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Tuesday, April 11, 2023

1 in 5 U.S. adults say they’ve had a family member killed by a gun, new study finds

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Nearly one in five American adults say they have had a family member who was killed by a gun, including suicides, according to a new study from the Kaiser Family Foundation. Roughly the same number (21%) said they have been personally threatened with a gun, the study found.

People of color were more likely to report witnessing gun violence or having family members who were killed by guns. More than one-third of Black adults said they had a family member who was killed by a gun, compared with 17% of White respondents and 18% of Hispanic adults who participated in the study.

Three in ten Black adults and one in five Hispanic adults said they had personally witnessed someone being shot, according to the study. A little more than one in five (22%) of Hispanic adults said they had seen someone being shot.

Black adults were also more likely to report feeling unsafe in their neighborhoods.

“While most adults overall say they feel either “very” (41%) or “somewhat” (41%) safe from gun violence in their neighborhoods, significant shares say they feel “not too safe” (13%) or not safe at all (5%),” KFF said in a statement announcing the results of the study. “One in six Black adults (17%) don’t feel at all safe in their neighborhoods, far greater than the share of White (2%) or Hispanic (9%) adults.”

Black (32%) and Hispanic adults (33%) were also a little more than three times more likely to report worrying daily or almost daily that a family member will become a victim of gun violence than White adults (10%).

The study found that 41% of all adults said they lived in a household with guns. Of those with guns in the home, 75% said the guns were “stored in ways that don’t reflect some common gun-safety practices,” KFF said. 

“Specifically, about half (52%) say that a gun in their home is stored in the same location as ammunition; more than four in 10 (44%) say that a gun is kept in an unlocked location; and more than a third (36%) say that a gun is stored loaded,” KFF said.


If you or someone you know is in emotional distress or a suicidal crisis, you can reach the 988 Suicide & Crisis Lifeline by calling or texting 988. You can also chat with the 988 Suicide & Crisis Lifeline here.

For more information about mental health care resources and support, The National Alliance on Mental Illness (NAMI) HelpLine can be reached Monday through Friday, 10 a.m.–10 p.m. ET, at 1-800-950-NAMI (6264) or email info@nami.org.



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Monday, April 10, 2023

Preventive care court ruling unlikely to spark big changes

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Health insurance companies are now free to require cost-sharing for preventive services, but don’t expect that to happen any time soon.

Since a federal judge struck down an Affordable Care Act requirement that patients have access to certain services at no cost, the health insurance sector made clear that nothing would change in the short term, even though the ruling took effect immediately. Industry organizations such as AHIP and insurers such as Elevance Health and Kaiser Permanente swiftly issued statements assuring their members that preventive care would continue to be covered without cost-sharing.

The Justice Department plans to appeal the judge’s decision. And it may seek a stay in the meantime that would restore the preventive medicine rules, so the judiciary likely will be considering this case for months, at least. Whatever the final outcome, health insurance companies are not expected to reimpose cost-sharing for many, if not all, preventive care, said Paul Schuhmacher, a principal at the consulting firm Aarete.

Following the court ruling and eliminating no-cost access to preventive medicine would upset policyholders and attract unwanted attention, Schuhmacher said. “A bad PR move is something that would have huge negative effects to their company and their bottom line,” he said.

Plus, several major insurance companies belong to conglomerates that also offer patient care at clinics and pharmacies—such as CVS Health’s Aetna and MinuteClinic—that benefit from providing more services. “Most payers have very good profits. They’re not looking for that type of disruption to their business,” Schuhmacher said.

The no-cost preventive care guarantee has proven popular and has little impact on insurance company finances because the expenses are factored into members’ premiums. ACA-mandated preventive services account for just 3.5% of private health insurance companies’ annual spending, the Health Care Cost Institute reported last year.

According to the Health and Human Services Department, 150 million people have insurance plans subject to the preventive care policy. The Kaiser Family Foundation reports that 60% of people with private health insurance receive preventive services such as cancer tests, depression screening and the HIV prevention medication known as PrEP each year.

In fact, it was common before the ACA for at least some preventive care to be covered without cost-sharing, said Sabrina Corlette, a professor and co-director of the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy.

“Insurers generally lobbied against the law writ large,” Corlette said. “But I think there were other provisions that worried them more than this one.”

Employers, who provide health benefits to the majority of Americans, likewise don’t plan to cut back on preventive coverage regardless of the legal dispute.

According to an Employee Benefit Research Institute survey from October, 80% of businesses don’t intend to scale back these benefits even if the courts decide they can. Employers cited retention and recruitment, negative health outcomes, health inequities and low costs as reason to maintain the benefit. Requiring out-of-pocket spending would save employers less than 0.5% on healthcare spending, according to a separate Employee Benefit Research Institute report.

If the court decision stands, health insurance companies can pick and choose what preventive services to cover without cost-sharing, rather than adhere to those recommended by the U.S. Preventive Services Task Force, said Lynn Blewett, a health policy and management professor at the University of Minnesota.

Insurers are less likely to indefinitely cover the costliest preventive services or treatments that are from single sources, such as Gilead’s PrEP drug Truvada (also knowns as emtricitabine-tenofovir), and more likely to cover those widely available, Schuhmacher said. Complicating the cost analysis is that Americans don’t tend to remain with the same insurer long enough for the financial benefits of prevention to accrue to the companies that paid for early interventions, he said.

Insurance companies also would be swayed by patient advocacy groups, Blewett said. Organizations representing the interests of HIV/AIDS patients, for example, would emphasize importance of cost-free screenings and treatments and highlight research showing that any amount of cost-sharing discourages use, she said. “It’s one of the key ways we prevent transmission of HIV. It’s a prevention strategy for the whole country,” she said.

