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4 Cincinnati health care workers awarded free trip to 2021 Super Bowl – WLWT Cincinnati

Registered nurse Beth Day is known for her tireless work and commitment to helping others.Taking on long hours and extended shifts amid the worst months of the pandemic, she loves what she does, never expecting to be thanked, in such a big way."I'm very grateful to be able to do this, it's a once in a lifetime opportunity for most people," Day said.Day and three other TriHealth nurses are headed to the 2021 Super Bowl. They're just four of nearly 7,500 vaccinated front-line health care workers that'll attend the big game with free tickets and game day experiences directly from the NFL."I've been to a couple of Bengals games but nothing that was of any significance like the Super Bowl," Day said.Nurse Manager Stephanie Long helped select Day for this major opportunity. She'll be representing TriHealth's Good Sam hospital at Evendale."I've worked with Beth for 10 years, she always has a positive attitude, always willing to do anything you need her to do," Long said. "With all the COVID chaos she was willing to go anywhere that was needed."Soon she'll be off to Tampa, rooting on her team of choice."The Chiefs, all the way!" Day said.Knowing her efforts to keep people safe played a small part in making a game like this one, even possible.

Registered nurse Beth Day is known for her tireless work and commitment to helping others.

Taking on long hours and extended shifts amid the worst months of the pandemic, she loves what she does, never expecting to be thanked, in such a big way.

"I'm very grateful to be able to do this, it's a once in a lifetime opportunity for most people," Day said.

Day and three other TriHealth nurses are headed to the 2021 Super Bowl.

They're just four of nearly 7,500 vaccinated front-line health care workers that'll attend the big game with free tickets and game day experiences directly from the NFL.

"I've been to a couple of Bengals games but nothing that was of any significance like the Super Bowl," Day said.

Nurse Manager Stephanie Long helped select Day for this major opportunity. She'll be representing TriHealth's Good Sam hospital at Evendale.

"I've worked with Beth for 10 years, she always has a positive attitude, always willing to do anything you need her to do," Long said. "With all the COVID chaos she was willing to go anywhere that was needed."

Soon she'll be off to Tampa, rooting on her team of choice.

"The Chiefs, all the way!" Day said.

Knowing her efforts to keep people safe played a small part in making a game like this one, even possible.

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4 Cincinnati health care workers awarded free trip to 2021 Super Bowl - WLWT Cincinnati

RI field hospital nurse one of 75 New England health care workers to attend the big game – WPRI.com

SCITUATE, R.I. (WPRI) Holley Tucker received the surprise of a lifetime last week.

The Scituate resident and manager at one of the states field hospitals learned Friday that she was one of 76 New Englanders invited to attend Super LV in Tampa this Sunday.

Tucker and 75 other health care workers from all six New England states were invited by New England Patriots owner Robert Kraft.

Its an honor for us to celebrate these health care workers by giving them a well-deserved break for a day and an opportunity to enjoy the Super Bowl, a reality that is only made possible because of vaccines, Kraft said in a statement. We hope that in doing so, others are also encouraged to get vaccinated as they are able.

Last month, the NFL announced they were inviting approximately 7,500 vaccinated health care workers to the game as a way to thank and honor them for their service throughout the pandemic.

We want to say thank you from the bottom of our hearts to all of the health care heroes who have risked their well-being to ensure ours. They are truly superheroes to us, Kraft said.

Tucker, who has worked at several of Lifespans hospitals throughout the pandemic including the field hospital in Providence, said while the past year hasnt been easy, this reward was unexpected.

I had no idea, Tucker said. I was totally overcome by every emotion I cant believe it.

Its been a really challenging year, its really pushed us to our limits, she continued.

Tucker and the other selected health care workers will board the Patriots plane and head to Tampa Sunday morning.

Once they arrive, the health care workers will attend the NFL TikTok Tailgate concert, which is being headlined by Miley Cyrus.

Tucker said while shes been to a Patriots play-off game, she never expected she would see a Super Bowl.

When asked who shes rooting for, the Patriots fan said its tough call, but she will always have love for Tom Brady.

Hes a very talented quarterback, she said. Hes won six Super Bowls for us, so how can you be mad? Both quarterbacks are very talented and both teams are very talented, so Im excited to watch them both play. I think they both have a lot to prove as one starts his career and one ends his career. Either way, its going to be a fantastic game.

Tucker also told 12 News this Friday is her birthday. She said this is one of the best birthday presents shes ever received.

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RI field hospital nurse one of 75 New England health care workers to attend the big game - WPRI.com

Long Beach moves from vaccinating health care workers to teachers. Mayor says their strategy is different from other cities – KCRW

While LA County is dealing with COVID-19 vaccination problems such as short supplies, long lines, and a complicated sign-up system, its a different story in Long Beach. There, the city is already vaccinating teachers and grocery store workers. Thats on top of health care workers, long-term care residents and staff, and people 65 and older. Long Beach has its own public health department, so it can set different rules than the rest of the county.

Long Beach Mayor Robert Garcia tells KCRW that vaccination shots have gone to 6500 educators from Long Beach Unified School District, plus 500-600 key staff at the citys community college. On Monday, critical frontline and custodial staff at California State University Long Beach got shots too.

The education sector, along with some of the privates and the independent schools, has been going really well. And something we're really proud of here in the city is getting more teachers vaccinated, he says.

If campuses are going to open for in-person classes, teachers and stuff must be vaccinated, and the supply right now is a big question, Garica says.

We really need more supply from the feds. And certainly the state's working on that. If we were able to vaccinate, let's say our K-12 teachers or K-5 teachers, I think we're much more likely to have some type of campus reopening this semester. But it's really going to be dependent on the school district, on the teachers, and how safe folks feel.

He adds what also matters are personal protective equipment and proper ventilation in classrooms.

Health care and food service workers

Health care workers are for the most part done, or over half of them are on their second doses. We have 100% of our skilled care facilities are done and staff and residents are all of course on their second dosage right now, Garcia says.

The city has also vaccinated its firefighters, police officers, emergency service workers. Now the concentration is on teachers and food workers.

We're moving right now into second doses. But we continue every single day, also focused on that 65-plus population. And you're just not hearing some of the same horror stories that you're hearing [from] other places across the country of the state.

How was Long Beach able to do this so quickly?

We made a decision early on that I think was really important. And when vaccines first started coming in, a lot of health jurisdictions made these decisions about, Well we're going to take what comes in, and we're going to plan it out over a certain period of time, so we don't run out. We're going to plan the next three weeks out and set aside this many per day for the next three weeks, Garcia recalls.

He explains Long Beachs different approach: We got the vaccine, and we said, Let's run out like tomorrow. Let's get it out as fast as possible. And if we run out, that is a good problem to have. And so that is a riskier approach in some ways. But it's worked for us. And so it's given us the opportunity to get the vaccine out the door faster and move through the tiers quicker.

Size is another factor. The city of Long Beach is smaller than the city of LA, and Long Beachs health department is smaller than LA Countys.

I mean, I have a lot of love and support for the leaders of the county system right now. They're doing a huge, huge amount of work and getting all these folks vaccinated. But yes, having our own health department allows us to make decisions faster and move quicker, and quite frankly, correct problems as they arise, Garcia says.

Supply is Long Beachs biggest challenge

We are vaccinating what comes in. But we could be vaccinating 10 times what we're doing right now if we had just more vaccines, and so we would be flying through all of these tiers. So whatever comes in, we get out the door, says Garcia.

He says hes hopeful about more organization happening at the federal level, and that Gov. Gavin Newsom has made changes in the last week or two that will allow vaccines to move more quickly statewide.

Hero pay and grocery store closures

The company Kroger says it's closing two stores in Long Beach after the city mandated hero pay a $4 per hour raise for grocery store workers during the pandemic. The raise is temporary, but 200 people could lose their jobs because of store closures.

It's completely just wrong and really shameful that this is what Kroger is doing. The supermarket chains are doing better than they ever have. And anyone that's gone into a grocery store and seen one of these workers, how can you look someone in the eye and tell them that they don't deserve a few extra dollars an hour as hazard pay during this pandemic? says Garcia. Hazard pair, heroes pay was something that supermarkets were doing over the summer when the situation was not even as bad as it is today.

He says the Long Beach City Council unanimously adopted this extra pay and he signed it into law. Immediately they took us to court, they tried to get a temporary restraining order. They lost. The judge did not grant their temporary restraining order on the ordinance. And now, we are going to continue to go to court later this month to protect these workers.

He adds that Long Beach will also work with people who might lose their jobs and try to get them placement at other stores or whatever support they need.

He says theres overwhelming support across the state. Just since we passed heroes pay, the city of Los Angeles adopted it. Oakland just adopted it last night. San Jose just adopted it last night. And there's a handful of other cities that are looking to do the same. So this is a movement across the state. And it's absolutely the right thing to do.

Kroger says these two stores were failing anyway, and that Long Beachs action overstepped their traditional management union bargaining process.

Yes. And they also said, I believe in their press release, that they're linking closure of the stores to the heroes' pay. So I think what they're saying is they would rather not pay and support their workers. We're going to be in court later this month, says Garcia.

A personal loss for Mayor Garcia

Garcia's mom and stepfather died of COVID-19 this past summer.

My mom was a health care worker. And so kind of her advice, even before the pandemic, and the way that she cared about science and about doing the right thing and supporting medicine, I think has really strengthened my ability to actually do the job, says Garcia.

I tell people all the time that when I see someone getting a vaccine, I view that as an opportunity to see that person's life, and that is a life-saving opportunity. And I know that my mom as a health care worker would have been at the front of the line getting her vaccination. And so I wake up thinking every day, you know, what can I do to help people, keep everyone and their family together?

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Long Beach moves from vaccinating health care workers to teachers. Mayor says their strategy is different from other cities - KCRW

Biden signs executive orders to expand health care access – CBS News

Washington President Biden on Thursday signed a series of health care-related directives he described as reversing "the damage" done by former President Donald Trump, which including taking action to rescind and target anti-abortion rules.

"I'm not initiating any new law, any new aspect of the law," Mr. Biden said in brief remarks from the Oval Office.

The president said he is "restoring the Affordable Care Act and restoring the Medicaid to the way it was before Trump became president, which by fiat he changed, made more inaccessible, more expensive and more difficult for people to qualify for either of those two items."

Mr. Biden's executive order allows for HealthCare.gov, the federal health insurance marketplace, to open for a special enrollment period from February 15 to May 15, which will allow Americans more time to sign up for health insurance coverage. The order also directs federal agencies to review rules and policies to ensure they do not hinder Americans' access to health care, such as those that may reduce affordability of health coverage or undermine the Affordable Care Act's protections for people with pre-existing conditions.

Mr. Biden also issued a presidential memorandum unwinding the Mexico City Policy, known as the global gag rule, which prohibits U.S. dollars from flowing to international non-governmental organizations that provide abortions, advocate to legalize and expand abortion access, or provide abortion counseling.

The rule dates back to 1984, under President Ronald Reagan, but has been revoked and reinstated by Democratic and Republican administrations, respectively. Former Presidents Bill Clinton and Barack Obama rescinded the policy, while Mr. Trump re-enacted and expanded it.

Mr. Biden's memorandum also directs the Department of Health and Human Services to review potentially dismantling a similar policy in the U.S. that bars money from Title X from going to health care centers that provide abortion services.

The president, who was vice president when Obamacare was enacted, vowed during his presidential campaign to protect and expand the 2010 health care law, as a group of Republican states and the Trump administration fought to kill Obamacare in a case pending before the Supreme Court. Mr. Biden has stressed that the coronavirus pandemic underscores the need for access to health care.

