In the News: September 22-28, 2016

Sg2 is dedicated to helping our clients interpret the latest news and trends in health care. Below you’ll find our analysis of this week’s key industry headlines, along with links to related Sg2 resources.

California Governor Signs Consumer Protection Legislation Into Law

On September 23, California Governor Jerry Brown signed into law a bill that that bans so-called “surprise medical bills” that occur when an out-of-network clinician provides services in an in-network facility. According to a SFGate article, the law requires “insurers to reimburse these out-of-network providers at 125% of the rate Medicare pays, or at the insurer’s average contracted rate, whichever is greater.” The law will go into effect in July 2017.

Rising out-of-pocket costs due to high-deductible health plans have caused many patients to become more discerning health care consumers. Moreover, consumer backlash is on the rise, as these patients are more sensitive to perceived discrepancies between the cost and value of health care services. Review this recent webinar, in which Sg2 and Vizient experts explore how organizations are changing their view of emergency care and expanding their focus outside traditional models to meet access challenges and value-based care demands.

“First of Its Kind” Precision Medicine Trial Demonstrates Improved Patient Outcomes

Recent clinical trials performed in Paris on advanced cancer patients found that those who underwent gene mapping and tailored treatment had their tumors grow back 30% more slowly compared to therapies the patients had previously received. Results of the trials were presented last week at the Molecular Analysis for Personalised Therapy conference in London, where the principal investigator said in a statement, “This is the first precision medicine trial to show that analyzing a person’s DNA improves treatment options for patients with late stage cancer.”

Oncology is undergoing rapid change, and all signs point to precision medicine, immunotherapy and big data as the future of cancer care. Given the renewed public attention and research dollars, the exciting clinical breakthroughs in immunotherapy and the use of data sharing to further precision medicine, the oncology world is beginning to leverage this “collective wisdom” to transform cancer care by improving treatment regimens, quality of life and, even, survival rates.

Read the recent Sg2 Expert Insight ASCO 2016: Cancer Care Reaches Its Inflection Point.

Short-term Funding Bill Includes $37 Million for CARA

Senate Republicans released a short-term funding bill that includes $37 million in new funding to fight the opioid crisis. The recently passed Comprehensive Addiction and Recovery Act (CARA) law has roughly $1 billion in targeted costs that have not been secured. The new short-term funding bill provides new resources for addressing opioid addiction in America, and could put CARA on the path toward additional funding

CARA was signed into law by President Barack Obama on July 22. It builds on earlier efforts to restrict access to addictive prescription opioids and expand access to treatment and acute intervention. CARA carves out initiatives to support prevention, treatment and recovery in specific populations affected by the epidemic. Read a recent Sg2 Expert Insight for our perspective on what CARA means for health care providers.

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As of February 11, 2016, Vizient, Inc. has completed its purchase of MedAssets Sg2 and spend and clinical resource management segments from Pamplona Capital Management, LLC. MedAssets revenue cycle business will continue to operate as a wholly-owned subsidiary of Pamplona Capital Management LLP.

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