Health Care Rounds

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...

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...

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...

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 vi...

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 t...

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...

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...

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 editor...

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 c...

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, hea...

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 r...

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...

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...

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-def...

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 p...

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 (MS...

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 27...

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...

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 tel...

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...

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), a...

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 s...

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 wit...

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. pr...

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 R...