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Biden signs executive orders to expand health care access - CBS News

Kudos to health care workers at vaccination clinic – Beckley Register-Herald

I would like to express my heartfelt gratitude to all the dedicated health care workers who were at the Raleigh County Convention Center on January 29, in 20-degree weather, to give the Covid vaccinations.

This event was so well organized and ran so smoothly it was unbelievable. Other states can learn from our example in West Virginia. A huge round of applause to the organizers and people in charge.

I know I felt like I won the lottery when I finally heard the phone ring and I was able to get an appointment for the vaccine. Hopefully, the new sign up on the Everbridge website will make things easier for others to get an appointment.

Again, a big thanks to those who made this event so successful.

Kathy Nordlund

Glen Morgan

We are making critical coverage of the coronavirus available for free. Please consider subscribing so we can continue to bring you the latest news and information on this developing story.

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Kudos to health care workers at vaccination clinic - Beckley Register-Herald

Global Healthcare Analytics Market Worth USD 80.21 billion by 2026; Launch of Project Apollo by Cerner to Boost Market – GlobeNewswire

Pune, India, Feb. 03, 2021 (GLOBE NEWSWIRE) -- According to the report, Healthcare Analytics market size is projected reach USD 80.21 billion by 2026. Global Healthcare Analytics market was USD 11.59 billion in 2018 and is anticipated to exhibit a CAGR of 27.5% during the forecast period set between 2019 to 2026.

Healthcare analytics market in North America was valued at USD 53.44 billion in 2018 and is also ex-pected to observe the highest growth during forecast period.

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Developed Healthcare Infrastructure to Facilitate Growth

The emergence of big data in healthcare can be a vital factor in boosting the healthcare analytics market revenue during the forecast period. Moreover, the rising venture capital investments by major companies will contribute positively to the healthcare analytics market trends in the forthcoming years. For instance, Cigna Ventures, a venture capital fund company invested $29.5M in Arcadia, a healthcare data and software company. The new development of Arcadia will help enhance patient care and adoption of value-based care models along with access to resources and tools to health care professionals

Cerner Corporation, an American health information technology solutions and services company launched a trailblazing platform, project Apollo. The new cognitive platform will provide computing resources to its healthcare users. The cloud-based automation platform is built on AWS infrastructure for speedy innovations to eliminate manual steps that cast obstructions for new advancement. The launch of the platform will have a positive impact on the healthcare analytics market share owing to the its next-gen technology for healthcare clients. The launch of the platform will have a positive impact on the healthcare analytics market share owing to the its next-gen technology for healthcare clients. Moreover, the deal between the Cerner and Geisinger will bolster healthy growth of the market during the forecast period.

INDUSTRY DEVELOPMENT:

Click here to get the short-term and long-term impacts of COVID-19 on this Market.

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Big Data is Transforming Healthcare Analytics Market

The advancement in technologies along with growing venture capital funding will aid the market in the region. Moreover, the adoption of electronic health records and presence of eminent players in the region. Europe is expected to hold a major share in the global market owing to the rising emphasis on healthcare and favorable reimbursement policies.

Asia Pacific is predicted to witness steady growth due to the growing awareness and adoption of healthcare analytics. Moreover, the developing healthcare infrastructure and high spending on healthcare will contribute positively to the market in Asia Pacific.

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The government backing for the technological developments in the healthcare sector is boosting healthcare analytics market. Moreover, huge investments are being made in digital healthcare organi-zations for the development of several products and solutions such as mhealth apps, IOT based healthcare solutions, electronic health records and big data analytics.

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Global Healthcare Analytics Market Segmentations:

By Product

By Application

By End User

By Geography

North America (U.S. and Canada)

Europe (U.K., Germany, France, Italy, Spain, Scandinavia, and Rest of Europe)

Asia Pacific (Japan, China, India, Australia, Southeast Asia, and Rest of Asia Pacific)

Latin America (Brazil, Mexico, and Rest of Latin America)

Middle East & Africa (South Africa, GCC and Rest of Middle East & Africa)

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Global Healthcare Analytics Market Worth USD 80.21 billion by 2026; Launch of Project Apollo by Cerner to Boost Market - GlobeNewswire

Change Healthcare Inc. Reports Third Quarter Fiscal 2021 Financial Results – Business Wire

NASHVILLE, Tenn.--(BUSINESS WIRE)--Change Healthcare Inc. (Nasdaq: CHNG) (the Company or Change Healthcare), a leading independent healthcare technology company, today reported financial results for the third quarter ended Dec. 31, 2020 of fiscal year 2021.

Our third quarter results demonstrate the strength of the Change Healthcare platform, and our ability to execute well on our growth strategy and financial objectives while navigating the pandemic, said Neil de Crescenzo, president and chief executive officer. During the quarter we saw continued demand across our platform. By advancing connectivity and driving innovation we have established a strong foundation to accelerate the delivery of the innovations and efficiencies essential to a brighter future for health care.

Fiscal 2021 Third Quarter Highlights:

Financial Summary

Recent Business Highlights

Impact of McKesson Exit on Comparability of Results

On March 10, 2020, Change Healthcare Inc. acquired the interest in Change Healthcare LLC (the Joint Venture) previously held by McKesson. The transaction resulted in Change Healthcare Inc. acquiring control of the Joint Venture, which was accounted for as a business combination and resulted in a new basis of accounting, and all of the business activities of the Joint Venture are now reported by the Company. Change Healthcare Inc. financial statements for periods prior to the acquisition were primarily limited to the equity method investment in the Joint Venture, and therefore did not reflect revenue, adjusted EBITDA, and other key measures. As a result, Change Healthcare does not consider comparison of the current operating results to the reported results of Change Healthcare Inc. for the same period in the prior year to be meaningful, and instead will compare our current quarter results to the prior quarter results of the Joint Venture, which have been recast to reflect the current segment structure, including the allocation of all corporate costs to the business units. This press release includes supplemental information for the recast results of the Joint Venture for the three and nine months ended December 31, 2019. The recast results for all quarters in fiscal year 2019 and fiscal year 2020 are available in the appendix to the earnings presentation and will be included as an exhibit to Change Healthcare Inc.s Form 10-Q.

Financial Results

Cash Flow and Balance Sheet Highlights

Net cash provided by operating activities was $487.2 million, free cash flow was $304.3 million, and adjusted free cash flow was $365.0 million, in each case, for the nine months ended December 31, 2020. For the nine months ended December 31, 2019, the Joint Venture reported net cash provided by operating activities, free cash flow, and adjusted free cash flow of $401.0 million, $213.8 million, and $324.9 million, respectively.

Net cash provided by operating activities, free cash flow, and adjusted free cash flow each is affected by pass-thru funds we receive from certain pharmaceutical industry participants in advance of our obligation to remit these funds to participating retail pharmacies. Such pass-thru funds on hand decreased by $10.1 million in the nine months ended December 31, 2020, reducing free cash flow for the period by that amount, and increased by $1.8 million for the Joint Venture for the nine months ended December 31, 2019. The increase in cash flow from operations, free cash flow, and adjusted free cash flow in the current period primarily resulted from improved working capital driven by strong collections.

The Company ended the quarter with approximately $137.4 million of cash and cash equivalents, and approximately $4,817.8 million of total debt. During the current period, the Company repaid $215.0 million on its Term Loan Facility.

Proposed Merger with OptumInsight

On January 5, 2021, OptumInsight (Optum), a diversified health services company and part of UnitedHealth Group, and Change Healthcare agreed to combine (the Merger). Under the terms of the merger agreement, Optum, through a wholly-owned subsidiary, will acquire all of the outstanding shares of Change Healthcare common stock for $25.75 per share in cash. The Boards of Directors of both UnitedHealth Group and Change Healthcare have unanimously approved the terms of the Merger, and the Board of Directors of Change Healthcare has recommended that Change Healthcare shareholders adopt the merger agreement. The Merger is expected to be completed in the second half of 2021 and is subject to applicable regulatory approval and other customary closing conditions.

Guidance

Due to the recently proposed Merger, we will no longer be providing financial guidance.

Webcast Information

Change Healthcare will host a conference call on Thursday, February 4, 2021, at 8:00 a.m. ET. Due to the previously announced transaction with OptumInsight, the Company will not be taking questions during the conference call.

Investors and other interested parties are invited to listen to the conference call via the Company's website at https://ir.changehealthcare.com/. The webcast will be available for on-demand listening at the aforementioned URL until February 4, 2022.

About Change Healthcare

Change Healthcare (Nasdaq: CHNG) is a leading independent healthcare technology company, focused on insights, innovation, and accelerating the transformation of the U.S. healthcare system through the power of the Change Healthcare Platform. We provide data and analytics-driven solutions to improve clinical, financial, administrative, and patient engagement outcomes in the U.S. healthcare system. Learn more at changehealthcare.com.

CHNG-IR

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995 with respect to the financial condition, results of operations and businesses of Change Healthcare. Some of these statements can be identified by terms and phrases such as anticipate, believe, intend, estimate, expect, continue, could, should, may, plan, project, predict and similar expressions. Change Healthcare cautions readers of this press release that such forward looking statements, including without limitation, those relating to the timing of the proposed merger and Change Healthcares future business prospects, revenue, working capital, liquidity, capital needs, interest costs and income, wherever they occur in this press release or in other statements attributable to Change Healthcare, are necessarily estimates reflecting the judgment of Change Healthcares senior management and involve a number of risks and uncertainties that could cause actual results to differ materially from those suggested by the forward looking statements.

Factors that could cause Change Healthcares actual results to differ materially from those expressed or implied in such forward-looking statements include, but are not limited to, the occurrence of any event, change or other circumstances that could give rise to the termination of the merger agreement; the inability to complete the proposed merger due to the failure to obtain stockholder approval for the proposed merger or the failure to satisfy other conditions to completion of the proposed merger, including that a governmental entity may prohibit, delay or refuse to grant approval for the consummation of the transaction; risks related to disruption of managements attention from Change Healthcares ongoing business operations due to the transaction; the effect of the announcement of the proposed merger on Change Healthcares relationships with its customers, operating results and business generally; the risk that the proposed merger will not be consummated in a timely manner; exceeding the expected costs of the merger; Change Healthcares ability to retain or renew existing customers and attract new customers; macroeconomic and industry trends and adverse developments in the debt, consumer credit and financial services markets; uncertainty and risks related to the impact of the COVID-19 pandemic on the national and global economy, Change Healthcares business, suppliers, customers, and employees; Change Healthcares ability to connect a large number of payers and providers; Change Healthcares ability to provide competitive services and prices while maintaining its margins; further consolidation in end-customer markets; Change Healthcares ability to effectively manage costs; Change Healthcares ability to effectively develop and maintain relationships with channel partners; a decline in transaction volume in the U.S. healthcare industry; Change Healthcares ability to timely develop new services and the markets willingness to adopt new services; Change Healthcares ability to maintain access to its data sources; Change Healthcares ability to maintain the security and integrity of its data; Change Healthcares ability to deliver services timely without interruption; Change Healthcares ability to make acquisitions and integrate the operations of acquired businesses; government regulation and changes in the regulatory environment; economic and political instability in the U.S. and international markets where Change Healthcare operates; risks related to international operations; the ability of outside service providers and key vendors to fulfill their obligations to Change Healthcare; litigation or regulatory proceedings; Change Healthcares ability to protect and enforce its intellectual property, trade secrets and other forms of unpatented intellectual property; Change Healthcares ability to defend its intellectual property from infringement claims by third parties; changes in local, state, federal and international laws and regulations, including related to taxation; Change Healthcares reliance on key management personnel; Change Healthcares ability to manage and expand its operations and keep up with rapidly changing technologies; our adoption of new, or amendments to existing, accounting standards; losses against which Change Healthcare does not insure; Change Healthcares ability to make timely payments of principal and interest on its indebtedness; Change Healthcares ability to satisfy covenants in the agreements governing its indebtedness; Change Healthcares ability to maintain liquidity, and other risks. For a more detailed discussion of these factors, see the information under the captions Risk Factors and Managements Discussion and Analysis of Financial Condition and Results of Operations in Change Healthcares most recent Annual Report on Form 10-K filed with the Securities and Exchange Commission (SEC) on June 4, 2020, and in Change Healthcares most recent Quarterly Report on Form 10-Q filed with the SEC on November 5, 2020.

