Founded in 2016, Precision Driven Health is a research partnership between New Zealands health IT sector, health providers and universities, aimed at improving health outcomes through data science. Ahead of the HIMSS20 conference, Kevin Ross, CEO of the organization, talks about the significance of data in delivering value-based care and the real challenges of collaboration between different stakeholders in data.

What are your thoughts on value-based care (vs the traditional fee-for-service model) and what can be done with healthcare data to create more value and personalized care for patients?

Value-based care is far preferable to a fee-for-service model, as long as we agree on value, and can be transparent in our approach. At its extreme, a fee-for-service model rewards someone who takes many attempts to get it right, whereas value-based care rewards the delivery of what matters in the most efficient way. Data has a huge role to play in this, particularly in helping to define and analyze the most appropriate metrics for value.

Data allows us to use a common language for value, and can make transparent the link between the activities undertaken in healthcare, and the value that is received by consumers. When data can be shared, people can see more clearly what they are receiving, and what is having the greatest impact. A fee-for-service tends to lead toward giving the same care for everyone, as we get good at efficiently delivering a particular procedure or program.

Data science allows us to analyze what works for different people, and if the objective is to deliver value, then the world of possibilities opens up. One person may benefit from medication, while another benefits from improvements to their living circumstances; value-based care gives us a framework to consider these in a common way.

As CEO of Precision Driven Health, what are some of the lessons learnt through coordinating collaborations between health professionals and data scientists in applying data science to enable precision health to become a reality?

Everyone is keen to collaborate and learn from each other, but there is often a lot of work up front to establish common language and understanding. We come with our biases, and are often unaware of how much they influence our thinking and expectations. I find that most people oversimplify the role of another collaborator and assume that it will fit into their own way of viewing the world.

For example, a data scientist thinks of a clinician as having a very transactional role of translating data into a diagnosis or next decision. While this may describe some of the core information exchange in clinical care, it is in reality only a small part of what happens and much of what happens is not captured in tidy data science language. Similarly, our clinicians often think that data science is one of two extremes either magic (just throw some data into a pot and out will come an answer), or predictable (the data will show that if we change X then Y will be improved). A good data science process involves a lot of workshopping, trial and error, human input and compromise.

What are your observations on the development of precision health in New Zealand? What opportunities do you see?

New Zealand has excellent quality data, enabled through a single identifier per person, known as the National Health Index. This allows twenty years of digital records to be linked and analyzed for historical patterns. Combining this data about a diverse population with excellent data scientists, clinicians and software developers, New Zealand is well positioned to be a testbed for innovations in precision health. Having a single-payer health system also helps to ensure that the best care for an individual usually corresponds with economic benefits to the whole system.

However, despite all of these advantages, the task is still very difficult. Healthcare changes slowly, and we must build public trust for/in new uses of data, and new ways of delivering care. Our clinical carers are not trained in data science, and our data scientists are new to healthcare so the changes that are readily seen in other industries have not yet taken hold on a large scale.

How do you think the use of healthcare data has led to better health outcomes in New Zealand? Could you give us some examples?

New Zealand has linked healthcare data to other government service data, including housing, education, justice. This has allowed us to understand the link between health and other social circumstances. As one example, a local health board has invested in improving the quality of homes in the neighborhood, to reduce the rates of respiratory issues caused by mold.

At the other end of the system, we have developed a localized calculator for the outcomes from elective surgery, developed based on all surgeries in the past ten years. We can now use this information for anyone considering a procedure, and explain what the outcomes are like for people like them. For minority groups who are not represented well in international studies, this allows a much better-informed conversation between surgeon, patient and family that helps to make the best long-term decisions.

Kevin Ross is a panelist at the HIMSS20 AsiaPac Summits Panel Discussion titled Preparing Data and Redesigning Metrics for Value-Based Care, scheduled for Wednesday, March 11 from 8.30am to 9.30am in room W240C. Additional registration is required click here for more details on the HIMSS20 AsiaPac Summit.

He is also the speaker for the session titled Ethical Machine Learning scheduled for Tuesday, March 10 from 1.30pm-2.30pm in room W207C.

Originally posted here:

Extracting data to deliver value-based care - Healthcare IT News

These three health care accounts have some similarities - and some very important differences.

There are a lot of acronyms when it comes to saving for your health care expenses. HSA, FSA, HRA. Which one should you choose?

Jonathon Hess of Athos Health, our Health Care Hacker, breaks down some of the differences.

HSA - Health Savings Account

FSA - Flexible Spending Account

HRA - Health Reimbursement Account

So, which one should you choose?

If you have the choice, Hess thinks you should alwayschoose the Health Savings Account (HSA). Some of the key reasons? It's your money, it rolls over so you never lose it, and it doubles as a retirement account.

If you have a question about your health care expenses, send it to us athealthcarehacks@kare11.com. We'll try to address it in the future episode.

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HSA, FSA, HRA: What's the difference? - KARE11.com

Efforts to alleviate long travel and wait times and appointment backlogs faced by military veterans at the VA Medical Center in East Orange have taken a small step forward with the approval of an alternate hospital site in Paramus where they can now receive care, but it may be awhile before a similar local alternative is offered in the Sussex/Warren county region.

The latest development, announced Friday by U.S. Rep. Josh Gottheimer, D-5th Dist., follows the June 2018 passage of federal legislation known as the VA MISSION Act. The law whose name is an acronym for "Maintaining Internal Systems and Strengthening Outside Networks" established a Community Care program intended to allow eligible veterans to receive care from non-VA facilities within their own communities.

At an October meeting with Vincent Immiti, director of the New Jersey Health Care System for the Department of Veterans Affairs, the congressman discussed issues faced by veterans seeking care at the VA hospital in East Orange including appointment delays of 30 days or more as well as frequent and abrupt appointment cancellations, often with little or no advance notice or explanation.

At the time, the congressman secured a commitment from Immiti to expedite the designation of Bergen New Bridge Medical Center in Paramus as a VA-approved community care provider so it, too, could begin accepting patient referrals for eligible veterans. According to Friday's announcement, covered veterans may now specify an eligible non-VA facility from which they would like to receive care, so long as the care is clinically necessary and not feasibly available through another VA facility.

"I've heard from veterans across the Fifth District who have had to drive over an hour, only to be met by long wait times and canceled appointments," said Gottheimer, who touted the fact that veterans in Bergen County would now have access to an alternate facility closer to home.

However, given the drive time of over an hour from most of Sussex and Warren counties to get to Paramus, it is not yet clear how much this announcement will help the veterans of northwest New Jersey.

