This document provides an overview and analysis of 2015 Open Payments data from the Centers for Medicare and Medicaid Services. It finds that total payments to physicians were similar to 2014 at around $7.5 billion, while the number of physicians receiving payments and reporting companies decreased slightly. It also analyzes trends in payments by category and company, finding that food and beverage payments decreased on average while consulting fees increased. Additional data and tools are available to further analyze payments by company, physician, and location.
Open Payments-Compliance Exec Summary-Final July 16Andrew Wiles
This document provides an executive summary and analysis of 2015 Open Payments data relating to the Sunshine Act. It summarizes key trends in total payments year-over-year and breaks down payments by category and company. Charts show national fair market rates and top companies by expenditure in different transfer of value categories. The last section describes tools and reports available from WorldDataOnline for further Sunshine Act compliance analysis.
This document provides an overview and assessment of issues impacting the healthcare environment and medical practices. It discusses key areas medical practices should assess to remain viable, such as participating in incentive plans, pursuing patient-centered medical home certification, and moving to ICD-10. The document also summarizes data on healthcare costs, the Affordable Care Act, Medicare payment reforms like alternative payment models, and changes being made by commercial insurers.
This newsletter provides updates on healthcare reform and its costs, workplace wellness programs, and medical clinics. It discusses how the Affordable Care Act will pay for expanding coverage, including new taxes starting in 2011-2018 on drug companies, insurers, and high-cost plans. It also links obesity to higher workers compensation costs and recommends integrating workplace safety with wellness efforts. Finally, it notes the growth of retail medical clinics and their lower costs compared to doctors' offices and emergency rooms.
HCA financail paper for Financial ManagmentJames Nichols
- Hospital Corporation of America (HCA) is one of the largest for-profit hospital operators in the US, with 162 hospitals and 113 outpatient surgery centers.
- It focuses on urban markets and is increasing investment in standalone surgical centers, which accounted for 38% of profits in 2014.
- HCA has significant debt of over $29 billion, making it highly leveraged and exposing it to interest rate risk. However, it has access to capital to fund expansion.
This document proposes a partnership between Rx Logic and a funding partner to build out a pharmaceutical logistics business. It notes opportunities in the market as pharmaceutical manufacturers increasingly outsource logistics. The plan is to start operations in a 25,000 square foot Illinois facility, obtain necessary licensing, and pursue small-to-mid sized pharmaceutical clients. Over 5 years, the partners aim to expand operations and add services to increase space, customers, revenue and profitability.
Healthcare payers exceeded federally mandated medical loss ratio with esignat...DocuSign
Healthcare payers need strategic plans to reduce wasted administrative resources, prevent profit loss, and keep premiums reasonable. Electronic signatures is one way of solving this problem.
Open Payments-Compliance Exec Summary-Final July 16Andrew Wiles
This document provides an executive summary and analysis of 2015 Open Payments data relating to the Sunshine Act. It summarizes key trends in total payments year-over-year and breaks down payments by category and company. Charts show national fair market rates and top companies by expenditure in different transfer of value categories. The last section describes tools and reports available from WorldDataOnline for further Sunshine Act compliance analysis.
This document provides an overview and assessment of issues impacting the healthcare environment and medical practices. It discusses key areas medical practices should assess to remain viable, such as participating in incentive plans, pursuing patient-centered medical home certification, and moving to ICD-10. The document also summarizes data on healthcare costs, the Affordable Care Act, Medicare payment reforms like alternative payment models, and changes being made by commercial insurers.
This newsletter provides updates on healthcare reform and its costs, workplace wellness programs, and medical clinics. It discusses how the Affordable Care Act will pay for expanding coverage, including new taxes starting in 2011-2018 on drug companies, insurers, and high-cost plans. It also links obesity to higher workers compensation costs and recommends integrating workplace safety with wellness efforts. Finally, it notes the growth of retail medical clinics and their lower costs compared to doctors' offices and emergency rooms.
HCA financail paper for Financial ManagmentJames Nichols
- Hospital Corporation of America (HCA) is one of the largest for-profit hospital operators in the US, with 162 hospitals and 113 outpatient surgery centers.
- It focuses on urban markets and is increasing investment in standalone surgical centers, which accounted for 38% of profits in 2014.
- HCA has significant debt of over $29 billion, making it highly leveraged and exposing it to interest rate risk. However, it has access to capital to fund expansion.
This document proposes a partnership between Rx Logic and a funding partner to build out a pharmaceutical logistics business. It notes opportunities in the market as pharmaceutical manufacturers increasingly outsource logistics. The plan is to start operations in a 25,000 square foot Illinois facility, obtain necessary licensing, and pursue small-to-mid sized pharmaceutical clients. Over 5 years, the partners aim to expand operations and add services to increase space, customers, revenue and profitability.
Healthcare payers exceeded federally mandated medical loss ratio with esignat...DocuSign
Healthcare payers need strategic plans to reduce wasted administrative resources, prevent profit loss, and keep premiums reasonable. Electronic signatures is one way of solving this problem.
http://www.FreeRxPlusAgent.com - FreeRxPlus Discount Prescription Card - Resi...Bob Vill
FreeRxPlus is a company that provides prescription drug savings cards that allow users to save up to 75% on prescription drugs at over 54,000 pharmacies. The company also offers savings on imaging and laboratory services. Individuals can become representatives of FreeRxPlus and build their own sales organization by sponsoring other representatives. Representatives earn commissions of $0.60 for each transaction made by using cards distributed by their sales organization. Building a large sales organization can lead to significant monthly and yearly commission earnings.