Health insurance companies will offer previews of their plans when they begin filing rate notices to state regulators next month. And some states have levers to pull to restore at least some of the no-cost services covered under the ACA. At least 15 have laws of their own, according to a report Corlette co-authored. States, however, generally don’t have regulatory authority over large-group health plans governed by the federal Employee Retirement Income Security Act of 1974.


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Sunday, April 9, 2023

FDA-Approved Drugs Not Recommended for Use or Reimbursement in Other Countries – Healthcare Economist

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Pham et al. (2023) uses data on regulatory decisions and health technology assessments (HTAs) in Australia, Canada, and the UK and compares them to the drugs that are FDA-approved in the US. They find that:

The FDA approved 206 new drugs in 2017 through 2020, of which 162 (78.6%) were granted marketing authorization by at least 1 other regulatory agency at a median (IQR) delay of 12.1 (17.7) months following US approval. Conversely, 5 FDA-approved drugs were refused marketing authorization by an international regulatory agency due to unfavorable benefit-to-risk assessments. An additional 42 FDA-approved drugs received negative reimbursement recommendations from HTA agencies in Australia, Canada, or the UK due to uncertainty of clinical benefits or unacceptably high prices. The median (IQR) US cost of the 47 drugs refused authorization or not recommended for reimbursement by an international agency was $115 281 ($166 690) per patient per year. Twenty drugs were for oncology indications, and 36 were approved by the FDA through expedited regulatory pathways or the Orphan Drug Act.

The full article is here.




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Friday, April 7, 2023

Pear Therapeutics files Chapter 11, lays off 170 employees

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Pear Therapeutics filed for Chapter 11 bankruptcy protection Friday and said it has eliminated most of its workforce.

The filing, in bankruptcy court in Delaware, comes just three weeks after the digital therapeutics company, said it was exploring strategic alternatives and might need to restructure or fold if it did not find a financial lifeline.

In the bankruptcy petition, the company listed $65.6 million in assets and $51 million in debt. The largest unsecured creditor is Perceptive Advisors, owed $10.4 million.

Boston-based Pear’s board authorized eliminating approximately 170 employees, or 92% of its full-time staff, according to a Wednesday Securities and Exchange Commission filing. The job cuts, which were completed Thursday, resulted in a one-time charge of approximately $1.2 million, primarily tied to severance payments, the company said.

The company said it will retain approximately 15 employees to work through the bankruptcy process and continue marketing efforts. Pear said it will seek buyers interested in specific assets or the entire company. 

Founded in 2013, Pear targeted clinician-prescribed therapies to target opioid use disorder, chronic insomnia and substance use.

The company went public in December 2021 in a $1.6 billion deal with special purpose acquisition company Thimble Point Acquisition Corp. Pear’s shares have dropped from a high of $6.48 per share on May 5, 2022 to  22 cents on Thursday.


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Digital health startups Done, Bicycle pivot following DEA proposal

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The trying circumstances of the COVID-19 pandemic underscored the demand for mental healthcare, and a relaxed regulatory environment inspired entrepreneurs and investors to dive into virtual behavioral health services. Now, the circumstances have changed, forcing these young companies to make difficult pivots to new models.

The federal public health emergency declaration is set to expire May 11, and along with it many of the regulatory flexibilities that enabled companies such as Bicycle Health, Done, Ophelia Health and ReKlame Health to gain business. In addition, law enforcement agencies took notice of rising prescriptions for controlled substances—which are popular as drugs of abuse and frequently diverted to the illegal market—and started cracking down on telehealth providers. Cerebral and Done, for example, have been under federal investigation since last year.

The pandemic was never going to last forever, but at least some in the digital behavioral health sector believed the favorable regulatory environment would.

“The industry almost assumed that these flexibilities would be permanent after the [public health emergency] ends,” said Ankit Gupta, founder and CEO of Bicycle Health, which offers remote prescriptions for buprenorphine (also known as Belbuca, Buprenex, Butrans, Probuphine, Sublocade, Suboxone and Subutex) to treat opioid use disorder.

Digital mental health providers that sprang up or expanded during the public health crisis filled a need for patients unable or unwilling to make in-person visits. Research and digital health venture firm Rock Health estimates that digital mental health companies have attracted nearly $60 billion from investors since 2020.

The authorities helped this trend along by waiving or easing regulations governing such as patient privacy and prescriptions for controlled substances including Adderall (also known as amphetamine/dextroamphetamine salts) for attention deficit hyperactivity disorder and the anti-anxiety drug Xanax (also knowns as alprazolam).

Now, the federal government is poised to restrict online prescribing, which means digital-first companies must offer in-person services or risk going out of business. These companies, which have limited funds and leaders with little to no experience managing in-person healthcare, will have to adapt. That could prove difficult for some.

“We can’t build brick and mortar locations. We’re in too many places, too many counties. We don’t have the money to do that,” said Zack Gray, co-founder and CEO of Ophelia Health, which specializes in prescribing opioid use disorder medications.

The executives who run these companies argue that stricter regulation would be bad for patients, as well as for their businesses. “Discontinuing a patient’s medication is extraordinarily dangerous because they’re going to experience cravings and withdrawal, they’ll be tempted to go to the black market, and they’re at high risk of overdose and death,” Gray said.

“The challenge that they’re facing is figuring out how to quickly transition those models that they built and scaled so quickly during the pandemic, so that they can survive and thrive in the post-pandemic landscape,” said Jeremy Sherer, digital health co-chair at law firm Hooper, Lundy & Bookman. “Part of it is just the nature of startups. You have companies that succeed and companies that fail.”

Enter the DEA

Losing the ability to prescribe medicines remotely would significantly hamper these companies, and that’s just what the Drug Enforcement Administration has in mind.

The DEA proposed a rule in February that would restore the pre-pandemic requirement that patients visit clinicians in person to obtain prescriptions for drugs such as Adderall and Ritalin (also known as methylphenidate) for ADHD and buprenorphine.

