Author: books

CVS Health has acquired Signify Health, besting Amazon, UnitedHealth Group and others in acquiring the home health platform.

CVS has entered a definitive agreement to acquire Signify Health for $30.50 per share in cash, representing a total transaction value of approximately $8 billion, CVS announced on Monday.

Signify was reportedly for sale by auction, with board members holding a meeting on Labor Day to discuss the bids.

Kyle Armbrester, CEO of Signify Health, said in a statement, “As we carefully considered our long-term strategic options, we determined that CVS Health is the ideal partner, given its focus on expanding access to health services and helping consumers navigate to the best sites of care.”

Following the close of the transaction, Armbrester will continue to lead Signify Health as part of CVS Health, CVS said. 

Private equity funds affiliated with New Mountain Capital, which owns approximately 60% of the common stock of Signify Health, have agreed to vote the shares they own in favor of the transaction, subject to customary exceptions. CVS Health and Signify Health anticipate that the transaction will close in the first half of 2023.

WHY THIS MATTERS

CVS Health, which acquired Aetna in 2018, has been expanding into the provider space through Minute Clinics and health screenings.

Home health is projected to grow due to an aging population and models for home care that expanded during the pandemic.

Walgreens Boots Alliance recently expanded into the market through the purchase of CareCentrix, a platform that coordinates care in the home for plans, patients and providers.

Signify Health offers a home health platform and in-home evaluations. It has a network of more than 10,000 clinicians across all 50 states and a nationwide value-based provider network, combined with proprietary analytics and technology platforms, CVS said, adding the acquisition would improve patient engagement, outcomes and care coordination.

“Signify Health will play a critical role in advancing our healthcare services strategy and gives us a platform to accelerate our growth in value-based care,” said CVS Health president and CEO, Karen S. Lynch. “This acquisition will enhance our connection to consumers in the home and enables providers to better address patient needs as we execute our vision to redefine the healthcare experience. In addition, this combination will strengthen our ability to expand and develop new product offerings in a multi-payor approach.”

THE LARGER TREND

Signify Health’s network of clinicians, physicians, nurse practitioners and physician assistants utilize home-based visits to identify a patient’s clinical and social needs and then connect them to appropriate follow-up care and community-based resources.

In 2022, Signify Health’s clinicians expect to connect with nearly 2.5 million members in the home, both in-person and virtually, according to CVS. On average they spend 2.5 times longer with a patient in the home than providers spend in the average primary care office visit, CVS said.

Since acquiring Caravan Health in March, Signify Health has further expanded its focus on value-based care and population health as a partner to over 170 providers participating in accountable care organizations serving Medicare beneficiaries. 

Signify Health recently announced that its ACOs generated more than $138 million in gross savings in 2021, and in 2023 the Caravan business is expected to serve ACOs representing over 700,000 people rivaling many standalone platforms, CVS said. 

As part of CVS Health, Signify Health will continue to advance its primary care enablement capabilities, including turnkey analytics, network and practice-improvement solutions, to help providers transition to value-based reimbursement and improve quality of care.

ON THE RECORD

“This is a major step as we continue to execute on our strategy,” said CVS Health Executive Vice President and Chief Financial Officer Shawn Guertin. “We expect the acquisition to be meaningfully accretive to earnings and, as a result, are increasingly confident we can achieve our long-term adjusted EPS goals as outlined at our Investor Day in December 2021.”

Twitter: @SusanJMorse
Email the writer: [email protected]

AI-backed imaging and care coordination company Viz.ai received FDA 510(k) clearance for an algorithm that could help determine the severity of a pulmonary embolism. 

The startup received the agency’s green light late last month for its RV/LV ratio algorithm, which measures the diameter of the ventricles of the heart to provide the ratio of the maximum right ventricle diameter compared with the left ventricle. Determining the ratio could help identify right ventricular dysfunction in the heart, which can be a sign of poor outcomes. 

