADHD) Amazon rolled out its PillPack at-home prescription drug delivery...
May 02, 2019•15 min•Ep. 47
In today’s episode, John returns to his conversation with renowned cancer researcher Dr. David S. Hong. Dr. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong has published more than 270 papers in leading academic journals. Topics include: Go/No-go decisions in clinical trials. Interchan...
Apr 25, 2019•27 min•Ep. 46
In this episode, John discusses Our Take on health care news in the first half of April 2019. He covers the Times/ProPublica report on Memorial Sloan Kettering Cancer Center, the proposed merger between Atrium Health and Wake Forest Baptist Health, and other top stories through April 15. A new report by The New York Times and ProPublica says leadership at Memorial Sloan Kettering Cancer Center (MSK) “repeatedly violated policies on financial conflicts of interest,” resulting in an environment in...
Apr 18, 2019•18 min•Ep. 45
In today’s episode, John has a fascinating conversation with renowned cancer researcher Dr. David S. Hong. Dr. Hong is deputy chair of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center. He also serves as associate vice president for Clinical Research and clinical medical director of the Clinical Center for Targeted Therapy. Dr. Hong has published more than 270 papers in leading academic journals. Topics include: The rise of immunotherapy and the Golden Age ...
Apr 11, 2019•29 min•Ep. 44
In this week’s episode, John reviews some pharma breakthroughs—along with one major setback—and discusses the bold statement by the Department of Justice (DOJ) regarding the Affordable Care Act (ACA). Highlights include: The Department of Justice issued a letter stating that it agrees with a federal judge who struck down the entire ACA as unconstitutional. The FDA approved the first drug to treat postpartum depression: Sage Therapeutics’ Zulresso (brexanolone). Amarin Corp. presented updated res...
Apr 04, 2019•18 min•Ep. 43
In today’s podcast, John Marchica sites down with the Director of Telehealth and of JeffConnect at the Thomas Jefferson University Hospitals, Mr. Frank Sites. Frank has decades of experience in this space and shares with us just what it took to get JeffConnect to become the robust telehealth program that it is today. Here are some of the interview highlights: Specifics about Jefferson Health’s telehealth program, JeffConnect, and the “buckets” it fills for the end users. Adoption by Jefferson pr...
Mar 28, 2019•35 min•Ep. 42
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 th...
Mar 21, 2019•12 min•Ep. 41
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...
Mar 14, 2019•30 min•Ep. 40
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 ...
Dec 20, 2018•12 min•Ep. 39
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...
Dec 13, 2018•8 min•Ep. 38
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...
Dec 06, 2018•9 min•Ep. 37
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...
Nov 29, 2018•10 min•Ep. 36