Change Healthcares forward-looking statements speak only as of the date of this press release or as of the date they are made. Change Healthcare disclaims any intent or obligation to update any forward looking statement made in this press release to reflect changed assumptions, the occurrence of unanticipated events or changes to future operating results over time.

Additional Information and Where to Find It

This press release may be deemed solicitation material in respect of the proposed acquisition of Change Healthcare by UnitedHealth Group. In connection with the proposed merger transaction, Change Healthcare will file with the SEC and furnish to Change Healthcares stockholders a proxy statement and other relevant documents. This filing does not constitute a solicitation of any vote or approval. Stockholders are urged to read the proxy statement when it becomes available and any other documents to be filed with the SEC in connection with the proposed merger or incorporated by reference in the proxy statement because they will contain important information about the proposed merger.

Investors will be able to obtain free of charge the proxy statement and other documents filed with the SEC at the SECs website at https://www.sec.gov. In addition, the proxy statement and Change Healthcares annual reports on Form 10-K, quarterly reports on Form 10-Q, current reports on Form 8-K and amendments to those reports filed or furnished pursuant to section 13(a) or 15(d) of the Securities Exchange Act of 1934 are available free of charge through Change Healthcares website at https://ir.changehealthcare.com. as soon as reasonably practicable after they are electronically filed with, or furnished to, the SEC.

The directors, executive officers and certain other members of management and employees of Change Healthcare may be deemed participants in the solicitation of proxies from stockholders of Change Healthcare in favor of the proposed merger. Information regarding the persons who may, under the rules of the SEC, be considered participants in the solicitation of the stockholders of Change Healthcare in connection with the proposed merger will be set forth in the proxy statement and the other relevant documents to be filed with the SEC. You can find information about the Companys executive officers and directors in its Annual Report on Form 10-K for the fiscal year ended March 31, 2020 and in its definitive proxy statement filed with the SEC on Schedule 14A on July 16, 2020.

Non-GAAP Financial Measures

In the companys earnings releases, prepared remarks, conference calls, slide presentations and webcasts, there may be use or discussion of non-GAAP financial measures. We believe such measures provide supplemental information to investors with regards to our operating performance and assist investors ability to compare our financial results to those of other companies in the same industry. The GAAP financial measure most directly comparable to each non-GAAP financial measure used or discussed, and a reconciliation of the differences between the comparable GAAP financial measure and each non-GAAP financial measure are included in this press release after the consolidated financial statements. These non-GAAP financial measures are calculated and presented on the basis of methodologies other than in accordance with GAAP. These non-GAAP financial measures should be considered only as supplemental to, and not as superior to, financial measures prepared in accordance with GAAP and may be defined and calculated differently by others in the same industry.

Consolidated Statements of Operations

Quarter to Date

(unaudited and amounts in thousands, except share and per share amounts)

Three Months Ended December 31,

2020

2019

2019

Change Healthcare Inc.

ChangeHealthcare LLC

Revenue:

Solutions revenue

$

735,264

$

$

752,533

Postage revenue

49,877

55,693

Total revenue

785,141

Excerpt from:

Change Healthcare Inc. Reports Third Quarter Fiscal 2021 Financial Results - Business Wire

Accenture rebuffed again in Healthcare.gov protest – FCW.com

Acquisition

Accenture Federal Services lost yet another protest in its effort to hold on to a contract operating the Healthcare.gov exchange that connects health insurance applicants to coverage available under the Affordable Care Act.

According to the Government Accountability Office, which adjudicates bid protests, Accenture's protest was denied because it was looking to alter the terms of the solicitation to favor its own incumbency.

Accenture initially obtained the business on a sole-source award made in 2013 in the wake of the troubled launch of the Healthcare.gov website. The company then won a five-year contract valued at more than $560 million to run the site that manages ACA enrollment and plan management.

In 2019, the Centers for Medicare and Medicaid Services (CMS) put out a call for a new contract to manage the federally facilitated exchanges, which covers access for health insurance customers whose states don't offer their own portals to sign up for coverage. CMS made the offering as a task order on the agencys $25 billion Strategic Partners Acquisition Readiness Contract (SPARC) vehicle.

CMS picked Deloitte to take over the contract valued at just under $400 million in November 2019. Accenture protested in December and Deloitte was again awarded the contract in February 2020. That led to another protest and, eventually, CMS issued an amendment to the solicitation in Nov. 17, with proposals due on Dec. 7 at 2pm. According to the timeline provided by GAO's decision, Accenture filed its protest -- with certain arguments redacted -- just a few hours before proposals were due.

Accenture objected to the solicitation's criteria for evaluating contractor experience. The company argued that the operation of a state-based exchange did not qualify a bidder to run the larger federal exchange.

In November, CMS amended its solicitation to note that systems qualify as being of a similar size to the Healthcare.gov system if it "requires a similar amount of work to build and operate," even if it processes a smaller volume of transactions.

According to CMS, 36 states use the Healthcare.gov platform, while other states run their own exchanges. The federal system processed 8.2 million enrollments in the recently concluded 2021 open enrollment period.

CMS, according to the GAO decision, felt that the Accenture protest was made to "diminish the competitiveness of offerors whose experience is limited to operating state-based health insurance exchanges."

GAO took the point. "Accenture is not prejudiced by this provision -- other than the 'prejudice' of potentially facing more meaningful competition," Armstrong wrote in his decision. GAO also noted that the protest was premature, since it was not yet known how CMS will evaluate the experience of offerors in light of the November amendment to the solicitation.

Accenture also argued in its protest that the revised solicitation doesn't take into account a "surge of new customers" brought in by the coronavirus pandemic. That argument wasn't specifically addressed in the decision. The Biden administration announced last week a new ACA special enrollment period from Feb. 15 to May 15 to attract underinsured and uninsured Americans to the program.

About the Author

Adam Mazmanian is executive editor of FCW.

Before joining the editing team, Mazmanian was an FCW staff writer covering Congress, government-wide technology policy and the Department of Veterans Affairs. Prior to joining FCW, Mazmanian was technology correspondent for National Journal and served in a variety of editorial roles at B2B news service SmartBrief. Mazmanian has contributed reviews and articles to the Washington Post, the Washington City Paper, Newsday, New York Press, Architect Magazine and other publications.

Click here for previous articles by Mazmanian. Connect with him on Twitter at @thisismaz.

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Accenture rebuffed again in Healthcare.gov protest - FCW.com

ZEISS partners with Microsoft for better patient care through data-driven healthcare and to enhance quality and efficiency in manufacturing – Stories…

ZEISS provides quality assurance solutions delivering meaningful information on parts dimensions, component behavior and defect detection (ZEISS).

Oberkochen, Germany, and Redmond, Wash., October 7, 2020 Today, ZEISS Group and Microsoft Corp. announced a multi-year strategic partnership to accelerate ZEISS transformation into a digital services provider that is embracing a cloud-first approach. By standardizing its equipment and processes on Microsoft Azure as its preferred cloud platform, ZEISS will be able to provide its customers with enhanced digital experiences, address changing market needs more quickly and increase its productivity.

Leveraging Azure high-performance compute, AI, and IoT services, ZEISS will work with Microsoft to provide original equipment manufacturers (OEMs) with new quality management solutions, enable microchip manufacturers to build more powerful, energy-efficient microchips, and deliver new digital healthcare solutions for improved clinical workflows, enhanced treatments, and device maintenance. Furthermore, ZEISS will create a seamless experience for its customers through one digital platform and manage all digital ZEISS products through one cloud-native platform to enhance continuous and agile product development.

Microsofts datacenter regions around the globe help meet the regional needs of ZEISS customers while delivering against highest security, privacy and resiliency standards. ZEISS will build on Microsofts experience in software development to grow its own digital capabilities while helping Microsoft enhance its customer-driven product innovation through deep industry insights.

Connected quality platform drives industrial efficiency

Initially, ZEISS will enable its solutions in the Industrial Quality & Research segment to be run on a connected quality platform built on Azure, allowing direct integration into the customers production process. The platform will help gain business insights and foster collaboration across domains, assets and processes that have traditionally been managed in siloed, proprietary systems.

ZEISS provides metrology and quality assurance solutions delivering meaningful information on parts dimensions, component behavior and defect detection. Real-time and large-scale analysis of data that is collected at all stages of the manufacturing process is key to efficient and effective quality assurance, tightly integrated with todays and tomorrows IoT-enabled production processes.

Quality is also a key objective of a new ZEISS audit trail solution, initially focused on highly regulated manufacturing industries, such as medical technology which is particularly sensitive to quality assurance. The solution will allow customers to identify root causes and react quickly on quality issues to reduce down-time and keep productivity up. The software will allow customers to track, trace, visualize and analyze process and product data with the help of Azure AI services to identify failure root causes more quickly.

High-performance computing enables more powerful, energy-efficient microchips

The ZEISS Semiconductor Manufacturing Technology segment (SMT) enables chip manufacturers worldwide to produce smaller, more powerful, more affordable and more energy-efficient microchips which are used in essentially every technical device today. Optical lithography applying deep ultra violet (DUV) and even extreme ultra violet (EUV) light allows to manufacture chips at structure sizes 4,000 times thinner than a human hair or, more scientifically, at single-digit nanometer sizes. Lithography systems include extremely complex and ultra-precisely shaped aspherical lenses (DUV) and mirrors (EUV). ZEISS SMT is a technological leader in this field of the semiconductor industry. Especially the development of next-generation, so-called High-NA EUV systems requires the most complex optical calculations calling for massive compute power.

Using Azure high-performance compute capabilities, ZEISS is now able to dynamically burst to the cloud to complement its sophisticated on-premises high-performance computing cluster and handle peaks more efficiently. Such capabilities enable the development of future leading-edge EUV lithography tools. Optical lithography and especially EUV technology advancements are driving digitalization and are keeping Moores Law alive for many years to come.

Data-driven healthcare solutions improve patient care

ZEISS Medical Technology provides comprehensive solutions for ophthalmic professionals and microsurgeons, consisting of devices, implants, consumables and services. Through the partnership, ZEISS will connect its medical technology to Microsofts cloud and leverage Azure AI and IoT technologies for new digital services such as improved clinical workflows, enhanced treatments, and device maintenance in a secure environment that enables compliance with regulatory requirements in the health industry. These solutions will help improve the quality of life of patients and drive progress, efficiency and access to healthcare.

