Rss Feed
Tweeter button
Facebook button
Webonews button

Sabra Health Care Vs. Omega Healthcare: Side-By-Side

Introduction

I hold small positions in Sabra Health Care (SBRA) and Omega Healthcare (OHI). Both are REITs leasing to the healthcare industry with a focus on skilled nursing facilities. In fact, both companies share several common operator-tenants.

Both OHI and SBRA share prices declined heavily since the quarter ended September 30, 2017. Readers may be aware that Sabra issued 16 million common shares on September 28, 2017 at $21 per share (source: NASDAQ Globe Newswire). As of November 16, 2017, SBRA shares closed at $19.05. Omega shares have shared a similar trend.

In this article, I wanted to review the two healthcare REITs side-by-side to evaluate whether one is particularly stronger investment candidate relative to the other. Among others, I independently computed several operating metrics and liquidity measures. Read on for the calculations and my conclusion.

Show Me The Dividend

Without further ado, let me start bombarding you with the metrics. First of all, I recognize that there’s a good chance you, the reader, is a dividend investor. Me, too! So, here is how the two companies stack up side-by-side.

Dividend Yield

Basically, both companies yield a relatively high 9%+, with a slight edge going to Omega Healthcare (which mainly is following the recent sell-off). Also, worth noting is that Omega had the stronger absolute dividend growth over prior year in the high single-digit %.

(As an aside, Sabra shares jumped so much since 2016 year-end, because of the merger with Care Capital Properties.)

Winner: Omega. But, not by much.

Reference Financial Info

The following reference financial info was mostly keyed in using 2017 Q3 10-Q (for the quarter ended 9/30/2017). These base figures will set the stage for the computations to follow and I wanted to share these with you for reference.

Source: Author’s data entry. [Original worksheet: sbra_vs_ohi_side-by-side.xlsx]

I need to make a quick explanation about the column labeled “Omega w/out imp.” That refers to what Omega’s financials would look like if I exclude the non-cash impairment charge for direct financing lease of $198 million.

In this article, I won’t debate the merits of whether or not the figure should be deemed reflective of on-going operations. Rather, I want to present the metrics both with and without that particular impairment charge. Okay, back to metrics.

Operating Metrics

Based on the financial table shared above, one can re-compute the following metrics.

Recognize that these are neither GAAP measures nor conventionally disclosed REIT measures. However, these made sense to me as operating metrics I’d like to know if I were running the business.

For instance, Both Omega and Sabra derive over 80% of their total revenues from renting. That helps me understand that both are mostly in the business of being a landlord. Clearly, Omega is more involved in “other” activities.

OpEx ratio is simply total operating expense (including interest expense) divided by total revenues. You can see how these were computed in the source spreadsheet. Here, I find that Sabra is the more frugal spender. That’s important for me to know as an investor.

With respect to distributions made relative to FFO, both come out in the low 80%-range if you exclude the impact of the aforesaid $198 million impairment charge. On a NAREIT FFO basis, Omega’s distributions exceeded its FFO for the 9-months ended September 30, 2017.

Rent income yield was computed as annualized rental income divided by gross real estate assets. It was a way of seeing for a given amount of asset, how much income is that asset producing in rent? In that measure, Omega was the winner. But, then unlike Sabra, Omega was recognizing quite a bit of impairment activity. That means both you and I need to dig a little deeper into the quality of Omega’s assets and drivers of the impairment charges. Sadly, that deep dive is out of scope here and will have to be done in a separate analysis.

Winner: Sabra. But Maybe.

Liquidity/Credit Quality

Both companies issue investment grade debt as measured by your rating agencies (I excluded Fitch rating for simplicity). Ba1 is one grade lower than Baa3, so Omega’s unsecured debt is rated slightly higher.

Also, note that a greater portion of Omega’s debt is unsecured. That gives some strength to Omega’s case relative to Sabra.

(For those unfamiliar with debt, unsecured is better in this case. Secured debt basically means that the Bank has secured a specific lien on some hard asset of the business, most likely a real estate property. An unsecured debt would be made based on the creditworthiness and enterprise value of the overall business.)

That said, I find that Sabra has the lower overall debt burden relative to equity, but higher debt burden relative to its annualized FFO (for Omega, using the FFO excluding impairment).

In terms of servicing current interest expenses, I find both companies similar. (Here, note that this coverage calculation is my proforma, as it is simply FFO over interest expense from the income statement.)

As for upcoming maturities, I actually like Sabra’s maturity schedule much more. It will have very little payments until 2019, but the maturing payments should be manageable through 2020. Omega has one big balloon maturity in 2021. That’s good for the next few years, but it means management will be busy restructuring or refinancing the debt in a few years’ time.