“With this clearance, the Viz PE Solution now includes both detection of clot in the lungs and degree of strain on the right heart,” Dr. Kenneth Rosenfield, section head of vascular medicine and intervention at Massachusetts General Hospital and cofounder of the PERT Consortium, said in a statement. Viz.ai is a sponsor of the PERT Consortium, which focuses on research and care for pulmonary embolism.

“This will enable clinicians to quickly triage patients and treat them appropriately, by providing a powerful tool for early detection and risk stratification. This expedited critical decision-making will undoubtedly save lives.”

THE LARGER TREND

This clearance marks Viz.ai’s third 510(k) so far this year. In late July, it announced Viz Subdural had been cleared to flag potential cases of subdural hemorrhage. It also received a 510(k) in February for an algorithm designed to detect cerebral aneurysms. 

Viz.ai most recently raised a $100 million Series D round that boosted its valuation to $1.2 billion. When the round was announced in April, the company said it would use the capital to fuel growth and add new triaging capabilities to its platform. Founded in 2016, Viz.ai has scooped up more than $250 million in venture dollars.

There are a number of companies focused on using AI to detect and triage potential health concerns based on imaging results. Earlier this summer, Aidoc raised $110 million in a Series D funding round to continue expanding its platform, which includes its AI tools and care-coordination software. It recently received FDA 510(k) clearances for tools to find and triage potential brain aneurysms and pneumothorax, or a collapsed lung.

In May, RapidAI received clearance for its own pulmonary embolism-focused tool. Other companies in the AI imaging space include Gleamer, Nanox and Qure.ai.

The stereotype of a typical college student’s diet is pretty grim. Ramen and fast food. Keggers and 2 a.m. pizza. All-nighters fueled by Red Bull and Cool Ranch Doritos®. Mostly tragic dining hall food.

As with most stereotypes, this isn’t an accurate characterization. Oh, there’s plenty of pizza and energy drinks, but college isn’t really the health wasteland it’s made out to be. Many students eat normal meals at normal hours more often than not. They make at least some attempt to choose healthy fare. Dining halls try to present a variety of nutritious options—by conventional standards, not Primal ones, of course, but they do try.

This is to say, it’s entirely possible to eat healthy in college. Granted, we might want to adjust our standards for what “healthy” looks like in this context (occasional all-nighters are better than frequent all-nighters). And even then, it’s not always easy. Kids who live on campus are limited to what they can prepare in cramped dorm rooms and forage from campus dining services. Time is often at a premium. Grocery bills add up, and getting to the grocery store isn’t always easy. Many students simply aren’t prepared for the responsibility of procuring and preparing their own food.

The purpose of today’s post is to share some tips for how to eat healthy in college dining halls or on a budget. Use these ideas as inspiration, but know that you, dear student, don’t have to follow them to a tee to be healthy. We’re not trying to turn you into social pariahs who are unable to enjoy the occasional late-night drive-thru run with friends or movie night with piles of candy and popcorn.

You have youth on your side, so you can probably get away with more excursions than we older folks. Still, good nutrition is vitally important. Your body and brain are still developing, and the rigors of college mean you’re frequently low on sleep and high on stress. Nutrient-dense, satisfying food is one of the ways you can support yourself and, to some degree, offset (or at least not add to) the stressors you can’t control.

How to Make Healthier Food Choices in College

1. Get to know your surroundings.

Finding the best food options at the best prices means shopping around.

Explore the dining hall options. Even if you plan to eat mostly on campus using a meal plan, large universities often have multiple dining halls and minimarts for students. You might discover that the dining hall across campus has far superior breakfast options, but you prefer to stick closer to your dorm for dinner.

Check out the local grocery stores, delis, and markets. See which ones have the best prices. Sign up for club cards and coupon apps. If you’re not thrilled by the offerings, consider ordering periodically from places like Thrive Market or Amazon. Perhaps your roommate or other students on your floor will want to go in on orders together.

Scope out restaurants within walking or biking distance.

Look for farmer’s markets on or near campus. This is one of the best ways to get fresh fruits and vegetables at good prices.