Cloud-native ZEISS platforms enhance customer experience and boost internal productivity

ZEISS Digital Innovation Partners and ZEISS Corporate IT already partner very closely with Microsoft and will further intensify and scale this partnership going forward. Together with Microsoft, ZEISS Corporate IT has developed a cloud-native digital integration platform running on Azure to integrate all customer-facing digital ZEISS products into ZEISS Enterprise IT. ZEISS can apply the latest technology developments and share its manufacturing and medical technology insights at the same time to support Microsofts customer-driven product innovations.

ZEISS Digital Innovation Partners builds on these integration capabilities and uses Azure cloud and DevOps services to enable a seamless and coherent end-to-end digital journey for ZEISS customers, for example quality experts and eyecare professionals. The digital customer interaction platform MY ZEISS will integrate various customer-facing solutions into one platform so that customers can easily manage their Zeiss touchpoints through one central web application.

As a global leader in optics and optoelectronics, ZEISS is committed to digitally enable its customers business models, products, and services. We are proud to join forces with Microsoft in our quest to apply precision optics, IoT capabilities, artificial intelligence and machine learning to the most demanding processes in healthcare and manufacturing, says Dr. Karl Lamprecht, ZEISS President and CEO. Improving the patients life and doctors work and driving industrial quality assurance in the production process have always been top of mind for us. We are taking our expertise to the next digital level together with Microsoft, a leading innovator and provider of digital technologies.

Zeiss is driving innovations across industries to improve the quality of individual lives and create industrial efficiencies by overcoming data silos and integrating digital experiences, said Scott Guthrie, Executive Vice President Cloud + AI at Microsoft. Harnessing the power of Microsofts cloud, AI and IoT services, ZEISS is transforming into a leading digital services provider.

ZEISS and Microsoft will also explore opportunities to collaborate and co-innovate across other ZEISS segments and units including Consumer Markets, ZEISS Ventures and Corporate Research and Technology.

About ZEISS

ZEISS is an internationally leading technology enterprise operating in the fields of optics and optoelectronics. In the previous fiscal year, the ZEISS Group generated annual revenue totaling more than 6.4 billion euros in its four segments Semiconductor Manufacturing Technology, Industrial Quality & Research, Medical Technology and Consumer Markets (status: 30 September 2019).

For its customers, ZEISS develops, produces and distributes highly innovative solutions for industrial metrology and quality assurance, microscopy solutions for the life sciences and materials research, and medical technology solutions for diagnostics and treatment in ophthalmology and microsurgery. The name ZEISS is also synonymous with the worlds leading lithography optics, which are used by the chip industry to manufacture semiconductor components. There is global demand for trendsetting ZEISS brand products such as eyeglass lenses, camera lenses and binoculars.

With a portfolio aligned with future growth areas like digitalization, healthcare and Smart Production and a strong brand, ZEISS is shaping the future of technology and constantly advancing the world of optics and related fields with its solutions. The companys significant, sustainable investments in research and development lay the foundation for the success and continued expansion of ZEISS technology and market leadership.

With over 31,000 employees, ZEISS is active globally in almost 50 countries with around 60 sales and service companies, 30 production sites and 25 development sites. Founded in 1846 in Jena, the company is headquartered in Oberkochen, Germany. The Carl Zeiss Foundation, one of the largest foundations in Germany committed to the promotion of science, is the sole owner of the holding company, Carl Zeiss AG.

Further information at http://www.zeiss.com

About Microsoft

Microsoft (Nasdaq MSFT @microsoft) enables digital transformation for the era of an intelligent cloud and intelligent edge. Its mission is to empower every person and every organization on the planet to achieve more.

Microsoft Media Relations

WE Communications for Microsoft(425) 638-7777rrt@we-worldwide.com

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ZEISS partners with Microsoft for better patient care through data-driven healthcare and to enhance quality and efficiency in manufacturing - Stories...

New Funding to Bring Mental Health Care to Homeless Shelters, Encampments – WTTW News

The city of Chicago on Tuesdayannounced $8 million in grants to 32 organizations to expand mental health care servicesat 20 clinics around the city. The move comes after years of debate over city-run clinics that were shut down during the administration of former Chicago Mayor Rahm Emanuel. But Tuesdays announcement also included news about mental health services for some of Chicagos most vulnerable residents.

The city plans to set aside $1.6 million a year in federal funds to provide mental health services to Chicagoans experiencing homelessness. The money will go to Lawndale Christian Health Center and Heartland Alliance Health to work with people living in encampments and in shelters.

Were already there in the shelters, but this will allow us to expand to additional shelters, said Ed Stellon, executive director of Heartland Alliance Health. It will also allow us to add more services, especially a lot more behavioral health services.

Its part of a holistic approach, addressing not just mental and physical health care, but other factors that play into health, like safety, housing and access to food.

Behavioral health is a big driver of all of this, Stellon said. If Im also hearing voices, or Im incredibly sad and depressed and down it might not be the priority to take care of myself.

(WTTW News)

Even when they cant serve people in person, Heartland wants to use some of the funding on telehealth services.

We can meet that need, even if we have to be remote because of the pandemic, or just because were not there that day, Stellon said.

Heartland works in about 20 shelters on the citys North and South sides. Lawndale Christian Health Center works in about a dozen West Side shelters. LCHC is also planning to use the money to bring in behavioral health and primary care providers and to work on COVID-19 infection control and testing.

Its really going to be an all-out effort to see how we can take care of some of the most vulnerable that we have in our society, said Dr. Thomas Huggett, director of mobile health for Lawndale Christian Health Center.

Its also a way to address the inequities that have long plagued Chicago. Huggett says when the city housed people at high risk during the pandemic in hotel rooms, 70% were African American. It really is a racial equity issue, he said. We want to make sure that folks experiencing homelessness really get the services that they need and deserve.

Working on the West Side, Huggett is keenly aware of the epidemic within the pandemic: opioid overdose deaths, the vast majority of which are related to fentanyl, a synthetic opioid that is many times stronger than morphine.

As we are improving our psychiatry care, we also want to improve our care of folks who are suffering with opioid use disorder to make sure they get the medications and the support that they really need in their recovery process, Huggett said.

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New Funding to Bring Mental Health Care to Homeless Shelters, Encampments - WTTW News

Healthcare companies cashing in on financing vehicle boom – Modern Healthcare

While RSM's analysis isn't broken down by industry, healthcare has clearly been a big beneficiary. On Tuesday, Medicare Advantage startup Clover Health announced it will go public through a $3.7 billion merger with the SPAC Social Capital Hedosophia Holdings Corp. III. Last week, telehealth provider Hims, Inc. said it will go public through a $1.6 billion combination with Oaktree Capital Management, also a SPAC. In July, acute-care telemedicine provider SOC Telemed revealed it, too, will go public using SPAC Healthcare Merger Corp. in a combination worth $720 million.

The investment bank Jefferies said Tuesday there have been 16 SPAC transactions focused on the healthcare industry so far 2020.

In their IPO paperwork, SPACs outline the type of company they're looking to buy, such as health IT or life sciences. Federal securities law prohibits them from naming specific targets or reaching out to target companies before they go public.

The shift to telehealth during the COVID-19 pandemic has shown digital health technology to be indispensable and has triggered a wave of renewed interest among investors.

Countless patients and providers have used digital health services for the first time during the pandemic, and have realized it can work in many cases, Wolf said. Other aspects of patients' lives, such as shopping, school and dining are customized and convenient.

"Except perhaps the most important part of our lives," he said. "People are recognizing this and pouring money into it."

There's a number of reasons behind the recent rise in SPAC IPOs. Perhaps the biggest is the pandemic-induced volatility in the stock market and leveraged loans market. With many companies struggling to raise capital the old-fashioned way, they've turned to SPACs.

The typical IPO process involves a lot of risk, cost and time. First off, there's a drawn-out underwriting process where bankers price the shares. Executives then hit the road to charm investors. After all that, they could have a bad day when their stocks officially hit the market, said Albert Vanderlaan, a partner in Orrick's technology companies and capital markets groups.

"They've effectively de-risked and taken the IPO book-building process of out of it without having to go through that level of uncertainty that's attributed to the capital markets for an IPO," he said.

With a SPAC, the process of going public is faster and quieter, Wolf said.

"There's a lot of uncertainty with the traditional IPO process," he said. "But with the SPAC, you've already raised all this money and you just come up to me and say, 'We'll buy you.' It's more of a private conversation."

Another factor is the uptick in public market valuations. While previously there wasn't much added benefit to going through the IPO process, valuations being at an all-time high means more companies want to tap into that, Watson said. The temporary closure of the leveraged loans market in the second quarter also made it very difficult to execute private equity buyouts, she said.

Another plus for SPACs is the fact that more reputable names are getting involved, as opposed to the 1990s and early 2000s, Vanderlaan said. Prominent hedge fund manager Bill Ackerman, for example, announced a $4 billion IPO for his SPAC, Pershing Square Tontine Holdings, Ltd., in July. And private equity firm Apollo Global Management's SPAC, Apollo Strategic Growth Capital, filed for an IPO worth $750 million last month.

Investors tend to feel more secure putting their money in SPACs because SPACs are required to spend the money raised through their IPOs within two years or return it to their investors, said John Washlick, a shareholder with Buchanan, Ingersoll & Rooney. They're also limited in how they can spend the money.

That said, investors still need to research the executives behind any SPAC they consider buying into, Washlick said. Investors should make sure those involved have good track records, especially in the industry they're targeting.

"Raising money is one thing, but what are you going to do with it?" he said. "How are you going to spend it responsibly so that my $10 becomes more than $10? I'm looking for a return on it, not to give it back."

Due diligence is equally important for companies looking at merging with SPACs. Experts recommend companies get a capital commitment and assurance they'll be able to keep their management team.

Many SPACs are subsidiaries of private equity firms. Much like private equity buyouts, there is wide variation in how much involvement the new owners will have in their companies, Watson said. Today's SPACs tend to be led by industry insiders who have expertise in the areas they're targeting, which can be a boon to the companies they buy. "Some are very hands on," Watson said. "Some make the investment and sit in the background."

For private equity-owned SOC Telemed, which provides telemedicine to more than 500 hospitals in 47 states, having access to the healthcare industry expertise within Healthcare Merger Corp.'s executive ranks was one draw behind the deal, said Paul Ricci, SOC Telemed's interim CEO. Another obvious one was the rapid access to capital, he said.

"Virtualized care became an important element of dealing with the pandemic and the pandemic revealed to people how flexible this class of care delivery is," Ricci said, "and therefore I think there is an accelerated focus on investments behind it."

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Healthcare companies cashing in on financing vehicle boom - Modern Healthcare

Health care is already benefiting from VR – The Economist

Oct 1st 2020

A SOLDIER WATCHES a car approaching a check-point on a hot, dusty road. As the vehicle slows to a stop in front of him, he asks the driver to get out and show his identification. Seconds later, the rattle of gunfire pierces the air, followed by a bang and an intense, searing flash. Knocked to the ground and scrambling to safety, the soldier turns to see a flaming wreck where the car had been just moments before.

The scene pauses. A voice in the soldiers ear says: Lets rewind the simulation to the seconds just before the explosiondescribe exactly what happened. The voice is a therapist, speaking to a veteran who is placed in a virtual environment. The simulation they are watching has been modelled on the veterans own experiences in a war zone, events that have led him to develop post-traumatic stress disorder (PTSD).