Winner: Mixed. It’s a tie.

Tenants/Other

We can’t end an article like this without looking at tenants; these are landlords, after all!

I was surprised to see that Sabra has a better occupancy ratio in the upper 80%-range. I was surprised because I’ve read many articles asserting how Omega was best in class in the skilled nursing category.

It also struck me how much lower the occupancy rate is for these two REITs relative to high performing retail REITs like Realty Income (O) and Tanger Factory Outlets (SKT), whose occupancy rates will be in the high 90%-range. For example, see my post on Tanger and Retail REITs for those occupancy rates.

Digging little more, we find that Omega has little less concentration from top 5 tenant-operators. But, both share some operators that many readers will recognize as distressed. Note below the EBITDAR coverage as shared by Sabra Health Care in its 2017 Q3 supplemental presentation.

Omega and Sabra both share top tenants Genesis and Signature, and neither have a very strong income coverage of debt obligations.

In fact, in its November 8, 2017 8-K filing, Genesis Healthcare announced plans to restructure its obligations with counterparties Welltower Master Lease and Sabra Master Leases, among others.

I feel like this last comparison is like seeing who has the stinkier feet. There are no winners in that game. This last aspect of the business model is a little bit disappointing. The conservative investor should require a healthy margin of safety. If you step back and consider a business model lending to or leasing to those with limited (or shaky) ability to payback your money, then you have a business model with little margin of safety. It is my hope – and I’m sure the management’s hope as well – that the parties can work out a payment plan that works, and that the operating health of these tenants will improve over time. As for Sabra, its management already has announced plans to dispose of Genesis-related assets.

Loser: Both. Though a slight edge to Sabra.

Here again, the source file: sbra_vs_ohi_side-by-side.xlsx

Conclusion

I compared Sabra Health Care and Omega Healthcare because I have small positions in both companies. Further, both have a material skilled nursing facility exposure and share top common tenants.

Specifically, I independently computed several operating metrics and liquidity measures. My conclusion is that on the whole, Sabra appears to be the better operator with the stronger overall business mix (e.g. higher occupancy, higher interest coverage).

That said, it is clear that both REITs are operating under some market distress. So, I likely will not be adding to my positions in spite of the appealing dividends.

Disclosure: I am/we are long OHI, SBRA.

I wrote this article myself, and it expresses my own opinions. I am not receiving compensation for it (other than from Seeking Alpha). I have no business relationship with any company whose stock is mentioned in this article.

Additional disclosure: I am not a financial advisor. The research was done for myself, and I am sharing it with the readers.

Article source: https://seekingalpha.com/article/4126049-sabra-health-care-vs-omega-healthcare-side-side

Depressed fathers are more likely to have teenage children with the mental health disorder, first study of its kind …

  • This occurs regardless of whether the teenagers’ mothers suffer from it
  • Previous research reveals mental health disorders can sometimes be inherited
  • Misconception is mothers are more influential over mental health than fathers
  • Men are less likely to seek depression treatment, which could impact their child
  • Researchers from University College London analysed 13,838 people

Alexandra Thompson Health Reporter For Mailonline

26

View
comments

Depressed fathers are significantly more likely to have teenage children who also suffer from the mental health condition, new research reveals.

This occurs regardless of whether the adolescent’s mother has the disorder, according to the first study of its kind.

Previous research reveals certain mental health conditions are genetic, suggesting depression may be hereditary.

Lead author Dr Gemma Lewis from University College London, said: ‘There’s a common misconception that mothers are more responsible for their children’s mental health, while fathers are less influential – we found that the link between parent and teen depression is not related to gender.

‘If you’re a father who hasn’t sought treatment for your depression, it could have an impact on your child.’ 

Depressed fathers are significantly more likely to have teenage children who also suffer (stock)

Depressed fathers are significantly more likely to have teenage children who also suffer (stock)

DEPRESSION INCREASES THE RISK OF AN EARLY DEATH BY UP TO THREE TIMES BY SUPPRESSING THE IMMUNE SYSTEM 

Depression increases the risk of an early death by up to three times, research revealed last month.

Men’s risk of a premature passing increases three-fold when suffering from the mental health condition, while women’s risk is heightened by up to 51 percent, a study found.

Previous research reveals depression causes the release of stress hormones that suppress the immune system, putting sufferers at an increased risk of conditions such as cancer.

People with the mental health condition may also be more likely to have unhealthy lifestyle habits, including a poor diet, inactivity and excessive alcohol intake, past studies have shown.

