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Oscar Health has a vision of fairer pay for doctors and clearer pricing for patients

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Oscar Health leaders Josh Kushner and Mario Schlosser.

Oscar Health wants you to know that disrupting health insurance won’t happen overnight. But it will happen eventually.

The start-up, which ranks No. 12 on the 2018 Disruptor 50 List and is now in its sixth year, believes it finally has the formula in place to become profitable and improve the health-care experience for its members.

It comes down to a mix of technology, provider partnerships and member experience.




Oscar distinguishes itself from much larger rivals, including UnitedHealth, with its millennial-focused subway ads and iPhone apps for members to book appointments and get advice from doctors. But it has also done a lot of work behind the scenes to build an entirely new infrastructure for core insurance functions, like provider directories and processing claims.

“It’s a fairly simple thing,” said Oscar’s co-founder and CEO, Mario Schlosser. “We tried to do something complicated, and it took a long time to build the pieces to do it well.”

“We’ve now built them, and they’re clicking together,” he added.

One major undertaking is a new system to process insurance claims.

Schlosser said it’s a vast improvement from most claims processing systems, which are essentially cobbled together from 1970s programming tools.

Having its own infrastructure will allow it to do seemingly simple things that are often a struggle in the current health care systems, like paying doctors more for working peak hours like evenings and weekends, or giving members a clearer sense for how much procedures or tests will cost them.

The project, which has been going on for two years, comes off the back of Oscar’s $165 million fundraise from a mix of venture capital firms, including two branches of Google’s parent company Alphabet. That puts its valuation at more than $3 billion, one of the highest in the booming health-technology sector.

Stemming losses 

A few years ago, many in the health industry had all but written Oscar off as another start-up struggling to crack the insurance market.

In New York alone, the company’s home state, Oscar’s losses amounted to $92.4 million in 2015 and more than $124 million in 2016. In that year, it made some big changes, including raising premiums and tightening up its network in various states, which helped it stem its losses in 2017.

The company expects a much better result this year, claiming that its revenues from premiums are now higher than its pay-outs in medical claims. It chalks that up to tight partnerships with health systems in each state, which allows it to push members towards a more curated list of high-quality, but affordable, medical providers.

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The company now claims more than $300 million in gross premiums in Q1, and says it’s on track to pass $1 billion in revenue this year.

Throughout this year, it plans to grow at a rate of four to five cities per year, and is expecting to reach 260,000 members in 2018, up from a peak of 100,000 in 2017.

“Before you know it, we’ll be profitable,” Brian West, the company’s chief financial officer, told us recently. “It’s around the corner.”

Fending off uncertainty

That growth might have seemed improbable just a year ago given the rising uncertainty about the fate of the Affordable Care Act. Back in 2016, many of the largest insurers started pulling out of selling on the individual market in many states, citing heavy losses. In the aftermath of that, the Trump Administration made repeated promises to rip out and replace Obamacare.

But Oscar defended the ACA and the long-term survival of the individual market, where it now sells its plans in six states. It chose to do that despite its tangled web of alliances: One of its founders, Josh Kushner, is the brother of Trump’s advisor and son-in-law Jared Kushner.

These days, with the health legislation proving more resilient than expected, the company is able to focus on expansion.

It has dabbled in providing care and not just paying for it, with its first medical clinic in Brooklyn. It is also exploring other types of insurance, including selling to seniors through Medicare Advantage.

“Right now we are laser-focused on delivering a good experience and good cost outcomes, but we have the machinery that we can point at different markets,” said Schlosser.




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The Health 202: Trump’s moves haven’t yet significantly decreased the number of people with health insurance

THE PROGNOSIS

President Trump speaks at the Prison Reform Summit in the East Room at the White House on Friday. (Jabin Botsford/The Washington Post)

Maybe the number of people without health insurance isn’t dramatically worsening under the Trump administration, at least not yet.

Yes, some recent polls have indicated more Americans are dropping off health coverage after big gains under the 2010 Affordable Care Act. But a big, government survey released this morning shows only a tiny — and statistically insignificant — uptick in the share of Americans lacking coverage in 2017 compared to the year prior.

Last year, 9.1 percent of Americans didn’t have health insurance (that translates to 29.3 million people), according to a report on health insurance based on the National Health Interview Survey from the Centers for Disease Control and Prevention. That’s a negligible difference from the 9 percent of Americans without insurance in 2016.

You could read this survey two ways. First, it’s pretty unfortunate the U.S. still finds itself in a situation where a large share of the population — nearly 1 in 10 people — lack health coverage. For all our policymakers’ and lawmakers’ hand-wringing, they haven’t managed to put the country on par with most developed countries, which enjoy uninsured rates in the low single digits.

Second, it’s not yet clear that policies advanced by the Trump administration to eliminate parts of the ACA have done much yet to shrink its insurance expansions. Still, over the past few months, Democrats and liberals have been seizing on any indication they can find that the GOP-led administration is throwing people off health insurance.

“The Trump administration has spitefully tried to undermine the Affordable Care Act by eviscerating funding for ACA open enrollment advertising, deliberately creating massive confusion around ACA enrollment availability and making constant threats to cut off key ACA payments,” top House Democrat Nancy Pelosi (Calif.) said in January. “Together, these efforts have pushed the number of uninsured Americans up for the first time in a decade.”