Transforming the Provider Market: What Pennsylvannia Hospitals Can Learn from...James Case
The Maryland hospitals have gone through an unprecedented transformation in how their payments and operations are regulated. This transformation was not taken lightly and can serve as a guide for hospitals outside the State of Maryland as they look to take on additional financial risk in value-based contracts.
Monetary Administration In Healthcare PowerPoint Presentation Slides SlideTeam
Presenting this set of slides with name - Monetary Administration In Healthcare Powerpoint Presentation Slides. This deck consists of total of fourty slides. It has PPT slides highlighting important topics of Monetary Administration In Healthcare Powerpoint Presentation Slides. This deck comprises of amazing visuals with thoroughly researched content. Each template is well crafted and designed by our PowerPoint experts. Our designers have included all the necessary PowerPoint layouts in this deck. From icons to graphs, this PPT deck has it all. The best part is that these templates are easily customizable. Just click the DOWNLOAD button shown below. Edit the colour, text, font size, add or delete the content as per the requirement. Download this deck now and engage your audience with this ready made presentation.
Rightview Partners recommends that Community Health Systems sell itself to Universal Health Services due to CYH's high leverage and the attractive multiples being achieved in the hospital M&A market. An acquisition by UHS could help address CYH's leverage by being an all-equity deal. Alternatively, if CYH wants to grow, Lifepoint Hospitals would be a good acquisition target due to synergies. Valuation analyses show CYH is worth $57.86-$93 per share currently.
An advocacy group has developed a decision support tool to help consumers choose health insurance plans on public exchanges. The tool shows that out-of-pocket costs can vary by up to 600% depending on the metal level (bronze, silver, gold, platinum) of the chosen plan. By entering expected medical expenses and prescriptions, the tool calculates costs across different plan options and identifies the most cost effective choice. This is important because consumers often choose the lowest premium plan without considering other out-of-pocket costs, which can lead them to spend more over the course of the year.
Modeling State-based Reinsurance: One Option for Stabilization of the Individ...soder145
This document summarizes research on modeling state-based reinsurance programs to stabilize individual health insurance markets. Key findings include:
- An estimated $60 billion is spent annually in the individual market, with 2.5% of enrollees accounting for 48.8% of expenditures.
- State reinsurance programs with varying parameters could reduce insurer costs by $6-14 billion nationally per year.
- Estimated reinsurance costs for four states range from $300,000 to $1.8 billion depending on the attachment point and coinsurance rate.
- Federal transitional reinsurance and proposed legislation allocated $10 billion annually, consistent with these estimates.
Business Opportunity, B2B or Home Basedguest813628
Agents needed for distribution of FREE discount prescription cards for 50 million uninsured Americans. Life time residual income - Web Site - Cards , back office, and more provided so you can hit the ground running.
Provider/payor convergence: A prescription for growth?Grant Thornton LLP
As bottom lines shrink, payors and providers are beginning to see convergence, or vertical integration, as the path to growth, Panelists from Johns Hopkins Institutions, Buchanan Ingersoll & Rooney PC and Grant Thornton LLP share their experience.
This document summarizes trends in health care fraud and abuse enforcement in 2017. Overall liability was down from previous years. While fewer massive settlements occurred, some large pharmaceutical companies still paid over $50 million. Enforcement increased against long-term care facilities, hospice care, and Medicaid billing. Investigations of patient assistance programs grew. Prosecutors also pursued more individuals through exclusions and civil settlements. Opioid prescription enforcement remained aggressive through DEA actions and lawsuits against manufacturers. Predictions for 2018 include continued focus on controlled substances and individual accountability.
Join HRG Executive Director of CBO Services, Cassie Wise, as she discusses how to keep AR results stable when revenue is anything but stable. In this webinar, you will learn about the current state of Healthcare Accounts Receivable across America due to COVID-19 and understand different ways to calculate Accounts Receivable performance when there are large revenue fluctuations. You will walk away with steps to monitor your AR to ensure you are ahead of any potential cash and/or AR resolution disruptions.
Wellpoint is the largest health insurance provider nationally with over 34 million members. Through strategic acquisitions, Wellpoint has expanded its market presence and now operates Blue Cross Blue Shield plans in 14 states. Wellpoint aims to continue growing by targeting the uninsured, elderly, and large national employer accounts. Its strategy also includes wellness initiatives like investments in luxury health resorts to promote preventative healthcare and keep membership healthy.
Three CO-OPs have failed or will fail by the start of open enrollment on November 1st, according to a July report from HHS's Office of Inspector General. However, CO-OP executives remain optimistic, claiming the report provides an outdated assessment and that many CO-OPs have exceeded enrollment projections. While some CO-OPs are struggling with losses, others report growing their membership substantially. The future of CO-OPs remains uncertain as they try to compete against larger, more established insurers that are merging to reduce costs.
1. The document analyzes the potential impact and costs of state-based reinsurance programs using data from 2012-2015.
2. It estimates that reinsurance subsidies could range from $6.4 billion to $16 billion annually depending on the attachment point and coinsurance rate.
3. Reinsurance costs are estimated to range from close to $300,000 in Illinois to $2 billion in California under sample programs with an 80/20 coinsurance split.