Lead author Stephen Gilman from the Eunice Kennedy Shriver National Institute of Child Health and Human Development in Maryland, said: ‘For some individuals depression can be very serious condition.

‘It is very important to seek treatment for depression and to be vigilant about recurrences.’ 

How the research was carried out 

The researchers analysed 13,838 people  in two-parent families.

Childhood depression was measured when the study’s participants were seven or nine years old.

Teenage mental health was assessed at 13 or 14 years old.  

‘There has been far too much emphasis on mothers’ 

Results reveal depressed fathers are significantly more likely to have teenagers with the mental health condition.

This occurs regardless of whether the mother suffers from the disorder. 

Dr Lewis said: ‘There’s a common misconception that mothers are more responsible for their children’s mental health, while fathers are less influential – we found that the link between parent and teen depression is not related to gender. 

‘Men are less likely to seek treatment for depression. 

‘If you’re a father who hasn’t sought treatment for your depression, it could have an impact on your child. 

‘We hope that our findings could encourage men who experience depressive symptoms to speak to their doctor about it.’

Study author Professor Glyn Lewis added: ‘There has been far too much emphasis on mothers but fathers are important as well.’ 

The findings were published in the journal Lancet Psychiatry. 


Comments 26

Share what you think

The comments below have not been moderated.

The views expressed in the contents above are those of our users and do not necessarily reflect the views of MailOnline.

Close

 

Close

We will automatically post your comment and a link to the news story to your Facebook timeline at the same time it is posted on MailOnline. To do this we will link your MailOnline account with your Facebook account. We’ll ask you to confirm this for your first post to Facebook.

You can choose on each post whether you would like it to be posted to Facebook. Your details from Facebook will be used to provide you with tailored content, marketing and ads in line with our Privacy Policy.

Article source: http://www.dailymail.co.uk/health/article-5088289/Depressed-fathers-pass-teenage-children.html

This Company Made Up Fake News And Fake Celeb Quotes To Sell Supplements, FTC Says

One online ad claimed that Jennifer Aniston owed her youthful skin to a wrinkle-smoothing cream. On the website Every Day With Dr. Oz, the celebrity doctor and talk show host Mehmet Oz seemingly talked up a weight-loss pill. And a Men’s Health article reported that a supplement was making actor Jason Statham “jacked.”

But according to the Federal Trade Commission, this reporting and marketing was all untrue. The agency alleges it was part of a vast online network of fake news sites, fake customer testimonials, and fake celebrity endorsements that existed to promote unsubstantiated health claims about more than 40 weight-loss, muscle-building, and wrinkle-reduction products. It apparently worked: People nationwide spent $179 million on these products over a five-year period, the FTC alleges.

What’s more, the agency says, customers who thought they were signing up for “free” and “risk-free” trials were in fact automatically charged recurring monthly fees without their consent.

Three people who ran the promotional network through Tarr Inc., a Del Mar, California, company, have agreed to settle the charges, the FTC announced Wednesday. Under a court order, Tarr Inc. must pay the agency more than $6 million, and it is prohibited from using the marketing and sales tactics it had allegedly used. The company did not admit guilt.

Leonard Gordon, an attorney for Tarr Inc., told BuzzFeed News by email, “We’re pleased that the matter has been resolved.”

The FTC’s investigation sheds light on how it says this company appears to have spread unsubstantiated health claims like “LOOK 10 YEARS YOUNGER IN LESS THAN 4 WEEKS” and “30% MORE MUSCLE MASS IN 30 DAYS OR LESS!” across the internet. This breed of advertising has become ubiquitous online in part because it successfully mimics authentic news stories and bypasses traditional banner ads.

Article source: https://www.buzzfeed.com/stephaniemlee/ftc-tarr-supplement-settlement

Middle-Class Families Confront Soaring Health Insurance Costs

And even though he does not need an assistant for his work as a developer of mobile apps, Ian Dixon, 38, said he might hire an employee just so he could buy health insurance as a small business, at a cost far below what he and his family would have to pay on their own.

“If one word captures all this, it’s ‘helpless,”’ Mr. Dixon said. “There’s rage and anger and all that stuff in there, too. Any reasonable person would agree that this should not be happening. And there’s no one to go talk to about it. There’s no hope that this is going to get fixed.”

Photo

Sara Stovall said she might try to reduce her hours and income, so her family could qualify for subsidies on offer to poorer families to help pay for premiums.