House Minority Leader Nancy Pelosi (Drew Angerer/Getty Images)

Pelosi was referring to a Gallup survey released in January, which found that 3 million fewer people had health insurance at the end of 2017 relative to the end of 2016, based on more than 25,000 interviews. Another Gallup survey released this month and involving 160,000 interviews found the uninsured rate rose by statistically significant margins in 17 states last year.

And the Commonwealth Fund reported that the uninsured rate among non-senior adults rose from 12.7 percent in 2016 to 15.5 percent last year, based on interviews in February and March with 2,400 adults.

The negative picture painted by these surveys could turn out to be true, especially once we get a better sense of how people will respond when the penalty for lacking health coverage goes away next year.

And even if the insured rate remains relatively steady, more people will have access to somewhat leaner insurance coverage under policies the Trump administration is advancing. There is a trend, reconfirmed by today’s NHIS survey data, of more Americans buying high-deductible policies requiring them to pay a hefty sum before their benefits fully kick in. The survey found that 43.7 percent of privately insured people enrolled in a high-deductible health plan last year, compared to 39.4 percent in 2016.

But will the Trump administration, with its antagonism to the ACA, significantly reverse the Obamacare’s coverage gains? The NHIS survey is one of the best indicators we have of insurance coverage in the United States — and it seems to indicate the jury’s still out.

The survey got started in 1957 after Congress passed legislation authorizing the Public Health Service to annually collect information on the Americans’ health status and behavior. It’s designed by the CDC’s National Center for Health Statistics and administered by the Census Bureau. Instead of being taken over a few days or weeks, the survey is conducted throughout the year, drawing from a nationally representative sample each month.

Here are some of the survey’s other findings, from more than 78,000 people interviewed:

  • Among non-elderly adults, 12.8 percent are uninsured; 69.3 percent have private coverage and 19.3 percent have public coverage.
  • Among children under age 18, 5 percent are uninsured, 55 percent have private coverage and 41.3 percent have public coverage.
  • The uninsured rate is 27.7 among Hispanics, 14.1 percent among blacks, 8.5 percent among whites and 7.6 percent among those of Asian origin.

Correction: An initial version of this story stated there were 9 million Americans uninsured in 2016. The Health 202 has changed to clarify that 9 percent of Americans were uninsured.

New U.S. citizens gather at a naturalization ceremony on March 20 in L.A. (Mario Tama/Getty Images)

AHH: California is set to become the first state to provide health coverage to undocumented immigrant adults. “The proposal…  is one of the most daring examples yet of blue-state Democrats thumbing their nose at President Donald Trump as they pursue diametrically opposed policies, whether on immigration, climate change, legalized marijuana or health care,” Politico’s Victoria Colliver reports.

State Sen. Ricardo Lara has authored a bill to extend Medicaid coverage to eligible adults in California regardless of their immigration status, costing a hefty $3 billion per year. He and other Democrats say they want to build on the coverage gains made under the ACA by focusing on the state’s nearly 3 million remaining uninsured. About 60 percent of this population (1.2 million people) are undocumented immigrants who would qualify for the state’s Medicaid program, known as Medi-Cal, based on their incomes.

California Gov. Jerry Brown (D), who is leaving office later this year, has not yet committed to the plan, Victoria reports. “[He's] required by law to sign or veto bills passed this session by Sept. 30, just five weeks before the midterm elections,” she writes. “And the injection of immigration politics into the universal health care debate will likely provide talking points for both parties.”

Campus of the University of Southern California (USC) in Los Angeles. (AFP PHOTO / Robyn BeckROBYN BECK/AFP/Getty Images)

OOF: Five women are suing the University of Southern California, alleging sexual abuse by the school’s former gynecologist, Dr. George Tyndall. The lawsuits, filed yesterday, are likely just the first of many and could signal extended litigation and large financial settlements in the growing scandal, Tim Arango writes for the New York Times. Four unnamed women have filed a second lawsuit calling the former gynecologist a “serial sexual predator” and blaming the school for “actively and deliberately” covering up Tyndall’s predations for years.

“The lawsuits stem from an investigation published last week by The Los Angeles Times that accused Dr. Tyndall of abusing patients for years at the university,” Tim writes. “The case has raised difficult questions about how the university’s senior leadership has handled the case, with some students circulating a petition demanding the resignation of C.L. Max Nikias, the university’s president….The complaints in the two lawsuits outline in vivid detail a litany of alleged abuses and inappropriate sexual comments by Dr. Tyndall over years.”

OUCH: African American kids are taking their lives at about twice the rate of their white counterparts, according to a new study that shows a widening gap between the two groups, The Post’s Amy Ellis Nutt reports. The 2001-2015 data, published yesterday in the journal JAMA Pediatrics, confirms a pattern first identified several years ago when researchers at Nationwide Children’s Hospital in Ohio found that the rate of suicides for black boys and girls ages 5 to 12 exceeded that of young whites.

It’s a startling finding because historically, suicide rates in the United States have been higher for whites than blacks across all age groups. That remains the case for adolescents ages 13 to 17, according to the new study. White teens continue to have a 50 percent higher rate of suicide than black teens.