2. Stock your dorm room.

Create a mini-kitchen in your dorm room with a few essential tools to prepare quick meals and snacks. This could include:

• Mini-fridge with freezer
• Small blender, like a Magic Bullet or Ninja Personal Blender
• Microwave
• One-cup coffee maker
• Basic cooking implements (cutting board, knife)
• Plate, bowl, utensils

This simple, compact set-up lets you make all sorts of meals that require little or no cooking—salads, smoothies, soup, protein oatmeal, and more. Many dorms also have shared kitchen spaces. Look to see what kind of appliances and tools they provide and whether there is a refrigerator/freezer you can use.

Keep a selection of groceries on hand that you can turn into a quick breakfast on the go (smoothie bowl, microwave egg bites) or to snack on between classes (trail mix, apple with peanut butter and a cheese stick). Here’s a basic shopping list to get you started:

• Frozen berries
• Frozen spinach and other vegetables
• Yogurt
• Protein powder
• Salad mix
• Salad dressing
• Canned tuna or other fish
• Canned or pre-cooked chicken
• Nuts and trail mix
• Nut butter
• Beef sticks, jerky
• Fresh fruits and veggies that can be eaten raw
• Dips (ranch dip, hummus, guacamole)
• Cheese sticks, sliced cheese, cottage cheese
• Soup, bone broth
• Condiments

3. Make the most of the dining hall.

I still think about the fabulous salad bar in my university’s dining hall where a chef would assemble a killer big-ass salad per student’s exact specifications. The dining hall also had good hot food options, fresh fruit, and, of course, pizza, french fries, giant dispensers of sugary cereal, and Chik Fil-A.

There are always options. Pick the ones that serve you best… most of the time, anyway.

4. Build meals around protein and produce.

When it’s time to eat, think protein and produce first. Try to get a decent serving of protein and at least one vegetable or fruit at every meal. This rule of thumb will help you put together meals that have the nutrients you need.

5. Make time for proper meals.

College life gets hectic, but try to minimize the number of meals you eat while running from one class to the next. Don’t skip breakfast, only to end up famished and grabbing something out of the vending machine at 11 a.m. Eat dinner before sitting down to cram for tomorrow’s exam. Eating in a relaxed, unharried state improves digestion, and keeping regular-ish meal times helps your circadian rhythm.

Speaking of your circadian rhythm, eating too late—and certainly eating in the middle of the night—really messes with your internal clock. The occasional late-night meal probably isn’t a big deal, but it really shouldn’t become an every weekend thing.

6. Eat fish once in a while.

It’s easy to get by on hamburgers, lunchmeat, and chicken fingers, but you need fish for those essential omega-3s. It doesn’t have to be fresh fish. Canned fish—tuna, sardines, salmon, cod livers—are fantastic and easy to keep in your dorm room.

7. Make simple swaps.

Don’t overcomplicate it. Ask for a lettuce wrap instead of a bun. Get grilled chicken fingers instead of fried. Get a side salad instead of tater tots. Opt for a burrito bowl instead of the plate of nachos. Not every time necessarily, but look for obvious chances to make a healthier choice, and take them.

8. Watch the alcohol intake. Coffee too.

This one needs no explanation. Consider the budgetary benefits, as well.

9. Control what you can; don’t worry about the rest.

Eating in the dining halls means ceding some control over ingredients and options. You’re probably not going to be able to avoid seed oils, for example. While not ideal, this isn’t something to stress about. Use avocado oil, olive oil, and butter or ghee when cooking for yourself. Big props if you don’t mind schlepping a bottle of avocado oil salad dressing to the dining hall. But as long as you’re doing the best you can with what’s available, this is a “don’t let perfect be the enemy of good” situation.

The goal isn’t to be a perfect Primal eater, and we definitely don’t want food to be a source of anxiety and misery. What you eat plays a huge role in how you feel, though. Therefore, it behooves you to pay attention to how you’re nourishing your body and to make self-supporting choices more often than not. Instead of thinking about what you “can’t” or “shouldn’t” eat, seek out foods that will help you feel physically well, mentally sharp, and energetic.

