September 15, 2019

Healthcare Industry Structural Changes Are Coming

The Structure of the Healthcare Industry will Change Radically

The healthcare industry is changing at a blistering pace. Healthcare policies, technologies, insurance coverage, and the new focus on patient experience have triggered the evolution of healthcare into something yesterday’s providers would never recognize. And, chances are, the healthcare of tomorrow will look drastically different than the care provided today.

Change had come slowly to healthcare industry legislation in the nation’s early years. The first attempt at national health insurance came about in 1905, with the formation of the American Association for Labor Legislation; Speaker of the House Thaddeus Sweet vetoed the bill. The next major change in the healthcare industry didn’t come along until 1965 when, after 20 years of heated debate in Congress, President Lyndon B. Johnson initiated legislation introducing Medicare and Medicaid. The 2010 Patient Protection and Affordable Care Act was the last major healthcare legislation.

While changes to healthcare law and healthcare insurance had came slowly, the nation’s demographics and need for medical care is now changing rapidly. Furthermore, advances in research and medical technology have fueled an astonishing metamorphosis in healthcare.

Factors Contributing to the Changing Landscape of Healthcare

Perhaps the most notable change in healthcare is its explosive growth: healthcare became the largest employer in the United States in the third quarter of 2018, according to The Atlantic.

The nation’s aging population is a major driver of the healthcare job boom. By the year 2025, one-quarter of the workforce will be older than 55. By 2030, more than 170 million people in the United States will have at least one chronic health condition, according to the American Hospital Association (AHA). The rising population of older adults, and the increasing number of people with chronic illnesses, will require a growing pool of healthcare workers. In fact, the U.S. Bureau of Labor Statistics (BLS) expects jobs in the healthcare industry to account for a large share of new jobs created through 2026.

Other factors, including the health insurance market and healthcare regulation, will affect the structure of the healthcare industry. About half of the privately insured are covered under self-insured plans, which can vary dramatically.

The healthcare system is also moving towards a financial model based on value, rather than on volume. This shift will change the focus from treating diseases in hospitals to keeping patients healthy and out of the hospital.

Expect Monumental Changes in the Healthcare Industry

To handle these changes, the structure of the healthcare industry will undergo radical transformation in a number of areas, from insurance to the makeup of the board and the role of clinicians in leading renovations within an organization.

Provider organizations offering insurance products will likely experience substantial restructuring because they are essentially creating new businesses in a highly volatile market. In fact, several health systems have already introduced health plans in recent years, according to the Healthcare Financial Management Association.

Organizations without such products are restructuring, creating regionally focused, value-based care teams and enhancing consumer engagement. Moving towards a value-based system requires increased collaboration between health systems and health plans, the implementation of patient-centric technology, increased adoption of virtual care options, and a greater focus on public health. It also requires greater understanding of patient motivation and behavior, so many healthcare organizations will restructure to include patient experience departments.

Changes in organizational structures will manifest themselves in a number of ways. Evolution of an organization’s structure may include centralization and professionalization of the board to look more like boards in other industries, for example. This shift allows senior business leaders with niche expertise to guide healthcare organizations through insurance, risk management, IT, consumer engagement, investments and capital allocation.

Many healthcare organizations are putting physicians in leadership roles, asking their clinicians to lead clinical informatics, care model transformation, and population health management initiatives. In this way, the Chief Medical Officer (CMO) is evolving into the role of Chief Transformation Officer.

While it is nearly impossible to predict where the healthcare industry will be at the end of the 21st Century, it is safe to say that healthcare in the United States will undergo more changes in the next 80 years than it has in the entire history of the nation.

SOURCES:

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Frank Magliochetti owes his professional success to his expertise in two areas: medicine and finance. After obtaining a BS in pharmacy from Northeastern University, he stayed on to enroll in the Masters of Toxicology program. He later specialized in corporate finance, receiving an MBA from The Sawyer School of Business at Suffolk University. His educational background includes completion of the Advanced Management Program at Harvard Business School and the General Management Program at Stanford Business School. Frank Magliochetti has held senior positions at Baxter International, Kontron Instruments, Haemonetics Corporation, and Sandoz. Since 2000, he has been a managing partner at Parcae Capital, where he focuses on financial restructuring and interim management services for companies in the healthcare, media, and alternative energy industries. Earlier this year, he was appointed chairman of the board at Grace Health Technology, a company providing an enterprise solution for the laboratory environment.