Lead author Jeffrey Bridge said the latest findings reinforce the need for better research into the racial disparities. “In 2017, research by Bridge and colleagues found that among children, ages 5 to 11, and young adolescents, ages 12 to 14, those who  took their own lives were more likely to be male, African American and dealing with stressful relationships at home or with friends,” Amy writes. “Children who had a mental health problem at the time of death were more likely than young adolescents to have been diagnosed with attention-deficit disorder or attention-deficit hyperactivity disorder.”

A nurse working with the World Health Organization shows a bottle containing Ebola vaccine at the town all of Mbandaka during the launch of the Ebola vaccination campaign on Monday. (AFP PHOTO / JUNIOR KANNAHJUNIOR KANNAH/AFP/Getty Images)

— An Ebola vaccination campaign began yesterday in Congo in an effort to combat the recent outbreak. One day earlier, the health ministry announced a nurse had died in Bikoro, bringing the total death toll to 27, the AP’s Saleh Mwanamilongo reports. The experimental vaccine, which is being provided by Merck, is still in testing stages, but was effective toward the end of the Ebola outbreak that killed more than 11,300 people in Guinea, Sierra Leona and Liberia from 2014 to 2016.

Congo’s health delegation, which includes the health minister and representatives of the World Health Organization and the United Nations, arrived for the campaign in Mbandaka, a port city on the Congo river with a population of 1.2 million where Ebola cases have been identified, Saleh writes.

Joseph James DeAngelo, the alleged “Golden State Killer,” makes his first appearance to face charges that include homicide and rape, in Sacramento County Superior Court. (AP Photo/Rich Pedroncelli, File)

— Another cold case has been cracked with the help of DNA information on a public genealogy website. Since November 1987, police received more than 300 tips about people who thought they had information about the alleged killer of a couple from Saanich, British Columbia. Those tips didn’t include William Earl Talbott II. But when investigators ran the killer’s DNA from the scene through the genealogy website GEDMatch, the information led them to Talbott, our colleague Meagan Flynn reports.

“Now they have charged Talbott, 55, with murder, saying his DNA profile found through his ancestors this month matches the DNA left at the crime scene 31 years ago,” Meagan writes.  “Talbott’s arrest marks the latest case in which detectives have nabbed a suspected killer using controversial familial DNA methods, taking advantage of public genealogy websites…to identify the suspect’s distant relatives and begin mapping his family tree.”

The arrest follows the use of the same website last month to track down relatives of Joseph James DeAngelo, the suspected Golden State Killer who allegedly committed a dozen murders and 45 rapes across California in the 1970s. The case led to a debate about the ethics of using public DNA information for police investigations.

HHS Secretary Alex Azar. (Melina Mara/The Washington Post)

— Today, Health and Human Services Secretary Alex Azar will attend the 71st World Health Assembly in Geneva, Switzerland, HHS officials have confirmed. The WHA is the decision-making body of the World Health Organization. Along with delivering a speech on the U.S. commitment to global health security, Azar will also attend official events focused on key public health challenges and participate in multiple bilateral meetings with health ministers and officials from other nations.

— A few more good reads from The Post and beyond:

Today

  • The Senate Health, Education, Labor and Pensions Committee holds a hearing on addressing shortages and improving care.
  • The House Veterans Affairs Committee holds a hearing on “Assessing VA’s Governance Structure.”

Coming Up

  • The Senate Health, Education, Labor and Pensions Committee holds an executive session on “Pandemic and All-Hazards Preparedness and Advancing Innovation Act of 2018” on Wednesday.
  • The Senate Appropriations Subcommittee on Interior, Environment and Related Agencies holds a hearing on the Indian Health Service 2019 budget on Wednesday.
  • The House Veterans Affairs Subcommittee on Economic Opportunity holds a legislative hearing on Wednesday.
  • The Senate Banking, Housing and Urban Affairs Committee holds a hearing on the status of the “Housing Finance System” on Wednesday.
  • The House Energy and Commerce Subcommittee on Health holds a hearing on “Reauthorization of the Children’s Hospital Graduate Medical Education Program” on Wednesday.
  • The Brookings Institution holds an event on opioids on Wednesday.
  • The Senate Finance Committee holds a hearing on rural health care on Thursday.
  • The Brookings Institution holds an event on medical marijuana in the United States on May 29.

Well-wishers welcome George H.W. Bush to Maine:

Trump says the Russia probe is a waste of taxpayer money. But his budget would fund the investigation into 2019:

Stephen Colbert on the leaks coming out of the White House:

Article source: https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2018/05/22/the-health-202-trump-s-moves-haven-t-yet-significantly-decreased-the-number-of-people-with-health-insurance/5b03173d1b326b492dd07e04/

California rebukes Trump with health care push for immigrants

California is poised to become the first state in the nation to offer full health coverage to undocumented adults even as the Trump administration intensifies its crackdown by separating families at the border.

The proposal — which would build on Gov. Jerry Brown’s 2015 decision to extend health coverage to all children, regardless of immigration status — is one of the most daring examples yet of blue-state Democrats thumbing their nose at President Donald Trump as they pursue diametrically opposed policies, whether on immigration, climate change, legalized marijuana or health care.

Story Continued Below

“California has never waited for the federal government, or for a political climate, to be able to take leadership on a whole host of issues,” state Sen. Ricardo Lara, author of the state Senate bill to extend Medicaid coverage to all adults, told POLITICO.

