World AIDS Day 2018: Theme, awareness slogans, history, key facts

1 in 4 people don't know they have HIV/AIDS. Know your risks=know your status. (World AIDS Day 2018 via WHO)

1 in 4 people don’t know they have HIV/AIDS. Know your risks=know your status. (World AIDS Day 2018 via WHO)

Today, that is December 1 2018, World Health Organisation (WHO) joins global partners and citizens to commemorate AIDS Day under the theme ‘Know Your Status’.

This is also an occasion to celebrate the 30th anniversary of World AIDS Day — a pioneering global health campaign first initiated by WHO in 1988.

2 objectives of the theme of AIDS Day 2018

It is estimated that currently only 75 per cent of people with HIV know their status.

WHO advocacy and communication for World AIDS Day 2018 with the theme ‘Know Your Status’ aims to achieve the following objectives:

  • Urge people to know their HIV infection status through testing, and to access HIV prevention, treatment and care services
  • Urge policy-makers to promote a ‘health for all’ agenda for HIV and related health services, such as tuberculosis (TB), hepatitis and non-communicable diseases
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T-Mobile offering a free 4K 50-inch TV when you buy a Samsung phone

Today, T-Mobile announced a new deal for new and existing T-Mobile customers. If you purchase any Samsung Flagship smartphone and add a new line of service or activate two lines of service if you’re a new customer, the carrier will give you a free Samsung 50-inch 4K TV.

In order to qualify, you need to register for the promotion online and the TV will be shipped to you at some later time. The offer will be available until free TV supply is depleted so there’s no official end date.

Samsung Galaxy S8 and Galaxy S9

It’s worth noting that T-Mobile didn’t say this was going to be a Smart TV so don’t expect one if you do want to take advantage of this deal. It may not be worth buying an extra phone and adding an extra line if you’re not going to use it just to get a free TV. Otherwise, if you are already going to buy a new Samsung phone and sign up for an extra line, then you might as well take advantage of this promotion.

To qualify, you need to purchase any Samsung flagship (Samsung Galaxy Note9, S9, S9+, S8, or S8 Active) on an Equipment Installment Plan and add a new line of service and then register to get the promotion online

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Variety of healthcare entities see a bright future for AI

A survey of 500 senior healthcare executives by Optum reveals optimism on the promise of artificial intelligence, offset by the work needed to achieve results.

Participating vice presidents and C-level executives that included CEO, COO, CFO, CTO and CMOs represented hospitals, clinics and delivery systems, life sciences organizations, health insurers and employers. Nearly all the executives reported that they believe AI can make the industry more affordable and accessible.

The survey indicates a tipping point has arrived in adoption of AI in healthcare, with significant investments to be made within the next five years, resulting in positive returns on investment for employers and insurers within three years, and a ROI for hospitals in four or five years.

About 22 percent of surveyed employers already are reporting AI implementations with nearly full deployment.

Further, some surveyed health organizations already are reporting initial AI benefits, with 43 percent of these early adopters automating business processes such as administrative operations and customer service, with 36 percent using AI to detect patterns in healthcare fraud, waste and abuse; and 31 percent using AI to monitor users of Internet of Things devices such as wearable technology, says Steve Griffiths, senior vice president and COO at Optum Enterprise Analytics.

In general, however, now is the time for healthcare organizations to hone artificial intelligence skills, he notes. These include analytics, modeling, machine learning and deep learning, math skills and development of epidemiology skills to identify the causes of disease and outcomes in populations. “We will need people who would help translate strategy into actions to drive business value,” he adds.

Also See: Why organizations need to know full benefits of artificial intelligence

Health organizations of all sizes can begin to hone their skills just as larger ones are doing, Griffiths counsels. “It’s important to have a small data science team, or partner with a larger organization while training existing employees.”

Such in-house training will be necessary because getting professional help could prove difficult as the industry is experiencing a talent crunch to a degree not previously seen. Talent is needed to tackle risk contracting, total cost of care and value-based care, all of which puts a strain on the existing analytics talent.

Steve Griffiths
Steve Griffiths

Organizations with resources should consider getting additional help from provider actuaries that have the math and statistical skills to conduct analytics, data science and computer sciences.

The best type of AI will be automated and operate in the background to perform tasks such as ensuring drugs are delivered in time, prior authorizations are automatically conducted and manual reviews are automated so that staff members, physicians and nurses aren’t spending their time manually reviewing charts and sending data out to insurers to get reimbursed.

The reality, Griffths concludes, is that providers will struggle for a bit as they seek to understand how they can change the tires while still driving down the road toward artificial intelligence. “This will take a corporate transformation strategy,” he believes.

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HHS Looks to Medicaid Demonstrations to Improve Mental Health

Secretary Azar recently spoke to the importance of Medicaid demonstrations in addressing mental health for adults and children.

HHS is addressing mental health through Medicaid demonstrations

Medicaid beneficiaries with mental health conditions are the targets of recent CMS efforts to boost health outcomes.

