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Geisinger Partners With Pharmas To Improve Diabetes Outcomes

Posted on October 10, 2017 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Geisinger has struck a deal with Boehringer Ingelheim to develop a risk-prediction model for three of the most common adverse outcomes from type 2 diabetes. The agreement is on behalf of Boehringer’s diabetes alliance with Eli Lilly and Company.

What makes this partnership interesting is that the players involved in this kind of pharma relationship are usually health plans. For example:

  • In May, UnitedHealth Group’s Optum struck a deal to model reimbursement models in which payment for prescription drugs is better structured to improve outcomes.
  • Earlier this year, Aetna cut a deal with Merck in which the two will use predictive analytics to identify target populations and offer them specialized health and wellness services. The program started by focusing on patients with diabetes and hypertension in the mid-Atlantic US.
  • Another example is the 2015 agreement between Harvard Pilgrim health plan and Amgen, in which the pharma would pay rebates if its cholesterol-control medication Repatha didn’t meet agreed-upon thresholds.

As the two organizations note in their joint press statement, cardiovascular disease is the leading cause of death associated with diabetes, and diabetes is the top cause of kidney failure in the U.S. population. Cardiovascular complications alone cost the U.S. more than $23 billion per year, and roughly 68 percent of deaths in people with type 2 diabetes in the U.S. are caused by cardiovascular disease.

The two partners hope to improve the odds for diabetics by identifying their condition quickly and treating it effectively.

Under the Geisinger/Boehringer agreement, the partners will attempt to predict which adults with type 2 diabetes are most likely to develop kidney failure, undergo hospitalization for heart failure or die from cardiovascular causes.

To improve the health of diabetics, the partners will develop predictive risk models using de-identified EHR data from Geisinger. The goal is to develop more precise treatment pathways for people with type 2 diabetes, and see that the pathways align with quality guidelines.

Though this agreement itself doesn’t have a value-based component, it’s likely that health systems like Geisinger will take up health plans’ strategies for lowering spend on medications, as the systems will soon be on the hook for excess spending.

After all, according to a KPMG survey, value-based contracts are becoming a meaningful percentage of health system revenue. The survey found that while value-based agreements aren’t dominant, 36 percent of respondents generated some of their revenue from value-based payments and 14 percent said the majority of revenue is generated by value-based payments.

In the meantime, partnerships like this one may help to improve outcomes for expensive, prevalent conditions like diabetes, high blood pressure, arthritis and heart disease. Expect to see more health systems strike such agreements in the near future.

Payor Recalls ED EMR After Problem Is Discovered

Posted on October 15, 2013 I Written By

Anne Zieger is veteran healthcare editor and analyst with 25 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

UnitedHealth Group has voluntarily recalled its emergency department EMR after a bug resulted in doctors’ notes not appearing in medical records, according to a story in Healthcare IT News.

Customers of the EMR, OptumInsight’s Picis ED PulseCheck, are spread across 35 facilities in more than 20 states. These users were notified of the issue — prescription notes not showing upon the prescription or patient chart — back in June, HIN reports.

Picis Inc., which was acquired by UHG in 2010, had already issued six software-related recalls since 2009, according to a Bloomberg report.  Incidents include one case where anesthesia-management software sold nationwide that in one case displayed one patient’s medical information in another patient’s file.

Another problem involved software sold worldwide in which on an unspecified number of occasions, the system failed to display discontinued status on medication orders.  Still others included issues causing failures to display appropriate allergy interaction warning and lock out of administrators, Bloomberg said.

While the recall is doubtless a black eye for Picis, the problems it has had are far from unusual. In fact, according to a study reported in the  Annals of Emergency Medicine, emergency department EMR designs vary widely, with some having problems which can compromise clinician workflow, communication and ultimately quality and safety of care.