Gottheimer previously had said he hoped to enable additional healthcare referrals to be made through Newton Medical Center and other local facilities, but so far it hasn't happened. With representatives of Newton Medical Center unavailable for comment Monday because of the Presidents' Day holiday, it could not immediately be determined how much progress, if any, has taken place on that front.

John Harrigan, president of Vietnam Veterans of America Chapter 1002 in Vernon, said in a phone conversation Monday that he would love it if veterans could access more healthcare services locally. "It would be great if somebody could work with the VA and do that," he said.

Currently, veterans have access to a VA outpatient clinic in Newton that operates mostly by appointment from 8 a.m. to 4:30 p.m. Monday through Friday. In addition to offering specialty referrals, the facility offers primary care and prescription services along with limited psychiatric and mental health services. For veterans like Harrigan who reside in northern Sussex County, an additional VA outpatient clinic also is located in Port Jervis, N.Y.

Harrigan said veterans can also receive basic, primary and prescription drug services on a walk-in basis at a CVS Minute Clinic in Sparta. Still, he said, being able to obtain specialty care at a local hospital or other facility would be of immeasurable value to veterans, particularly those with limited transportation options.

Gottheimer has said previously that he would like to see that become a reality for veterans from Sussex and Warren counties as well as those residing in Bergen County. We must always have the backs of those who have had ours, the brave men and women who have served our nation and defended our freedoms, he said.

Eric Obernauer can also be contacted on Twitter: @EricObernNJH or by phone at 973-383-1213.

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Efforts to expand veterans health care options continue - New Jersey Herald

Veterans Memorial Hospital Urgent Care is available seven days a week and designed for treating injuries or illnesses requiring immediate care, but not serious enough to require an emergency department visit.

Examples of what a patient may seek Urgent Care for could include back pain; bladder or urinary tract infection; cough; cuts, scrapes and bruises; diarrhea; fever, colds and flu; ear pain, swimmers ear, ear infection, or wax removal; insect or tick bite; joint pain; minor burn; nausea/vomiting; pink eye; rash; seasonal allergies; sinus and upper respiratory infection; sore or strep throat; strains/sprains; sudden back or neck pain; urinary problems or vaginal irritation/discharge. Most insurance does cover urgent care visits. Patients can usually expect to pay a copay or deductible for visits to Urgent Care treatment centers.

Urgent Care is offered every Monday through Friday evening from 5-9 p.m. and Saturdays, Sundays and holidays from 9 a.m. to 1 p.m. Patients may enter through the main entrance of the hospital and ask for urgent care. A registered nurse will assess each patient and decide if urgent care or ER is the level of care they need.

In addition to utilizing Urgent Care, Veterans Memorial Hospital also encourages community members to ask their provider if their care can be provided close to home, at Veterans Memorial Hospital. Many of the hospitals skilled care, surgical, maternity, laboratory, rehab and x-ray patients among others would have been sent elsewhere for their care, had they not specifically asked for local care.

Here is a list of some of the services patients can ask for locally for convenience:

Laboratory - Veterans Memorial Hospitals Laboratory has the ability to draw and run many lab tests locally. Specialists from out of town often require blood work prior to an appointment. Often those tests can be run locally and the results sent electronically the same day the blood is drawn. Weekly INR testing can also be completed by the hospitals lab as well as wellness testing which is provided daily from 7 a.m. to 2 p.m., Monday through Friday.

X-ray/Radiology Services - CT scans, mammograms, dexa bone densitometry scans, and ultrasounds are available the same or the next day.

Nuclear Medicine - Cardiac stress tests are available every Thursday at Veterans Memorial Hospital.

Respiratory Therapy - Pulmonary function testing is available the same or next day, overnight oximetry tests available within one or two days and sleep studies are scheduled within a month or less.

Rehabilitation - Physical therapy, Occupational therapy and Speech therapy can all begin within one to two days.

Nutrition and Diabetes - Consultations for nutrition or diabetes can also begin within one or two days.

We want everyone in our local communities to ask for local options before leaving the area for their health care, states Mike Myers, Administrator of Veterans Memorial Hospital. So many services can be provided close to home. Its convenient, top notch and our friendly staff truly shows how neighbors can care for neighbors.For questions on local medical testing and services, call Veterans Memorial Hospital at 563-568-3411.

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Urgent Care continues; Ask for other local health care options - Waukon Standard

Stephanie Rosas-Garcia

Three hours 22 minutes and 32 seconds have passed, and I have not moved from this hard seat in the basement of Jersey Citys Medical Center, but whos keeping track other than me. Certainly, not the three tired-looking members of staff who sit at the front desk shouting out peoples names from a list. By the time September has arrived, I have used all my paid time off, vacation and sick days to accompany my diabetic father to his countless doctor appointments appointments that could have been avoided had his treatment begun 11 years ago when he was first diagnosed with type 2 diabetes.

Unfortunately, a decade ago, access to anything but absolute emergency health care in New Jersey for an undocumented person was not feasible. Since then, and with the passing of the Affordable Care Act in 2010 by the Obama administration, hospitals have had an incentive to provide more care for uninsured patients. If hospitals did not meet the requirements, they were subject to a new $50,000 annual excise tax.

On average, a person in a private practice waits 30-35 minutes to be seen and 16 days to schedule a first-time visit with a new physician. Uninsured patients spend almost double that time to be seen and one to two months to schedule a new patient-physician appointment. The waiting time varies depending on location, staff numbers, among other reasons. Regardless of the new requirements, hospitals that care for a large population of charity care patients which includes those without insurance, or those without adequate coverage are only able to recover a small portion of the cost. The financial impact will depend, among other factors, on whether hospitals are located in states that expanded Medicaid coverage through the ACA.

As the debate for universal health care continues and Gov. Phil Murphy works to implement a state-based exchange, New Jersey needs to implement health care reform that includes undocumented residents. According to Migration Policy Institute analysis from 2012-2016, there were 526,000 undocumented folks living in New Jersey and 56% of those were uninsured. In addition, a 2018 report from New Jersey Policy Perspective showed that the state has the second-highest uninsured rate for children in the Northeast and many of these are from immigrant families. Research shows that if undocumented people have health insurance, usage of emergency rooms will decrease, there will be a healthier population, thus a stronger workforce. And simply stated, it is the right thing to do.