But at a time when Trump is already attempting to re-energize state Republican voters — he met with California conservatives at the White House last week to strategize against the state’s sanctuary policies — the initiative might be risky. For starters, it will be costly: The annual price tag to expand Medicaid benefits to poor adult immigrants without legal status is projected at $3 billion annually. Some also worry that extending health coverage could make California a magnet for undocumented immigrants from other states.

“It would give Republicans relevance in California they would never have before,” said David McCuan, a political analyst and political science professor at Sonoma State University. He suggested the proposal would energize Republican voters, who make up a quarter of the electorate, as well as conservative-leaning unaffiliated voters.

Any meaningful opposition could slow the plan’s progress through the state Legislature despite its strong backing from Democrats, providers and advocates for the poor.

Brown, who is leaving office later this year and has not yet committed to the plan, is required by law to sign or veto bills passed this session by Sept. 30, just five weeks before the midterm elections. And the injection of immigration politics into the universal health care debate will likely provide talking points for both parties.

“It seems to me astounding that California could consider an expansion like this at this particular moment,” said Paul Ginsburg, director of the USC-Brookings Schaeffer Initiative for Health Policy. He described the plan as “fiscally very dangerous” given California’s fragile long-term financial outlook and the potential negative effects of the Republican tax overhaul on the state’s budget.

But Lara, the son of undocumented Mexican immigrants who grew up without health coverage, contended the state is already paying for health care for the undocumented in the most expensive way possible, through hospital emergency rooms. He pushed unsuccessfully for a single payer health plan for California last year, and argues California needs to be a laboratory for social change by taking the lead on progressive causes.

“We are trying to address the fact that, whether you like it or not,” he said, “our undocumented community needs the care, and we are paying for it anyway.”

Democrats say they want to build on the coverage gains made under Obamacare by targeting the state’s nearly 3 million remaining uninsured — about 60 percent of whom are undocumented immigrants and 1.2 million of whom would qualify for the state’s Medicaid program, known as Medi-Cal, based on their incomes. Companion bills in the state Assembly and Senate have easily passed their respective health committees with party-line votes.

Still, the latest revisions to Brown’s proposed budget last week did not include significant increases in health spending — a move that frustrated some backers of the expansion, who note the state’s budget surplus has swelled to nearly $9 billion — about $3 billion more than expected.

“It’s doable for a fraction of the budget surplus we have,” said Anthony Wright, executive director of Health Access California, a consumer advocacy coalition. “We recognize if we were to do so, we would be the first state to expand Medicaid to an [undocumented] adult population.”

Wright acknowledged the price tag may look alarming but said it should be viewed within the context of Medi-Cal’s $100 billion budget. He also emphasized that covering only poor young people and the elderly — which the budget forecasts estimated at $140 million and $330 million, respectively — could be more achievable in the short term. A Senate health budget sub-committee on Thursday recommended covering undocumented adults over age 65 as part of the Senate funding package to be considered during negotiations.

California already provides emergency and pregnancy-related Medi-Cal benefits for undocumented immigrants to the tune of about $1.7 billion annually. The $3 billion for full Medi-Cal benefits assumes that all eligible adults would enroll in the program over 12 months, which is unlikely.

Micah Weinberg, president of the Bay Area Council Economic Institute, said the cost debate must take into account the measure’s broader benefits, including increased worker productivity and improved community health.

“Since most undocumented immigrants are productive members of society, it would, of course, be much better to give them all a path to citizenship and immediately naturalize them to make it easier for them to buy regular health insurance,” Weinberg said. “But just because we have bad immigration policy does not mean we shouldn’t have good health policy. And truly universal coverage is good health policy.”

Other health economists struck a more cautious note.

Jay Bhattacharya, a Stanford physician and health economist, said the plan should have a dedicated funding source, which could mean higher taxes. “Looking at the current surplus and saying we’re likely to have that forever so we should spend more doesn’t seem like a wise idea to me,” Bhattacharya said.

Bhattacharya also expressed concerns that the extension could exacerbate the state’s illegal immigration problems. “If you make a program like this available, undocumented workers in other states might be attracted to California because of this,” he said.

But Lara insisted the bill is not only a long-term cost-saver, it’s the right thing to do.

“All you have to do is say ‘immigration’ in Washington, D.C., and everyone runs to their respective corners,” he said. “That doesn’t happen in California.”

Article source: https://www.politico.com/story/2018/05/21/california-health-care-immigrants-trump-598037

What Barbershops Can Teach About Delivering Health Care

The more recent study went further, removing physicians almost entirely from the process. The control group consisted of barbers who encouraged lifestyle modification or referred customers with high blood pressure to physicians. In the intervention group, barbers screened patients, then handed them off to pharmacists who met with customers in the barbershops. They treated patients with medications and lifestyle changes according to set protocols, then updated physicians on what they had done.

The results were impressive. Six months into the trial, systolic blood pressure (the higher of the two blood pressure measures) in the control group had dropped about 9 mm Hg (millimeters of mercury) to 145.4, which is still high.

In the intervention group, though, blood pressure had dropped 27 mm Hg to 125.8, which is close to “normal.” If we define the goal of blood pressure management to be less than 130/80, more than 63 percent of the intervention group achieved it, compared with less than 12 percent of the control group.

It gets better. The rate of cohort retention — measuring how many of the patients remained plugged into the study and care throughout the entire process — was 95 percent.

