Healthcare Hot List – July 2014

 

 

McClelland Advocacy Healthcare Hot List

July 2014

 As the healthcare industry continues to reverberate with change, we take a look at the companies and individuals making waves in the healthcare world, who’s hot and who’s not:[1]

Hot:

  • Anthem Blue Cross of California: biggest winner in the Covered California open enrollment and recently obtained a highly favorable appellate court ruling regarding UCR reimbursements to non-contracted providers under California’s notoriously uncertain managed car laws.
  • Dr. Samir Qamar – pioneering physician-CEO continues to push his MedLion Direct Primary Care to new heights while founding a new physician led professional association for DPC physicians and co-founding MedWand, a remote diagnostic tool permitting telemedicine physicians to practice with real time data.
  • Sylvia Burwell – confirmed without real controversy, the new Secretary of HHS takes the helm in a challenging time
  • Dr. Kris Held – in a notoriously moribund and conservative profession, the San Antonio physician and Director at American Doctors 4 Truth continues to fight for her profession in a time when physicians cry out for real leadership.  In a leadership vacuum, Held is one to watch.
  • Sutter Health: Hospital arm ranks among the biggest non-profit health systems nationally as it inaugurates its second go round with its own HMO.  Sutter continues to engage everywhere it needs to be despite widespread criticism and settlement of a false claims case by CA’s Insurance Commissioner.
  •  Dr. Michael Patmas: Hard-charging CEO of Rockwood Health System in Spokane continues to be a strong voice for realigning physician payment models and improved patient care.  He and his organization performed brilliantly after a shooting tragedy at a Rockwood facility earlier this month.
  • Venture capital: billions continue to pour into e-health and telemedicine ventures as rumors surface Apple will incorporate e-health into its next iPhone and the iWatch.

Not:

  • Cal. Dept of Managed Health Care: Governor Jerry Brown’s Administration continues to demonstrate a deaf ear to healthcare as he appoints a journalist to the #2 slot at the nation’s only HMO regulator, amidst allegations of insufficient networks and rising consumer complaints in the Covered CA marketplace.
  • DaVita Health Care Partners: following a much celebrated merger between outpatient dialysis provider DaVita and Los Angeles’ medical group Health Care Partners once hailed as the next Cleveland Clinic or Mayo, the group withdrew from Medicare’s Pioneer ACO program and HCP founder Bob Margolis’ transitioned out.  The Company’s stock continues to perform well, though Zack’s Investment Research downgraded it to a sell this month,  however, almost no one is referring to the combined venture as the next big thing.
  • ObamaCare: following a brief lift in the polls after open enrollment numbers were released, the controversial law has settled back into a state of perpetual ineffectiveness as HHS admits that it can’t validate a third of enrollees, and CBO declares the law’s budgetary impact can no longer be scored.  As the federal and state exchanges seek to pressure insurers to keep premium increase down while broadening their networks, watch for the bailout.  The only way insurers can broaden networks and limit premium increases will be to access the federal risk corridors, which the Administration quietly increased.

 

McClelland Advocacy is a Sacramento-based law firm with expertise in healthcare litigation and corporate disputes, and in public policy and Constitutional litigation and challenges to state and local government actions.

 

 

 

 

 

[1] The Hot List constitutes the editorial opinion of the author and is not a representation of fact.  The Hot List is not compiled  through any quantifiable metric or survey.