Most undocumented people do not receive health care until their medical condition has advanced requiring more costly and complex solutions or they frequently go for care to emergency rooms, which are more expensive and designed to respond to problem issues, not prevent or reduce their severity. In 2013, the New Jersey Department of Health implemented the federal Delivery System Reform Incentive Program (DSRIP). It was designed to result in better health care for individuals and the population, and to lower the cost of emergency-room use by incentivizing hospitals to achieve performance goals related to quality of care and health outcomes. Implementing health care literacy and having community health workers aid patients in the process, the program helped to cut expenses in the states where it was implemented. A study by the United Hospital Fund on DSRIPs Promising Practices found that using community health workers in a care triage program decreased emergency-department visits from 184 in the 12 months preceding program enrollment to 56 visits in the six months post-enrollment. Using this model and providing undocumented people with health insurance that allows them to see a primary care physician once a year would surely reduce the use of emergency rooms and lead to a healthier population.

California recently became the first state to pass legislation to allow undocumented people to buy coverage on state-run exchanges with their own money and without using any public subsidy a change some have recommended for New Jersey. California officials believe this to be a cost-saving measure since 70% of undocumented people living there are in mixed-status families, whose members include people with different citizenship or immigration status. This change allows for everyone in the family to buy into coverage, not just some members. It is also the first state to offer government-subsidized health benefits to young undocumented adults. If New Jersey cannot agree on providing insurance to all undocumented New Jerseyans, we should at least consider providing health insurance for those below the age of 25. Californias legislation has proved that providing those under 25 with health insurance has been beneficial to the state.

In expanding care to those without legal residency status, New Jersey would thrive with a healthier community, the most vulnerable population would not have to spend their limited days off work every month to go to a doctor appointment, and hospitals would not be at capacity with charity care patients making it seemingly impossible to see everyone hence the hours-long waiting times and the five months it can take to schedule a visit to a specialist.

A recent report by New Jersey Policy Perspective agrees that coverage reduces adverse health outcomes for children, provides major social benefits, and lessens medical debt for residents. The 2019 study argues that over half of all uninsured children in New Jersey are eligible for New Jersey Family Care, the states Medicaid program. One reason for this high uninsured rate is because New Jersey has the sixth highest number of children in immigrant families in the nation and immigrant parents are reluctant to enroll their children in any public program for fear of federal anti-immigrant policies. Studies show that immigrant families are specifically concerned about the proposed public charge rule that could result in the denial of citizenship to legal-immigrant parents if their child received Medicaid. Since almost all of these children are eligible for coverage that is matched by the federal government under the status quo, New Jersey is losing up to $60 million annually in federal funds for uninsured children. It is estimated that between 22,500 to 52,500 citizen children in New Jersey Family Care with noncitizen parents could lose coverage because of the public charge rule.

Those who oppose these measures may argue that providing health insurance for undocumented people would incentivize migration and that New Jersey taxpayers should not subsidize their care. To those, I ask, What if you suddenly fell ill and lost your job and could not afford health insurance? Wouldnt you want help? How can you decide if a person deserves to live or not just because they do not have a Social Security number?

Extending access to care for undocumented immigrants would be a meaningful step to a more prosperous New Jersey. With the current Democratic presidential candidates unanimously agreeing to support policies that provide health care for undocumented people, New Jersey politicians or health care administrators should hold public forums or do assessments to understand what the population needs. And New Jersey should follow the lead of California in order to decrease the number of uninsured patients and thus help the hospitals financially and the state overall. New Jersey is heading in the right direction by issuing driver licenses to undocumented residents. Politicians must not forget about health care for all.

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Op-Ed: Why NJ Should Give Better Health Care Options to Undocumented Residents - NJ Spotlight

Another video of former New York City Mayor Michael Bloomberg has resurfaced. Back in 2011, the billionaire paid his respects to the Segal family for the passing of Rabbi Moshe Segal of Flatbush. During that time, Jewish families undergo Shiva, a 7-day mourning period. Bloomberg stopped by to issue his condolences to the family.

Interestingly enough, the then-mayor used the opportunity to talk about overcrowding in emergency rooms, Obamacare and a range of other issues, The Yeshiva World reported at the time. One of those topics included denying health care to the elderly.

"They'll fix what they can right away. If you're bleeding, they'll stop the bleeding. If you need an x-ray, you're gonna have to wait," Bloomberg said. "All of these costs keep going up. Nobody wants to pay any more money and, at the rate we're going, health care is going to bankrupt us."

But don't worry. He believes he has a way of addressing cost concerns.

"Not only do we have a problem but we gotta sit here and say which things we're gonna do and which things we're not. No one wants to do that," he said. "If you show up with prostate cancer, you're 95-years-olds, we should say, 'Go and enjoy. Have nice live a long life.' There's no cure and there's nothing we can do. If you're a young person, we should do something about it. Societys not willing to do that, yet. So they're gonna bankrupt us."

Who is Michael Bloomberg to decide who should and should not receive health care treatments? He has a tonof money and we know he'd do everything in his power to get the best doctors and treatment available if he or his loved ones became ill. They wouldn't be told they're too old or too broke, would they?

And who would be impacted by this decision? At what point is someone too old to treat? 60? 75? 80? What's the arbitrary number, Mike? Whatever random number you decide on?

What about those who have chronic illnesses, like diabetes or multiple sclerosis? Do they suddenly stop receiving treatment once they hit a certain age, because they're no longer deemed worthy?

And here I thought Democrats were supposed to want to take care of anybody and everybody. Guess not.

Read the original:

Bloomberg: We Can No Longer Provide Health Care to the Elderly - Townhall

A healthcare provider with a Glendale location has received a $150,000 grant to expand its dental services to more underserved children.

Comprehensive Community Health Centers, which also operates facilities with dental care in Eagle Rock and Sunland, will use the grant to partially fund the salaries of a pediatric dentist and general dentist.

Funds will come from L.A. Care Health Plan, a public agency that offers healthcare plans to low-income and other vulnerable populations, also known as a public option.

The agency awarded $1.65 million in grants for the purpose of expanding dental care to 11 healthcare providers throughout L.A. County, including Comprehensive Community Health Centers.

The reality is dental care is often overlooked, just as behavioral health is often overlooked, said Dr. Richard Seidman, chief medical officer of L.A. Care.

That leads to the progression of preventable tooth decay, which can lead to more serious, and more costly, medical problems, according to Seidman.

Were aiming to put the mouth back in the body and address the needs of the whole person, Seidman said.

Comprehensive Community Healths Glendale center has worked to integrate its medical and dental-care models, according to Toyin Idehen, director of development for all of the centers.