The barbershop customers were part of a population that is traditionally hard to reach. More than half of participants lived in households earning less than $50,000 a year, and more than 40 percent in households earning less than $25,000. On average, they were overweight or obese, about a third smoked, and more than a fifth had diabetes. Yet the improvement in blood pressure was more than three times that of the average of previous pharmacist-based interventions seeking to improve blood pressure, and many of those had focused on populations easier to reach.

Article source: https://www.nytimes.com/2018/05/21/upshot/what-barbershops-can-teach-about-delivering-health-care.html

What Agencies Need To Know About Working With Personal Health Information

Shutterstock

In the last 11 years at my company, I’ve worked with a number of clients in different verticals, each of which brings a new set of challenges. In the recent months, however, we have graduated to a new level of complexity, and we felt it was time to bring in the big guns.

Hospitals, private health professionals and everyone in between who possesses personal health information (PHI) within their electronic health record (EHR) systems has a great responsibility in their hands.

Providers stand, much like the Colossus of Rhodes ancient Greek statue, with a foot on each shore, directing an ongoing watercourse of private, high-value data such as electronic health records and other personal health information.

This issue forms a nexus between providing superlative patient services (thereby increasing overall patient satisfaction in competitive markets), building an internal culture of compliance and ensuring robust cybersecurity. Like digital jugglers moving multiple data balls, providers must:

• Identify where data travels.

• Provide secure workforce access.

• Improve data sharing points.

• Avoid data silos (vital medical information that is uncaptured, unreviewed or unshared, often due to platform limitations).

• Secure third-party vendor data access and management.

• Adopt and implement emerging technologies.

• Create platforms that empower patients.

Not only do providers have to continuously monitor, protect and track sensitive data, they must find ways to build in greater flexibility, scalability and shareability, while simultaneously reducing costs within restricted budgets.

When healthcare service providers become agency clients, these challenges become top of mind and a liability you don’t want to hold alone. I’ve learned a lot about properly managing and securing our client’s data, and here are a few of the most valuable takeaways for agencies working with healthcare service providers.

Patient Accessible Health Data

Ultra-sensitive PHI data is valuable not just to patients and providers but also to cybercriminals, who consider PHI to be high-value targets. They can sell PHI on the dark web for far more than other types of pirated information, such as social security numbers. By gaining access to medical records, criminals can also access patient financial data and records of care (including diagnostic histories, treating physicians and current medications such as opioids).

This might help to explain why, in recent years, we have seen a steady rise in healthcare data breaches, with more and more providers facing threats such as malware, ransomware (also called denial of service or DoS) and cyberextortion (where cyberattackers steal sensitive data and then threaten healthcare providers with data dumps). 

Controlling Access While Supporting Patients

Even if the provider does pay, there is no guarantee that the data will be returned. In some cases, the data may not even be accessible to the first hacker because secondary hackers can exploit the breach and overwrite the original intrusion and payment demands — basically stealing the same information again, with the data dumped or sold in the process.  

All of this leaves healthcare organizations vulnerable on multiple fronts. Security compliance can exceed the technological resources of healthcare organizations and even the best development team an agency can source. However, we have learned that hawkish risk analysis can help prevent and mitigate security breaches.

While working with our healthcare client, we dove deep into the security challenge and identified the following points as essentials. These have helped us to educate our client as well as identify the right partner for the job.

Foundational Requirements For Protecting PHI

1. Controlled Access: This means combining secure PINs, passwords and secondary verifications (such as code generators sent via text to smartphones or to email accounts), alongside encryption software for additional layers of screening on the patient side.

2. Regular Audits: Full compliance requires clear audit trails that track when, where and who has accessed protected files.

3. A Culture Of Security: Providers must cultivate a culture that fosters employee awareness and security compliance, such as protecting passwords and access points.

4. Redundant Safety Systems: Alongside storage volume encryption and system backups, redundant systems can prevent and/or limit the damage caused by cyber intrusions.

5. Ongoing Security Risk Assessment: This is most effective when aligned with hardened internal network security that limits access or slows the lateral movement of malware and/or cyber intrusion.

6. 24/7 Monitoring: Additional security can include off-site monitoring platforms, which provide comprehensive system monitoring with an at-a-glance dashboard for providers.

7. Secure Internal Access Points: Access must be gated with biometric or badge entry at secure storage points.

8. Updates And Security Patches: Providers should consider signing up for US-CERT alerts, which can prepare them for potential threats and exchange critical cybersecurity information as threats arise.

9. Awareness Of Medical Device Vulnerabilities: The Healthcare Cybersecurity and Communications Integration Center (HCCIC) released a statement in January of 2018 advising public healthcare providers to more closely monitor medical device security as well as personally identifiable information (PII) that is stored on cloud-based systems. (Although these are not computers, many of them run on systems that are vulnerable to malware attacks.)

10. Disaster Recovery Plans: Having a robust contingency plan allows healthcare providers to respond and recover faster in the event of an intrusion.

If you’re still reading this article, you can now feel the weight we felt on our shoulders when so much responsibility had been placed in our hands. Thankfully, we identified a few options within the healthcare data security space that have enabled us to continue our work without the worry of a data breach.