This is the Bravemind system, developed in 2005 by Albert Skip Rizzo and Arno Hartholt, experts in medical virtual reality at the University of Southern California, to treat soldiers returning home from the wars in Iraq and Afghanistan. Immersed in a virtual environment that mimics their traumatic experiences, veterans narrate the scene to a therapist, who can control how the events in the simulation unfold. The sounds, time of day and number of people or vehicles on the scene can all be customised. Over several sessions, the veteran is exposed to increasingly intense scenarios that get closer to reliving the memory of the original trauma. The aim of the therapy is to steadily dampen the veterans negative reactions to the memory. Bravemind is now used in around 60 treatment centres around the world.

Bravemind builds on a well-established psychological technique known as exposure therapy, in which people are brought to face their fears in a controlled way. VR adds a way of creating detailed, carefully tuned scenarios that can elicit different levels of fear. It works because, even when people know they are watching computer graphics, their brains nonetheless react to virtual environments as if they were real.

Someone who is afraid of heights will find that their heartbeat quickens and palms get clammy even if the precipitous drop they can see is clearly a computer graphic in a VR headset. This is because the brains limbic system, which controls the fight-or-flight response, activates within milliseconds in response to potential threats, long before the logical part of the brainwhich knows the VR experience is not physically realcan intervene.

Scientists have used VR systems to create and control complex, multi-sensory, 3D worlds for volunteers in their labs since the 1990s. Rather as an aircraft simulator can train and test pilots in a wide variety of settings, virtual worlds allow psychologists and neuroscientists to watch peoples cognitive and emotional responses in situations that are difficult to set up or control in the real world. But the technology has usually been too clunky and expensive for widespread clinical use.

That has started to change, thanks to the falling costs of computing and the increasing capability of the new generation of VR systems. At the same time, the scientific evidence base for the clinical uses of VR has grown. The technology has been successfully applied to tackling schizophrenia, depression and phobias (including the fear of flight, arachnophobia, social anxiety and claustrophobia), and reducing pain in cancer patients undergoing chemotherapy. It can help train spatial-navigation skills in children and adults with motor impairments and assist in rehabilitation after a stroke or traumatic brain injury. The kit can also be used to monitor people and identify medical problems: VR has been used to diagnose attention-deficit hyperactivity disorder (ADHD) and Parkinsons and Alzheimers diseases.

Though each condition is unique, researchers have found common ground rules for designing virtual experiences that work: therapists need to be in control of the scene, deciding what a patient sees and hears in order to modify the strength of the fearful stimulus; the therapy works best when the patient is embodied within an avatar, rather than floating, so that they feel present within the scene; and the patient needs agency, so that they can leave the scene if it gets too overwhelming for them. All this adds up to giving the patient the illusion of control and makes the VR experience feel psychologically real.

In some cases the therapeutic regime is so robust that, instead of a real-life therapist guiding a patient through an anxiety-inducing simulation, an animated avatar can do the job instead. A clinical trial showed that such an automated system, designed by Daniel Freeman, a psychiatrist at the University of Oxford, helped people reduce their fear of heights. In the simulation, a virtual counsellor guided patients up a virtual ten-storey office complex, where the upper floors overlooked a central atrium. At each floor, the counsellor set the patient tasks designed to test and help them manage their fear responses, such as walking to the edge of a balcony while the safety barrier was lowered or riding on a moving platform over the space above the atrium.

Dr Freeman found that six sessions of virtual, automated therapy over two weeks significantly reduced peoples fear of heights, compared with people who had no therapy. A similar automated virtual therapy for arachnophobia, developed by Philip Lindner at Stockholm University, helped patients eventually touch spiders. The reduction in fear was still apparent when the participants were followed up a year later.

For doctors, virtual environments also provide a risk-free way to practise important procedures. Surgeons operate in high-pressure environments with a lot of cognitive demands. Youve got to learn very rapidly, and youve got to make decisions under time pressure, with millimetre precision, says Faisal Mushtaq, a cognitive neuroscientist at the University of Leeds in England.

Practising with computer simulations can help. In the NeuroVR system, developed by a group of Canadian hospitals and universities, surgeons can use MRI scans from their patients to rehearse removing brain tumours before going in with the knife for real. The surgeon gets a 3D view of the tumour on screens and practises cuts and movements by manipulating instruments attached to a robotic arm that responds with haptic feedback. This allows users to sense whether they are cutting through hard or soft material, or through a tumour versus healthy tissue. An advantage of such a system is that, once a doctor is trained, the technology can be used to perform remote surgery. Both virtual training and remote procedures for patients are useful at a time when covid-19 has forced health-care systems around the world to keep doctors and non-emergency patients apart.

When surgeons try to reconstruct a limb, a key problem is identifying important blood vessels that need to be protected during the surgery. In the past a surgeon would try to identify those vessels using an ultrasound probe, but the process is lengthy and imprecise. So James Kinross, a consultant surgeon at Imperial College London, has been experimenting with Microsofts HoloLens, an augmented-reality headset, which can overlay computer-generated text and images onto the real world.

Dr Kinross has used a CT scan of a patients limb to highlight the most important blood vessels. He reconstructed that scan as a 3D model in Unity, a games engine. The HoloLens then overlaid that simulation onto the patients real limb in the operating theatre during treatment. What it meant was that the surgeon could immediately visualize, and very precisely map, the anatomy of these blood vessels, and very quickly identify them and protect them, says Dr Kinross, who has also used this technique during cancer surgery to help surgeons identify and protect healthy tissue. The adoption of the technology has proceeded very smoothly, he adds, because it is easy to learn and provides an immediate and very obvious advantage to the clinician.

He thinks the technology could be pushed much further and wants to try some real-time collaboration with his colleagues during a surgical procedure. So if youre running an operation thats challenging, or you want to have a discussion with a peer, its very easy to do and they can have a first-person view of what youre looking at, he says.

Medical uses for computer simulations are promising, but how useful they are will take time to evaluate. That will require robust clinical trials and discussions of frameworks for data protection on technologies that could, if their potential is achieved, become a new type of medical device.

We dont want to poison the well, says Dr Mushtaq. We dont want to put out systems that are ineffective, that are going to cost our health-care system, and that are going to negatively impact on the growth of this sector. His research focuses on closing some of those knowledge gaps by examining how the lessons users learn from practising on virtual simulators translate into skills in the real world. Surprisingly, the fidelity of the images to real surgery is not so important. Something can look very, very, flashyits got all the blood spewing everywhere and so on, he says. But it doesnt necessarily translate to better learning.

Defining the validity of a simulator can take several forms. The most basic is face validity, which reflects how well a simulation looks like the task in the real world. Construct validity is a way of comparing performance differences on the simulation between experts and novices. Finally, predictive validity is most useful, because it measures how well a persons performance on a simulator predicts their ability to do the same task in the real world.

This can also be used to flag when learners are struggling, and provide early intervention and support. Dr Mushtaq and his colleagues have demonstrated both construct and predictive validity for the Nissin (formerly Moog) Simodont dental-surgery simulator, used by the University of Leeds to train its students. In research published in 2019, they found that scores on the simulator predicted someones performance in a clinic two years later.

Video-game engines have made face validity easier to achieve for simulators. The next step is to measure construct and predictive validity more robustly. Unfortunately, precious little of this kind of validation work is undertaken by academics or companies selling simulators. To help grease the wheels and encourage researchers to build a body of knowledge, Dr Mushtaq and his colleagues recently created a set of tools and protocols that streamline human-behaviour research and make use of the Unity game engine as a platform. This Unity Experiment Framework takes care of the tedious programming stepsdownloading files that track all of a users movements, for example, or anonymising participantsneeded to turn the game engine into an environment optimised for studying people.

Mark Mon-Williams, a cognitive psychologist at the University of Leeds who has worked with VR for more than two decades, reckons simulated worlds have huge potential for improving education and physical and mental health. But if youre going to make the most of that powerful set of tools, he says, then use the scientific process to ensure that its done properly.

This article appeared in the Technology Quarterly section of the print edition under the headline "Getting better"

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Health care is already benefiting from VR - The Economist

Health Care: The Best and the Rest | by David Oshinsky – The New York Review of Books

Which Country Has the Worlds Best Health Care?

by Ezekiel J. Emanuel

PublicAffairs, 453 pp., $30.00

Bow your heads, folks, conservatism has hit America, The New Republic lamented following the 1946 elections. All the rest of the world is moving Left, America is moving Right. Having dominated both houses of Congress throughout President Franklin Roosevelts three-plus terms in office (19331945), Democrats lost their majorities in a blowout. Some blamed it on the death of FDR, others on the emerging Soviet threat or the bumpy return to civilian life following World War II. The incoming Republican Class of 46 would leave a deep mark on history; its members, including Californias Richard Nixon and Wisconsins Joseph McCarthy, were determined to root out Reds in government and rein in the social programs of the New Deal.

One issue in particular became fodder for the Republican assault. In 1945 President Harry Truman had delivered a special message to Congress laying out a plan for national health insurancean idea the pragmatic and immensely popular FDR had carefully skirted. As an artillery officer in World War I, Truman had been troubled by the poor health of his recruits, and as chairman of a select Senate committee to investigate the defense program during World War II, his worries had grown. More than five million draftees had been rejected as unfit for military service, not counting the 1.5 million discharged for medical reasons following their induction. For Truman, these numbers went beyond military preparedness; they spoke to the glaring inequities of American life. People with low or moderate incomes do not get the same medical attention as those with high incomes, he said. The poor have more sickness, but they get less medical care.

Truman proposed federal grants for hospital construction and medical research. He insisted, controversially, not only that the nation had too few doctors, but that the ones it did have were clustered in the wrong places. And he addressed the principal reason that forced so many Americans to forgo vital medical care: They cannot afford to pay for it.

The facts seemed to bear him out. Close to half the counties in the United States lacked a general hospital. Government estimates showed that about $11 million was spent annually on new treatments and cures for disease, as opposed to $275 million for industrial research. Though the nation claimed to have approximately one physician per 1,500 people, the ratio in poor and rural counties regularly dipped below one per 3,000, the so-called danger line. On average, studies showed, two thirds of the population lacked the means to meet a sustained health crisis.

The concept of government health insurance was not entirely new. A few states had toyed with instituting it, but their intent was to replace wages lost to illness or injury, not to pay the cost of medical care. Trumans plan called for universal health insuranceunlike the Social Security Act of 1935, which excluded more than 40 percent of the nations labor force, mostly agricultural and domestic workers. Funded by a federal payroll tax, the plan offered full medical and dental coverageoffice visits, hospitalization, tests, procedures, drugsto all wage and salary earners and their dependents. (Needy persons and other groups were promised equal coverage paid for them by public agencies.)

People would be free to choose their own doctors, who in turn could participate fully, partly, or not at all in the plan. Private health insurance programs would continue to operate, with policyholders required to contribute to the federal system as wella stipulation the president compared to a taxpayer choosing to send a child to private school. What I am recommending is not socialized medicine, Truman insisted. Socialized medicine means that all doctors work as employees of government. The American people want no such system. No such system is here proposed.

It did him no good. At the first Senate hearing on the proposal, Ohios Robert A. Taft, a perennial presidential candidate known to his admirers as Mr. Republican, denounced it as the most socialistic measure that this Congress has ever had before it. A shouting match ensued, with one Democrat warning Taft to shut your mouth up and get out of here. Taft retreated, but not before vowing to kill any part of the plan that reached the Senate floor.