Cancer Genetics reported on its Q4 and full year 2016 earnings. Key highlights included 50% revenue growth in 2016 to $27 million, driven by increases in biopharma, clinical, and discovery services. The company realized operational efficiencies through integration of acquisitions, reducing expenses. However, the company reported a net loss of $15.8 million for 2016. In Q4 2016, revenue increased 32% to $7.2 million while expenses decreased, though the company reported a net loss of $2.8 million. Additionally, Cancer Genetics completed a $12 million debt refinancing to repay existing debt and access additional capital.
Healthcare Services Sector Update - June 2017Duff & Phelps
The S&P Healthcare Services Index increased 7.2% over the last month, outperforming the S&P 500, which remained relatively flat over the same period. The best performing sectors were Psychiatric Hospitals (up 15.6%), Healthcare Staffing (up 12.9%), and Skilled Nursing (up 12.4%). Read the report for more detail on sector activity.
The document provides an overview of Accountable Care Organizations (ACOs) and their relationship to the pharmaceutical industry. It discusses the goals of ACOs in improving quality of care while reducing costs. While initial results of ACOs are mixed, with some evidence of cost savings and improved quality, establishing the infrastructure has incurred significant start-up costs. The document also reviews the current pharmaceutical landscape and identifies opportunities for collaboration between ACOs and pharmaceutical companies, such as reducing hospital readmissions through better treatment adherence and education.
This document provides an overview of Illinois Investment Banking's current holding of Abbott Laboratories stock. It introduces the two analysts, Jack Shen and Moby Xu, and outlines their agenda which includes a company overview, industry analysis, financial analysis, valuation, and recommendation for the stock holding. The company overview section details Abbott Laboratories' business segments and leadership. It analyzes the company's performance within each segment from 2013-2015.
The Medicare Diabetes Prevention Program (MDPP) Expanded Model team provided a tutorial about enrollment in the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
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The Impact of the AMP Final Rule: Legal, Operational, and Financial Considera...Epstein Becker Green
Part 1 of a webinar series that examines the average manufacturer price (“AMP”) Final Rule and its effect on drug pricing and contracting. Hosted by Epstein Becker Green and EBG Advisors.
The long-awaited issuance of the Final Rule addressing AMP under the Medicaid Drug Rebate Program has provided clarity in some respects but left other issues open to interpretation. In the wake of the Final Rule, other regulatory developments are already showing signs of further impacting many of the same issues.
Using the AMP Final Rule as a baseline, we will address the evolution of some of the most significant issues affecting drug pricing and contracting. We hope you can attend one or both of the sessions in this two-part series.
In this session, Constance A. Wilkinson, Member of the Firm at Epstein Becker Green, will address how the AMP final rule can impact your business. This discussion will examine various legal, operational, and financial factors, including the impact on fee-for-service arrangements with customers, value-based pricing, and reimbursement.
http://www.ebglaw.com/events/the-effect-of-the-average-manufacturer-price-final-rule-on-drug-pricing-and-contracting-part-1-the-impact-of-the-amp-final-rule-legal-operational-and-financial-considerations/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Kalderos describes how compromised data associated with MDRP affects inaccurate Pharma Mfr payments to States leading to overpayments and compliance issues with 340B Covered Entities
This document contains samples of graphic design work including logo designs, promotional postcards and magazine articles for a non-profit organization and grocery store as well as product photography and an illustration. The samples showcase the designer's skills in branding, marketing, and visual communication for both non-profit and commercial clients.
http://www.FreeRxPlusAgent.com - FreeRxPlus Discount Prescription Card - Resi...Bob Vill
FreeRxPlus is a company that provides prescription drug savings cards that allow users to save up to 75% on prescription drugs at over 54,000 pharmacies. The company also offers savings on imaging and laboratory services. Individuals can become representatives of FreeRxPlus and build their own sales organization by sponsoring other representatives. Representatives earn commissions of $0.60 for each transaction made by using cards distributed by their sales organization. Building a large sales organization can lead to significant monthly and yearly commission earnings.
Transforming the Provider Market: What Pennsylvannia Hospitals Can Learn from...James Case
The Maryland hospitals have gone through an unprecedented transformation in how their payments and operations are regulated. This transformation was not taken lightly and can serve as a guide for hospitals outside the State of Maryland as they look to take on additional financial risk in value-based contracts.
Monetary Administration In Healthcare PowerPoint Presentation Slides SlideTeam
Presenting this set of slides with name - Monetary Administration In Healthcare Powerpoint Presentation Slides. This deck consists of total of fourty slides. It has PPT slides highlighting important topics of Monetary Administration In Healthcare Powerpoint Presentation Slides. This deck comprises of amazing visuals with thoroughly researched content. Each template is well crafted and designed by our PowerPoint experts. Our designers have included all the necessary PowerPoint layouts in this deck. From icons to graphs, this PPT deck has it all. The best part is that these templates are easily customizable. Just click the DOWNLOAD button shown below. Edit the colour, text, font size, add or delete the content as per the requirement. Download this deck now and engage your audience with this ready made presentation.
Rightview Partners recommends that Community Health Systems sell itself to Universal Health Services due to CYH's high leverage and the attractive multiples being achieved in the hospital M&A market. An acquisition by UHS could help address CYH's leverage by being an all-equity deal. Alternatively, if CYH wants to grow, Lifepoint Hospitals would be a good acquisition target due to synergies. Valuation analyses show CYH is worth $57.86-$93 per share currently.