Under the draft regulation, 30-day prescriptions for Schedule III to Schedule V controlled substances would be available through telehealth, but patients must make in-person appointments to get refills. Patients whose treatments begin before the end of the public health emergency could wait six months before physically visiting a prescriber under the proposal.

“It makes sense that the DEA would be trying to limit over-prescribing of controlled substances based on their mission and their current investigations,” said Libby Baney, a partner at Faegre Drinker Biddle & Reath who specializes in health information technology law. Even as companies transition to hybrid models, the DEA will remain skeptical of digital health companies prescribing controlled substances, she said.

Pivoting operations

The comment period on the DEA’s proposal closed last Friday, leaving companies wondering whether the agency will modify the rule to address their concerns. This uncertainty has companies questioning their next steps. Candace Richardson, an investor in digital health start-ups at venture capital firm General Catalyst, said the regulation will test these companies’ operational readiness.

“The advice I’ve been giving is to have contingency plans, be prepared to shift, figure out what changes you can wait on doing until maybe next year versus what you need to do now,” Richardson said.

ReKlame Health founder and CEO Evans Rochaste said he is waiting for the final rule. ReKlame Health, which launched in 2020, provides prescribing services aimed at people of color with ADHD, depression, addiction and other conditions in New Jersey, New York and Florida.

Ophelia Health is making contingency plans, but leasing and staffing physical clinics isn’t feasible for the company, which launched in early 2019 and has been operating exclusively via telehealth since the pandemic began, Gray said. The first priority is getting current patients connected to in-person visits, he said. Looking ahead, the company will have to create a process to bring on new patients, and is partnering with a network of DEA-registered providers, he said.

Bicycle Health has a physical location in each of the 32 states where it operates, Gupta said. But the company would be have a hard time accommodating its 20,000 patients in person, and is encouraging them to visit primary care providers. For patients who don’t have one, the company is building partnerships with local clinicians.

Bicycle Health expects to lose 5% of its existing patients and attract 20% fewer new patients as a consequence of the DEA regulation, Chief Medical Officer Dr. Brian Clear said.

Done, an ADHD treatment provider founded in 2019, has made a push to open more physical offices but real estate and labor costs are obstacles, said Done Senior Executive Leader Sean Arroyo. The company expects to have 45 locations in 18 states as of this month and plans to open another 40 offices within the two months, he said.

“In January, we started to make a really hard push knowing this was going to be a transition that had to happen and started making investments because you can’t turn things on in 30 days,” Arroyo said. “The technology that it takes to build, the personnel that it takes to hire in the environment that we’re in—it’s just expensive.”


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High inflation and housing costs force many Americans to delay needed care

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At a health-screening event in Sarasota, Florida, people gathered in a parking lot and waited their turn for blood pressure or diabetes checks. The event was held in Sarasota’s Newtown neighborhood, a historically Black community. Local Tracy Green, 54, joined the line outside a pink-and-white bus that offered free mammograms.

“It’s a blessing because some people, like me, are not fortunate, and so this is what I needed,” she said.

Green wanted the exam because cancer runs in her family. And she shared another health worry: Her large breasts cause her severe back pain. A doctor once recommended she get reduction surgery, but she’s uninsured and said she can’t afford the procedure.

In a 2022 Gallup Poll, 38% of American adults surveyed said they had put off medical treatment within the previous year due to cost, up from 26% in 2021. The new figure is the highest since Gallup started tracking the issue in 2001. In a survey by KFF released last summer, 43% of respondents said they or a family member delayed or put off health care because of costs. It found people were most likely to delay dental care, followed by vision services and doctor’s office visits. Many didn’t take medications as prescribed.

The Newtown screening event — organized by the nonprofit Multicultural Health Institute in partnership with a local hospital and other health care providers — is part of an effort to fill the coverage gap for low-income people.

Green explained that her teeth are in bad shape but dental care will also have to wait. She lacks health insurance and a stable job. When she can, she finds occasional work as a day laborer through a local temp office.

“I only make like $60 or $70-something a day. You know that ain’t making no money,” said Green. “And some days you go in and they don’t have work.”

If she lived in another state, Green might be able to enroll in Medicaid. But Florida is one of 10 states that haven’t expanded the federal-state health insurance program to cover more working-age adults. With rent and other bills to pay, Green said, her health is taking a back seat.

“I don’t have money to go to the dentist, nothing,” she said. “It’s so expensive. Now, to get one extraction, one tooth pulled, it’s like $200-$300 that you don’t have. So I don’t know what to do. It’s like fighting a losing battle right now.”

In the KFF poll, 85% of uninsured adults under age 65 said they found it difficult to pay for health care. Nearly half of their insured counterparts said they struggled with affordability as well.

The U.S. inflation rate hit a four-decade peak last year, and parts of Florida, including the Tampa metro area, often fared even worse.

“We see an increasing desperation,” said Dr. Lisa Merritt, executive director of the Multicultural Health Institute.

The nonprofit, which helps people access low-cost care, is based in Newtown, where, inland from Sarasota’s lavish beach communities, many residents live below the poverty line, lack insurance, and face other barriers to consistent and affordable care.

“It’s very difficult for people to be concerned about abstract things like getting screenings, getting regular health maintenance, when they’re contending with the challenges of basic survival: food, shelter, transportation often,” Merritt said.

Merritt and her team of volunteers work to build trust with residents who may not be aware that support is available. They help people apply for low-cost insurance coverage, free medication programs, and other resources that can reduce treatment costs. Volunteer Bonnie Hardy said the people she serves have many financial worries, but one thing tops the list.

“Right now? A place to stay,” said Hardy. “Housing is horrible.”

