New Tech Tonics Podcast: Jess Mega of Verily Actually Is Making the World a Better Place

This blog was originally posted on Venture Valkyrie.

J-Mega-PhotoJessica Mega, an accomplished cardiologist and now Chief Medical Officer at Alphabet’s Verily (formerly Google Life Sciences), says she joined the venerable Silicon Valley company to help patients. According to Jess, physicians who love patients need to lean into the tech world because great tech that doesn’t actually change care doesn’t have much of a chance, implying also that it doesn’t have much of a point.

Very early to the concept of what is now called Precision Medicine, Jess helped pioneer the idea of large scale patient data collection (e.g., a study with multiple countries, 1000 sites, 20,000 patients) while studying the individual effects of medications, such as Plavix among populations. She was early to the concept of joining genetic, clinical and phenotypic information together to inform medicine, a concept she has imported to Verily as they take on some of the most challenging clinical problems together with world class medical partners such as Novartis, Dexcom, J&J and the American Heart Association, among others.

Jess imbues her work with the enthusiasm of someone who feels that work is play and that a real contribution is possible every day. She brings the kind of empathy and humanity to Silicon Valley that makes the effective intersection of tech and healthcare seem not just desirable, but also achievable. She just may be making the world a better place.

We are delighted to host Jess on Tech Tonics today. You can listen to her interview by clicking below or find it on iTunes by clicking HERE or on the Connected Social Media website HERE.

Before Thursday’s ACA repeal and replace vote – a throwback to 2012

Before Thursday’s ACA repeal and replace vote, we’d like to share a post from 2012, when Disruptive Women in Healthcare Founder Robin Strongin moderated a panel held by The Hill at the Republican National Convention on the future of health care policy. Among the panelists were former Sen. Trent Lott; Rep. Tom Price; Dr. Donald Palmisano, MD, JD, former president of the American Medical Association; and Sally Greenberg, Executive Director of the National Consumers League.

2012-08-29-GN-Strongin Robin-2

Check out the recap (with video) of that event:

http://www.disruptivewomen.net/2012/09/07/robin-strongin-disrupts-the-rnc/

 

Beyond Repeal and Replace

Robin Strongin

While most of the attention in the health zone is being sucked up by the latest attempt to repeal ACA and replace it with God knows what, there exists a disturbingly high number of health related issues that never seem to get the attention they deserve.

So I thought I would remind us about a few of them — (would love to hear from others–what else should be on this list?):

  • Hunger: do you have any idea how many children go to school hungry? How many older people do not get enough nutrition? How many homeless people and people living in poverty go to bed hungry?
  • Hospitals’ tax-exempt status: what are hospitals giving back to their communities?  If they aren’t, why do they still maintain non-profit status?
  • When we talk about Quality in/of health care–what does that really mean? Are we delivering quality health care and if not, what can be done?
  • Patient’s rights/wishes–do people really understand what they should/can be asking/demanding? Are individual’s wishes being honored, especially at the end of life?
  • Workforce–are we training and maintaining adequate health teams–if not, what can we do differently?  What/who should the health workforce of the future include?
  • Young adults with chronic diseases–we don’t often “see” or know about 14.5 million young adults who struggle everyday–to stay in school, to work, to attain/maintain independence?
  • Mental health services–where are the beds? the services desperately needed?
  • Increasing women in real health care leadership positions (C-suite; boards; equity partners) and related to this, Increasing access to capital for women innovators
  • Violence against women (and girls); sexual assault (civilians and military)–we are so far from where we need to be on this one
  • Bias: how best to conquer unconscious bias in delivering health care to individuals who may be “different” from the health care practitioner–gender sensitivity/language challenges/socioeconomic status/race/mental health status

None of this is easy.   We have to keep pushing forward.