An advocacy group has developed a decision support tool to help consumers choose health insurance plans on public exchanges. The tool shows that out-of-pocket costs can vary by up to 600% depending on the metal level (bronze, silver, gold, platinum) of the chosen plan. By entering expected medical expenses and prescriptions, the tool calculates costs across different plan options and identifies the most cost effective choice. This is important because consumers often choose the lowest premium plan without considering other out-of-pocket costs, which can lead them to spend more over the course of the year.
Modeling State-based Reinsurance: One Option for Stabilization of the Individ...soder145
This document summarizes research on modeling state-based reinsurance programs to stabilize individual health insurance markets. Key findings include:
- An estimated $60 billion is spent annually in the individual market, with 2.5% of enrollees accounting for 48.8% of expenditures.
- State reinsurance programs with varying parameters could reduce insurer costs by $6-14 billion nationally per year.
- Estimated reinsurance costs for four states range from $300,000 to $1.8 billion depending on the attachment point and coinsurance rate.
- Federal transitional reinsurance and proposed legislation allocated $10 billion annually, consistent with these estimates.
Business Opportunity, B2B or Home Basedguest813628
Agents needed for distribution of FREE discount prescription cards for 50 million uninsured Americans. Life time residual income - Web Site - Cards , back office, and more provided so you can hit the ground running.
Provider/payor convergence: A prescription for growth?Grant Thornton LLP
As bottom lines shrink, payors and providers are beginning to see convergence, or vertical integration, as the path to growth, Panelists from Johns Hopkins Institutions, Buchanan Ingersoll & Rooney PC and Grant Thornton LLP share their experience.
This document summarizes trends in health care fraud and abuse enforcement in 2017. Overall liability was down from previous years. While fewer massive settlements occurred, some large pharmaceutical companies still paid over $50 million. Enforcement increased against long-term care facilities, hospice care, and Medicaid billing. Investigations of patient assistance programs grew. Prosecutors also pursued more individuals through exclusions and civil settlements. Opioid prescription enforcement remained aggressive through DEA actions and lawsuits against manufacturers. Predictions for 2018 include continued focus on controlled substances and individual accountability.
Join HRG Executive Director of CBO Services, Cassie Wise, as she discusses how to keep AR results stable when revenue is anything but stable. In this webinar, you will learn about the current state of Healthcare Accounts Receivable across America due to COVID-19 and understand different ways to calculate Accounts Receivable performance when there are large revenue fluctuations. You will walk away with steps to monitor your AR to ensure you are ahead of any potential cash and/or AR resolution disruptions.
Wellpoint is the largest health insurance provider nationally with over 34 million members. Through strategic acquisitions, Wellpoint has expanded its market presence and now operates Blue Cross Blue Shield plans in 14 states. Wellpoint aims to continue growing by targeting the uninsured, elderly, and large national employer accounts. Its strategy also includes wellness initiatives like investments in luxury health resorts to promote preventative healthcare and keep membership healthy.
Three CO-OPs have failed or will fail by the start of open enrollment on November 1st, according to a July report from HHS's Office of Inspector General. However, CO-OP executives remain optimistic, claiming the report provides an outdated assessment and that many CO-OPs have exceeded enrollment projections. While some CO-OPs are struggling with losses, others report growing their membership substantially. The future of CO-OPs remains uncertain as they try to compete against larger, more established insurers that are merging to reduce costs.
1. The document analyzes the potential impact and costs of state-based reinsurance programs using data from 2012-2015.
2. It estimates that reinsurance subsidies could range from $6.4 billion to $16 billion annually depending on the attachment point and coinsurance rate.
3. Reinsurance costs are estimated to range from close to $300,000 in Illinois to $2 billion in California under sample programs with an 80/20 coinsurance split.
Cancer Genetics reported on its Q4 and full year 2016 earnings. Key highlights included 50% revenue growth in 2016 to $27 million, driven by increases in biopharma, clinical, and discovery services. The company realized operational efficiencies through integration of acquisitions, reducing expenses. However, the company reported a net loss of $15.8 million for 2016. In Q4 2016, revenue increased 32% to $7.2 million while expenses decreased, though the company reported a net loss of $2.8 million. Additionally, Cancer Genetics completed a $12 million debt refinancing to repay existing debt and access additional capital.
Healthcare Services Sector Update - June 2017Duff & Phelps
The S&P Healthcare Services Index increased 7.2% over the last month, outperforming the S&P 500, which remained relatively flat over the same period. The best performing sectors were Psychiatric Hospitals (up 15.6%), Healthcare Staffing (up 12.9%), and Skilled Nursing (up 12.4%). Read the report for more detail on sector activity.
The document provides an overview of Accountable Care Organizations (ACOs) and their relationship to the pharmaceutical industry. It discusses the goals of ACOs in improving quality of care while reducing costs. While initial results of ACOs are mixed, with some evidence of cost savings and improved quality, establishing the infrastructure has incurred significant start-up costs. The document also reviews the current pharmaceutical landscape and identifies opportunities for collaboration between ACOs and pharmaceutical companies, such as reducing hospital readmissions through better treatment adherence and education.