Taft was not without allies. A predictable coalition soon emerged, backed by pharmaceutical and insurance companies but directed by the American Medical Association, which levied a $25 political assessment on its members to finance the effort. At its crudest, the campaign pushed a kind of medical McCarthyism by accusing the White House of inventing ways to turn a brave, risk-taking people into a bunch of dainty, steam-heated, rubber-tired, beauty-rested, effeminized, pampered sissieseasy pickings for the nations godless cold war foe. UNAMERICAN SYSTEM BLUEPRINTED IN THE KREMLIN HEADQUARTERS OF THE COMMUNIST INTERNATIONALE, read one AMA missive describing the origins of Trumans plan.

Precious freedoms were at stake, Americans were told: when the president claimed that medical choices would remain in private hands, he was lying; federal health insurance meant government control; decisions once made by doctors and patients would become the province of faceless bureaucrats; quality would suffer and privacy would vanish. Skeptics were reminded of Lenins alleged remarklikely invented by an opponent of Trumans heath planthat socialized medicine represented the keystone to the arch of the socialized state.

The economist Milton Friedman once described the AMA as perhaps the strongest trade union in the United States. It influenced medical school curriculums, limited the number of graduates, and policed the rules for certification and practice. For the AMA, Trumans proposal not only challenged the professions autonomy, it also made doctors look as if they could not be trusted to place the countrys needs above their own. As a result, the AMA ran a simultaneous campaign congratulating its members for making Americans the healthiest people in the world. The existing system worked, it claimed, because so many physicians followed the golden rule, charging patients on a sliding scale that turned almost no one away. If the patient was wealthy, the fee went up; others paid less, or nothing at all. What was better in a free society: the intrusive reach of the state or the big-hearted efforts of the medical community?

Given the stakes, the smearing of national health insurance was not unexpected. What did come as a surprise, however, was the palpable lack of support for the idea. For many Americans, the return to prosperity following World War II made Trumans proposal seem less urgent than the sweeping initiatives that had ended the bread lines and joblessness of the Great Depression. Even the Democratic Partys prime constituencyorganized laborshowed limited interest. During the war, to compensate workers for the income lost to wage controls, Congress had passed a law that exempted health care benefits from federal taxation. Designed as a temporary measure, it proved so popular that it became a permanent part of the tax code.

Unions loved the idea of companies providing health insurance in lieu of taxable wages. It appeared to offer the average American the sort of write-off reserved for the privileged classes, and indeed it did. Current studies show that union members are far more likely to have health insurance and paid sick leave than nonunion workers in the same industry. Employer-sponsored health insurance now amounts to the nations largest single tax exemption, costing the government more than $250 billion annually in lost revenue.

At about the same time, popular insurance plans like Blue Cross emerged to offer cheap, prepaid hospital care, followed by Blue Shield for doctors visits. In 1939 fewer than six million people carried such insurance; by 1950, that number had increased fivefold. In the years after Trumans plan died in Congress, the government filled some of the egregious gaps in the private insurance system with expensive programs for the poor, the elderly, and others in high-risk categories, thereby cementing Americas outlier status as the worlds only advanced industrial nation without universal health care.

What the United States does have in common with several of these nations, says Ezekiel Emanuel in his valuable Which Country Has the Worlds Best Health Care?, is that its health care struggles have not been unlike theirs, despite the markedly different outcomes. The United Kingdom, for example, decided in favor of national health care at the very moment that Trumans plan was being shredded. And the main adversary turned out to be the British Medical Association, which used the hated specter of Nazism (as opposed to Bolshevism) to demonize the proposed National Health Service as a Hitlerian menace run by a medical fuhrer.

The NHS succeeded because the Labour Party won a landslide victory in 1945 in a country battered by war and facing a bleak economic futureprecisely the opposite of the American experience. Opinion polls in the UK showed strong support for a government-run system offering universal, comprehensive, and free health care financed by general taxation. But the threat of a physicians strike forced Labours health minister, Aneurin Bevan, to scrap the idea of turning doctors into full-time government employees. Senior specialists (or consultants) would be allowed to see private patients beyond their salaried employment in Britains government-run hospitals, and general practitioners could retain their status as independent contractors, though they would get virtually all their income through the NHS. Generous pensions and other benefits sweetened the deal. I stuffed their mouths with gold, Bevan recalled.

The UK and the US are the bookends of the eleven health care systems that Emanuel has studiednot so much to determine which one is best or worst, as which one most closely resembles a socialized system. (The others are Australia, Canada, China, France, Germany, the Netherlands, Norway, Switzerland, and Taiwan.) The UK excels in universal coverage, simplicity of payment, and protection of low-income groups. While the NHS remains quite popular, it also is seriously underfunded: the UK ranks dead last in both health care spending per capita ($3,900) and health care spending as a percentage of gross domestic product (9.6) among the six European nations under examination. The most common complaints, not surprisingly, concern staff shortages and wait times for primary care appointments, elective surgeries, and even cancer treatments, which can stretch for months. The public does not want to replace the system with an alternative, writes Emanuel. All the public wants is a fully operational NHS.

By contrast, the US health care systemif one can call it thatexcludes more people, provides thinner coverage, and is far less affordable. It combines socialized medicine practiced by the Department of Veterans Affairs, four-part federal Medicare (A, B, C, D) for the elderly and disabled, state-by-state Medicaid for the poor, health coverage provided by employers, and policies bought privately through an insurance agent or an Affordable Care Act exchangeall of which still leave 10 percent of the population unprotected. Among the biggest problems, says Emanuel, is that Americans are baffled by their health care: uncertain of the benefits theyre entitled to, the providers that will accept their insurance, the amount of their deductibles and copays, and the accuracy of the bills they receive. It is a system, moreover, in which people are regularly switching insurers out of choice or necessitya process known as churning. The United States basically has every type of health financing ever invented, Ezekiel adds. This is preposterous.

And extremely expensive. America dwarfs other nations in both health care spending per capita ($10,700) and health care spending as a percentage of GDP (17.9). Hospital stays, doctor services, prescription drugs, medical devices, laboratory testingthe excesses are legion. Childbirth costs on average about $4,000 in Western Europe, where midwives are used extensively and charges are bundled together, but close to $30,000 in the US, where the patient is billed separately by specialistsradiologists, pathologists, anesthesiologistswhom she likely never meets, and where charges pile up item by item in what one recent study called a wasteful overuse of drugs and technologies. There is no evidence that such extravagance makes for better health care outcomes. The rates of maternal and infant death in the US are higher than in other industrialized nations, partly because the poor, minorities, and children are disproportionately uninsured.

For head-spinning price disparities, however, nothing compares to pharmaceuticals. Americans account for almost half the $1 trillion spent annually for prescription drugs worldwide, while comprising less than 5 percent of the worlds population. It is probably no coincidence that the pharmaceutical industry spent almost twice as much on political lobbying between 1998 and 2020 as its nearest competitor, the insurance industry. (The hospital/nursing home industry came in eighth.) Drug companies won patent protection, restraint-free pricing, and direct-to-consumer advertising (outside the US, only New Zealand allows this). This high spending for drugs, writes Emanuel, with some understatement, is a result of high drug prices, not high drug use by Americans.

How do other countries keep drug costs down? By using the full power of government (or a surrogate) to negotiate lower prices, as opposed to the market fragmentation that diminishes consumer leverage in the United States. Some governments shop for pharmaceuticals, paying no more than the lowest prices charged by other developed nations. And some use an internal metric that pegs prices to what that country already pays for drugs in the same class. Canada, which employs both methods, has become a haven for consumers south of the border, even though the importation of prescription drugs into the United States is generally illegal. Emanuel favors no single approach; he is open to almost anything that avoids the highway robbery Americans wearily tolerate. I am agnostic about how best to regulate drug prices, he admits, but having some objective and rigorous system for setting prices is definitely better than leaving it to drug companies with monopoly pricing power.

Emanuel is a man of many lists. I rank everything, he writes:

I rank the 10 best meals Ive ever had (#1 Alinea in Chicago). I rank chocolates (#1 Askinosie). I rank Alpine cheeses (#1 is a tie between Alpha Tolman and Alp Blossom). I rank colleges. I rank academic departments of bioethics and health policy that compete with my own. I rank the meals I cook, the races I run, the bike rides I take, the speeches I give.

A bit obsessive, no doubt, though its hard to imagine anyone better suited to rank the worlds health care systems than an oncologist with a Harvard medical degree and a Harvard Ph.D. in political philosophy who was deeply involved in crafting the Affordable Care Act and currently chairs the Department of Medical Ethics and Health Policy at the University of Pennsylvania. Emanuel likes controversy and the limelight that comes with it. Several years ago, he wrote an essay for The Atlantic insisting that he had no interest in living past seventy-five, the approximate age, he said, at which people appear more burdensome than productive. Rather than killing himself, Emanuel vowed to refuse all measures to prolong his life, from cancer screenings to antibiotics to the flu shot. (Those who skimmed the lengthy piece may have overlooked the disclaimer I retain the right to change my mind carefully tucked into the final paragraph.) Few people took him seriously, I suspect, beyond the likes of Newt Gingrich and Sarah Palin, who had previously (and falsely) accused Emanuel of wanting to create death panels to deny treatment to the elderly and disabled.

Ranking the worlds health care is something of a cottage industry. The gold standard, until now, has been the Commonwealth Fund, which publishes periodic assessments comparing the US system to those of ten other countries, much as Emanuel has done. The 2017 Commonwealth study includes two nations (Sweden and New Zealand) not on Emanuels list; his study includes two nations (Taiwan and China) not on the Commonwealth list. Both employ similarly broad categories such as access, equity, coverage, efficiency, financing, and delivery. The Commonwealth studies rely heavily on surveys of patients and primary care doctors, as well as comparative data drawn from sources like the World Health Organization. Emanuel takes a more qualitative approach, providing histories of each nation that elegantly describe the impact of politics and culture on current policy. He also is more hesitant to rely on data that are not easily compared among nations with different approaches to managed care. Such numbers, he writes, must be taken with heaping grains of salt.

So who are the winners and losers? The 2017 Commonwealth study ranks the UK first, followed closely by Australia and the Netherlands. In last place, hands down, is the United States, which fails in almost every category. Emanuel ranks the United States next to lastbut only because his study includes China. While acknowledging dramatic progress made there in health care outcomes such as infant mortality and life expectancy, Emanuel has little good news to report about China beyond the hope that its rapidly growing middle class will soon be demanding better medical care.

And first place? The answer isblank. There are too many variables and too few precise measurements to pick an overall winner, Emanuel confesses to the reader on page 351. The best that he can do is to lump the eleven nations into tiers, with Germany, the Netherlands, Norway, and Taiwan at the top. Which ranks highest depends on your priorities. If your main ones are the choice of doctor and hospital, short waiting times, and good long-term care, you probably will pick Germany. If youre focused on rock-bottom prescription drug prices and an outstanding electronic records system, Taiwan is the place. If you worry about copayments and deductibles, England and Canada await. Finding the best heath care, it appears, is harder than finding the best Alpine cheese.

Shortly after this book was published, Emanuel was interviewed on a podcast with a very insistent host. Asked point-blank which nation had the best health care, he first refused to say. I was ready for your evasive answer, the host responded. Which system would you want to buy into? Cornered, Emanuel chose the Netherlands. I think that they have a very good combination, he declared:

You get to choose your private insurer, you get to choose your primary care doctor. And their primary care doctors are really gatekeepers to a higher level of care. Theyre also innovative. But there are lots of other alternatives Id be more than happy with.