How the Wrong Medicaid Reforms Could Devastate Young People with Complex Medical Needs

This post was authored by Sophia Jan MD, MSHP; Ahaviah Glaser, JD; and Rebecca Kim. It was originally published by the Children’s Hospital of Philadelphia Research Institute Policy Lab blog

Current proposals to simultaneously repeal the Affordable Care Act (ACA) and reform the federal Medicaid program would be devastating to children and young adults with disabilities and complex medical needs. Even if the final ACA replacement plan continues to allow young people to stay on their parents’ insurance plans until they turn 26 – which is a benefit largely supported on both sides of the political aisle – the most medically complex among them rely on Medicaid because of the extraordinary level and cost of care needed.

Today, Medicaid covers 10.2 million adults and children with serious illnesses or disabilities whose health needs create significant financial burden for patients and their families. For example:

  • Medicaid pays for physical therapy, occupational therapy and speech therapy that children with cerebral palsy and other developmental disabilities may receive through school.
  • Medicaid covers private-duty nursing and assistive technology — such as ventilators, feedings tubes and communication devices — that children with disabilities may need to attend school and avoid placement in institutional settings.
  • Medicaid frequently fills in coverage gaps for privately insured children with disabilities since over one-third of insured children with disabilites report inadequate coverage.

These individuals and their families have much to lose with the Medicaid reform proposal currently on the table.

The Switch to Medicaid Per Capita Caps

The ACA replacement plan unveiled Monday night in the U.S. House of Representatives recommends converting Medicaid to a “per capita cap” program, which would provide states with a predetermined amount of funding for each Medicaid enrollee. This type of proposal also gives states more flexibility to decide Medicaid eligibility and service options. Far from a new idea, proposals to reform Medicaid in this way go back at least as far as 1981. Supporters have always presented these proposals as a way for the federal government to save billions of dollars and give states more control. Sounds good, so what’s the catch?

First, per capita caps endanger funding for medically complex children. Under a Medicaid per capita cap, the federal government will likely determine the limit of reimbursement for each child enrolled in Medicaid based on the average health care cost of a child eligible for Medicaid today. It is reasonable to assume that the reimbursement rate per child will be set fairly low, since children make up 50 percent of the Medicaid population, but only contribute to 20 percent of the program’s costs. This may leave insufficient funding for medically complex children whose health care costs are significantly higher than those of other children.

To illustrate, a Medicaid-eligible child costs Pennsylvania $3,561 per year on average. By contrast, a family with a child who has suffered spinal cord injuries may require over $7,000 per month for the mechanical ventilation keeping their child alive. Medicaid per capita caps would not account for the differential health care needs of this family and would shrink both states’ overall budget and ability to care for all children regardless of their health care needs.

Loss of EPSDT

Additionally, all children covered by Medicaid are at risk of losing essential health services they are currently guaranteed. Today, to receive federal funds for their Medicaid programs, states must provide insurance coverage and Early and Periodic Screening, Diagnostic and Treatment (EPSDT) services to all children under 21 who qualify for Medicaid based on their health status or family income. EPSDT is a comprehensive set of screenings and preventive services that catch problems early, before they have the chance to escalate. States must also guarantee children have access to all treatment services that Medicaid providers deem medically necessary from these screenings and services.

EPSDT services, which were designed to meet the unique health care needs of children, could be eliminated with major cuts to Medicaid spending through per capita caps. This is because the financial burden of keeping people covered would fall to the states, which would have more flexibility to decide who qualifies for Medicaid and which services to cover. Medicaid coverage would, therefore, be on the negotiating table when states are faced with difficult budgetary decisions. Children with disabilities could lose access to essential services and, in all likelihood, would be left with no affordable insurance options that meet their health care needs. In Pennsylvania alone, over 13,000 people with intellectual disabilities are already waiting to receive Medicaid-funded services.

Impact on therapies children receive in school

For decades, Medicaid has also allocated funding to schools that provide special education and certain medically necessary services to children with disabilities under the Individuals with Disabilities Education Act (IDEA). By reducing federal spending and eliminating the possibility of adjusting funding levels based on changing needs, per capita caps would likely force school districts to compete with hospitals and health care centers for precious Medicaid dollars, and they’d likely take the most significant hit. Schools would be forced to pay for special education programs with funds allocated for general education, potentially reducing the amount of money available to pay for teachers, counselors, nurses and extracurricular programming for all students.