This document provides an overview of Illinois Investment Banking's current holding of Abbott Laboratories stock. It introduces the two analysts, Jack Shen and Moby Xu, and outlines their agenda which includes a company overview, industry analysis, financial analysis, valuation, and recommendation for the stock holding. The company overview section details Abbott Laboratories' business segments and leadership. It analyzes the company's performance within each segment from 2013-2015.
The Medicare Diabetes Prevention Program (MDPP) Expanded Model team provided a tutorial about enrollment in the model.
- - -
CMS Innovation Center
http://innovation.cms.gov
We accept comments in the spirit of our comment policy:
http://newmedia.hhs.gov/standards/comment_policy.html
CMS Privacy Policy
http://cms.gov/About-CMS/Agency-Information/Aboutwebsite/Privacy-Policy.html
The Impact of the AMP Final Rule: Legal, Operational, and Financial Considera...Epstein Becker Green
Part 1 of a webinar series that examines the average manufacturer price (“AMP”) Final Rule and its effect on drug pricing and contracting. Hosted by Epstein Becker Green and EBG Advisors.
The long-awaited issuance of the Final Rule addressing AMP under the Medicaid Drug Rebate Program has provided clarity in some respects but left other issues open to interpretation. In the wake of the Final Rule, other regulatory developments are already showing signs of further impacting many of the same issues.
Using the AMP Final Rule as a baseline, we will address the evolution of some of the most significant issues affecting drug pricing and contracting. We hope you can attend one or both of the sessions in this two-part series.
In this session, Constance A. Wilkinson, Member of the Firm at Epstein Becker Green, will address how the AMP final rule can impact your business. This discussion will examine various legal, operational, and financial factors, including the impact on fee-for-service arrangements with customers, value-based pricing, and reimbursement.
http://www.ebglaw.com/events/the-effect-of-the-average-manufacturer-price-final-rule-on-drug-pricing-and-contracting-part-1-the-impact-of-the-amp-final-rule-legal-operational-and-financial-considerations/
These materials have been provided for informational purposes only and are not intended and should not be construed to constitute legal advice. The content of these materials is copyrighted to Epstein Becker & Green, P.C. ATTORNEY ADVERTISING.
Kalderos describes how compromised data associated with MDRP affects inaccurate Pharma Mfr payments to States leading to overpayments and compliance issues with 340B Covered Entities
This document contains samples of graphic design work including logo designs, promotional postcards and magazine articles for a non-profit organization and grocery store as well as product photography and an illustration. The samples showcase the designer's skills in branding, marketing, and visual communication for both non-profit and commercial clients.
Este documento presenta información sobre los sistemas de drenaje en carreteras y vías. Explica que el drenaje superficial tiene el propósito de alejar las aguas de las carreteras para evitar su influencia negativa. Describe algunos componentes clave de los sistemas de drenaje como sumideros transversales, drenajes longitudinales y canales. También cubre conceptos como drenaje agrícola, estudio del drenaje transversal y alcantarillas, y los criterios de diseño de drenaje que incluyen factores topogr
O documento descreve um experimento realizado por alunos para determinar a densidade de uma moeda de 1€ usando o método de deslocamento de água. Eles mediram a massa da moeda, seu volume deslocado na água e calcularam sua densidade em 7,49 g/cm3. Como o cobre puro tem densidade de 8,93 g/cm3, concluíram que a moeda não é feita de cobre 100% puro.
FOSDEM - Does your configuration code smell?Tushar Sharma
The wide adoption of configuration management and the increasing size and complexity of the associated code, prompt for assessing, maintaining, and improving the configuration code's quality. We can leverage traditional software engineering knowledge and best practices to develop and maintain high quality configuration code. This talk brings the smell metaphor to configuration domain. This talk introduces configuration smells, their types with various examples, tools to detect them, and suggestions to refactor them.
Sunshine Act Compliance Analysis by WorldDataOnline. Comprehensive, individual, and highly specific company reports will be available shortly. https://worlddata.online/Product/Subscription/LATEST---2015---Sunshine-Act-Compliance-Analyzer
The document discusses employer forum discussions on healthcare reform in 2009. It covers topics like changing the supply and demand curve for healthcare, the various players involved, why reform is happening now versus the 1990s, potential models for reform, and impacts on employers and employees. It also provides information on controlling costs, current bills being considered, and actions employers can take to manage healthcare costs.
American Community provides health insurance plans. It was established in 1938 and is headquartered in Livonia, MI. It offers flexible health insurance plans called Community Flex in 12 states currently and will expand to 13 states in January 2009. The plans have different deductible levels and cover things like office visits, prescription drugs, and dental coverage as options. Contact information is provided for representatives in different states.
The number of uninsured Americans has risen to 50.7 million, or one in six people. This is the highest rate since 1987 and is due to rising healthcare costs, loss of employer-provided insurance during the recession, and families cutting costs by going without coverage. While the Affordable Care Act aims to address this problem, it does not cover prescription drug costs, and over 40 million Americans still lack adequate pharmacy benefits. The growing senior population also faces issues with the Medicare "doughnut hole" and fixed incomes not covering medication costs. Overall, over half of Americans have inadequate or no health insurance.