High housing costs have started to ease in recent months, but data shows rent in Sarasota has risen nearly 47% since the pandemic began in 2020. Hardy helps people find housing and connects them with programs that cover costs like utilities and security deposits. The goal is to stabilize their lives, and she said that can improve health.

“Because they’re more comfortable now,” she said. “They feel like, hey, the rent is paid, I can let my guard down, maybe I can go get the medical attention I need.”

Research shows putting off health care can lead to bigger problems. The Gallup Poll found 27% of respondents delayed treatment due to costs even for “very or somewhat serious” conditions.

Some people may be holding off on treating medical issues because of health care debt. An investigation from NPR and KHN found about 100 million people in America had medical debt. About 1 in 8 of them owe more than $10,000, according to a KFF poll.

Treating cancer or chronic conditions like diabetes early can save lives and be less expensive than treating advanced-stage illnesses, according to the Centers for Disease Control and Prevention.

Doctors at the health screening event in Newtown said it’s critical to help residents obtain preventive care. At the health fair, substitute teacher Crystal Clyburn, 51, got a mammogram on the mammography bus and had her blood pressure checked.

Clyburn doesn’t have health insurance and said she relies on free events to stay on top of her health.

“I just try to take advantage of whatever that’s out there, whatever that’s free,” she said. “You have to take care of yourself because you can look healthy and not even know you’re sick.”

After the cuff came off, a doctor told Clyburn her blood pressure was a little high but not high enough that she needed to take medication. Clyburn smiled, thanked him, and left relieved to know that the cost of prescription drugs was one expense she wouldn’t have to worry about.

This article is from a partnership that includes WUSF, NPR, and KHN.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.


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Thursday, April 6, 2023

Marburg virus outbreak: What to know about this lethal cousin of Ebola

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Oyewale Tomori is a virologist and fellow at the Nigerian Academy of Science.


In April, the Centers for Disease Control and Prevention warned doctors about two growing outbreaks of deadly Marburg virus in Africa. World Health Organization officials confirmed in February an outbreak in Equatorial Guinea of the highly infectious disease, which is in the same family as the virus that causes Ebola. The Conversation Africa’s Wale Fatade and Usifo Omozokpea asked virologist Oyewale Tomori about its origin and how people can protect themselves against the disease after cases were confirmed in Ghana in July 2022.

What is the Marburg virus and where did it come from?

Marburg virus causes the Marburg Virus Disease, formerly known as Marburg hemorrhagic fever. The virus, which belongs to the same family as the Ebola virus, causes severe viral hemorrhagic fever in humans with an average case fatality rate of around 50%. It has varied between 24% to 88% in different outbreaks depending on virus strain and case management.

It was first reported in 1967 in a town called Marburg in Germany and in Belgrade, Yugoslavia (now Serbia). There were simultaneous outbreaks in both cities. It came from monkeys imported from Uganda for laboratory studies in Marburg. The laboratory staff got infected as a result of working with materials (blood, tissues and cells) of the monkeys. Of 31 cases associated with these outbreaks, seven people died.

After the initial outbreaks, other cases have been reported in different parts of the world. Most were in Africa – Uganda, the Democratic Republic of Congo, Kenya, South Africa, and more recently in Guinea and Ghana. Serological studies have also revealed evidence of past Marburg virus infection in Nigeria.

While the host, or reservoir, of the virus is not conclusively identified, the virus has been associated with fruit bats. In 2008, two independent cases were reported in travelers who had visited a cave inhabited by Rousettus bat colonies in Uganda.

How is it spread?

It is spread through contact with materials (fluids, blood, tissues and cells) of an infected host or reservoir. In the case of the monkeys from Uganda imported into Marburg, laboratory staff obviously got infected through contact with the tissues and the blood of the monkeys.

There can also be human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and with surfaces and materials. This includes materials like bedding, and clothing contaminated with these fluids.

But there’s a great deal we don’t know: For example, whether contact with bat droppings in caves can cause infections in people.

What are the symptoms? And how bad can they be?

After an incubation period of between 2 to 21 days, there is a sudden onset of the disease marked by fever, chills, headache, and myalgia.

Around the fifth day after the onset of symptoms, maculopapular rash, most prominent on the trunk (chest, back, stomach), may appear. Nausea, vomiting, chest pain, a sore throat, abdominal pain, and diarrhea may appear. Symptoms become increasingly severe and can include jaundice, inflammation of the pancreas, severe weight loss, delirium, shock, liver failure, massive hemorrhaging, and multi-organ dysfunction.

The mortality is around 50%, and could be as high as 88% or as low as 20%.

This tells us it’s quite a severe infection. The two people infected in Ghana both died.

Can it be treated?

Not really, but early supportive care with rehydration, and symptomatic treatment, improves survival.

What can people do to protect themselves?

Avoid exposure to the virus as much as possible, and protect against discharges from infected people.

Also, because of the similarities in the symptoms of many hemorrhagic fever diseases, especially during the early stages, there is a need for reliable laboratory confirmation of a case of Marburg virus infection. And once that is done – as with Ebola – the person must immediately be isolated and avoid contact with other people.

What should be done to ensure the virus doesn’t spread?

There is no holiday from disease outbreaks. That means as a country, surveillance cannot take a break or a holiday.

Given that there have been cases in Ghana, it’s time to be on the alert. Proper screening is called for. Arrivals from Ghana and other West African countries must be checked at the ports of entry.

Unfortunately, it doesn’t appear as if anybody is thinking of that now. The attitude seems to be: oh, there are only two cases in Ghana.

But I think it’s the best time to be on the alert at the ports of entry, especially for people from countries where cases are reported. Studies done in Nigeria in the the 1980s and more recently in the 1990s provide evidence of possible previous infections with Marburg virus – or a related virus – in certain Nigerian populations. This leads me to believe that the virus is probably more widespread than we think it is. We need an improvement in diagnosis which can help us do the detection as quickly, and as efficiently as possible.