The idea is to screen children for tooth decay, also known as dental caries, while they are getting their medical checkups.

If risk is identified, the child can potentially walk over to the dental-care provider and receive treatment the same day.

That could reduce the number of times parents have to take off work and children have to take off school, as well as other burdens that low-income and communities of color in particular face when accessing healthcare, according to Idehen.

Now, Comprehensive Community Health will try to build the same model at its newer Sunland center, where the pair of dentists the provider plans to hire will focus their time.

We are kind of replicating and marrying what we are doing at Glendale because it is a successful program, Idehen said.

Last year, the Glendale center saw 4,315 children in its dental department. About 9,330 dental patients in total were treated across all sites during the same year. Nearly 700 were uninsured.

Thats a huge number, Idehen said.

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Local healthcare provider receives grant to expand child dental care - Los Angeles Times

The holy grail for technology companies working in the healthcare industry is becoming the gateway for all healthcare data.

Big legacy providers like Epic and Cerner are trying to reach out to hospital networks to hoover up all of their data. Google is interested in it. Salesforce is interested in it. Everyone wants to be the resource that organizes and manages healthcare data for physicians and hospital providers, including San Francisco-based startup Innovaccer, which has raised $70 million in new financing to finance its mission.

The new investment from firms including Steadview Capital, Tiger Global, Dragoneer, Westbridge Capital, the Abu Dhabi investment firm Mubadala Capital and Microsofts corporate investment arm M12.

These are deep-pocketed investors for whom money is no object, but Innovaccer has shown a fair bit of traction among hospitals and health systems with its data analysis and management platform.

The companys software pulls from datasets, generated by Cerner and Epics healthcare records, insurance companies and pharmacies, to create a more holistic view of a patient, the company says.

Since its launch in 2014, Innovaccer has provided a single source or healthcare information for 3.8 million patients and saved healthcare systems more than $400 million, the company said.

Healthcare still needs a lot of work to become patient-centered and connected by organizing information and making it more accessible. It is really important to make patient data seamlessly available to all providers along the patients care journey, said Abhinav Shashank, the co-founder and CEO at Innovaccer, in a statement. We have been fortunate to work with transformational healthcare initiatives that our amazing customers are engaged in. The vision of helping healthcare work as one needs a connected and open technology framework. We are excited to be at the forefront of providing the tech platform for our customers to drive that change.

Its technology relies on over 200 APIs to take data from health plans, primary care providers, pharmacies, labs and hospitals and serves that data to 25,000 care providers. The company hopes to take that number to over 100 million healthcare records and 500,000 caregivers over the next several years.

Its a lofty goal, but one that appeals to the Ravi Mehta, the founder of the $2.5 billion hedge fund Steadview Capital.

By using their connected care framework coupled with their leading-edge data aggregation and analytics platform, they are unifying patient records and enabling care teams to coordinate patient care at a new level, said Mehta. We believe this will achieve greater efficiencies, enable better care and reduce overall healthcare spend in the years to come.

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Innovaccer wants to be the service that unifies all healthcare data - TechCrunch

News Release, US Department of Veteran Affairs

WASHINGTON The U.S. Department of Veterans Affairs (VA) partnered with Verizon, Medivis, and Microsoft, effective Feb. 12, as part of its efforts to deliver Veterans VAs first advanced, 5G-enabled, clinical care system at theVA Palo Alto Health Care System.

The public-private partnership, Project Convergence, will be led by VAsNational Center for Collaborative Health Care Innovationand work to help identify potential clinical uses for technology that combine emerging health care innovations with 5G capabilities.

Last year, President Trump challenged America to be among the first to provide 5G wireless services, and VA met that challenge, said VA Secretary Robert Wilkie. Our hospital in Palo Alto, California is currently one of only a handful of 5G enabled health facilities in the world. Were excited to use this hands-on opportunity to work with our partners to develop foundational practices and deploy advanced medical solutions to serve our nations Veterans.

Project Convergence will unveil and demonstrate initial clinical uses of the combined technology at the upcomingHealth Information and Management Systems Society conferencein Orlando, Florida, March 9-13.

The Southern Maryland Chronicle is a local, small business entrusted to provide factual, unbiased reporting to the Southern Maryland Community.While we look to local businesses for advertising, we hope to keep that cost as low as possible in order to attract even the smallest of local businesses and help them get out to the public. We must also be able to pay employees(part-time and full-time), along with equipment, and website related things. We never want to make the Chronicle a pay-wall style news site.

To that end, we are looking to the community to offer donations. Whether its a one-time donation or you set up a reoccurring monthly donation. It is all appreciated. All donations at this time will be going to furthering the Chronicle through hiring individuals that have the same goals of providing fair, and unbiased news to the community. For now, donations will be going to a business PayPal account I have set-up for the Southern Maryland Chronicle, KDC Designs. All business transactions currently occur within this PayPal account. If you have any questions regarding this you can email me at davidhiggins@southernmarylandchronicle.com

Thank you for all of your support and I hope to continue bringing Southern Maryland the best news possible for a very long time. David M. Higgins II

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VA partners with Verizon, Medivis, and Microsoft to advance health care services for Veterans - The Southern Maryland Chronicle

Kahuna Workforce Solutions (Houston, TX) and Intermountain Healthcare (Salt Lake City, UT) are announcing today the completion of a commercialization agreement wherein Kahuna has exclusively licensed Intermountain Healthcares unique competency management content for healthcare organizations. Under terms of the agreement, Kahuna will market and distribute Intermountains competency management content within its proven SaaS platform and offer the combined solution to the healthcare market. The digital competency assurance platform will enable integrated healthcare systems to track and manage their workforce capabilities to meet enterprise staffing needs.

Healthcare organizations are undergoing a massive move toward digitization as they strive to operate more efficiently and more consistently relative to the accepted standard of care. Processes from orientation to continuous learning to staffing are all being examined. The conclusion for many is that the current manual, paper-laden processes are not scalable or sustainable and typically result in costly redundancies, siloed data, and general frustration.

Having digitized their own clinical competency management processes, Intermountain Healthcare has realized operational efficiencies and has validated their clinical competency content with over 3.6 million competency assessments. These efforts have resulted in a significant ROI with over $13 million in savings in the first six years, and an amazing record of zero Joint Commission audit findings with their digitized competency content.