With an ever-growing expansion of cloud services, even in the healthcare space, the need for cybersecurity and compliance is at an all-time high, and I sincerely don’t expect the requirements to be lowered.

Article source: https://www.forbes.com/sites/forbesagencycouncil/2018/05/21/what-agencies-need-to-know-about-working-with-personal-health-information/

Ebola deaths rise to 26, says Congo health ministry



KINSHASA, Congo (AP) Congo’s health ministry says there is one new death from Ebola, bringing to 26 the number of deaths from the deadly outbreak in Equateur province in the country’s northwest.


Four new cases have been confirmed as Ebola, said the health ministry in a statement released early Sunday. A total of 46 cases of hemorrhagic fever have been reported in the current outbreak, including 21 confirmed cases of Ebola, 21 probable and four suspected.


Congo President Joseph Kabila and his Cabinet agreed Saturday to increase funds for the Ebola emergency response which now amounts to more than $4 million. The Cabinet endorsed the decision to provide free health care in the affected areas and to provide special care to all Ebola victims and their relatives.


The spread of Ebola from a rural area to Mbandaka, a city of more than 1 million people, has raised alarm as the deadly disease can spread more quickly in densely populated urban centers.






The World Health Organization on Friday decided not to declare the outbreak a global health emergency, but it called the risk of spread within Congo “very high” and warned nine neighboring countries that the risk to them was high. WHO said there should be no restrictions to international travel or trade.


A new experimental Ebola vaccine will be used to try to contain the outbreak. The vaccine is still in the test stages, but it was effective in the West Africa outbreak a few years ago. Vaccinations are expected to start early in the week, with more than 4,000 doses already in Congo and more on the way.


A major challenge will be keeping the vaccines cold in this vast, impoverished, tropical country where infrastructure is poor.


While Congo has contained several Ebola outbreaks in the past, all of them were based in remote rural areas. The virus has twice made it to Kinshasa, Congo’s capital of 10 million people, but was rapidly stopped.


Health officials are trying to track down more than 500 people who have been in contact with those feared infected, a task that became more urgent with the spread to Mbandaka, which lies on the Congo River, a busy traffic corridor, and is an hour’s flight from the capital.


The outbreak was declared more than a week ago in Congo’s remote northwest. Its spread has some Congolese worried.


“Even if it’s not happening here yet I have to reduce contact with people. May God protect us in any case,” Grace Ekofo, a 23-year-old student in Kinshasa, told The Associated Press.


A teacher in Mbandaka, 53-year-old Jean Mopono, said they were trying to implement preventative measures by teaching students not to greet each other by shaking hands or kissing.


“We pray that this epidemic does not take place here,” Mopono said.


The WHO appears to be moving swiftly to contain this latest epidemic, experts said. The health organization was accused of bungling its response to the earlier West Africa outbreak the biggest Ebola outbreak in history which resulted in more than 11,000 deaths.


There is “strong reason to believe this situation can be brought under control,” said Robert Steffen, who chaired the WHO expert meeting last week. But without a vigorous response, “the situation is likely to deteriorate significantly,” he said.


This is Congo’s ninth Ebola outbreak since 1976, when the disease was first identified. The virus is initially transmitted to people from wild animals, including bats and monkeys. It is spread via contact with bodily fluids of those infected.


There is no specific treatment for Ebola. Symptoms include fever, vomiting, diarrhea, muscle pain and at times internal and external bleeding. The virus can be fatal in up to 90 percent of cases, depending on the strain.


___


Follow Africa news at https://twitter.com/AP_Africa

Article source: http://www.tampabay.com/ebola-deaths-rise-to--says-congo-health-ministry-ap_worldc1c7913f8ff64763af551af62aeadd68

How tomato sauce can boost your gut health

If like me, you enjoy the occasional bowl of pasta with fresh tomato sauce, then I’ve got great news for you. Research fresh out of the pan has found that cooked tomato sauce helps to improve the activity of probiotics in the gut.

Does tomato sauce boost gut health? And if so, should we choose raw or cooked?

Over the past few years, researchers and consumers alike have been taking interest in whether or not the foods that eventually reach our tables are “functional.” But what are functional foods?

“All foods are functional to some extent because all foods provide taste, aroma, and nutritive value,” explains researcher Clare Hasler in a Journal of Nutrition article.

“However,” she goes on to clarify, “foods are now being examined intensively for added physiologic benefits, which may reduce chronic disease risk or otherwise optimize health.” And those foods seen to bring specific health benefits are deemed “functional.”

Probiotic foods — such as certain types of yogurt, kefir, or kimchi — fall into this category, as they boost the population of good bacteria in our guts, which contribute to our overall health in many ways.

Now, however, researchers from the Universitat Politècnica de València in Spain are looking at how gut bacteria interact with antioxidants in the gut.

Specifically, senior researcher Ana Belén Heredia and her team were interested in seeing how tomato sauce — rich in antioxidants — would behave in the presence of good bacteria in the gut.

And, since tomato sauce can be served raw or cooked, they wanted to understand what effect this would have on the antioxidant-gut bacteria interaction.

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Antioxidants and probiotics

Tomatoes are considered a healthful food because, among other things, they contain a pigment called lycopene — an antioxidant that helps to protect cells from damaging factors. Existing research also suggests that tomatoes have probiotic properties — that is, that they can boost the activity of healthful bacteria in the gut.