On top of this, countries need to improve their disease surveillance and laboratory diagnosis to enhance and improve the capacity for a more definitive diagnosis of viral hemorrhagic fever infections.

The Conversation

This article is republished from The Conversation under a Creative Commons license, where it was originally published in July 2022.


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Carastar Health Opens Diversion Crisis Center In Alabama

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Carastar Health (Montgomery, Ala.), formerly known as the Montgomery Area Mental Health Authority, opened new diversion crisis center for mental health in Montgomery, according to the website wsfa.com.

The new clinic has 10 observation beds, where patients can spend up to 23 hours, and 16 inpatient beds.

The project aims to improve access to services to help reduce visits to hospital emergency rooms for those in crisis.


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Meridian Plans $100M MOB, Cancer Center In New Mexico

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Healthcare real estate developer and owner Meridian (Walnut Creek, Calif.) is planning a 95,000-square-foot multispecialty medical office building (MOB) and comprehensive cancer care center in Santa Fe, N.M.

Situated on 18 acres, the $100 million, three-story building will offer a range of services including primary care, general surgery, cardiology, pulmonary, medical oncology, infusion, imaging, lab, pharmacy, breast surgery, and orthopedics. Nexus Health (Santa Fe, N.M.) will provide the healthcare services for the facility.

Additionally, the project will house up to 50 infusion bays, a lab, and advanced imaging with interventional radiology. A sky bridge, linear accelerator vault, and 520 parking stalls are also planned as well as shell space for future expansion.

The project team comprises Page Southerland Page Inc. (architect; Houston), Skiles Group (general contractor; Richardson, Texas), and Tierra West (civil engineer and surveyor; Albuquerque, N.M.).


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Wednesday, April 5, 2023

Memorial Sloan Kettering Files Plans For 31-Story Pavilion In New York

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Memorial Sloan Kettering Cancer Center (MSKCC) in New York filed plans to construct a new 31-story inpatient building on its main campus on Manhattan’s Upper East Side, according to the website newyorkyimby.com.

The 1 million-square-foot MSK Pavilion will house cancer care, surgery, and medical research and will replace an old building housing medical student residences and administrative offices.

Zoning plans call for 28 operating suites and 202 inpatient beds, as well as a skybridge to connect the new building to MSK’s existing main hospital.

A projected completion date for MSK Pavilion has not been released, according to the article

The project team will include CannonDesign (designer; New York) and Foster + Partners (architect; New York).


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New Strategies On Using Artwork To Alleviate Patient Anxiety

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Positive distractions in hospitals, including playrooms, indoor gardens, and art installations, can help improve the patient experience and promote healing by helping to alleviate worrisome thoughts and focus.

But with hospital budgets stretched thin by lower reimbursement rates and rising labor, equipment, and supply costs, these solutions could easily be deemed as “nice to haves” rather than “need to haves.”

Fortunately, it doesn’t have to be a choice. Here are some ways hospitals are creating positive distractions to ensure engaged communities, happier patients, and better outcomes.

Using artwork to connect to the community

Hospitals are expected to remain under intense financial pressure for the foreseeable future. This means funding for new construction will likely prioritize revenue-generating spaces, such as diagnostics, procedures, and inpatient stays.

Rather than undertaking costly additions or expansions to accommodate things like TV screening rooms or atriums, hospitals should look to ceilings, floors, walls, corridors, and elevator bays that can be transformed into meaningful positive distractions. But instead of adorning this underused real estate with generic art, hospitals can use interactive art installations and experiences to create welcoming experiences that offer comfort and community connection.

One example is the Odessa Brown Children’s Clinic in Seattle. As the new clinic was being designed, community members expressed that they didn’t want the space to feel clinical. They also stressed the idea of “no blank walls.” In response, the design team wrapped the space in murals by local Black and indigenous artists that honor the clinic’s legacy and celebrate its cultural heritage.

Another project utilized the flooring to make an impact as well as connect with the community. In the waiting area of Chief Andrew Isaac Health Center in Fairbanks, Alaska, the flooring is inlaid with a 30-foot diameter circular calendar.

The calendar showcases seasonal events, including planting, hunting, and fishing, as well as traditional celestial milestones, such as the solstices. It’s designed to allow parents to teach children about their culture, while allowing young patients to think about something different than their medical condition.

Interactive displays for waiting rooms and corridors

New technologies, such as high-quality LED screens, motion sensors, and artificial intelligence, are creating opportunities for positive distractions. Examples include interactive art installations, displays, and surfaces.

At a waiting area at an academic medical center in Southern California, children and teens will soon be able to use a touchscreen to create customized animals, including baby bears, rabbits, and deer. These animals are then “released” into a virtual forest where patients can follow their activity.

Motion sensors will detect a child’s movement, prompting actions in the virtual forest, such as fish jumping in a stream or butterflies gathering around the patient.

Healthcare facilities can also use interactive displays and digital media to turn overlooked areas into experiences that evoke natural surroundings, which can help reduce stress and improve well-being.

For example, at Great Ormond Street Hospital for Children in London, interactive digital wallpaper transforms the hallways outside operating rooms into an enchanting forest nature trail. Patients can touch the wall to reveal animated woodland creatures such as deer, hedgehogs, and birds.

Employing technology as positive distractions

With technology rapidly evolving, the possibilities for creating new types of positive distractions are endless. Using an app at home, patients take a photo of something they cherish and upload it to an ever-changing digital mural in the hospital. There, they can see their contributions publicly displayed to create a sense of connection and comfort.

Another options is for a patient to touch the art and leave a mark on it that persists after they leave. This can also help build a sense of community, rather than isolation, in the hospital.