Credit
Matt Eich for The New York Times

The situation here in Charlottesville is an extreme example of a pattern that can be seen in other places around the country. The Affordable Care Act is working fairly well for people who receive subsidies in the form of tax credits, said Doug Gray, the executive director of the Virginia Association of Health Plans, which represents insurers. But for many others, especially many middle-class families, he said, “the premium is outrageous, and it’s unaffordable.”

Congress’s repeated efforts to repeal President Barack Obama’s signature health law have rattled insurance markets. Actions by President Trump and his administration have added still more uncertainty. Now, Senate Republicans have attached a provision to their $1.5 trillion tax cut that would repeal the health law’s mandate that most Americans have health insurance or pay a penalty.

All of those actions — along with flaws in the law itself — are having real-world impact.

“We share their pain,” Michael M. Dudley, the president and chief executive of Optima Health, said of his Virginia customers now shopping for policies on the health law’s online exchange. “The rate increases are very high. We can’t minimize that because it’s a fact.”

The Dixon family, which includes two girls ages 1 and 3, has been paying $988 a month this year for insurance provided by Anthem Blue Cross and Blue Shield. But Anthem plans will not be available in Charlottesville next year. The company told customers that uncertainty in the insurance market “does not provide the clarity and confidence we need to offer affordable coverage to our members.”

The online federal marketplace, HealthCare.gov, recommended another plan for Mr. Dixon in 2018. The new plan, offered by Optima Health, has premiums of $3,158 a month — about $37,900 a year — and an annual deductible of $9,200.

Advertisement

Continue reading the main story

Alternatively, Mr. Dixon could pick a lower-cost plan offered by Optima with premiums of about $2,500 a month, or $30,000 a year. But the deductible would be much higher. The Dixons would need to spend $14,400 a year for certain health care services before Optima would begin to pay.

The Stovalls are facing similar mathematics.

“Our premiums will triple to $3,000 a month, with a $12,000 deductible, and that is far, far out of reach for us,” Ms. Stovall said after researching the options for her family of four on HealthCare.gov. “We are not asking for free health insurance. All we want is a reasonable chance to buy it.”

Photo

Mr. Dixon credited the Affordable Care Act with encouraging him to work for himself as a mobile app developer.

Credit
Matt Eich for The New York Times

Subsidies are available to help low- and moderate-income people pay premiums, but no financial assistance is available to a family of four with annual income over $98,400.

Optima, a division of Sentara Healthcare, invited customers to share their personal stories on its Facebook page, and they obliged, with a fusillade of plaintive and sardonic comments.

Bill Stanford, who works for a floor-covering business in Virginia Beach, said, “Optima Health Care just raised my premium from an absurd $1,767 a month to an obscene $2820.09 per month,” which is more than the mortgage payments on his home for a family of four.

Newsletter Sign Up

Continue reading the main story

“At an average of $60 per visit,” Mr. Stanford said, “I could visit the doctor’s office 45 times a month for the premium that I’m paying. I think we will probably drop our insurance and get a gap policy.” Such short-term insurance is meant to fill temporary gaps, but typically does not cover maternity care or treatment for pre-existing medical conditions.

Mr. Dudley said in an interview that Optima, a Virginia company, felt an obligation to continue serving Virginians when larger national insurers were pulling back. But, he said, Optima is affected by the same factors destabilizing insurance markets elsewhere. These include President Trump’s decision to terminate certain federal subsidies paid to insurers and doubts about the future of the requirement for most Americans to have insurance — the individual mandate, which would be eliminated by the Senate Republicans’ tax bill.

And in the Charlottesville area, Mr. Dudley said, costs are high because many people receive care from an expensive academic medical center at the University of Virginia.

Carolyn L. Engelhard, director of the health policy program at the university’s School of Medicine, acknowledged that teaching hospitals often charged more. But another factor, she said, is that Virginia has not regulated insurance rates as aggressively as some other states.

Did You Sign up For Insurance Under the Affordable Care Act? Share Your Experience.

The Times would like to hear from Americans who are signing up for insurance under the Affordable Care Act.


Consumers are feeling the effects.

“Obamacare helped me,” Ms. Griffith said. “I had a pre-existing condition, could not get insurance and had to pay cash, nearly $30,000, for the birth of my first baby in 2010. For my second pregnancy in 2015, I was covered by Obamacare, and that was a huge financial relief.”

Advertisement

Continue reading the main story

But the costs for next year, she said, are mind-boggling.

She and her husband, both self-employed, expect to pay premiums of $32,000 a year for the cheapest Optima plan available to their family in 2018. That is two and a half times what they now pay Anthem. And the annual deductible, $14,400, will be four times as high.