"Digitizing our orientation processes has been a game-changer. We started 11 years ago and invested significant time and resources into standardizing our role-based curricula and observational assessments into required behavioral expectations. Defining the exact skills each role needed and providing the content in a digital platform has made the entire organization more efficient," said Tammy Richards, Intermountains Assistant Vice President of Professional Practice and Learning. "This solution helps our staff work at the top of their license and gets them doing the work theyre qualified to do as quickly as possible. Working with Kahuna, we now have the opportunity to take what weve done to a whole new level and bring this solution to our peers across the healthcare industry."

The Kahuna/Intermountain solution vastly improves these processes through the combination of leading-edge technology and best-in-class competency content. The combined Kahuna/Intermountain solution achieves the following:

Kahuna brings a best-of-breed competency management platform that has been built to serve the needs of complex global competency assurance environments. Kahunas CEO, Jai Shah, said of the partnership, "We have worked very hard to build a skills platform that works for regulated environments and always knew we could deliver significant value in healthcare. To enter the market with a gold standard organization such as Intermountain Healthcare as both a customer and a partner is just an amazing opportunity."

Intermountain provides validated competency and skills content that has been curated to suit a number of various roles (nursing and non-nursing). This content library can fill the gap for systems needing assessment criteria designed by healthcare professionals and organized in a user-friendly format. "Oftentimes, the inertia in competency or skills initiatives is the lack of alignment on the actual content. Beyond being associated with a great brand like Intermountain, the idea that we can offer such high-quality validated content to the healthcare market makes this partnership very exciting," added Shah.

"Our market analysis confirmed that the competency management processes for clinical personnel are ripe for improvement across our industry. By partnering with Kahuna, we are bringing something revolutionary to healthcare institutions by addressing very real and material inefficiencies," said Mike Phillips, M.D., Managing Director and Partner for Intermountain Ventures. "While this partnership with Kahuna marks an important milestone for our internal innovation program and for Ventures, more importantly, this solution creates significant internal value while also laying a foundation for how other institutions can plan, develop, and deploy their clinical resources in the future."

Story continues

About Kahuna Workforce Solutions

Kahuna Workforce Solutions is transforming competency management and workforce planning. The flagship Kahuna platform helps organizations gain an objective view of their workforces capabilities, measure talent supply against current and future demand, and maximize the return on training investment. Kahuna is used in a wide array of industries, including oil and gas, healthcare, manufacturing, construction, and aerospace. For more information, visit http://www.kahunaworkforce.com/healthcare.

About Intermountain Healthcare

Intermountain Healthcare is a regional system of 24 hospitals, 215 clinics, a Medical Group with 2,500 employed physicians and advanced practice clinicians, a health insurance company called SelectHealth, and other health services in Nevada, Idaho, and Utah. In Nevada, Healthcare Partners is an Intermountain Healthcare company. Intermountain Healthcare is widely recognized as a leader in transforming healthcare by using evidence-based best practices to consistently deliver high-quality outcomes and sustainable costs.

View source version on businesswire.com: https://www.businesswire.com/news/home/20200219005494/en/

Contacts

Torrye Metoyertorrye.metoyer@kahunaworkforce.com

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Kahuna Workforce Solutions and Intermountain Healthcare Create Partnership Focused on Revolutionizing Competency Management in Healthcare - Yahoo...

Of the many ingredients that go into quality healthcare, comprehensive patient data is close to the top of the list. No one knows this more than Mayur Saxena, CEO and founder of Droice Labs. Saxena created his startup while he was pursuing his doctorate degree at Columbia University, and working at healthcare company conducting clinical trials on new medication. Hes energized by the plethora of opportunities to improve healthcare using artificial intelligence (AI) and machine learning.

Mayur Saxena, CEO and founder of Droice Labs, is energized by the plethora of opportunities to improve healthcare using artificial intelligence (AI) and machine learning.

Patient data is notoriously disorganized and complex, he said. With machine learning, healthcare professionals can organize that information to better understand the disease of every patient and reach them faster with interventions that improve their lives. Its an amazing feeling when you talk with someone whos recovered from an illness because they received the right care.

The idea behind Droice is to make messy data neat, so people can spend less time organizing it and more time analyzing it.

Insights drive personalized patient care

The startup has collected data from 50 million patients in working with healthcare providers, payors, and government organizations in the U.S. and Europe. Healthcare professionals in hospitals, pharmaceutical firms, medical device manufacturing, and insurance rely on Droice Labs natural language understanding (NLU) technology. NLU make sense of patient information in multiple languages from anywhere such as electronic medical records (EMR), insurance claims, research reports, and medical devices.

Our machine learning system takes all the data about an individual into account, and breaks it down so that a doctor, pharmaceutical scientist or healthcare insurer can understand patients better and faster, said Saxena. Instead of repetitive, disparate one-on-one diagnoses and follow-up care, were automating personalized care for a much larger patient population. With shared insights across a large patient population, physicians can chart disease progress and prescribe the best treatment plan. Clinical research into new drugs that took years could be reduced to days or weeks.

Saxena said that one hospital reduced the amount of time it took to arrive at an appropriate diagnosis for patients by over 20 percent.

SAP.iO Foundry opens up world of healthcare opportunities

Droice Labs recently participated in the latest healthcare-focused accelerator program at SAP.iO Foundry New York. It was one of seven up and coming startups working with hospital system providers, employee health and wellness solutions, medical devices, and health IT.

Weve learned so much about customers in the healthcare industry from SAPs sales and product teams, said Saxena. These large organizations have unique needs, and were grateful for the opportunity to partner with SAP, a company with a massive presence across so many geographies. Weve gained valuable insights about strategic global selling and scaling our technology to meet the unique requirements of these customers.

The Droice Labs machine learning platform is now downloadable on the SAP App Center.

Turning long-time passion into thriving startup

Droice Labs reflects Saxenas long-time personal and career commitment to healthcare. After earning his undergraduate degree in bioengineering and biomedical engineering, he worked in high-performance computing in Singapore before arriving in the United States. Thats when he acted on his passion, exploring how AI and machine learning can help improve patient care, and potentially eradicate disease.

Were looking at data from hundreds of thousands of patients a day, helping improve their care pathways across the healthcare system, said Saxena. We have the technology to work with patient data at scale. Im most excited about working together with recognized healthcare experts using state-of-the-art technology to address major challenges in this complicated, regulated industry.

Digitally trustworthy strategy

In an environment where patient concerns and regulations around data control continue to increase, Saxena emphasized his companys strategy of digital trust.

Everything we do is designed to respect individual patient privacy, he said. We dont possess related identifying data on patients, and we remove any identifiers. Working in a mission critical environment like healthcare brings a set of responsibilities. If there is a population suffering from disease, and by looking at their information we can partner with healthcare providers to help make their quality of life better, thats what well do. But we dont participate in business models targeted to specific individuals.