This is hardly a revelation. The Dutch have long been content with their system. It doesnt lead in any of the main categories, but it does everything well. Where Emanuel and fellow rankers part ways is in their vision of the future. Emanuel is bullish on America. He sees it emerging as a world health care leader, despite its dismal current standing and the politically charged opposition of most Republicans to meaningful change. The United States does excel on some dimensions, particularly innovation and experimentation in payment models and care delivery, he writes. Im optimistic about [its] long-term performance. Time will tell.

The first order of business, Emanuel believes, is universal coverage. No system that shuts out so many people can claim to be just or effective. Other industrialized nations have achieved universal coverage through automatic enrollment, and Emanuel thinks it could work here by funneling people into Medicaid or one of the lower-cost insurance exchanges. The process will entail larger government subsidies for the uninsured and underinsured, including middle-class families, but it will also ease the rampant confusion that keeps millions of Americans from claiming the benefits they already are entitled to. Emanuel sees automatic enrollment as both essential and nonthreateninga social good requiring little systemic change.

More controversial is his recommendation aimed at bringing some order to the current system. He likes the idea of having everyone covered by one of two options: either employer-sponsored insurance or a government-sponsored alternative that combines Medicare, Medicaid, and the Obamacare exchanges into a coherent entity. At the very least, it would be simpler to navigate, streamline medical billing, reduce the administrative quagmire faced by providers, and supply some added leverage against monopolistic price-gouging. Studies estimate that the United States spends a staggering $500 billion annually on billing and insurance-related costs, with $240 billion classified as excessor waste. The average US physician practice spends four times as much on billing as its Canadian counterpart.

It is hard to imagine that anyone intended to design a system this dysfunctional. The good news, says Emanuel, is that underperformance of such magnitude inevitably spurs innovation. The surge in costs has generated new interest in payment models that have worked elsewhere, such as capitation, which pays the physician a fixed fee for a patients care over a specified period of time, and bundling, which puts multiple health care services under a single billing code. America is becoming a leader in coordinating the care of patients with chronic physical and mental conditionsinnovations Emanuel clearly lays out here. Even the systems once-static care delivery system has been invigorated by additions like the physicians assistant, who is licensed to treat illness and prescribe medication, and the virtual office visit that has become so essential during the current pandemic.

Covid-19 arrived just as Emanuels book was heading to the printer. Not surprisingly, his editor asked him to compose an addendum suggesting what the coronavirus might tell us about the nations health care system. Written obviously in haste, it still covers the bases rather well. The absence of universal coverage, combined with high deductibles and copays, made it less likely for people with symptoms to seek medical help, thus endangering them and the rest of us. Americas hospitals and health care facilities now face a sea of red ink, with losses estimated in the hundreds of billions of dollars. Elective surgeries, a primary revenue stream, have slowed to a trickle, while prices for drugs and protective equipment have steadily mounted. It is too early, of course, to attempt a serious ranking of the effectiveness of countries responses to Covid-19. That surely will come, with perhaps predictable results. What can be noted at this point is the exemplary performance of the nations front-line health workers and first responders.

There are signs that the pandemic has had an effect on public attitudes. Since June, voters in deep red Oklahoma and Missouri have defied their political leaders by supporting constitutional amendments that require the expansion of eligibility for Medicaid, one of the provisions of Obamacare that many Republican-controlled state governments have refused to implement. South Dakota may follow suit in 2022. The AMA has also evolved over the years: its current vision on health care reform now calls for freedom of choice, freedom of practice, and universal access for patients, which is another way of saying that it endorses the expansion of the Affordable Care Act for those without insurance while still opposing a single-payer national health plan. This alone is progressseventy-five years after President Trumans clarion call for health care justice.

Continued here:

Health Care: The Best and the Rest | by David Oshinsky - The New York Review of Books

Diversity in health care starts at the beginning – Nevada Today

Since 1968, National Hispanic Heritage Month has been recognized by the federal government and celebrated across the United States annually, from Sept. 15 to Oct. 15 to acknowledge the history, culture, and contributions of Americans whose ancestry can be traced to over 20 countries in Latin America, including Mexico, Central and South America, and the Caribbean. There are approximately 60 million people residing in the U.S. representing approximately 18% of the population, who have ancestries connected to these countries.

The University of Nevada, Reno School of Medicine (UNR Med) and University Health join in celebrating this annual commemoration as part of our commitment to diversity and inclusion and our ongoing efforts to increase the representation of Hispanics, and others from populations underrepresented in medicine, who serve our community as healthcare providers.

Diversity in health care benefits students and their future patients.

Diversity enhances the learning experience of all students through broadened perspectives, intellectual engagement, social skills, empathy, and racial understanding all critical components of medical education for future physicians. Ultimately, diversity helps equip future physicians to combat health care disparities, which will positively impact health care outcomes for their patients.

The future of medicine doesnt just lie in technological advancements or scientific discoveries, says first-year medical student, Leanne Perez. The future of medicine is about diversity, and reflecting a new, dynamic generation of doctors who represent every and any patient.

UNR Med is making great strides in training a broader spectrum of future physicians, capable of relating to patients and speaking their language, both literally and figuratively.

For second-year UNR Med medical student Sergio Trejo, being Hispanic and a Spanish speaker has been an enormous asset in understanding cultural subtleties and prominent social health determinants. I volunteer as an interpreter and student provider for clinics that serve underserved communities and interact with English language-challenged patients in navigating the health care field. When patients are able to precisely describe what brings them into the clinic in their own language with a health care professional who understands them, theyre overcome with a sense of relief and gratefulness. This is my motivation for dedicating my career to serving underserved populations, especially those who face massive language barriers.

Diversity in health care advances academic excellence.

The Association of American Medical Colleges (AAMC) reports that Hispanic matriculation to U.S. medical schools was 6.2% for the 2018-19 academic year. At UNR Med, the number of enrolled Hispanic medical students has more than doubled since 2011, reaching 20% for the 2020-21 academic year. In addition, more than half of the UNR Med Class of 2024 medical students represent UNR Med Mission-Based Diversity Groups, reflecting Nevadas diverse population. During this same period of time, the size of our application pool continued to grow and the average academic credentials of incoming students remained consistent or improved.

Commitment to diversity starts with engaging in outreach that exposes young people from groups underrepresented in medicine to role models and that inspires them to pursue a career in healthcare, said Tamara Martinez-Anderson, director of admissions. It is also reflected in a holistic admissions process that requires academic and professional readiness for medical school, but also considers how each candidates diverse competencies, attributes and backgrounds align with our mission and values. We know that achieving our vision of a healthy Nevada benefits when we enroll future doctors who are collaborative, resilient and adaptable and who are committed to providing compassionate, sensitive and culturally competent care.

UNR Meds total enrollment of Hispanic students is around 54 students, including the School of Medicine, Physician Assistant Studies Program and Speech Pathology and Audiology student bodies. Over the past four years, UNR Med has nearly tripled Latinx and Black faculty representation.

Diversity in health care starts long before medical school.

Pre-med pipeline programs and initiatives have been shown to help underrepresented students better prepare for the medical school admissions process. Developing and expanding these avenues of educational support continue to be a strong priority for UNR Meds Office of Admissions.

The mission of the Community of Bilingual English-Spanish Speaker Exploring Issues in Science and Health (CBESS) program is to create opportunities to position bilingual high school students as insiders into STEM-healthcare fields. CBESS aims to increase diversity in the health care workforce by providing programming for Spanish-English bilingual high school juniors through networking events with health care professionals, medical school tours, and a variety of other activities. The initiative is collaboration between the Universitys College of Education, Raggio Research Center, School of Community Health Sciences and School of Medicine.

Sergio Trejo became involved with CBESS, and his experience as a student in the program led him to choose UNR Med for medical school. Ive always been interested serving underserved communities, especially those who face prominent language barriers. I decided to attend UNR Med because Tamara Martinez-Anderson and other faculty demonstrated how UNR Med has similar goals in striving to alleviate health disparities for Nevada's underserved populations and beyond.

In support of first-generation and low-income undergraduate students who are preparing for the medical school application process, the Office of Admissions has partnered with the University of Nevada, Reno TRiO Scholars Program to offer pre-med advising and learning support. Also available is a one-year Post-Baccalaureate Certificate that provides a small and select group of students, frequently from non-traditional or underrepresented backgrounds, with the opportunity to demonstrate their academic readiness in a pipeline program that mimics the intensity of medical school.

Another pipeline program involves early interventions to make reaching the goal of medical school more sustainable over the long term. The BS-MD Program grants exceptional high school students conditional direct-entry admission to UNR Med upon completion of all requirements of a structured, four-year undergraduate pre-med program at the University of Nevada, Reno.

As a first-generation medical student, Leanne Perezs dream of becoming a physician felt discouraging at first, so the BS-MD program was key to guiding her throughout her undergraduate degree all the way to medical school. I am honored to represent the Hispanic community, as it is so important for minority populations to identify with their physicians. Coming from an underrepresented community, I am so proud to attend a medical school that prioritizes diversity and outreach.

Our commitment to diversity is a pledge to seeing that all members of our community are able to access the quality health care they need, said UNR Med Dean, Thomas L. Schwenk, M.D. In northern Nevada, we not only have great health care infrastructure but a School of Medicine that is actively partnering with our health care community to build relationships and increase access to, and equity in health care for all.

UNR Meds success in recruiting, enrolling and graduating increasing Hispanic medical students is reflective of the broader University of Nevada, Reno goal to become a Hispanic-Serving Institution, with Hispanic students making up at least 25% of the undergraduate, full-time student population.

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Diversity in health care starts at the beginning - Nevada Today

Respiratory therapists: Vital part of health care team – Brownwood Bulletin

Special to the Bulletin

WednesdayOct7,2020at4:42PM

Respiratory therapists and the work they do will be observed during Respiratory Therapist Week later this month, Oct. 25-31.

Respiratory therapy (RT) is part of the critical care team in a hospital, from newborns to elderly. RT also has hands-on care for COVID 19 patients.

RT is usually thought of as the people who give breathing treatments. However, it goes a lot further than that. RT is part of a core and experienced team who responds to all respiratory and cardiac arrests.

RTs education certainly focuses on the heart and lungs, but RT professionals learn so much more. From simple lab values, chest X-rays, CT scans to hemodynamics, RT manages ventilators from neonates to geriatrics.

All of the RT professionals at Brownwood Regional Medical Center are required to have special certifications including ACLS (advanced cardiac life support), PALS (pediatric advanced life support, and NRP (neonatal resuscitation program).

There is much more RT could tell the public. Brownwood Regional Medical Center has an amazing RT team with more than 115 years combined experience.

The medical diretor is Dr. Roy Byrd.

What is Respiratory Care Week? (2020 Ultimate Guide)

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Respiratory therapists: Vital part of health care team - Brownwood Bulletin

MedaSource: Depth and Breadth in Life Sciences and Healthcare Consulting – BioSpace

According to Forbes, the healthcare services market exceeds $50 billion, which isnt surprising given the complexity of the interactions between biotechnology companies, pharmaceutical companies, medical device companies, distributors, health care institutions, organized physician groups and other stakeholders. Its also a field that largely works in the background and is involved in a rapidly expanding list of activities, including digital health transformation, market growth, operational efficiency and others.

One such company is Medasource, which was founded in 2000 and falls under the umbrella of the Eight Eleven Group, a leading human capital solutions firm specializing in technology and business support. Both are headquartered in Indianapolis.

Medasources practice areas include Health IT, Business Applications, Revenue Cycle Management and Pharmaceutical & Life Sciences.