“I have no choice,” Ms. Griffith said. “I agree that we need to make changes in the Affordable Care Act, but we don’t have time to start over from scratch. We are suffering now.”

Jill A. Hanken, a health lawyer at the Virginia Poverty Law Center, said, “People who qualify for premium tax credits are finding very affordable plans with low premiums, and those consumers are quite pleased.” But she added: “For people who don’t qualify for tax credits, the cost of plans has truly skyrocketed. They can’t afford or don’t want to pay the high premiums.”

When the Affordable Care Act was adopted in 2010, Democrats like Nancy Pelosi, who was then the House speaker, said the law would make it easier for people to switch jobs or start their own businesses because they would not have to worry about losing health insurance.

“We see it as an entrepreneurial bill,” Ms. Pelosi said, “a bill that says to someone, if you want to be creative and be a musician or whatever, you can leave your work, focus on your talent, your skill, your passion, your aspirations because you will have health care.”

And for a few years, Mr. Dixon said, that idea was appealing. “I would not be an entrepreneur if it were not for Obamacare,” he said.

With soaring premiums, that option is less attractive.

“When I saw the insurance prices for 2018, my initial instinct was to try and go back to my previous employer,” Mr. Dixon said. “But that would just smell of desperation.”


Continue reading the main story

Article source: https://www.nytimes.com/2017/11/16/us/politics/obamacare-premiums-middle-class.html

How Medicare Pales Against Health Care Abroad

Credit: Shutterstock

The American public really likes Medicare: in a Harvard School of Public Health survey, 72% had a favorable opinion of the federal health program for people 65+ and 54% in a Kaiser Family Foundation poll said Medicare is “working well for most seniors.” But a new, bubble-bursting 11-country survey finds that, in reality, Medicare pales against many other nations that also have universal health coverage for their older populations.

More precisely, according to the Commonwealth Fund’s 20thInternational Health Policy Survey, the health and well-being of many of those in Medicare is generally worse than for people over 65 in the 10 other countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland and the United Kingdom). The headline for the survey, just published in Health Affairs: Adults 65 and older in the U.S. are sicker than those of a similar age in other countries with universal health coverage and are more likely to go without needed care because of costs.

Dissatisfaction Among High-Need People Around the World

Lest you think health care is stellar in the other nations surveyed, however, there’s this: across all 11, many “high-need” people 65+ (those with multiple chronic conditions and/or trouble with the basic activities of daily living) expressed dissatisfaction with the quality of health care they’d received.

Also on Forbes:

The U.S. has a significantly higher rate of high-need older adults (43%) than most of those other countries, however. And, the researchers said, high-need elderly are more likely to suffer economic hardship, experience depression and anxiety, live alone and feel socially isolated and be at greater risk for falls than those who aren’t high need. America also has the highest proportion of people 65+ with multiple chronic conditions.

More Financial Barriers for Older Americans

“U.S. seniors face more financial barriers to care than those in other countries and are, in effect, hit with a triple whammy — higher health care costs, higher out-of-pocket costs and because the U.S. doesn’t invest heavily in social services, they are more likely to struggle to have their basic needs met,” said Robin Osborn, lead author of the study and vice president and director of the International Program in Health Policy and Practice Innovations at The Commonwealth Fund, a private foundation studying America’s health care system.

Said Commonwealth Funds President Dr. David Blumenthal: “Clearly there are struggles everywhere, but here in the U.S., we are hearing loud and clear that many of our seniors, especially those who are sickest, need more support if they are going to get the health care they need and live healthy lives.” The United States, the researchers noted, has disproportionately low spending on social care services, compared to health services. While some countries spend $2 on social services for every dollar on health care, the U.S. spends less than 60 cents.

One caveat about the survey: older adults living in nursing homes and other facilities weren’t sampled.

The Survey’s Key Findings on Medicare vs. Other Countries

Now to some of the key findings in the survey, the Commonwealth Fund’s first one looking at the experiences of high-need older adults. “The real test of a health care system is how well it performs for patients with the greatest need,” said Osborn. And, she added, “our focus on the high-need elderly brought into sharp relief the extent to which they were exposed to financial barriers when it came to care.”

Here’s how America’s Medicare system performs against the other 10 nations:

41% of Americans 65+ said it was somewhat difficult to get after-hours care. While that was better than the 64% of Swedes who had this complaint, it was much worse than in the Netherlands and Norway, where under 30% had problems getting after-hours care.