The number of uninsured Americans has risen to 50.7 million, or one in six people. This is the highest rate since 1987 and is due to rising healthcare costs, loss of employer-provided insurance during the recession, and families cutting costs by going without coverage. While the Affordable Care Act aims to address this problem, it does not cover prescription drug costs, and over 40 million Americans still lack adequate pharmacy benefits or have high deductibles. The growing senior population also faces issues with Medicare coverage gaps and high out-of-pocket drug costs. RX Cut offers a free prescription discount card program that can help save thousands by providing discounts of up to 75% on medications with no fees or restrictions.
- HealthWarehouse.com is an online pharmacy founded in 2007 that aims to provide affordable medications and health tools to consumers nationwide.
- It has experienced strong revenue and prescription growth in recent years and aims to further grow by enhancing its online portal and pursuing strategic acquisitions.
- The company sees opportunities in disrupting the traditional drug supply chain model by eliminating inefficiencies and providing price transparency to consumers.
Healthcare Valuations in an Era of Reform and UncertaintyPYA, P.C.
PYA Principal Jim Lloyd's AICPA Health Care Industry Conference presentation explored reform and current environment highlights, healthcare transactions and affiliations, valuation considerations, and regulatory issues.
Top 30 US Accountable Care Orgaizations_Feb, 2017Levi Shapiro
The document discusses the rise of Accountable Care Organizations (ACOs) and their impact on healthcare providers and commercial teams. It provides definitions for the different types of ACOs, including those focused on Medicare, Medicaid, commercial payers, and pioneers that take on more risk. The summary lists the top 30 ACOs ranked by number of physician affiliations, with the largest having over 7,000 participating physicians. Commercial teams will need to adapt their strategies to target decision makers within ACOs rather than individual providers, as ACOs consolidate influence over treatment and purchasing decisions.
Renco Direct Healthcare offers an alternative to traditional health insurance that allows customers to access care at reduced costs. For a monthly fee of $88, customers gain access to a network of over 700,000 medical providers including doctors, hospitals, dentists and vision care. Customers can save 10-80% on office visits, procedures, and prescription drugs. The program also covers pre-existing conditions with no annual or lifetime limits on coverage. By using Renco's negotiated rates and bypassing insurance company overhead, customers can lower their healthcare costs significantly compared to traditional insurance plans.
Colonial Life And Accident Broker Presentation 1011mrwhayes
The document discusses the rising costs of health care in the US and the challenges it poses for employers and consumers. It notes the proliferation of health insurance acronyms and complexity of the system. Various factors driving up costs are outlined, including an aging population, increased medical inflation, and government intervention. This has led employers to shift more costs to employees through higher deductibles and premiums. Consumer-driven health plans such as health reimbursement accounts (HRAs) and health savings accounts (HSAs) are presented as ways to help control costs by making consumers more responsible for health care spending.
- NSA is a multi-level marketing company that sells nutritional supplements, primarily Juice Plus+, and offers business opportunities for individuals to become distributors.
- As a distributor, individuals can earn income from retail sales of products, building a team of other distributors, and receiving residual income from their team's sales over time.
- Research studies have shown that Juice Plus+ raises antioxidant levels in the blood and provides various health benefits such as reducing DNA damage and improving immune system function.
- NSA is a multi-level marketing company that sells nutritional supplements, including its flagship product Juice Plus+. It was founded in 1970 and is now an international company with over $6 billion in sales across 21 countries.
- Juice Plus+ is a capsule supplement made from concentrated fruit and vegetable juices. Independent clinical trials have shown it significantly increases antioxidant levels in the blood and provides various health benefits such as reducing DNA damage and lowering homocysteine levels.
- NSA distributors can generate income through retail sales of products, building a customer base, and receiving commissions from the sales of their team. The company also offers benefits for high-achieving distributors through its National Marketing Director program.
Health care update jan-2016-american-health care-groupMary Hagan
The latest information about health benefits for employers, human resource professionals, caretakers, Medicare recipients, and more.
Contact Erin Hart if you would like this presentation at your school, office, or community group.
The document summarizes key aspects of the U.S. healthcare system, including how it is funded, how providers are paid, factors driving rising costs, and challenges around sustainability. It addresses these topics through discussing Medicare/Medicaid payment models, employer-sponsored insurance, measures of quality, and factors influencing costs such as administrative overhead and intensity of services provided. The document uses questions to test the reader's understanding of important healthcare concepts like DRGs, preferred provider organizations, and drivers of "good" practice patterns.
This document summarizes The Alliance Cooperative, a not-for-profit cooperative that provides health care benefits and services to self-insured employers. Key points include:
- The Alliance was founded in 1990 by seven Madison-area employers and is member-owned.
- Between 2010-2012, the average annual increase in medical costs per employee for Alliance members was 4.6%, lower than the national average.
- The Alliance has contracts with over 63 hospitals, 5,100 doctors, and other provider types across over 2,675 clinic sites.
- The claims process involves health providers submitting claims to The Alliance, who reprices and sends to the third-party administrator to pay according to the employer's plan
This document provides an overview of a proposed VEBA health plan for a group of dentists, including details about the two plan options, premium rates, and instructions for completing a required personal health questionnaire (PHQ). Key information includes: the VEBA plan allows for consistent nationwide coverage; the two plan options vary in deductibles and premiums; and fully and accurately completing the PHQ is important for determining acceptance into the plans.
Quest Diagnostics held a second quarter 2005 conference call to discuss financial results.
- Revenues grew 6.2% to $1.6 billion driven by a 5.3% increase in testing volume and a 1.2% increase in revenue per test.