In the current study, the research team conducted in vitro experiments to see how Lactobacillus reuteri — one of the main bacterial species that contribute to gut health — would interact with antioxidants derived from tomato sauce, and how the cooking process would influence that interaction.

For this purpose, the researchers chose to use pear tomatoes, as they have a higher content of lycopene.

“We have evaluated the viability of the probiotic strain along the digestive process individually and the presence of antioxidants from vegetable sources, as well as the impact of the probiotic strain on the changes suffered by antioxidant compounds and the resulting bioaccessibility,” explains Heredia.

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Cooked or raw?

The results of their experiments — now published in the Journal of Functional Foods — indicate that the digestive process resulted in a loss of antioxidants, both in the case of raw and cooked (fried) tomato sauce.

Also, the presence of L. reuteri appeared to prevent some of the antioxidants from being absorbed into the blood system.

At the same time, however, the research team found that the antioxidants from the tomato sauce enhanced the positive effects of L. reuteri. And in this context, cooked tomato sauce appeared to be more effective than the raw equivalent.

Cooking the sauce also transformed the lycopene present in the tomato — a process known as cis-trans isomerization — which actually helped to preserve the integrity of this antioxidant through the digestive process, allowing more of it to be absorbed.

“We worked with raw and fried tomato to determine the impact of processing,” notes Heredia.

And among the results, we found that serving meals rich in probiotics with fried tomato sauce boosts its probiotic effect; as well as causing a progressive isomerization of the lycopene of the tomato, from form cis to trans throughout digestion, which positively results in an increased final bioaccessibility of this carotenoid.”

Ana Belén Heredia

These results suggest that, when assessing foods for health benefits, it is important to look not only at the effects that cooking may have on them — by submitting their components to various chemical transformations — but also at the impact of the digestive process on these nutrients.

An increased awareness of both of these effects, the researchers argue, would allow companies in the food industry to create truly “functional” foods that can boost our health.

Article source: https://www.medicalnewstoday.com/articles/321855.php

Donald Trump knows terrifyingly little about women’s health


President Trump has shown himself to be deeply interested in women’s bodies: As a radio show guest, he graded them, part by part. As a presidential candidate, he attributed tough questions from them to their wayward bleeding. And now, as president, he’s restricting their access to health care. A rule Trump is expected to outline Tuesday will strip sexual health funding from clinics that perform or refer for abortions, which if Texas’s experiment is any guide, will vastly reduce women’s access to effective forms of contraception in the name of preventing abortion.

Despite his heroically keen focus on the female form, Trump has flaunted ignorance of the kind of material that gets covered in basic sex ed. On video aired by MSNBC’s Chris Hayes, Microsoft founder Bill Gates recalls ruefully that Trump asked him, on two separate occasions, what the difference is between the HIV and HPV viruses. This is basic stuff, but he shows no interest in really mastering it, despite the vast power he now exerts over the lives of those it affects.

In theory, this is information that Trump — who once joked that avoiding sexually transmitted diseases was his personal Vietnam — might find relevant to his own life. After all, two women who say they had extramarital affairs with the president, former Playmate Karen McDougal and adult performer Stormy Daniels, separately told CNN’s Anderson Cooper that Trump did not use a condom. “You know, we talked about it right beforehand,” McDougal, who described a 10-month relationship, told Cooper. “He was starting to and then he’s like, I don’t like these things.” According to the Centers for Disease Control and Prevention, “consistent and correct use of latex condoms is highly effective in preventing sexual transmission of HIV, the virus that causes AIDS,” and “consistent and correct use of latex condoms may reduce the risk for genital human papillomavirus (HPV) infection and HPV-associated diseases (e.g., genital warts and cervical cancer).”

Disregarding the weight of medical evidence about how to reduce health risks isn’t just a personal choice that Trump has made for himself; it’s also his administration’s policy. The Department of Health and Human Services announced last month it would lower its standard of evidence to encourage programs for teens that favor “sexual risk avoidance,” or abstinence. Never mind that the rigorous nine-year study the department itself commissioned of four federally funded abstinence-only programs showed they had “no overall impact on teen sexual activity.”

The rule to be announced Tuesday is expected to deny Planned Parenthood and independent clinics of millions of dollars they receive under the Title X program to provide low-income women with services like cancer screenings, birth control and tests for pregnancy and sexually transmitted diseases. Under long-standing federal restrictions, none of the funds go to abortion services, but the new rule would reportedly bar funds from any clinic that performs or refer for abortions. Or, in the words of the White House, “ensure that Federal funds are not used to fund the abortion industry.”

This is consistent with a promise Trump made during the campaign, when he praised Planned Parenthood but said they would be defunded unless they ceased providing abortions. “I said defund. I didn’t say pay. I said I have a lot of respect for some of the things they do, the cervical cancer on women,” he told Fox News’s Sean Hannity in February 2016, though who can know if he understood that the way the clinics prevent “the cervical cancer on women” is by vaccinating against and screening for HPV. But Planned Parenthood would get no funds to perform those services, Trump went on, “not while they do abortions.”

Republicans, including House Speaker Paul D. Ryan (Wis.), claim other health clinics can step into the breach opened by excluding Planned Parenthood and other clinics. That’s not what a study published last year in the New England Journal of Medicine found; in the two years after Texas barred Planned Parenthood from receiving state women’s health funds, Texas women’s access to the most effective forms of contraception dropped by a third, and births among women covered by Medicaid grew 27 percent.