31% of Americans age 65+ who are high-need skipped medical care because of their costs. That’s more than 15 times the rate in Sweden. Older Americans have comparatively high out-of-pocket expenses in Medicare, with co-payments, deductibles and premiums and bills for prescription drugs. Also, Medicare doesn’t cover certain expensive health costs such as hearing aids. In Canada, the Netherlands and the United Kingdom, there are no deductibles or cost sharing for primary care. France exempts people from cost sharing for primary care and prescription drugs if they have any of 32 chronic conditions.

25% of Americans 65+ said they were often worried about having enough money to buy nutritious meals and pay for housing, utilities or medical needs. In France, the Netherlands, New Zealand, Norway, Switzerland, Sweden and the U.K., only 10% or less had similar concerns.

24% of Americans 65+ who needed help with activities of daily living (like eating and dressing) said they didn’t get the help they needed because of costs. That was the highest of all countries surveyed. Just 6% or less in Sweden, France, the Netherlands and the U.K. said they didn’t get this kind of help due to costs.

Citing costs, in the past year, 23% of Americans 65+ either didn’t go to the doctor when they were sick, didn’t fill a prescription or skipped a dose or didn’t get a recommended test or medical treatment. America ranked worst on this measure. By contrast, no more than 5% of people 65+ in France, Norway, Sweden and the U.K. skipped needed care because of costs. (This statistic is shown in the graphic in the article, where figures are percentages.)

22% of Americans 65+ spent $2000 or more out-of-pocket for health care in the past year. In every other country surveyed other than Switzerland (31%), fewer than 10% of residents 65+ spent $2,000 or more.

15% of Americans 65+ reported going to the emergency room for a condition that could have been treated by a regular doctor or place of care had one been available — the highest of all nations in the survey. Rates of avoidable ER visits were 8% or below in all the other countries surveyed except Canada (11%). “Going to the emergency room, particularly for the elderly, will increase the fragmentation of care,” said Osborn. “These patients probably won’t have their health records, so they’ll be repeating tests. And they may not remember what happened in the ER when they do go to their doctor.”

Older adults in the U.S. — as well as in Canada and the U.K. — were the most likely to say they didn’t always or often hear from their regular doctor on the same day when they contacted the physician with a medical concern. But truly long waiting times to see a doctor when sick were most prevalent in Germany, Canada, Sweden and Norway; there, 26 to 34% said they had to wait six or more days for an appointment in the past year (18% of Americans said this).

All told, Blumenthal said, as a nation, “we are a little complacent about the value and benefits of Medicare.”

The Silver Lining for Medicare Beneficiaries

Where America’s health system for its older Americans shined in the survey, however, was on prevention and staying healthy.

More than half (53%) of Americans 65+ with a regular doctor or place of care said their physician talked to them about exercise and healthy eating —  the highest of all nations. Similarly, 63% of Americans 65+ who felt they are at risk for falls said their doctor discussed falls with them, a higher rate than all the other countries except France (65%) and Australia (tied with the U.S. at 63%).

But “across all countries, most survey respondents said their physicians were not engaged with them in conversations about mental health,” said Osborn. “That’s a missed opportunity. Depression when coupled with other chronic conditions can increase costs 50% or more.”

When asked about pending legislation that could help Medicare beneficiaries in a significant way, Blumenthal pointed to the bipartisan-sponsored CHRONIC Act (Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care). “It would support chronic care to a greater extent than current Medicare,” he noted. For example, the bill would extend the federal Independence at Home program for the chronically ill who are homebound and offer more flexibility for nontraditional, nonmedical services for Medicare Advantage plans.

A final thought: No one country performed the best on all measures in the Commonwealth Fund survey. “So every country can learn from the others,” said Osborn.

Article source: https://www.forbes.com/sites/nextavenue/2017/11/15/how-medicare-pales-against-health-care-abroad/

This Health Supplement Company Made Millions By Making Up Fake News And Fake Celeb Quotes, FTC Says

One online ad claimed that Jennifer Aniston owed her youthful skin to a wrinkle-smoothing cream. On the website Every Day With Dr. Oz, the celebrity doctor and talk show host Mehmet Oz seemingly talked up a weight-loss pill. And a Men’s Health article reported that a supplement was making actor Jason Statham “jacked.”

But according to the Federal Trade Commission, this reporting and marketing was all untrue. The agency alleges it was part of a vast online network of fake news sites, fake customer testimonials, and fake celebrity endorsements that existed to promote unsubstantiated health claims about more than 40 weight-loss, muscle-building, and wrinkle-reduction products. It apparently worked: People nationwide spent $179 million on these products over a five-year period, the FTC alleges.