Unlike traditional murals, which can become monotonous after frequent viewing, evolving artwork can be a constant source of surprise and inspiration. This feature is especially important to patients in physical rehabilitation who sometimes need incentives to keep moving.

Embedding digital elements that can be discovered by a visitor over time, aka “Easter Eggs,” within a care environment can offer moments of surprise or daily puzzles that can be solved. In turn, these features create a sense of discovery that can go a long way in buoying feelings, incentivizing movement, and speeding recovery.

Benefits of supporting staff

Studies show that patients also benefit when caregivers can access experiences that enhance their positive well-being. Often times, it’s impossible for staff to leave their unit to walk in an indoor garden or go outside to decompress. Weaving positive distractions into spaces closer to staff ensure they can benefit from artwork as well.

By capitalizing on these technologies and collaborating with innovative designers and artists, hospitals can integrate positive distractions into every part of the patient experience. This will help immerse patients in a care environment that promotes healing from start to finish.

 

Katie Barnard is the head of content strategy at ESI Design, NBBJ’s New York experience design studio. She can be reached at kbarnard@esidesign.com. Eric LeVine is creative director and principal-in-charge of NBBJ’s Seattle Environmental Graphic Design studio. He can be reached at ELevine@nbbj.com. Jessica Radecki, AIA, is a healthcare director at NBBJ (Portland). She can be reached at JRadecki@nbbj.com. Emily Webster is a studio design leader at ESI Design. She can be reached at ewebster@esidesign.com.

 


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E4H Environments for Health Architecture Adds New Team Member

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Healthcare and health sciences firm E4H Environments for Health Architecture (E4H; Boston) has added Andrew Pardue as an associate partner at its office in Charleston, S.C.

Pardue has been a healthcare architect and planner for the last 13 years. His work experience includes the planning and design of large-scale healthcare facilities, academic medical centers, replacement hospitals, ambulatory surgery centers, and medical office buildings.


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Tuesday, April 4, 2023

CMS proposes nursing homes, psychiatric facilities payment bump

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Skilled nursing facilities would get a 3.7% Medicare reimbursement increase in fiscal 2024 under a proposed rule the Centers for Medicare and Medicaid Services published Tuesday.

CMS also pledged that a long-awaited and controversial regulation establishing minimum staffing ratios at nursing homes will debut this spring. President Joe Biden announced that policy, along with other nursing home industry initiatives, during his State of the Union address in 2022, but CMS has yet to take action to implement it. The nursing home industry strongly opposes federal staffing ratios.

The nursing home payments proposal incorporates new market basket data, a projected increase in productivity and the effects of the Patient Driven Payment Model case-mix classification system the agency finalized in 2018.

CMS also is considering adopting new measures for the skilled nursing facility value-based purchasing program, including data on staff turnover, patients’ functional status after discharge, hospitalization rates for long-term nursing home residents and a modified metric for readmissions.

The draft regulation would make changes to the quality reporting program as well, including updated measures for resident and staff COVID-19 vaccination status.

Nursing home trade groups voiced their approval of boosted federal payments.

“We appreciate that CMS has considered the soaring costs nursing home providers are grappling with due to the labor crisis and record inflation in recent years. It is vital that Medicare reflect the increasing costs—including those imposed by government mandates—nursing homes are facing to ensure our vulnerable residents can access the care they need. We look forward to submitting comments to CMS on this proposed rule,” said American Health Care Association President and CEO Mark Parkinson in a statement on Tuesday. The AHCA represents more than 14,000 long-term care facilities.

Separately, CMS proposed a 1.9% increase in Medicare payments to inpatient psychiatric facilities in fiscal 2024. That draft regulation includes provisions that would assess those providers’ health equity efforts, such as the percentage of patients they screen for social determinants of health. The agency also proposes adopting a patient experience metric. The draft regulation includes similar changes to tracking COVID-19 vaccinations to the nursing home and inpatient rehabilitation provider proposed rules for fiscal 2024.


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Johnson & Johnson offers nearly $9 billion to settle talc lawsuits

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Johnson & Johnson said Tuesday that it will offer at least $8.9 billion to resolve thousands of lawsuits filed by people alleging that the company’s products containing talc caused cancer

In a news release, the health and consumer goods company said that its latest proposal to settle the talcum powder litigation, which is payable over 25 years, is $6.9 billion more than its previous offer in connection with a 2021 bankruptcy filing by its LTL Management unit. 

Women have filed a barrage of suits in recent years alleging that J&J’s baby power gave them ovarian cancer or mesothelioma, a cancer that strikes the lungs and other organs.

J&J continues to deny that its talcum powder poses health risks, saying that the settlement offer does not constitute an admission of wrongdoing.

“The company continues to believe that these claims are specious and lack scientific merit,” said Erik Haas, worldwide vice president of litigation at Johnson & Johnson, in a statement. “However, as the bankruptcy court recognized, resolving these cases in the tort system would take decades and impose significant costs on LTL and the system, with most claimants never receiving any compensation.”

J&J has stopped selling its talcum-based baby powder worldwide.

This is a developing story.


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Joint Commission data show hospital falls up in 2022

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Healthcare organizations and patients reported more than 1,400 serious adverse events to the Joint Commission in 2022, an increase from recent years, according to data released Tuesday.

Falls, delayed care and wrong-site surgeries continued to be the biggest contributors to severe patient harm and death, the Joint Commission concluded.

The sentinel events in the Joint Commission’s annual review only represent those voluntarily reported and these findings can’t be seen as a representation of industrywide trends, the accrediting organization said in a news release. The figures nevertheless offer a glimpse into patient harm at the 547 healthcare organizations that submitted adverse event reports for 2022.