In recent remarks to the National Association of Medicaid Directors in the national capital, HHS Secretary Alex Azar said “successful partnership between our leadership at HHS and the leaders of every state Medicaid program is vital to delivering on the mission of HHS and the mission of the Medicaid program: improving the health and well-being of the Americans we serve.”

Nearly 1.3 million individuals are treated for mental health and substance abuse disorders under the Medicaid expansion, according to an estimate by health care economists Richard G. Frank of the Harvard Medical School and Sherry Glied of New York University.

And Medicaid’s an essential source of care for those with mental illness or addiction, according to The National Council. In 2014, Medicaid spending represented 25% of all mental health expenditures in the nation and 21% of all substance use disorder spending. Approximately 29% of those who receive health insurance coverage through the Medicaid expansion either have a mental health condition, a substance use disorder, or both. Generally, those uninsured prior to the Affordable Care Act had a higher prevalence of behavioral health conditions than the overall population.

Through Medicaid, numerous states with the highest opioid overdose death rates expanded access to medication-assisted treatment. For example, Medicaid pays for between 35-50% of all medication-assisted treatment in Kentucky, Maine, Pennsylvania, Ohio, and West Virginia

By covering low-income childless adults up to 138% of the federal poverty line, Medicaid expansion enabled 1.29 million low-income individuals with substance use disorders to gain access to coverage unavailable to their counterparts in non-expansion states.

With half of Medicaid expansion states enduring revenue shortfalls in the last half of FY 2016, they lack the ability to make up for any reduction in federal Medicaid support. The Medicaid expansion has enabled significant statewide savings in Connecticut, Nevada and Washington, where the states reduced their state general funds required for behavioral health. Arkansas, Colorado, and Michigan reported expected reductions in general funds spending for the uninsured ranging from $7 million to $190 million in 2015.

Starting in April 2017, the Trump Administration called for a new era of state-federal partnership in Medicaid, he said. “I believe a great deal of progress has been made on that front already. But I am optimistic that much more progress is still ahead of us, and I want to talk about what that looks like today.”

While acknowledging it’s been a complicated and contentious process, he emphasized it’s also been cooperative and deliberative.

All Medicaid demonstration waivers carry substantial requirements around monitoring and evaluation, “but we know these are even more important when we are taking the bold and innovative steps we are taking here,” Azar added.

“As part of the waivers we’ve granted, we’ve set careful guardrails that require states to protect their most vulnerable beneficiaries, and only required community engagement from beneficiaries whose circumstances allow them to participate. We’re also attentive to the paperwork burdens imposed on both beneficiaries and states, although we believe the benefits of setting the right incentives can far outweigh these costs. All of these costs and benefits will be carefully evaluated for each waiver we approve.”

While both the federal government and state governments invest a significant portion of their budgets in the Medicaid program, to succeed, more than money from both sides is needed to achieve Medicaid innovation, he said.

“At the federal level, this administration is willing to offer historic flexibility for programs to innovate.” In return, we expect state commitments to invest in innovations and produce results, he continued.

There is tremendous potential for this approach to confront the serious health challenges our country faces. (We believe) progress has already been made on these challenges, and I believe more is around the corner.”

Azar encouraged all Medicaid directors and stakeholders to contemplate how they can promote community engagement. “In setting up the demonstrations, we’re building on a robust academic literature that shows community engagement, such as employment, can have substantial benefits for well-being.” Finding work, he continued, is associated with significant improvements in mental and physical health — and programs set up to improve Americans’ health should, where feasible, reflect that.”

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30 rising stars in healthcare IT

A new wave of younger healthcare IT executives are rising up to take on leadership roles in the industry. Here’s a glimpse of some of the new rising stars in healthcare information technology who are likely to guide the industry over the next 10 to 20 years.

Tarik Alkasab, MD

Alkasab recently was a lead author of a study in the Journal of the American College of Radiology that advocated an open authorizing system for point of care decision support tools. He and his colleagues contend that decreasing unnecessary variation in radiology reporting is a key to success in value-based payment models and also is good for patient care. The goal is to represent radiology clinical guidelines as structured and machine-readable Extensible Markup Language documents. Also advocated is development of new tools that voice recognition vendors can use to extend the commercial tools currently in use.

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HIT Think What ‘Amazon healthcare’ could look like in 5 years

While Amazon has grabbed headlines this week by announcing the location of its new headquarters (to be split between New York and Northern Virginia), the healthcare industry has been keeping a close eye on the retail, technology, and logistics giant for several months now.

Over the past year, the company has hired a slew of former healthcare leaders, acquired the direct-to-consumer pharmacy business PillPack, and moved forward with a high-profile venture to jointly manage the health of its employee population alongside JPMorgan Chase and Berkshire Hathaway.

These moves have led many to speculate as to how Amazon could disrupt the healthcare industry. And while these musings often come alongside a healthy dose of well-warranted skepticism, there’s little doubt that Amazon is unique among the growing list of outside players eyeing the healthcare space.