Say you take at face value the claim that the policy change is about reducing the number of abortions. If so, wouldn’t it make more sense to follow in the footsteps of Colorado, which cut its teen abortion rate in half when a pilot program provided the same effective, long-acting reversible contraception free?

Instead, this is an administration that has dragged migrant teenagers seeking abortions to court and considered subjecting them to medically-unproven experiments in “abortion reversal.” All because, in the words of a top Trump administration official, “refuge is the basis of our name and is at the core of what we provide, and we provide this to all the minors in our care, including their unborn children, every day.” And yet it’s also the same administration that plans to separate living children from their migrant parents and is considering warehousing them on military bases. The administration has already withdrawn funding from family planning groups working overseas if they refer for or counsel about abortions — leaving women in the same places Trump called “s—hole countries” in more desperate conditions and, according to prior research from the Bush era, likely increasing the number of unsafe abortions.

What explains these seemingly disparate actions is that for Trump, and social conservatives whom he is amply repaying for their support, medical facts, public health considerations, or carefully assembled empirical studies are beside the point. It’s about values, about who gets to be empowered to make their own decisions and who will be subject to the most brutal forms of control, and whose historically enforced power will remain intact. If you’ve gone to one of those sex-ed classes, and not the abstinence kind, you might have heard that knowledge is power. Again and again, the Trump administration — and indeed the president himself, the archetype of a man insulated from consequences — has shrugged in reply: when you have power, who needs knowledge?

Article source: https://www.washingtonpost.com/news/posteverything/wp/2018/05/20/donald-trump-knows-terrifyingly-little-about-womens-health/

WHO Says New Ebola Outbreak Is Not Yet a Top Health Emergency

Article source: https://www.nytimes.com/2018/05/18/world/africa/who-ebola-outbreak.html

A longtime Google investor draws this simple chart on a napkin to explain health tech to company founders

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Krishna Yeshwant, a doctor and investor with GV, Alphabet’s venture firm, takes a lot of meetings with entrepreneurs that have lofty goals to fix health care.

But different patients have different needs.

So to help entrepreneurs empathize with their users, he came up with a simple, foursquare box that he’ll scrawl on a napkin, in meetings. He drew it for me at HLTH, a major health conference, that happened in Las Vegas earlier this month.

Yeshwant came up with the idea while practicing medicine.

He soon realized that his own patients, many of whom are lower-income and struggling with complex health problems, wouldn’t adopt the same solutions as the tech workers in his Google network.

He also learned in the clinic that social needs shouldn’t be divorced from medical problems; they’re inextricably linked. And entrepreneurs need to keep both in mind, not just the person’s health history.

“It’s hard to get your medicine if your pharmacy keeps changing because you have to keep going to different shelters, and sometimes your shelter is in a new city and you don’t have a car, or a cell phone, or a credit card, or a bank account, or you can’t read or speak English,” he explained.

The key is to build a deep understanding of the user. “It’s hard for someone who hasn’t walked in those shoes to have full empathy for the patient,” he said.

Start-ups in each category

One of the first things he’ll ask the entrepreneur to do is to point to where their product might be in the box. Some are dead on, while others haven’t thought it through.

Here are a few examples of companies that Yeshwant and I would put in each category. This is broadly the case, although there might be exceptions:

  • Low medical/low social needs: Virtual doctor apps, concierge primary care, wellness tests (23andMe, Forward, One Medical)
  • High medical/low social needs: Cancer tests, expensive therapies and medical devices (ZappRx, Turing Pharmaceuticals, Merck, Pfizer, Medtronic)
  • High social/ low medical needs: Services to treat depression in homeless vets, home monitoring tools for seniors that are starting to “age in place,” transportation services to help people get to appointments (PatientPing, Circulation Health, Pear Therapeutics)
  • High social/high medical needs: Programs for Medicaid patients to treat diabetes, services to help people without insurance access the medications they need (Cityblock Health, GoodRx, Aledade, CareMore, Iora Health)

According to Yeshwant, far more tech entrepreneurs gravitate to opportunities to serve those with the lowest medical and lowest social needs — essentially their own network. Those with a health background tend to be more eager to tackle the opposite population with the highest medical and social needs, as they’re aware that this group is the biggest driver of health costs.

In his view, venture capital often lean towards the therapeutics companies that fit into the low social complexity/high medical complexity quadrant, such as costly novel drugs for cancer or diabetes. In January, a single therapy to treat a rare form of blindness received a price tag of $850,000.

Who’s left out?

Yeshwant says he’s found companies in all four boxes, but the biggest struggle involves finding investments in the low medical complexity/high social complexity quadrant. It’s particularly hard to find ideas in that quadrant with a strong business model.

He’d particularly like to see more investment in tools and services to support people with substance abuse issues, such as alcohol and opiates, as well as people who struggle with homelessness or transportation gaps.

“We often ignore people in this category because they are young or healthy enough to still be able to cope in shelters or by riding the bus, but their situation is a set-up to move from low medical complexity to high medical complexity when chronic diseases start to set in and they are unable to afford or organize themselves to access basic care,” he said.

What do you think about this “foursquare framework?” Let me know @chrissyfarr on Twitter.