Here are a few takeaways:

  • The total number of reported sentinel events increased by 19% in 2022 compared with 2021, and by 78% compared with 2020. Most events were voluntarily self-reported to the Joint Commission by accredited or certified healthcare entities.
  • Of the reported sentinel events, 20% were associated with patient death, 44% with severe temporary harm and 13% with unexpected additional treatments or procedures.
  • The number of reported events involving falls rose from 173 in 2020 to 611 in 2022. Last year, 40% were due to patients walking, 23% involved patients falling out of bed and 10% happened while patients used the restroom.
  • The Joint Commission cited a lack of fall-risk assessments and inadequate communication between staff during care transitions as root causes for the increased number of falls.
  • In the delayed treatment category, 46% of events were related to a delay in care, 38% to a missed diagnosis, 14% to an abnormal test result not being addressed and 2% to an incorrect diagnosis.
  • Among the sentinel events related to treatment delays, 66% resulted in death, 17% in severe harm and 14% in permanent harm.
  • Nearly 90% of reported sentinel events in 2022 occurred in hospital settings.
  • In the home care setting, 43% of reported serious adverse events involved fires related to medical equipment.
  • The top sentinel event in ambulatory care settings was wrong-site surgeries at 25% of reported events.

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Digital health funding in Q1 buoyed by 6 deals

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The new reality for digital health funding was present in the first quarter of 2023 despite a slight uptick in mega deals.

A report from Rock Health, a research and digital health venture firm, showed funding for the first three months of 2023 totaled $3.4 billion across 132 total deals. Six mega deals with more than $100 million in funding accounted for 40% of this total. The six deals were from Monogram Health ($375M), ShiftKey ($300M), Paradigm ($203M), ShiftMed ($200M), Gravie ($179M) and Vytalize Health ($100M).

Related: Digital health funding takes a dive in 2022

There were the same number of mega deals from the past three months as there were the entire second half of 2022. But even with this early momentum for large deals, funding throughout the sector has slowed. Throughout the first three months of 2023, digital health companies received $3.4 billion in funding. In each of the past two years, those first-quarter totals topped $6 billion.

Experts say founders seeking venture capital backing just don’t have as much leverage as in previous years.

“Investors are pickier in terms of the solutions they see in the market,” said Peter Micca, national health tech leader in Deloitte’s audit practice. “They want to see a track record. They want to see the size of the [total market demand].”

Investors echoed similar sentiments. Their expectations for digital health companies have fundamentally changed in the past 18 months.

“If anyone didn’t believe we were in a different market condition, [Silicon Valley Bank’s failure] put a stamp on it,” said Dr. Justin Norden, a partner at venture capital firm GSR Ventures. “The world is different.”

The Rock Health report shows that those six larger deals lifted the entire sector. Adriana Krasniansky, research manager at Rock Health, said these deals came from venture firms that had leftover financial reserves and that are selectively choosing which companies to fund.

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Other venture firms without these reserves are holding off. Even with six deals greater than $100 million, the number of later-stage deals dropped precipitously. In 2021, there were 149 Series C and later deals. In 2022, there were a total of 70. Through the first quarter in 2023, there were only 10 later-stage deals. There were 183 deals in the first quarter of 2022 compared to 132 in 2023.

“There used to be a discount for health tech versus other parts of tech because people knew healthcare was harder,” Norden said. “Those models have all soured somewhat from an investor standpoint when capital is more expensive.”

Uncertainty at root of shifting expectations

While investors and experts are still encouraged by healthcare’s need for new digital solutions, they say the overall environment won’t be as friendly for founders.

“I think it’s going to be a tough year for founders,” Krasniansky said. “The funding approach right now is really difficult.”

The shift is leading some founders to consider exit opportunities. Pear Therapeutics, a digital therapeutics company, said last month without financial help it may need to liquidate or restructure.  Mindstrong, a digital mental health company, sold its technology assets to a former competitor last month after shuttering its patient service offerings.

While macroeconomic factors are at play, the nascent nature of digital health and uncertainty over of how companies will be valued long term could be partially to blame, experts say.

“What kind of multiples do you assign on early growth stories that have yet to achieve profitability?” asked Scott Schoenhaus, managing director of healthcare IT equity research at KeyBanc Capital Markets. “I think that’s probably part of the reason you’ve seen pullback from venture capitalists and private equity funding.”

This story first appeared in Digital Health Business & Technology.


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Monday, April 3, 2023

Infinigate Group Appoints Kristiina Leppänen as new Chief Financial Officer

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Rotkreuz, Switzerland: 03/04/23: The Infinigate Group, the value-add distributor of cybersecurity, secure network and secure cloud, is appointing Kristiina Leppänen as the new Chief Financial Officer.

Kristiina brings over 25 years’ experience in international finance and leadership, with deep expertise in M&A, change management and a strong track record of value creation. This is demonstrated by the key role she played in the creation of Europe’s second largest Electronics Manufacturing Services, having been instrumental to the successful merger of two companies, the Enics Group and GPV International, and having driven profitable growth globally.

Kristiina Leppänen

Kristiina Leppänen

Kristiina helps to steer the next phase of the Infinigate Group’s evolution, following its considerable expansion through both organic and acquisitive growth, to achieve the potential inherent in the combined assets of the Infinigate Group and the buoyant cybersecurity market.

“I am excited to join the Infinigate Group at this important juncture, with a world of opportunity ahead. I look forward to applying my knowledge and experience, adding structure and realising our considerable potential by working in close alignment with the teams, in what is clearly a high-energy environment.”

In addition to her financial expertise, Kristiina is a skilled people leader and places particular focus on fostering group spirit and promoting fruitful collaboration.

Klaus Schlichtherle, Chief Executive Officer of the Infinigate Group, says: “I am delighted to welcome Kristiina to the Infinigate Group family. Her talent and experience provides us with the financial steering needed for our next phase of growth – to our €5B revenue target by 2027.”