Amazon’s commitment to innovation and self-disruption have enabled it to gain a massive foothold in the economy. It’s set to account for 49 percent of all online sales in the United States in 2018 and counts 100 million people as prime members—almost a third of the U.S. population. And Jeff Bezos, Amazon’s CEO, has signaled he is willing to put in the work and investment to go after the healthcare industry, despite its immense complexity. He commented that, “[h]ard as it might be, reducing healthcare’s burden on the economy while improving outcomes for employees and their families would be worth the effort. Success is going to require talented experts, a beginner’s mind, and a long-term orientation.”

So what would “Amazon Health Care” look like? We see at least five potential paths forward—and they’re not mutually exclusive.

Employer aggregator
The quickest (and likely least disruptive) way Amazon could make its mark on healthcare is through its own employee population. The company has already started down this path through its partnership with JPMorgan Chase and Berkshire Hathaway; the three companies manage healthcare spending for a combined 1.2 million employees.

In the grand scheme of things, this venture involves a relatively limited number of lives spread over a number of markets, but it does give Amazon an innovation function of sorts—the company has already announced that it plans to experiment with running its own health clinics for employees in the Seattle area.

Moreover, the CEO of the venture—Atul Gawande, who began leading the effort on July 9—is known as a disruptive thinker in the industry. To have national-level implications, however, the venture will need to secure more companies’ involvement or find other ways to export successful models beyond the three founding members.

Next-generation retail pharmacy
Amazon’s acquisition of PillPack, combined with its “Basic Care” line of over-the-counter products, could make it a formidable player in the retail pharmacy space. Amazon already has an established track record of competing on cost and convenience, and the organization’s timely shipping processes could rival the convenience of a community pharmacy.

By acquiring PillPack, Amazon is positioned not only to compete for the high-cost, chronically ill patients to whom PillPack currently caters, but to make a major play for the growing number of self-pay pharmaceutical customers.

While Amazon’s growth in pharmaceuticals may have historically been limited by the company’s inability to earn in-network status from major PBMs, insured patients are increasingly discovering that they can cut drug prices by paying out-of-pocket. By making prescription prices readily available through its online marketplace, Amazon-PillPack could use its existing platforms to encourage patients to shop around based on price, potentially prompting more insured patients to pay out-of-pocket for their prescriptions.

Global healthcare logistics specialist
Without question, Amazon’s shipping network is one of the most robust in the country—and that positions Amazon to have a massive impact on the healthcare supply chain. A number of the Advisory Board’s own members have told us they’ve proactively reached out to Amazon for help in revamping their supply chain. Some hospitals have even begun to independently use Amazon Business to streamline their supply chains—such as Summit Pacific Medical Center in Washington, which uses Amazon’s “dash” buttons to address 90 percent of its supply chain needs.

Currently, Amazon is not equipped to offer more highly specialized medical tools. But if the organization was to expand into these offerings, it could have a major impact in addressing the fragmentation issues that currently plague the healthcare supply chain and undercutting some of the cost inflation that distributors currently levy.

Consumer-focused technologies
Perhaps no aspect of Amazon’s business model causes both more concern and more excitement than the potential healthcare applications of its consumer-facing technology platform.

In the healthcare industry, where the customer experience is often confusing and fragmented, the ability to make interactions frictionless and seamless would go a long way. There are a multitude of ways Amazon could bring its brand of simplicity to healthcare—as a patient engagement platform, an EHR, a transparency tool or even as an insurance broker.

It should be noted that tech giants, such as Microsoft and Google, have made previous attempts to break into this space with limited success. Microsoft’s HealthVault shut down in 2018 and Google Health shut down in 2012. But the growing popularity of wearables technology and Alexa’s health-related capabilities suggest consumers today may be more willing than ever to engage with new technological models—a factor that could give Amazon the edge where others have failed.

Primary care operator
Finally, there’s the potential that Amazon could move into the care delivery space as a primary care operator. According to CNBC, Amazon has begun to open a pilot primary care clinic for a “select group of employees” and plans to expand access to more workers next year. The company has also been hiring primary care experts since last year, including Christine Henninsgaard, the former vice president of operations at One Medical, and Martin Levine from Lora Health.

According to Michael Yang, a health investor at Comcast Ventures, Amazon may be using these as a pilot before expanding the strategy beyond their employees.

Amazon already has several advantages that could give it a head start in the care delivery space, particularly the requisite online presence to get into telemedicine and, with the recent acquisition of Whole Foods, a potential entrée into the brick-and-mortar clinic space.

While none of these five visions are a reality today, the fact that Amazon is exploring so many aspects of the industry is reflective that the market is truly ripe for disruption, whether by Amazon or other outside players. Indeed, the mere prospect of Amazon moving into healthcare has already begun to catalyze action within the industry—Amazon is, without a doubt, one of the driving factors behind the current wave of mega-mergers pursuing vertical integration sweeping across the industry.

For hospital and health system leaders, Amazon could be an attractive partner in some areas (like supply chain) and a formidable combatant in others (like care delivery). Strategies to control cost, improve access, and drive reliability in quality and service will position providers to withstand the threat of outside disruption.

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