- Earnings per share grew 14% to $0.59, and operating income margin expanded.
- Guidance for 2005 was reiterated with earnings per share growth of 14-16% and revenue growth of 5-6% expected.
Your Bottom Line: What the Affordable Care Act Means For Your Nebraska Small ...Small Business Majority
Hosted by the United States Department of Health and Human Services and Small Business Majority. This webinar focused on what the new healthcare law, the Affordable Care Act, means for Nebraska small businesses. It focused on both federal and state provisions to help local small business owners understand how the law will affect them.
The Healthcare Revenue Cycle: How to Optimize PerformanceHealth Catalyst
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1. Copyright WorldDataOnline LLC 2016
Pharma & Medtech
Commercial Compliance
54 Companies pay >$2,500 to Individual Californian Docs
Av. Food & Bev payment now $24
Pharma eradicates Entertainment
Gulf widens between pharma. & medtech payments
2. Overview
Data relates to the latest 2015 Open Payments - General File.
Outputs concentrate on:
National year-on-year summary of Open Payment changes
National fair market rates
Food & Beverage >$1,500 in California
Top companies by expenditure by ToV* payment category
Average payment values for top companies in each category
* Transfer of Value Payments – see definition slide
3. National year-on-year summary of Open Payment data changes
Total payments are effectively the same from 2014 - 2015 at $7.47B v $7.52B
Number of physicians receiving a payment is static YoY at 618,000
Total number of records published has shows no growth at 11.9M
Average payment received by physicians (total payments/no. physicians receiving payment) has no
differential at $12,120 in 2014 against $12,168 in 2015
Only real change is in the number of companies reporting under the Physician Payments Sunshine Act–
which has seen a decrease by 8% to 1456
4. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
California Food & Beverage (F&B) Payments
• 59 companies had F&B payments > $1,500
• 54 companies had F&B payments > $2,500
A single bar line represents the value in $ of all F&B
payments made to an individual Californian physician
in one year by one company (pharmaceutical or
medical technology)
X axis represents 298 Physicians who received
>$1,500 in the year for F&B from one company
The data does NOT include amalgamation of value for
organizational reporting structure i.e. Zendry Pharma
Inc., Zendry LLC, Zendry Biotech Inc., are each
treated individually
Does not account for F&B related to KOL subsistence
0.00
2,000.00
4,000.00
6,000.00
8,000.00
10,000.00
12,000.00
14,000.00
Physician1
Physician11
Physician21
Physician31
Physician41
Physician51
Physician61
Physician71
Physician81
Physician91
Physician101
Physician111
Physician121
Physician131
Physician141
Physician151
Physician161
Physician171
Physician181
Physician191
Physician201
Physician211
Physician221
Physician231
Physician241
Physician251
Physician261
Physician271
Physician281
Physician291
Total Food & Beverage Payments > $1,500 to an
Individual Californian Physician in a Year by a
Single Company
$
5. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
325,804,125
102,600,328
73,264,311
72,557,546
61,948,837
61,603,640
54,071,173
G E N E N TE CH, IN C. ZIM M E R BIOM E T HOLDIN G S,
IN C.
M E DTR ON IC V ASCU LAR , IN C. DE PUY SY N THE S PR ODUCTS
LLC
STR Y KE R COR POR ATION M E DTR ON IC SOFAM OR
DAN E K USA, IN C.
ASTR AZE N E CA
PHAR M ACE UTICALS LP
All Transfer of Value Payments - Top Seven Companies by $
Total Amount of Payment US Dollars
6. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$2,152,500
$50,967 $16,654 $3,890 $32,410
$559,000
$15,299 0
500000
1000000
1500000
2000000
2500000
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
Celgene Corporation Valeant Pharmaceuticals
North America LLC
AstraZeneca Pharmaceuticals
LP
Medline Industries, Inc. K2M, Inc. Intuitive Surgical, Inc. E.R. Squibb & Sons, L.L.C.
Charitable Payments - Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
7. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$2,037 $1,989
$981
$6,630
$2,156
$3,091
$3,972
0
1000
2000
3000
4000
5000
6000
7000
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
$14,000,000
Novartis Pharmaceuticals
Corporation
Valeant Pharmaceuticals North
America LLC
Iroko Pharmaceuticals, LLC Ormco Corporation ACell, Inc. Implant Direct Sybron
International LLC
Tulsa Dental Products LLC
Faculty & Speaker Payments for Accredited & Non Accredited Education Programs
- Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
8. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$4,503
$4,372
$3,701
$5,083
$2,858
$3,459 $3,528
0
1000
2000
3000
4000
5000
6000
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
$14,000,000
$16,000,000
$18,000,000
Stryker Corporation Zimmer Biomet Holdings, Inc. Pfizer Inc. DePuy Orthopaedics Inc. Boston Scientific Corporation Merck Sharp & Dohme
Corporation
Allergan Inc.
Consulting Fee Payments - Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
9. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$2,193
$1,343
$1,447
$1,009
$1,931
$1,750
$756
0
1000
2000
3000
4000
5000
6000
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
Intuitive Surgical, Inc. KARLSTORZ Endoscopy-
America
Arthrex, Inc. Coloplast Corp Smith & Nephew, Inc. Meda Pharmaceuticals, Inc. ACell, Inc.