Potential Solutions

One way to decrease the potentially devastating impact that per capita caps will have on children with disabilities is to place children with disabilities and other medically complex conditions into a different category from their healthier peers, essentially creating a “high-risk pool” for Medicaid-eligible children. Alternatively, Medicaid-eligible children with disabilities could be grouped together with adults who also qualify for Medicaid due to disability, which may minimize loss of Medicaid coverage — and the requisite delivery of medical and nursing care services — that frequently occurs when emerging adults with disabilities transition from pediatric to adult health care services.

Lawmakers will confront many difficult decisions in the coming weeks and months, but whether to pursue reforms that will inevitably cut access to care for our most vulnerable populations should not be one of them. As Dr. Ezekiel Emmanuel wrote this week in his New York Times op-ed, “this would be even worse than going back to the days before the Affordable Care Act.” Sweeping cuts to a program that nearly half of all U.S. children — and most children with very complex medical conditions — rely upon for the health care they need to survive and thrive is not the answer. We must find thoughtful ways to improve the efficiency and quality of health care in order to achieve the shared goals of bringing down health care costs and improving health outcomes for everyone.

Rebecca Kim is an MD/MPH student at the University of Pennsylvania. She works with Dr. Sophie Jan and the Multidisciplinary Intervention Navigation Team (MINT) at CHOP on their efforts to improve transitions to adult care.

In Honor of International Women’s Day 2017…

In Honor of International Women’s Day 2017, we give a shout-out to our Disruptive Women to Watch in 2017!

http://www.disruptivewomen.net/2017/01/30/17-disruptive-women-to-watch-in-2017/

aveyLinda Avey

Co-founder 23andMe and Co-founder and CEO, Curious Inc.

Biography

BrintonDr. Roberta Diaz Brinton

Inaugural Director, Center for Innovation in Brain Science, University of Arizona Health Sciences

Biography

CarrilloDr. Maria C. Carrillo

Chief Science Officer, Medical and Scientific Relations, Alzheimer’s Association

Biography

ComerMeryl Comer

Founding Board Member, USAgaistAlzheimer’s and President, Geoffrey Beene Foundation Alzheimer’s Initiative

Biography

CrooksDr. Glenna Crooks

Founder and CEO SageMyLife.

Biography

HallerStacy Pagos Haller

President and CEO, BrightFocus Foundation

Biography

HendersonMarsha B. Henderson

Assistant Commissioner for Women’s Health (OWH), U.S. Food and Drug Administration (FDA)

Biography

LangbaumDr. Jessica Langbaum

Principal Scientist, Banner Alzheimer’s Institute and Associate Director, Alzheimer’s Prevention Initiative

Biography

LathanDr. Corinna E. Lathan

Co-founder, Board Chair and CEO, AnthroTronix

Biography

LesserJill Lesser

President, WomenAgainstAlzheimer’s Network and Board Member, UsAgainstAlzheimer’s

Biography

MikulskiSenator Barbara Mikulski

Senator, retired

Biography

PfeiferDr. Andrea Pfeifer

CEO, AC Immune

Biography

PoslunsLynn Posluns

Founder, President and Board Chair, Women’s Brain Health Initiative (WBHI)

Biography

SeeleDr. Pernessa Seele

CEO & Founder The Balm In Gilead, Inc.

Biography

ElizabethTaylor2Dr. Reisa Sperling

Director, Center for Alzheimer’s Research and Treatment; Professor of Neurology, Harvard Medical School; Director of Clinical Research, Memory Disorders Unit, Brigham and Women’s Hospital and Director, Neuroimaging Program, Massachusetts Alzheimer’s Disease Research Center

Biography

TomainoDr. Concetta Tomaino

Executive Director and Co-Founder, Institute for Music and Neurologic Function

Biography

TomainoTrish Vradenburg

Founding Board Member and Vice-Chair, UsAgainstAlzheimer’s

Biography




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