Saxena expected his companys rapid growth trajectory to continue, and it was easy to see why. According to Gartners 2020 CIO Survey, AI is the healthcare industrys top game-changing technology. These analysts predicted 75 percent ofhealthcare delivery organizationswill invest in an AI capability to explicitly improve either operational performance or clinical outcomes by 2021.

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AI Is Top Game-Changing Technology In Healthcare Industry - Forbes

Tuesday, 18 February 2020

In 2018, one Belgian in twenty did not go to see a GP, dentist or go to hospital, Mutualits Libres announced on Tuesday in a press release.

Freelancers, Brussels inhabitants, men and singles are especially concerned, they stipulated in their review. They, therefore, advocate raising awareness specifically in the case of these profiles so that the persons concerned can benefit from sufficient preventative health care.

Mutualits Libres conducted a study to determine the percentage of non-users of medical care. The figure was 5.4% in 2018, a decrease in comparison to a similar study in 2010 when it stood at 7%.

Not consulting a health-care provider for a year also means not benefiting from prevention services, it pointed out in the press release. This can be detrimental to health in the long run and also lead to an increase in health care costs, as much for the patient as for medical insurance concerns.

The mutual society presents a typical non-users of medical care profile based on its affiliates reimbursement data. This mainly concerns freelancers (20% of non-users), men (70%), Brussels inhabitants (33%), young persons (average age 34), singles (60%) and persons living on low incomes.

In order to increase prevention, Mutualits Libres considers that it would be necessary to establish information campaigns, notably in certain districts in Brussels.

The Brussels Times

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One Belgian in twenty did not use health care in 2018 - The Brussels Times

Dr Priit Tohver is on a mission to make health data more usable.

The man overseeing the digital transformation and innovation of health and welfare systems in Estonia, became inspired as a medical student when he tried to use electronic health records (EHRs) for a study on ocular melanoma.

That showed me how unsuitable the current health data is for any kind of analytics, he explains. To this day it drives me to make the health data we gather more structured and useful, not only to researchers and innovators but to physicians themselves, so that it can feed back into the healthcare system and we can learn as we go.

At the HIMSS20 conference,Tohver will talk about a subject close to his heart social determinants of health.

Since 2018, the Ministry of Social Affairshas been undertaking a project to identify disadvantaged youths aged 16-26 that are at danger of falling through the cracks of society.

By combining different state-level databases, researchers have identified young people not in education, training or employmentso that they can be offered assistance from case workers.

By not being in education or employment youre putting your health at a disadvantage, so by addressing these factors smartly youre achieving a health outcome, Tohver says.

But the project has not been without its hurdles. We experienced the challenges of combining data sets - even if you can do it on a technical level and the data is interoperable, there are challenges when it comes to the legal space and change management, because this data is usually sitting in silos.

Initially, there was hesitancefrom officials about screening people without their consent. But, Tohver says feedback from the public has been positive and few have chosen to opt out of having their data processed in future. The programme has helped around 800 young people so far and provided valuable learnings for future projects.

We learnt how this data can be combined, what kind of permits are needed, and that this kind of smart screening can be done after the EUs General Data Protection Regulation (GDPR), Tohver says.

The ministry now aims to leverage its learnings to better detect the risk of cardiovascular eventsby training an algorithm to analyse patients social background alongside clinical data.

Theres a long-standing understanding that about 60% of health is dependent on things outside of the healthcare system and genes, such as social status and health behaviour. This is our first attempt to start tying that in on a systematic level.

Once people at risk are identified, interventions could be offered to them, such as discussing statin treatment and other optionswith their primary care physician.

Data can transform how evidence-based our decisions are, how many people suffer from medical error and the recovery process of people living with chronic disease. Theres always something that can be done better, Tohver concludes.

The HIMSS20 conferenceis set for March 9-13 at the Orange County Convention Center in Orlando, Florida.Tohver will talk at Population health management toolbox for the future and Updates from the Nordic Interoperability Project.

Healthcare IT News is a HIMSS Media publication.

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Leveraging the value of data - Healthcare IT News

Published: 01/16/20 03:50 pm EST

Updated: 01/16/20 06:39 pm EST

COLUMBUS, Ohio (AP) Thousands of retired public employees will have to pay more of their health care costs starting in 2022 after trustees for the Ohio Public Employees Retirement System voted Wednesday to reduce health care benefits.

The trustees voted 9-2 on changes that will affect current and future retirees, beginning January of 2022. Those changes include cutting the monthly allowance paid to retirees who are eligible for Medicare ages 65 and older and eliminating the health care plan for retirees who arent eligible for Medicare.

The changes will result in cuts in health benefits for 304,000 workers when they retire and 213,000 current retirees.

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Without the changes, the retirement system projected its $11.3 billion health care fund would run out of money by 2030.

Under the changes, the monthly allowance to help offset health care costs that is paid to retirees who are Medicare eligible will drop from between $225 and $405 per month to a range of $178 to $315 per month. The system plans to give retirees not eligible for Medicare money that they can use to buy insurance on the individual market.

The retirement system has $94 billion in assets for pension benefits and serves 1.14 million people.

2020 by The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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Ohio's retired public employees to see cuts in health care benefits - 10TV

Planned Parenthood pledges $45M for 2020

Planned Parenthood is expected to spend $45 million on the 2020 election backing candidates who favor abortion; reaction and analysis from Former Planned Parenthood clinic director Abby Johnson.

The $45 million Planned Parenthood has pledged for 2020 candidateswould be better spent onhealth care for low-income women, former Planned Parenthood director and pro-life advocate Abby Johnson said Saturday.

The pledge marks the organization's biggest electoral effortin its history, supporting presidential, congressional and state-level candidates.Earlier thisweek, thegroup launched its"WeDecide2020" campaign in six key battleground states.

PLANNED PARENTHOOD LAUNCHES 2020 INITIATIVE WITH ENDORSEMENTS, 5-FIGURE AD BUY

Appearing on "Fox & Friends: Weekend" with host Rachel Campos-Duffy, Johnson noted that while Planned Parenthoodsunkover $25 million in the 2016 campaign, President Trump still upset former Secretary of State Hillary Clinton.

Johnson told Campos-Duffy that the political campaign"isn't really about health care for them."

"Health care is down very, very low on their list of priorities," she said. The organizationlost $60 million in Title X funding"by their choosing, because they refused to stop referring and providing abortions."