Mr. Frank Magliochetti MBA
Managing Partner
Parcae Capital

www.parcaecapitalcorp.com
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Wearable Sensors: Identify Early Signs of Disease

Wearable Sensors May Help Identify Early Signs of Disease

Wearable technologies may be able to do much more than monitor a person’s blood pressure or total number of steps each day, according to a new study, which suggests wearable sensors can detect early signs of serious disease.

Wearable biosensors, otherwise known as wearables, are a low-cost technology capable of measuring physiological parameters continuously or frequently. Biosensor technology is a promising approach to monitoring physiological measurements, and these devices could potentially identify significant changes in health conditions. Capable of passive and routine recording, the technology can provide immediate real-time delivery of multiple measurements to the wearer or physician. Software simplifies the technology, so using wearable biosensors requires minimal training and attention from the wearer or the clinician.frank-magliochetti-biosensors-healthcare-report

In addition to physiological measurements, wearable devices can capture the wearer’s physical activities, such as walking, running, and biking, often in conjunction with a GPS to provide information about the location of the activity.

Wearables can Track Health and Provide Useful Health Information

The newest generation of portable biosensors can measure health-related physiology changes during various activities. The goal of the study, published in PLOS Biology in January 2017, was to investigate the use of portable biosensors in this capacity and their potential role in health management, specifically in the diagnosis and analysis of disease.

The researchers fitted participants with between one and seven commercially available activity monitors. Over the course of the study, the scientists recorded more than 250,000 daily measurements, including participants’ heart rate, skin temperature, blood oxygen, sleep and calories expended collected from up to 43 individuals. The scientists then combined biosensor information with medical measurements to develop a personalized, activity-based normalization framework, which they used to identify abnormal physiological signals and detect disease.

Several participants reported minor cold-like illnesses in the study’s first two years. At the onset of these illnesses, the sensors detected higher than normal readings for skin temperature and heart rate. Blood tests showed an increase in inflammation before symptoms occurred.

Biosensors-frankmagliochetti-reportThe devices could detect physiological differences, namely variations in heart rate patterns, between insulin-sensitive and insulin-resistant individuals. The researchers also found interesting physiological changes associated with alterations in environment. Participants’ blood oxygen levels decreased during high-altitude flight, for example, and this decrease in oxygen levels correlated with fatigue.

The wearables even detected physiological changes in one person – lead author of the study, Michael Snyder – who later turned out to have Lyme disease. The geneticist never developed the telltale bulls-eye rash that usually precedes the condition, but his smart watch and other sensors detected changes in his own oxygen levels and heart rate. Shortly afterwards, Snyder developed symptoms and received an official diagnosis of Lyme disease.

The researchers concluded by saying the portable biosensors can provide information useful for the monitoring of personal activities and physiology. These devices will likely play an important role in health management and access to care by those traditionally limited by geography or socioeconomic class.

Lead author of the study, Michael Snyder, said in a press release that today’s wearables are “the equivalent of oral thermometers but you’re measuring yourself all the time.” He added wearables might someday act as a “check engine” light that tells the wearer when it is time to see a doctor.

Source

http://journals.plos.org/plosbiology/article?id=10.1371/journal.pbio.2001402

http://www.biosciencetechnology.com/news/2017/01/testing-wearable-sensors-check-engine-light-health-0

Frank Magliochetti is Managing Partner for Parcae Capital

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release new sites dedicated to the industry. Frank currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

Medication Adherence in the United States  

United States:  Medication Adherence Check Up

Non-adherence includes stopping, not starting, or taking less than the prescribed amount of a medication. More than half of all adults in the United States with a chronic illness report at least one episode of non-adherence to their prescription medication, according to the first National Report Card on Adherence. This report card, developed bymedical-adherance_frankmagliochettireport the National Community Pharmacists Association (NCPA), gives Americans a weak score when it comes to takingmedications as prescribed.