Sometimes, the self-supportive choice will be to embrace the social experience of going to the all-you-can-eat buffet with your dorm buddies at 11 p.m. If you do that a few times a week, week in and week out, you’ll feel like hot garbage after a while. Remember the 80/20 principle: strive to make healthier choices most of the time, recognizing that college life is messy and fun and sometimes inherently unhealthy. Just like I’d never suggest that college students must get 8.5 hours of sleep every single night because it wouldn’t be realistic for myriad reasons, I’d never suggest that you must make healthy eating your top priority at every meal. College life isn’t set up for that.

You don’t have to embody the stereotype of an unhealthy college student, though, either. Seek out people who, like you, want to find a good balance between relishing your time at college and also taking care of themselves so they can truly get the most out of every part of the experience.

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By Amy Norton
HealthDay Reporter

TUESDAY, Sept. 6, 2022 (HealthDay News) — Surgery for uterine fibroids can often be done through minimally invasive techniques that avoid a hospital stay. But Black and Hispanic women may be less likely to receive these treatments, a recent study finds.

Uterine fibroids are non-cancerous growths in the uterus. Sometimes they cause no problems, but when they do — like heavy monthly bleeding and pain — treatment may be necessary.

One option is surgery: a myomectomy, which removes just the fibroids; or a hysterectomy, which removes the uterus. Either surgery can often be done in a minimally invasive way — vaginally or through small incisions in the abdomen.

Yet in the new study, researchers found that Black and Hispanic women often did not receive those less extensive procedures — instead getting traditional surgery, with a large abdominal incision and a hospital stay.

The reasons are not completely clear, the researchers said.

But the investigators did find that Black and Hispanic women were less likely than white women to see a doctor who specialized in minimally invasive techniques.

Uterine fibroids are very common, but especially so among Black women, said researcher Dr. Rebecca Schneyer, an obstetrician/gynecologist at Cedars-Sinai Medical Center, in Los Angeles.

Studies show that about 80% of Black women will have uterine fibroids by age 50, as will 70% of white women. But Black women typically develop them sooner: By some estimates, one-quarter of Black women have fibroids by age 30.

They are also more prone to having numerous or large fibroids, suffer more intense symptoms, and more often undergo surgery compared to white women.

“That’s all the more reason we should be trying to reduce disparities in care,” Schneyer said.

Traditional abdominal surgery for fibroids is generally safe. But it causes more pain and blood loss, and has a longer recovery time than minimally invasive procedures.

For the new study — recently published in the Journal of Minimally Invasive Gynecology — Schneyer’s team examined records of more than 1,300 women who had surgery for uterine fibroids at Cedars-Sinai in recent years.

Most had a minimally invasive myomectomy or hysterectomy, but there were substantial racial gaps: Among white women, 81% underwent minimally invasive procedures, versus 57% of Black women and 65% of Hispanic women. Asian women, meanwhile, had a rate comparable to white women.

Schneyer said there are times when traditional surgery is the better option, depending on the number of fibroids or size of the uterus, for example.

But those factors did not explain the disparities in surgery type, the study found.

Instead, Black and Hispanic women were less likely than white women to see a doctor who specialized in minimally invasive techniques: They often saw an obstetrician/gynecologist without that “sub-specialty” training.

Why is unclear, since all patients were treated at the same medical center and nearly all had private insurance.

It’s possible, Schneyer said, the doctors whom Black and Hispanic women initially saw were less likely to refer them to sub-specialists, perhaps due to “implicit biases.”

But she suspects that “disparities in awareness” might play a bigger role: White women may be more likely to know about minimally invasive options, or seek a second opinion.

Dr. Hye-Chun Hur specializes in minimally invasive gynecologic surgery at NYU Langone Hospital Brooklyn. She said that in her experience, some patients with uterine fibroids are indeed more likely to “doctor shop” and seek second or third opinions, while others accept the initial option presented to them.

The onus should be on doctors, both Schneyer and Hur said, to explain all treatment options.

It’s also important, they said, for primary care doctors and general ob/gyns — the ones who refer women to sub-specialists — to be aware that minimally invasive procedures can often be done even when there are numerous fibroids or the uterus is large.