"And, instead of saying, 'You know, well OK, we are going to take this $45 million and put it into health care for low-income women' ... they're putting it and investing it into fringe candidates who believe in abortion up until birth," Johnson said.

"Our country is at a crossroads, but now its time for us to reclaim our power," Jenny Lawson, Planned Parenthood Votes executive director,said in a statement. "In 2020, were fighting back and electing reproductive champions up and down the ballot -- because our futures depend on it."

Johnson said the2020 election is extremely important for Planned Parenthood. "If they can win this election, they can overturn state [anti-abortion]regulations that have been very effective nationwide," she said.

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"But, you know, I think that more and more people are standing up ... to Planned Parenthood," Johnson said, noting that the pro-life Susan B. Anthony Liston Friday launched a $52 million campaign tohelp keep President Trump in office.

"That's really exciting," she said.

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Former Planned Parenthood director on $45M 2020 pledge: This is 'not really about health care' - Fox News

A U.S. senator from Indiana wants to expand broadband and telemedicine to improve maternal and infant health.Republican Sen. Todd Young is co-sponsoring the "Data Mapping to Save Moms' Lives Act." He visited Clark Memorial Health on Friday to promote the bill, and to learn more about their OB Navigator telehealth program. The bill requires the Federal Communications Comission to track two things: broadband access and maternal health data. The information will be used to determine where to expand high-speed internet across the U.S."Smartly investing in broadband technology can really improve access to health services and reduce the cost of our health care expenditures ultimately, as well," said Young.Young says Indiana is the third-worst state in the nation for maternal mortality and the seventh-worst for infant deaths.

A U.S. senator from Indiana wants to expand broadband and telemedicine to improve maternal and infant health.

Republican Sen. Todd Young is co-sponsoring the "Data Mapping to Save Moms' Lives Act." He visited Clark Memorial Health on Friday to promote the bill, and to learn more about their OB Navigator telehealth program.

The bill requires the Federal Communications Comission to track two things: broadband access and maternal health data. The information will be used to determine where to expand high-speed internet across the U.S.

"Smartly investing in broadband technology can really improve access to health services and reduce the cost of our health care expenditures ultimately, as well," said Young.

Young says Indiana is the third-worst state in the nation for maternal mortality and the seventh-worst for infant deaths.

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Indiana senator unveils bill aimed at improving health care among mothers, babies - WLKY Louisville

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On the week of the biggest annual meeting for biotech investors, biotech funds saw their steepest outflows since late July.

In his regular note tracking a sample of healthcare/biotech-dedicated funds, Piper Sandler analyst Christopher J. Raymond wrote that in the seven days ending at the close of business on January 15, roughly $787 million left the funds. Thats a 0.95% drop and the largest number since the last week in July, when $872 million left the funds.

The week includes most of the J.P. Morgan Healthcare Conference, which drew thousands of biotech, pharmaceutical, and other health-care executives and investors to San Francisco for days of meetings. The SPDR S&P Biotech ETF (ticker: XBI) fell 2% on the first day of the conference, January 13, on disappointment over the absence of any major acquisitions. But the index rose as the conference progressed, up 2.9% on January 14 and 0.7% on January 15.

The weeks outflows followed a strong week, which saw inflows of $891 million.

The sample of funds that Raymond tracks includes 121 funds with roughly $84 billion in assets, and is reported by Lipper/AMG Data Services.

This is a key dynamic to monitor as periods of net inflows historically correspond with biotech outperformance while periods of net outflows correspond with sector underperformance, Raymond wrote.

The XBI is up 2.1% so far this year, while the iShares NASDAQ Biotechnology ETF (IBB) is up 1.5%.

Write to Josh Nathan-Kazis at josh.nathan-kazis@barrons.com

Excerpt from:

Investors Fled Biotech Funds This Week During the Biggest Health-Care Conference of the Year - Barron's

SAN FRANCISCO Yet another J.P. Morgan Healthcare Conference is done. Was it worth it?

All in all, this was a really pleasant week in San Francisco. The weather this year was an A-minus. There was a noticeable drop in attendance. Meeting rooms werent jam-packed. Ubers and Lyfts were easy to hail and coffee shops were bustling but not overloaded.

Maybe thats the simple solution to the hand-wringing over the future of JPM: fewer of you, plus sun.

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But FOMO!

The JPM circus has too many tents. It wasnt always this way. Once upon a time, everyone fit semi-comfortably in a single hotel on Union Square. And it was called JPM for a reason it was to serve the monied interests of a certain large Wall Street investment bank. And, in that sense, it has continued to serve that purpose. Its pay-to-play on a billion-dollar scale. Jamie Dimons health care bankers assemble a roster of presenting companies that either already pay investment banking fees, or will eventually. The select group of investor clients who fill the seats pay trading commissions to the banks brokers.

Im not passing judgment. Thats simply the way Wall Street works.

But at a certain point, JPM changed. Other investment banks and biopharma hangers-on bumrushed San Francisco to pick Dimons pocket. Then things got complicated. The conference got bigger, more unwieldy, less fun? Last year, we reached peak disgruntlement over rapacious hoteliers and the citys well-documented social and public health problems.

Maybe wed be better leaving JPM to J.P. Morgan.

What would everyone else do? For starters, there are dozens of alternative health care investment conferences held in New York, Boston, London, Miami, and Las Vegas. There are 51 other weeks during the year to attend those meetings.

Heres another idea. BIO, the industry trade group, should rethink and revamp its own investor conferences held in New York in February and San Francisco in October. Lets be honest, these events, which attempt to promote smaller biotechs, are not showstoppers.

How about merging the BIO events with Biotech Showcase, the largest, non-awful, non-JPM Week conference that also attracts smaller biotechs and their investors? Keep the San Francisco locale but move the combined events to October. Id attend.

Similarly, non-investor biotech folks cramming into San Francisco this week have plenty of other places to go. This is not an industry lacking attractive travel opportunities. Medical, science, and research meetings span the globe. Enjoy them!

BIO, again, should show some more leadership here by expanding its annual convention. There isnt a non-investor event held in San Francisco this week that couldnt happily inhabit a bolstered BIO convention, usually held in June in wonderful cities like San Diego, Boston, or Washington, D.C.

Anywhere but San Francisco in January. Leave that to J.P. Morgan.