The Centers for Disease Control and Prevention (CDC) says that 80 percent of all medical treatments involve medication. The CDC also estimates that 20 to 30 percent of prescriptions go unfilled.

There is some good news in medication adherence trends, however. A study published in September 2016 shows that low adherence for anti-hypertensive medications decreased among Medicare beneficiaries from 37.4 percent in 2007 to 31.7 percent in 2012.

medication-adherance-appsTechnology is helping to improve adherence rates. Smartphone apps and other technologies have created a new medication adherence market, which offers computerized solutions that remind patients to take medications and take other measures to improve adherence. The global medication adherence market is growing at a significant rate, according to a P&S Market Researchpress release, boasting a 17.5 percent CAGR during 2016-2022.

 

Reasons for Poor Adherence

There are many reasons patients do not take prescriptions as directed. Forgetfulness, concerns about side effects, poor understanding of the need to take medications, affordability, and difficulty getting to the pharmacy are common reasons for poor adherence.

Pharmacy connectedness, which is a feeling of familiarity with a pharmacy provider, is an important factor when it comes to medication adherence. Only 36 percent of those who get their prescriptions by mail report pharmacy connectedness in the report card, while 67 percent of those who visit a chain pharmacy and 89 of those who go to a neighborhood pharmacy report a personal connection with their pharmacists. Patients living in the Northeast and Midwest are slightly more likely to report pharmacy connectedness; those living in urban areas are less likely to

Affordability is another primary predictor in whether a patient will take a medication as prescribed. Whether or not insurance pays for the drug, overall health and income often factor into the affordability of a medication.

Improving Medication Adherence

Healthcare providers can help patients improve medication adherence. Pharmacists are at the front line of addressing non-adherence. Establishing pharmacy connectedness with new patients and improving person connections with existing customers can help these healthcare professionals engage with clients, provide better information about the importance of taking medications as prescribed, and encourage them to better comply with medication regimens. Because of their greater personal connection with patients, independent pharmacists may be in particularly good position to optimize adherence.

Practitioners also play a vital role in stressing medication compliance, monitoring adherence, and helping patients manage side effects and other complicating factors that might prevent patients from taking medication as prescribed. Keeping patients well informed about health conditions can also improve compliance. Both prescribers and pharmacists can help reduce non-adherence by helping economically vulnerable patients find the most affordable medications.

Information, communication, and patient support help patients become engaged and involved in their own health care; they also improve patient satisfaction and loyalty. The results of the scorecard survey suggest patient engagement can reduce the currently high levels of prescription medication in the United States, and address the associated costs and health risks of non-adherence.

Source

http://www.ncpa.co/adherence/AdherenceReportCard_Full.pdf

https://www.cdc.gov/cdcgrandrounds/pdf/gr-pharmacists-10-21-2014.pdf

https://www.ncbi.nlm.nih.gov/pubmed/27432867

http://www.prnewswire.com/news-releases/global-medication-adherence-market-expected-to-grow-with-175-cagr-during-2016-2022-ps-market-research-574469501.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

frankmagliochetti_ParcaeCapital

C -Diff Rates Highest in the Northeast  

Highest C-Diff Rates in US are in the Northeast

Frank Magliochetti Report

Clostridium difficile (C. difficile or C. diff) is a deadly superbug that causes severe illness, diarrhea and sometimes death in thousands of people in the United States each year. Now a study shows that infection rates of these antibiotic-resistant bacteria are highest in the Northeastern section of the nation.

northeast_frankmagliochettidifficileinfection causes inflammation of the colon and diarrhea severe enough to be life threatening. The Centers for Disease Control and Prevention (CDC) saysC. difficile is now the most common microbial cause of hospital-acquired infections in U.S. hospitals, and that these infections cost up to $4.8 billion annually in excess healthcare costs – and that number reflects the costs for just for acute care facilities, not for nursing homes or other healthcare institutions.

diffcaused nearly half a million infections in 2011, and 29,000 patients died within 30 days of receiving their initial diagnosis ofC. difficileinfection that year. C. difficile infections are usually a regional problem, as patients transfer from hospitals to nursing homes and back into the community, which allows the disease to spread.