What’s more, the agency says, customers who thought they were signing up for “free” and “risk-free” trials were in fact automatically charged recurring monthly fees without their consent.

Three people who ran the promotional network through Tarr Inc., a Del Mar, Calif., company, have agreed to settle the charges, the FTC announced Wednesday. Under a court order, Tarr Inc. must pay the agency more than $6 million, and it is prohibited from using the marketing and sales tactics it had allegedly used. The company did not admit guilt.

Leonard Gordon, an attorney for Tarr Inc., told BuzzFeed News by email, “We’re pleased that the matter has been resolved.”

The FTC’s investigation sheds light on how it says this company appears to have spread unsubstantiated health claims like “LOOK 10 YEARS YOUNGER IN LESS THAN 4 WEEKS” and “30% MORE MUSCLE MASS IN 30 DAYS OR LESS!” across the internet. This breed of advertising has become ubiquitous online in part because it successfully mimics authentic news stories and bypasses traditional banner ads.

Article source: https://www.buzzfeed.com/stephaniemlee/ftc-tarr-supplement-settlement

Express Scripts signs a deal with start-up Propeller Health as it ups investment in digital health

<!– –>



Tim Wentworth, CEO of Express Scripts.

Express Scripts, the largest pharmacy benefits manager in the U.S., has struck a deal with a Bay Area start-up to better treat patients with chronic respiratory problems.

The start-up, called Propeller Health, has an FDA-approved set of apps and tools for people with asthma and chronic obstructive pulmonary disease, or COPD, such as a connected inhalers that are synced up to a user’s smartphone.

The idea behind the program is to help patients avoid over-using their so-called “rescue inhalers,” which could worsen symptoms over time, and to make sure they don’t neglect their controller medications that can be taken at anytime to prevent flare-ups. Essentially, it’s about saving money by helping patients prevent bad and expensive outcomes, like trips to the emergency room.

Propeller also provides insight into other factors that might make symptoms worse for people with these conditions, like weather changes. And as part of the deal, Express Scripts has said it will provide dedicated pharmacists to support patients by reviewing the data and providing real-time feedback.

The companies plan to launch the service to patients enrolled in Express Scripts’ Pulmonary Care Value Program in early 2018.

The goal is to make a dent in the estimated $1.3 billion annual cost of treating asthma and COPD, said Express Scripts’ chief innovation officer Glen Stettin.

It’s unclear how many patients will sign up to the program, he said, but about 5 million are eligible — and about 12 to 15 percent of those are likely afflicted with one of these conditions. So it could be as many as 750,000 people.

This partnershipcomes at a time when many suspect that Amazon will someday compete with Express Scripts and other pharmacy benefits managers, as it moves into the multibillion dollar pharmacy market. Express Scripts sits between payers, like employers, and the rest of the health system, and will negotiate prices with drug manufactures.

Some believe that Amazon can undercut this set of companies, automate processes and ultimately bring down drug prices.

But Express Scripts, which currently counts Amazon as a customer, said the timing is purely coincidental. “Considering that we’ve been working on this for the past three years, I wouldn’t say it’s related to any recent news events,” said Stettin.

Express Scripts CEO Tim Wentworth has also stressed that becoming a pharmacy benefits manager is “a lot more than dispensing drugs,” and therefore, it has a strong position in the market.

Both companies declined to share the financial terms of the deal. But they did say that Express Scripts will pay Propeller as patients start to use its offering, rather than the insurers themselves.

The partnership is part of a broader trend of insurance companies, employers and pharmacy benefits managers looking for ways to reduce health costs by leveraging digital tools from Silicon Valley companies, like apps and sensors. Propeller is one of a small group of start-ups that refer to themselves as “digital therapeutics,” meaning they use technology to augment or replace traditional medicines.

“Through this partnership we’re getting to a size and scale we haven’t before,” said Propeller Health CEO David Van Sickle.

The first ‘digital pill’ has just been approved — here’s how it could revolutionize health care

<!– –>



Pill split

The era of the digital pill is upon us.

Regulators at the U.S. Food and Drug Administration just greenlighted a tiny, swallowable sensor called Abilify MyCite that tracks when the patient takes their meds. The tablet is specifically targeted to people with mental health conditions like schizophrenia and bipolar disorder and is the first of its kind to get approved.

Digital pills, which typically include a sensor about the size of a grain of sand, can travel safely through the body and communicate with some kind of external device, like an app or a wearable patch.

They aim to solve a big and expensive problem: Patients not taking their meds on time, or at all. That costs taxpayers somewhere in the realm of $100 billion to $289 billion a year in the U.S. alone.