Excerpt from:

The truth about the JP Morgan Healthcare Conference: Less is more - STAT

An MRI scan that cost $1,400 here went for $450 in Britain and $190 in Holland. Thirty tablets of a drug to reduce the risk of blood clots (Xarelto) cost $380 here, $70 in Britain, $80 in Switzerland and $60 in Holland. Hospital admission for angioplasty is $32,000 here, $15,000 in Australia, $12,000 in Britain, $7,000 in Switzerland, $6,000 in the Netherlands.

Add to those differences the latest outrage in health-care costs: surprise medical billing, when even well-insured patients can wake up from surgery finding that they owe thousands of dollars, because someone treating them while they were unconscious was out of their insurance network.

Princeton economists Anne Case and Angus Deaton (a Nobel winner) recently summarized the problem by labeling it an $8,000-a-year annual health-care tax paid by U.S. families. This is the difference in costs between what we pay for health care and what people in other countries pay. As Case put it: We can brag we have the most expensive health care. We can also now brag that it delivers the worst health of any rich country.

Why call this expense a tax? Well, for one, if you want health coverage, you cant escape it. But even if you dont and good luck with that you still cant escape the tax, as both employer- and government-provided health care extract payments through lower paychecks and public financing.

Case and Deaton may be erring on the low side in their $8,000-per-family figure. The Organization for Economic Cooperation and Development puts per-person spending in the United States at $8,950 a year. That compares with $5,060 in Germany, $3,470 in Canada and just $3,140 in Britain. If we assume a family of three, we would get an annual health-care tax of $11,670 compared with Germany and more than $17,000 compared with the cost of health care in Britain.

How can such differences persist, especially in a service where consumption is so essential to well-being? If ice cream were that much more expensive here, wed have a lot to squawk about, for sure. But it wouldnt be a matter of life and death.

An obvious, and correct, answer as to why U.S. health care is so expensive is because we do so little, relative to other systems, to control costs. But its worse than that. We do a fair amount to make health care more expensive.

First, our system of private insurance costs far more than single-payer systems like Canadas, and also more than countries with private but heavily regulated insurers like Germany. OECD data show that as a share of health spending, our administrative costs are three times that of Canadas and twice that of Germanys. Getting our administrative costs closer to those in other countries would require regulating private insurers and expanding public coverage, but it could save us at least 10 percent of our total health-care bill.

Next, we pay twice as much to our health-care providers and for prescription drugs as everyone else. The latter costs us more than $3,000 per family per year. We pay more than twice as much for medical equipment, costing us a bit less than $1,500 per family per year. Doctors and dentists cost us close to an extra $750 per family per year.

One reason for the outsize costs of these inputs to U.S. health care is that government policy protects our providers. When it comes to manufactured goods, like cars and clothes and almost everything on the shelves of Walmart, economists and policymakers push for free trade and more competition. But when it comes to health-care providers, these same authorities turn protectionist.

In areas like prescription drugs and medical equipment, this protection is explicit: Manufacturers are granted patent monopolies. The government will arrest anyone who sells protected items in competition with a patent holder.

In the case of doctors, we have maintained or increased barriers that make it difficult for qualified foreign physicians to practice in the United States. We also prevent other health-care professionals, such as physicians assistants and nurse practitioners, from doing many tasks for which they are entirely competent. There is a similar story with dentists and dental hygienists.

Other countries directly control drug prices. In France, the government determines whether a new drug is an improvement or a copycat, and, if the drug is deemed useful, the government negotiates drug prices with the manufacturers and caps their revenue. When sales exceed the cap, the manufacturer must rebate most of the difference back to the government.

Here in the United States, we give drug companies and medical equipment manufacturers patent monopolies and allow them to charge whatever they want. We dont even let the government use its massive leverage to negotiate lower drug prices for Medicare beneficiaries. Thats what makes these goods expensive; theyre almost always relatively cheap to produce.

This is fixable. It would take regulating costs, reducing reimbursements to providers and increasing competition.

The pharmaceutical industrys rationale for cost-exploding medical patents is that it helps incentivize research and innovation. Without them, its likely that pharmaceuticals and medical equipment companies would do less speculative research. But it would take a fraction of the savings from reducing such protectionism to replace patent-support research with publicly supported research (for which we already spend $40 billion a year).

In terms of boosting competition, allowing foreign doctors whose training meets our standards to more easily practice medicine here would bring U.S. physicians pay in line with international standards. Of course, our doctors pay much more for their education than doctors trained elsewhere, so part of this new structure would also require reducing the domestic cost of medical education and alleviating some of the educational debt burden that U.S.-trained doctors have acquired.

Increasing competition would also require using antitrust measures to push back on the pricing power engendered by the consolidation of both hospital groups and medical practices. An analysis by the New York Times of 25 metro areas found that hospital mergers have essentially banished competition and raised prices for hospital admissions.

Even if we succeed in raising competition and reducing protectionism, health care will still be too expensive for many low- and moderate-income families, many of whom have suffered stagnant incomes in recent decades. Like every other wealthy country, we will need to get on a path to universal coverage. But whatever form that takes, if we can significantly reduce our current health-care tax, the savings will easily be large enough to extend quality, affordable coverage to every American.

Jared Bernstein, chief economist to former vice president Joe Biden, is a senior fellow at the Center on Budget and Policy Priorities.

Dean Baker is a senior economist at the Center for Economic and Policy Research.

This column first appeared in the Washington Post.

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Reducing the Health Care Tax - CounterPunch

LONGVIEW, Texas A Longview man was sentenced Friday for federal violations involving Medicare fraud, according to the U.S. Attorney Joseph D. Brown.

According to the attorney's office, Joseph Valdie Kimble, 57, pleaded guilty on Sep. 11, 2019 to health care fraud and was sentenced to 30 months in federal prison.

Kimble was also ordered to pay restitution in the amount of $751,986.30 to Medicare and Medicaid, and was ordered not to seek or retain employment in the health care fraud industry while serving three years of supervised release.

According to information presented in court, Kimble operated Tiger EMS, a business providing non-emergency ambulance transport, mostly between skilled nursing centers and hospitals and dialysis centers.

Ambulance providers may bill for ambulance services only if there is a demonstrated medical need.

Kimble disregarded medical necessity requirements and billed Medicare and Medicaid for ambulance services provided to patients for whom ambulance transport was not medically necessary.

This case was investigated by U.S. Health and Human Services Office of Inspector General and the Texas Attorney Generals Medicaid Fraud Control Unit and prosecuted by Assistant U.S. Attorneys Alan R. Jackson and Frank Coan.

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Longview ambulance operator sentenced to 30 months in prison for health care fraud - CBS19.tv KYTX