 

C. Diff Rates Have Been Highest in the Northeast – for a Decade

Rates of this deadly superbug were highest in the Northeast over the last decade, according to a study published in the American Journal of Infection Control.

Researchers from the University of Texas analyzed 2.3 million cases of C. difficile infection that occurred between 2001 and 2010. They found the highest incidence of the infection in the Northeast, where about eight patients developed a C. difficileinfection for every 1,000 patients discharged from a hospital. The Midwest had the second highest C. diff infections at 6.4 infections per 1,000 discharges, followed by the South at five per 1,000 and the West at 4.8 infections per 1,000 discharges.

Deaths from C. difficile infections were highest in the Midwest at 7.3 percent and among older adults at 9 percent.

The scientists also discovered that C. difficile is a seasonal disease. Most cases occurred in the spring, infecting 6.2 people for every 1,000 discharges. Infection rates were second highest in the winter at 5.9 per 1,000, followed by summer and fall.

The rates of C. diff infections for adults and older adults followed the overall trends, with most adults developing a C. diffinfection (CDI) during spring. CDIs among children were highest in the winter.

“The peak incidence in the spring could be attributed to increased utilization of antibiotics in winter months,” explain the authors of the study. “Prior studies have found a 1 to 2 month lag time between antibiotic exposure and the development of CDI.”

Controlling the Risk of C. Difficile Infections in all 50 States

Over-prescribing and inappropriate prescribing of antibiotics raises the patient risk of CDI. About half of all patients receive an antibiotic at some time during hospitalization, according to CDC statistics, but 30 to 50 percent of antibiotics prescribed in hospitals are incorrect or unnecessary. Using proper infection control procedures and careful prescribing of antibiotics can prevent CDIs.c-difficile-frankmagliochetti

CDIs are usually associated with medical care; patients who take antibiotics and receive medical care are at the highest risk for aC. difficile infection.

Doctors often prescribe broad-spectrum antibiotics that kill a wide variety of dangerous bacteria. Unfortunately, these antibiotics can also kill off beneficial bacteria living in the human gut. These beneficial bacteria help digest food and boost the immune system to help protect the body against infection. Taking antibiotics can suppress these beneficial bacteria for several weeks or even months, which leaves the body vulnerable to pathogens – such as C. difficile – when the individual comes into contact with a contaminated surface or with another person with the disease. Unnecessary use of antibiotics and poor infection control increases the speed at which C. difficile spreads within a facility or between facilities when a patient transfers.

C. difficile infections cause immense suffering and death for thousands of Americans each year,” said Tom Frieden, M.D., M.P.H, and Director of the CDC. “These infections can be prevented by improving antibiotic prescribing and by improving infection control in the health care system. CDC hopes to ramp up prevention of this deadly infection by supporting State Antibiotic Resistance Prevention Programs in all 50 states.”

Source

https://www.ncbi.nlm.nih.gov/pubmed/25952045

http://www.cdc.gov/media/releases/2015/p0225-clostridium-difficile.html

https://www.cdc.gov/hai/organisms/cdiff/Cdiff_clinicians.html

Frank Magliochetti is Managing Partner for Parcae Capital.

  • North Andover, Massachusetts

This column of posts is directed at the Healthcare Industry.  Frank plans to release a new site dedicated to the industry.  He currently assists companies who are building, restructuring, transforming and resurrecting there business’s. An example of his client base are, Xenetic Biosciences , IPC Medical Corp, Just Fellowship Corp, Environmental Services Inc., Parsons Post House LLC, ClickStream Corporation as well as having a business talk radio show; The Business Architect on the URBN network.

frankmagliochetti_ParcaeCapital