Education Payments - Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
10. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$208
$68
$137
$52 $46
$83
$73
0
100
200
300
400
500
600
$0
$10,000
$20,000
$30,000
$40,000
$50,000
$60,000
$70,000
$80,000
$90,000
American Orthodontics
Corporation
Marco Ophthalmic, Inc. Luminex Corporation Straumann USA LLC TERUMO MEDICAL
CORPORATION
Romark Laboratories, LC Hitachi Medical Systems
America, Inc.
Entertainment Payments - Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
11. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$17 $19 $15 $15 $21 $23 $20 $16 $19 $14 0
100000
200000
300000
400000
500000
600000
700000
800000
$0
$2,000,000
$4,000,000
$6,000,000
$8,000,000
$10,000,000
$12,000,000
$14,000,000
AstraZeneca
Pharmaceuticals LP
Janssen
Pharmaceuticals, Inc
Pfizer Inc. Novo Nordisk Inc Boehringer Ingelheim
Pharmaceuticals, Inc.
AbbVie, Inc. SANOFI-AVENTIS
U.S. LLC
GlaxoSmithKline,
LLC.
Takeda
Pharmaceuticals
America, Inc.
Actavis Pharma Inc
Food & Beverage Payments - Top Ten Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
12. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
$2,109
$1,564
$1,970
$2,755
$1,495
$3,103
$5,013
0
1000
2000
3000
4000
5000
6000
$0
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
$6,000,000
Gilead Sciences Inc Lundbeck LLC The Medicines Company Cardiovascular Systems Inc. Aqua Pharmaceuticals W. L. Gore & Associates, Inc. Hiossen, Inc.
Honoraria Payments - Top Seven Companies by $
Total Amount of Payment US Dollars Number of Payments Included in Total Amount Average Payment
13. For additional insight by specific company and/or brand please email info@worlddata.online or
visit here
1,949 1,896
3,511
2,693
182 78 24
2,029
337
Compensation for
services other than
consulting, including
serving as faculty or
as a speaker at a
venue other than a
continuing
education program
Compensation for
serving as faculty or
as a speaker for a
non-accredited and
noncertified
continuing
education program
Compensation for
serving as faculty or
as a speaker for an
accredited or
certified continuing
education program
Consulting Fee Education Entertainment Food and Beverage Honoraria Travel and Lodging
National Fair Market Values for Key SG&A Payment Categories
(Average Values in $ per category)
Total
14. Sunshine Act Compliance Analyzer
• Analyze the data yourself!
• Study Open Payments by any dimension:
• Individual company & brand
• Physician
• Even zip code
• Invaluable new tool for compliance
• Benchmark your position V competitors
• Identify outliers – down to zip code
• Excel based - simple to use
• Email info@worlddata.online to book a
demonstration
TO GAIN INSTANT ACCESS
CLICK HERE
15. Sunshine Act Compliance Report
• Let someone else do the analysis!
• See where you are an outlier
• Know your results & your competitors
• Identify local areas of non-compliance
• Study fair market values
• Assess your meal-cap compliance by state
• Purchase a bespoke or syndicated report – your
choice!
Call today on (941) 726-8125
Email info@worlddata.online
16. About WorldDataOnline and the Sunshine Act Compliance Analysis
WorldDataOnline manages and adds value to the U.S’s most complex open healthcare data. Our analysts
have rich expertize in developing solutions to help payers, providers and life science companies.
All content in the Executive Summary slide deck is constructed from our state-of-the-art Open Payment
interrogation system – the Sunshine Act Compliance Analyzer (SACA).
SACA is available for use by Compliance departments on a subscription basis.
17. Contact details
Start investigating your data using the Sunshine Act Compliance Analyzer today!
For immediate access to a reduced cost trial period, simply click here.
To learn more about how the system could help your compliance:
Call today on: (941) 726-8125
Email: info@worlddata.online
To read more articles on this year’s Sunshine Act data please click here.
18. Disclaimer & Conditions
In producing this Executive Summary slide deck WorldDataOnline explicitly does not:
Intend to draw conclusions, inferences or interpretations from the data. The data is presented on a
factual basis, being derived from original atomic level records produced by the Centers for Medicare &
Medicaid (CMS) om the 30th June 2015.
Accept any liability for the data’s content or subsequent use
Any person or company wishing to use the data can do so for non-commercial purposes, providing
reference is made to the original source of the material – www.worlddata.online
All General WordDataOnline Terms apply to the data
19. Definitions
Transfer of Value (ToV) Payment Categories are those provided by CMS and entered by the manufacturer or
Group Purchasing Organization (GPO) during the open payments submission process and include: Honoraria,
Travel & lodging, Food & beverage, Entertainment, Education, Consulting fees, Compensation for services as a
faculty or speaker, Compensation for services other than consulting, Gifts, Grants, Charitable payments,
Royalties & license fees, Current or prospective ownership, Space rental or facility fees & Unknown
Selling, General & Administrative (SG&A) - for the purposes of the Executive Summary, the ToV categories
have been split into Selling, General & Administrative (SG&A) related payments and non SG&A.
SG&A Related Categories include: Honoraria, Travel & lodging, Food & beverage, Entertainment,
Education, Consulting fees, Compensation for services as a faculty or speaker, Compensation for
services other than consulting
Non SG&A Related Categories include: Gifts, Grants, Charitable payments, Royalties & license fees,
Current or prospective ownership, Space rental or facility fees, Unknown
Return to Overview slide