Michael Haas, Medasources Pharmaceutical & Life Sciences Vertical Director, describes the company as a national healthcare consulting and project services company."

"We partner with hundreds of customers across health systems, pharma, biotech and device companies across the U.S. to drive clinical research and improve patient care, Haas said.

And they are by no means a small consulting firm. They have significant reach across the United States with 32 physical offices and thousands of medical & scientific consultants on assignment this year.

Haas indicates that they partner with industry leaders to provide the expertise needed across critical functions, including translational sciences, medical affairs, clinical development, safety, research informatics and regulatory affairs. They partner to manage entire projects and complement existing teams.

For example, Haas said, our consultant pool is comprised of the scientific, clinical, analytical, and technical expertise needed to drive research and commercial operations. Additionally, our provider vertical focuses on assisting large health systems and academic medical centers execute clinical research and trials.

The COVID-19 pandemic, Haas notes, has been a disruptive year for much of the healthcare and life sciences industry.

He said that early on, Clinical Laboratory teams and Clinical Trials Offices within their healthcare delivery portfolio came to a standstill, while Clinical Engineering teams rushed to ensure proper inventory levels and functionality of critical equipment.

However, this summer, they have been quickly scaling clinical laboratory teams as COVID-19 testing increased along with growing patient volumes and procedures.

With big pharma, weve focused on consulting efforts around the design, management and monitoring of new infectious disease studies, Haas said.

In addition, Medasource has partnered with numerous state governments, cities and counties to build and manage entire teams to combat the spread of COVID-19 throughout the U.S.

Medasource also has two key Workforce Transformation Solutions, Elevate and Project Patriot. Elevate is an entry-level consulting program designed, to infuse your culture with the best and brightest associate or junior-level candidates, Haas said. Our clients use this program to address succession planning and build cost-effective, scalable teams.

Project Patriot is the companys national Veteran consulting program. It assists all veterans and transitioning military and their families by, he said, engaging, equipping and empowering them to successfully explore careers in the healthcare and life sciences industries.

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MedaSource: Depth and Breadth in Life Sciences and Healthcare Consulting - BioSpace

Value-based Care After COVID-19: What Healthcare Leaders Need to Know – Medical Economics

In truth, COVID-19 only emphasized providers need to diversify by augmenting fee-for-service (FFS) income with VBC revenue streams. As patient volumes and FFS payments dried up, provider performance data shows that savings per case in bundled payment programs remained high and capitated payments continued. Financially, providers who chose to stay in VBC contracts but opt out of the risk associated with COVID-19 patients will likely fare better than those who did not.

Thats good, because there are unmistakable signs that VBC is poised to accelerate.

First, the economic burdens caused by the pandemic have intensified pressure to reduce healthcare spending. Governments, employers and consumers all are demanding greater value for their healthcare dollars. Moreover, the Centers for Medicare & Medicaid Services (CMS) has voiced its intent to double down on VBC and accelerate new mandatory bundled payment models.

Although prior to the pandemic less than 20% of Medicare spending was in VBC contracts, CMS has announced it wants to move 100% of Medicare providers into two-sided risk arrangements by 2025. Likewise, CMS wants half of its Medicaid and commercial contracts in VBC models by 2025and most commercial payers are following their lead.

But even if Medicare fails to reach 100% participation by 2025, the momentum shift is clear. VBC is moving ahead.

Join the race in progress

In some organizations, historical payer/provider tensions fuel a mindset that VBC contracts are stacked against providers. What providers should understand, however, is that VBC arrangements actually offer opportunities to improve care for their patients while also increasing revenue as compared with fee-for-service.

One key to doing so is to join the VBC race sooner rather than later. CMS has offered voluntary VBC initiatives since 2012, which means a sizable number of providers are already gaining valuable experience. Keep in mind:

Manage risk through knowledge

After deciding to make the shift to VBC, there are ways to manage risk and increase the upside potential. To start, providers must understand how each VBC program works and where the risk lies.

There are dozens of VBC options available from both government and commercial payers, and most are complicated. Medicare programs, though challenging, typically are more accessible and transparent than most commercial plans. For that reason, it generally makes sense for providers to make their initial foray into VBC through a Medicare initiative.

Regardless, its essential to understand exactly how a given VBC arrangement works. For example, organizations must know the standards against which they will be measured. Make sure to recognize the biases in the model as well. Regional wage indices, for instance, create better pricing in some markets and pricing disadvantages in others. Similarly, peer-adjusted trend factors in the Bundled Payments for Care Improvement Advanced (BPCI-A) program have created favorable price opportunities for some bundles and negative pricing for others.

ACOs must understand how their benchmarks are set, and how that affects their ability to succeed against those benchmarks. Even the best-designed contracts have biases, so it is imperative to understand what they are and how they could impact the ability to perform within the contract.

Since risk mitigation depends on properly managing episodes of care, providers should also assess their capacity to redesign care pathways. Ask questions such as:

Once providers fully understand how a VBC program works and their capacity to operate within it, data analysis is crucial to risk management. Through data, providers can see whether the juice is worth the squeeze by quantifying risk, improvement opportunities and potential reward.

That process starts with looking at historical performance in the areas where organizations will be measuredsuch as hospital readmission rates or skilled nursing facility lengths of stay, for example. Organizations should evaluate how their providers measure against regional peers on those metrics. Also consider the organizations appetite for loss. In situations where the data identify an unpalatable risk level, providers can use insurance products designed to protect against downside risk in specific programs.

Welcome new opportunities

COVID-19 has solidified the need for VBC; its here to stay.

Although VBC represents a substantial shift in the healthcare ecosystem, providers must not overlook the tremendous revenue potential it affords in addition to its patient care benefits. The transition may seem daunting, but there are ways to box and manage the risk. The earlier providers start down the VBC path, the greater their chances for long-term VBC success.

York is vice president of value-based care at Coverys. Terry is CEO of Archway Health

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Value-based Care After COVID-19: What Healthcare Leaders Need to Know - Medical Economics

Free sessions on legal and financial issues for those with neurological conditions – Norton Healthcare

The 2020 Neuroscience Expo will host a morning of free online sessions with legal and financial advisers, tailored exclusively to those dealing with a neurological condition and their caregivers.

Living a happy, fulfilling life goes beyond exceptional medical care. It includes caring for the whole person and their day-to-day struggles.

This Norton Neuroscience Institute event gives individuals living with a neurological condition and their family, caregivers, support care providers and others a way to collect valuable information.

Friday, Oct. 23, 9 a.m. to 12:30 p.m.

This years Norton Neuroscience Institute conference will be livestreamed, but space is limited.

Register Today

This years track for legal and financial resources features the following sessions:

Learn how to create a life care plan for you or a loved one.

Jefferey Yussman and Gordon Homes

Living with a disability can be challenging and requires planning for future needs. Youll learn ways you can financially prepare for the future.

Jefferey Yussman and Gordon Homes

If you wanted to know about the importance of having your affairs in order, this presentation will outline the various legal documents that would ensure your peace of mind.

Victor E. Tackett Jr.

Is it time to apply for disability? Where do I begin? Learn the latest on Social Security disability applications and the process of filing a disability claim.

Sam Schad

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Free sessions on legal and financial issues for those with neurological conditions - Norton Healthcare

Telemedicine and Digital Health to Set the Tone for Healthcare – Medical Device and Diagnostics Industry

Digital health, especially telemedicine, is going to play a prominent role in healthcare going forward, a panel at the Cleveland Clinic Innovation Summit said on Tuesday.

The focus on digital health has been spurred by the outbreak of COVID-19. One of the viruses long-lasting impacts is sure to be the rapid integration of telemedicine.

During the panel, Matt Kull, Chief Information Officer of Cleveland Clinic, spoke noted that telemedicine isnt going to be another fad.

On the telehealth perspective, I think thats here to stay, Kull told fellow panel members during the innovation summit. I think thats going to become the norm and its going to allow us to reach more people where they are and ways they want to be met.

Kulls comments echo three physician surveys conducted by Jason Mills, a medtech analyst at Canaccord Genuity. Mills and colleagues also noted the shift to telehealth in a report published April 13th.

"The COVID-19 pandemic set off an accelerated shift to virtual communication in nearly every forum in which humans interact and, similarly, ... the medical device sector is also embracing the virtual worldand will perhaps continue to do so long after the COVID crisis abates, Mills and colleagues wrote.

During the Cleveland Clinic Innovation Summit, the panel was asked if the idea of telemedicine was under-or-over-hyped. Richard Zane, MD, Chief Innovation Officer of UC Health chimed in on the question.

Telemedicine is far under-hyped, Zane said. The future of whatever were going to describe as virtual care is going to scale very quickly and very robustly.

While the majority of the panel agreed the technology was under-hyped, Allistair Erskine, MD Chief Digital Officer for Mass General Brigham offered another opinion.

Virtual is the new black right now, Erskine said. Were at the top of the curve. We went from 100 visits to 12,000 visits a day. But we still have to digitally upscale our providers and we still have to digitally upscale our patients the ones that are not used to navigating across all these new technologies themselves.

He added, we have to worry about payment reform. Right now, its hot because its paid for. In the future, it could not be paid for and then may slip more into a value-based care arrangement. The broad range of digital health is only going to grow in the future. A report from VynZ Research shows the market was valued at $111 billion in 2019 and is set to reach $510 billion by 2025 observing a CAGR of 29%.

Kyle Rose, an analyst with Canaccord said digital health could be vital to help medtech solutions exist in markets where pharmaceuticals solely existed.

Rose wrote, augmented by a coalescence of AI, software, and back-end data analytics, among other factors, which we think will make devices both smarter and increasingly less-invasive, we view novel med-tech interventions well positioned to increasingly capture share in a segment of the market historically dominated by pharmaceuticals, expanding medtechs reach further upstream.

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Telemedicine and Digital Health to Set the Tone for Healthcare - Medical Device and Diagnostics Industry

The 14 US health care billionaires, according to Forbes – The Daily Briefing

Forbes recently released its 2020 list of the 400 wealthiest people in America, which includes 14 U.S. billionaires who made their fortunes in the health care industry.

The 23 US health care billionaires (and how they made their fortunes)

For the 39th annual "Forbes 400" list, the magazine reached out to more than 700 individuals whom Forbes considered to be candidates. Analysts with Forbes reviewed financial documents, court records, assets, debt, and other factors to determine the candidates' wealth. According to Forbes' Jennifer Wang, analysts also met with the candidates in person, by phone, or virtually. In addition, Forbes interviewed the candidates' "employees, handlers, rivals, peers, and attorneys," Wang reports.

Ultimately, Forbes "took into account all types of assets: stakes in public and private companies, real estate, art, yachts, planes, ranches, vineyards, jewelry, car collections, and more," and "factored in debt and charitable giving" to determine the list, Wang writes. According to Forbes, individuals must have at least $2.1 billion in wealth to make the list. Forbes notes that 10 people who were on last year's "Forbes 400" list fell off this year's list as their fortunes declined "directly" because of the novel coronavirus pandemic.

Overall, the richest people in America, according to Forbes, are:

This year marks the third consecutive year that Bezos has topped the "Forbes 400" list, Forbes notes.

Forbes divided the billionaires on its list into several categories, including those whose fortunes were made primarily in the health care industry. The health care list did not include billionaires such as Bezos, who made their fortunes in other industries but have also ventured into health care.

The U.S. billionaires included in Forbes' health care category, in order of 2020 net worth, are:

See the rest here:

The 14 US health care billionaires, according to Forbes - The Daily Briefing



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