When patients don’t get their scripts filled or finish a dose, their symptoms get worse and they often end up in the hospital. The hope for this new category of tech is to provide health providers with a GPS tracking system of sorts for the human body. By tracking a patient’s compliance with their regimen, rather than relying on what they self-report, they can nudge them if needed.





Another big-picture goal for digital pills is to better tailor or personalize medications for patients.

Clinical trials aren’t known for their diversity, which has resulted in medications being prescribed in a one-size-fits-all manner. One outcome is that women will often end up taking larger doses than required, as a medication has been tested out on a larger male.

A third hope is that a digital pill, when analyzed alongside other vital signs, can provide some insight into how a patient is responding to their meds in real time and allow physicians to adjust their dose as needed.

Could tech replace pills?

Digital pills are designed to augment traditional therapies. But some in the medical community believe that tech can someday replace pills altogether — a category sometimes referred to as “digital therapeutics.”

Digital therapeutics goes beyond sensor-laden pills to include other digital elements, like coaching via a mobile app to help a patient achieve a better health outcome.

As an example, one company in the space, Propeller Health, has a program for people with chronic respiratory disease that includes a mobile app and a rescue inhaler packed with sensors. The idea is that Propeller can track which patients aren’t taking their controller meds frequently enough, and alert them to that fact. The company also looks at external triggers, such as weather events and air quality.

These technologies tend to have a clear business model, if they can prove that they work. Propeller’s solution is compelling for pharmacy benefits managers, insurers and pharmaceutical companies, which are all looking for ways to make medications more effective and prevent costly health outcomes like a trip to the emergency room.

But a more ambitious set of start-ups sees a future where a digital regimen could replace a pill entirely.

The idea is that a virtual coach, in combination with other services, could help a patient change their behavior to become more healthy or less anxious. And in these cases, they wouldn’t require a pill at all. One example of that is Big Health, which has an app that is designed to treat insomnia by training users to change their habits around bedtime. Or Virta Health, which helps people with type 2 diabetes get off their meds through a combination of exercise and nutrition.

As venture capitalist Vijay Pande recently put it, in the future “it’s going to seem backward and even barbaric that our solution to everything was just giving out pills.”





Playing

Share this video…

Watch Next…

AMA opposes any weakening or pullback of Obamacare’s minimum health benefits

<!– –>



Ulysses Hernandez (L), an insurance agent from Sunshine Life and Health Advisors, speaks with Yuricel Duran as she shops for insurance under the Affordable Care Act at a store setup in the Mall of Americas on November 1, 2017 in Miami, Florida.

The nation’s largest physicians’ group voted Tuesday to oppose any watering down or elimination of Obamacare’s required minimum health coverage benefits.

The American Medical Association’s move came after months of unsuccessful efforts by Republican congressional leaders to repeal and replace major parts of Obamacare.

A number of those bills would have weakened or gutted Obamacare’s so-called essential health benefits.

Those EHBs cover 10 categories that health insurance plans must cover, and include emergency services, hospitalization, pregnancy and newborn care, prescription drugs, lab service and preventative care.

Republicans had considered loosening the rules around EHB coverage because doing so would have allowed insurers to charge lower premiums to customers. The EHB mandate has been blamed for driving up premium prices in the individual insurance market higher than they had been before passage of the Affordable Care Act.

The AMA said Tuesday that its opposition to any weakening of the EHB mandate was based on a report by the group’s Council of Medical Service that raised concerns about the effects of such a move.

That report noted “if insurers are allowed to offer plans with skimpier coverage, plan designs could potentially discriminate against people with pre-existing conditions.”

“In addition,” the report said, “individuals who use services and benefits no longer included in the EHBs could face substantial increases in out-of-pocket costs.”



AMA CEO urges Senate not to repeal Obamacare


Playing

Share this video…

Watch Next…

US tax bill should include repeal of health insurance mandate: Senate Republican leader

WASHINGTON (Reuters) – Senate Republican leader Mitch McConnell on Tuesday threw his support behind including a repeal of the Obamacare mandate for individual health insurance in the Senate’s tax reform bill.

“We’re optimistic that inserting the individual mandate repeal would be helpful and that’s obviously the view of the Senate Finance Committee Republicans as well,” McConnell told reporters.

Reporting by Susan Cornwell and Richard Cowan; Writing by Makini Brice; Editing by David Alexander

Article source: https://www.reuters.com/article/us-usa-tax-senate/us-tax-bill-should-include-repeal-of-health-insurance-mandate-senate-republican-leader-idUSKBN1DE2QD