“A lot has changed in the past 20 years,” Schneyer said. “More often than not, minimally invasive surgery is an option.”

For women who have traditional surgery recommended, Hur said, “seeking a second opinion is always a good idea.” But they should try, if possible, to get that opinion from a specialist in minimally invasive techniques, she added.

Schneyer also stressed that non-surgical options are available, including medications that control bleeding caused by fibroids.

Any treatment, Hur said, needs to be individualized — based not only on symptoms, but a woman’s age and pregnancy plans.

Sometimes fibroids affect fertility, she noted, so some young women might consider having the growths removed, even if they are not causing symptoms.

That may be especially important, Hur said, for Black women, as they are at greater risk of developing numerous fibroids at a younger age.

More information

The U.S. Office on Women’s Health has more on uterine fibroids.

SOURCES: Rebecca Schneyer, MD, obstetrics and gynecology, Cedars-Sinai Medical Center, Los Angeles; Hye-Chun Hur, MD, MPH, director, gynecology services, NYU Langone Hospital Brooklyn, and clinical associate professor, obstetrics and gynecology, NYU Grossman School of Medicine, New York City; Journal of Minimally Invasive Gynecology, July 3, 2022, online

SOURCES:

Nick Battle, EdD, vice president, Association of Black Therapists; professional counselor licensed in Maryland, Virginia, and the District of Columbia.

Earl Turner, PhD, associate professor of psychology, Pepperdine University; founder, Therapy For Black Kids; member, American Psychological Association Task Force on Police Use of Force Against African Americans; founder, Turner Psychological and Consulting Services.

Maya Nelson, mental health counselor, Brave Health.

American Psychological Association: “APA Dictionary of Psychology.”

The Lancet: “Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study.”

Journal of Research on Adolescence: “Perceived Racial Discrimination and Self-Esteem in African American Youth: Racial Socialization as a Protective Factor.”

Current Epidemiology Reports: “Perceived Racial/Ethnic Discrimination and Mental Health: a Review and Future Directions for Social Epidemiology.”

Journal of Health and Social Behavior: “Stress and the Mental Health of Populations of Color: Advancing Our Understanding of Race-related Stressors.”

Sept. 6, 2022 – Attention parents: The nation’s leading pediatric medical society is urging you to make sure your children get a flu shot this fall to prevent and control the spread of the illness.

The American Academy of Pediatrics this week called on parents and caregivers to seek flu vaccines for their kids as soon as they are available in the fall. The group is encouraging parents to catch up on all other vaccines for their children, too.

“As a pediatrician and a parent, I consider the flu vaccine as critical for all family members,” Kristina A. Bryant, MD, said in a statement about the academy’s recommendations. “We should not underestimate the flu, especially when other respiratory viruses like COVID-19 are circulating within our communities. Besides making your child miserable and wreaking havoc on your family’s routine, influenza can also be serious and even deadly in children.”

Only 55% of children ages 6 months to 17 years had been vaccinated against influenza as of early April – down 2% from the previous April – and coverage levels were 8.1% lower for Black children compared with non-Hispanic white children, according to the CDC. In the 2019-2020 flu season, 188 children in the United States died of the infection, equaling the high mark for deaths set in the 2017-2018 season, the agency reported.

American Academy of Pediatrics guidelines recommend children ages 6 months and older be vaccinated with the flu vaccine every year. Depending on the child’s age and health, they may receive either a shot, which has an inactive version of the flu virus, or the nasal spray, which has a weakened form of the virus. (The academy has more information about the different vaccines here.)

Children ages 6 to 8 months old who are getting flu vaccines for the first time should receive two doses at least 4 weeks apart. Pregnant women can get the flu vaccine any time in their pregnancy. Influenza vaccines are safe for developing fetuses, according to the academy.

The group stressed the importance of flu vaccines for high-risk and medically vulnerable children and acknowledged the need to end barriers to immunizations for all people, regardless of income or insurance coverage. In 2020, an estimated 16.1% of children in the United States were living in poverty, up from 14.4% in 2019, according to the U.S. Census Bureau.