About the Infinigate Group
The Infinigate Group is a value-add distributor, fully committed to sustainable, leading-edge cybersecurity solutions. Founded in 1996 in Switzerland, it has grown to incorporate the entire EMEA region, with offices in 30 countries and partners in more than 50. Our more than 1,200 dedicated employees, half of them with in-depth technical knowledge, are passionate about best-of-breed cybersecurity, secure networks and secure cloud for SMB and enterprise market segments, for on-premise and cloud-based IT infrastructure. The Infinigate Group relies on strong country organisations, which can adapt to the needs of their respective partners, MSSPs and vendors, by providing technical, marketing, sales and professional services. For additional information visit: http://www.infinigate.com/

Since 2022 Nuvias, Vuzion and Starlink are part of the Infinigate Group. Find out more about our new offerings at www.Nuvias.com, www.Vuzion.cloud and www.StarlinkME.net

ENDS

For further press information, please contact:

Markus Drewes: Markus.Drewes@Infinigate.com

Orietta Sutherberry: +44 (0)7741 149 367 – Orietta.Sutherberry@Infinigate.com


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Infinigate Group Appoints Catherine Oudot as new Managing Director in France

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Paris, France: 03/04/23 – Infinigate, the value-add distributor of cybersecurity, secure networks and secure cloud, is appointing Catherine Oudot as Managing Director of Infinigate France.

Catherine brings over twenty years’ experience in the IT channel, having been responsible for channel management and business development, marketing and sales strategy, with substantial revenue growth results, across both channel and vendor organisations, including Arrow, Check Point, Malwarebytes, and more recently as Head of Channel in France for Kaspersky.

Catherine Oudot

Catherine Oudot

In her role, Catherine will realise the potential that the recent Infinigate acquisitions offer, bringing the local team together as a close-knit, high-performing unit, closely aligned to the objective of delivering added value to partners and vendors alike.

“I am excited to help our partners take advantage of the opportunity offered by a dynamic French market added to the extended potential the extended Infinigate organization enables by supporting them in assisting their customers in their digitisation journey. We have a real unique, innovative offering thanks to our specialist services, grounded in our cybersecurity expertise. I am looking forward to uniting the team and providing the leadership to enable it to achieve its potential”.

Infinigate will assist small and medium sized channel partner organisations, a sizeable part of the French channel, in developing targeted and differentiated offerings for their business audience. Catherine will lead Infinigate France and its ongoing expansion in cloud offering, leveraging her passion for innovation and team development.

Andreas Bechtold, President, Europe, Infinigate Group, comments: “The French market offers a substantial opportunity for development for Infinigate. Catherine will lead our French team to take advantage of the considerable growth prospect available to us and our partners, leveraging her expertise, experience, energy and determination.”

About the Infinigate Group
The Infinigate Group is a value-add distributor, fully committed to sustainable, leading-edge cybersecurity solutions. Founded in 1996 in Switzerland, it has grown to incorporate the entire EMEA region, with offices in 30 countries and partners in more than 50. Our more than 1,200 dedicated employees, half of them with in-depth technical knowledge, are passionate about best-of-breed cybersecurity, secure networks and secure cloud for SMB and enterprise market segments, for on-premise and cloud-based IT infrastructure. The Infinigate Group relies on strong country organisations, which can adapt to the needs of their respective partners, MSSPs and vendors, by providing technical, marketing, sales and professional services. For additional information visit: http://www.infinigate.com/

Since 2022 Nuvias, Vuzion and Starlink are part of the Infinigate Group. Find out more about our new offerings at www.Nuvias.com, www.Vuzion.cloud and www.StarlinkME.net

ENDS

For further press information, please contact:

Markus Drewes: Markus.Drewes@Infinigate.com

Orietta Sutherberry: +44 (0)7741 149 367 – Orietta.Sutherberry@Infinigate.com


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Saturday, April 1, 2023

CDC says multi-state salmonella outbreak that hospitalized 3 is linked to flour

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The Centers for Disease Control and Prevention said in an investigation notice published on Thursday that flour is believed to be the source of a multi-state salmonella outbreak that has sickened about a dozen people and hospitalized three.

It’s not clear what brand the outbreak could be related to, the agency said.

“State and local public health officials are interviewing people about the foods they ate in the week before they got sick. Of the 7 people interviewed, 6 (86%) reported eating raw dough or batter,” the CDC said. “Flour was the only common ingredient in the raw dough or batter people reported eating. Investigators are working to identify a specific brand of raw flour that is linked to illnesses.” 

Most flour is raw, meaning that it hasn’t been treated to kill germs that cause food poisoning. When flour is mixed into dough or batter and baked, salmonella germs are killed in the process, but people can get sick from the raw dough or batter.

No deaths have been linked to the outbreak at this time, the CDC said. Sick people have been identified in California, Illinois, Iowa, Minnesota, Missouri, Nebraska, New York, Ohio, Oregon, Tennessee and Virginia. The first illness was reported in early December 2022, the agency said. 

“The true number of sick people in this outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses,” the agency said in the investigation’s details

To avoid illness, the agency recommends not eating raw dough or batter, because even small amounts can cause illness. Baked goods should also be prepared according to instructions, to make sure germs are fully killed. This warning is in effect even when there is not an outbreak, the CDC said. 

Heat-treated flour, which is not raw, can be used as a substitute in recipes for homemade playdough or in raw goods. 

Symptoms of salmonella include diarrhea, fever and stomach cramps. The symptoms can start within six hours of starting the bacteria, but can begin as much as six days later. Most people recover without treatment in four to seven days, the CDC reports. Older people, children and those with weakened immune system may need to be hospitalized if they experience a severe illness. The CDC recommends calling a healthcare provider if you experience a diarrhea for more than three days, a high fever, signs of dehydration or extreme vomiting. 


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