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BOSTON--(BUSINESS WIRE)--OmniClaim, a leader in payment integrity and overpayment recovery, today announced it has strengthened its leadership team with the addition of Joseph Alberta as Senior Vice President of Sales. In his new role, Alberta will be responsible for developing and executing direct and indirect sales strategies to ensure OmniClaim’s continued growth and innovation in the marketplace. “Joe is a dynamic sales leader who will help us continue to scale our business and expand our payment integrity program,” said Dave O’Donnell, Chairman and Chief Executive Officer of OmniClaim. “He takes a hands-on approach and has a proven track record of executing and driving consistent, measurable results. We expect Joe to play a key role in OmniClaim’s continued evolution.” Alberta is the second strategic hire for OmniClaim following the addition of Nadine Hays as Chief Growth Officer in April of this year. With close to 20 years’ experience in the healthcare technology space, Alberta joins OmniClaim from Verscend, where he was Vice President of Payer and Employer Enterprise Sales. A graduate of the College of the Holy Cross, previous roles have included Vice President of Population Health Sales at Verisk Health and Regional Sales Director at Ingenix Inc. (now OptumInsight). “Joe brings with him a significant knowledge of market trends and needs and an acute understanding of the challenges faced by our clients and prospects,” said Tim O’Donnell, President and Chief Operating Officer of OmniClaim. “We are very excited about the addition of both Joe and Nadine and how that positions OmniClaim for ongoing growth and expansion in many areas. We look forward to leveraging their experience and insight as we continue to innovate and deliver the highest possible value to our clients by recovering the most savings available.” OmniClaim is an industry leader in payment integrity and overpayment recovery, delivering significant financial results while minimizing provider abrasion. We accomplish this through our unique combination of strong relationships with payers and providers, proprietary predictive analytics, and unparalleled subject matter expertise. Our credibility with over 3000 provider organizations nationwide leads to more successful audits with fewer appeals and minimal provider abrasion. We consistently deliver on aggressive cost containment goals and our 100% client retention since our inception is the result. For more information, visit the OmniClaim website at www.omniclaim.com.

News Article | July 27, 2017
Site: www.businesswire.com

LENEXA, Kan.--(BUSINESS WIRE)--Mediware Information Systems Inc. announced today that Bill Miller will join as Chief Executive Officer, effective immediately. Miller most recently served as Chief Executive Officer of OptumInsight at Optum, a subsidiary of UnitedHealth Group that is the largest health services company in the world. In his new role, Miller will work closely with Mediware’s management to build and accelerate the company’s platform, further expanding its footprint in the alternate care and human and social services markets. He succeeds Kelly Mann, who joined the company as a CEO in 2007. “I want to thank the team at Mediware for their dedication, innovation, and hard work over the last several years. Mediware is a best-in-class company and it’s been a privilege to have played a leading role,” said Mann. “Bill is an accomplished industry executive with valuable operational skills and creative insights. With his leadership and the ongoing support of our partners at TPG, I am confident that Mediware is well positioned for its next chapter of growth.” Miller brings to Mediware more than 20 years of experience in the healthcare and technology sectors. While at OptumInsight, he led the company to unprecedented growth, seeing its revenues expand from $1.5 billion to over $5 billion and driving tremendous growth in the payer, provider, life sciences, and analytics market places. Prior to OptumInsight, Miller served as the Vice President of Technologies at Cerner Corporation, where he oversaw the company’s technology businesses as well as its managed services, outsourcing, and advanced technology consulting practices. “Having spent my entire career in the healthcare and technology industries, I have known Mediware as an industry leader with a deep understanding of the marketplace and an ongoing commitment to quality and client service,” said Miller. “I am excited about their strong position in the expanding markets they serve, and look forward to working with TPG and the Mediware team to build on the momentum that the company has achieved to-date.” “We would like to thank Kelly and congratulate him on a long and successful tenure at Mediware,” said Nehal Raj and Jeff Rhodes, Partners at TPG. “Bill’s joining marks the next step in growing the company’s robust software platform, following its recent acquisition of Kinnser Software. His strong track record of building and growing companies in the healthcare and technology sectors make him a great strategic fit for the team. We look forward to working closely with Bill to continue building the company’s extensive set of high-quality solutions, helping more payers and alternate care providers efficiently navigate and manage workflow operations.” The appointment of Miller marks the next step for Mediware as it looks to further expand and deepen its offering. Most recently, Mediware acquired Kinnser Software, adding a home health and hospice portfolio to its existing offering of SaaS solutions for human and social services, blood management, and medication management. As part of the transaction, Kinnser CEO Chris Hester joined Mediware as a member of the senior leadership team. TPG Capital, the global private equity platform of alternative asset firm TPG, acquired Mediware in February for an undisclosed sum. Since 1980, Mediware has provided software solutions to healthcare providers and has since expanded to serve many state and federal agencies. Mediware’s solutions are perfect for high-growth, complex patient care environments that remain underserved by existing vendors. The company employs more than 650 subject matter experts who deeply understand business and care processes in highly specialized acute, non-acute, and community-based care settings and have years of experience integrating systems. Mediware’s portfolio of solutions currently includes human and social services, blood solutions, cellular therapy, homecare, medication management, rehabilitation, and respiratory therapy. For more information about Mediware products and services, visit www.Mediware.com. TPG is a leading global alternative asset firm founded in 1992 with more than $73 billion of assets under management and offices in Austin, Beijing, Boston, Dallas, Fort Worth, Hong Kong, Houston, London, Luxembourg, Melbourne, Moscow, Mumbai, New York, San Francisco, Seoul, and Singapore. TPG’s investment platforms are across a wide range of asset classes, including private equity, growth venture, real estate, credit, and public equity. TPG aims to build dynamic products and options for its investors while also instituting discipline and operational excellence across its investment strategies and the performance of its portfolio. For more information, visit www.tpg.com.

News Article | July 27, 2017
Site: www.reuters.com

(Reuters) - Mediware Information Systems Inc [MEDWI.UL], a healthcare technology company owned by private equity firm TPG Capital LP, has hired Bill Miller to lead the company as it looks to build out its presence in post-acute care and human services, the company said on Thursday. Miller was previously the chief executive officer of OptumInsight, a subsidiary of UnitedHealth Group Inc, the world's largest healthcare services company. He will replace Kelly Mann, who has been CEO of Mediware since 2007. “I am excited about their strong position in the expanding markets they serve, and look forward to working with TPG and the Mediware team to build on the momentum that the company has achieved to-date,” Miller said in a statement. TPG Capital completed its acquisition of Mediware from buyout firm Thoma Bravo LLC earlier this year for an undisclosed sum. Mediware sells software programs that help with administration and costs savings to healthcare providers including blood banks, behavioral health providers, home healthcare providers and more. It is poised to grow significantly in the coming years, as healthcare providers aim to cut costs through the use of new technologies and increasingly rely on outpatient care centers rather than traditional hospitals. As chief executive of Mediware, Miller told Reuters he plans on pursuing a balanced growth strategy across its various areas of focus, ranging from human services to home health and more. He added that he Mediware will rely on a blend of organic growth and acquisitions. Earlier this year, Mediware acquired Kinnser Software, which provides software for home health and hospice providers. Thoma Bravo took Mediware private in 2012 for $195 million and built it out with acquisitions including Bowman Systems, which focuses on homeless management. TPG has previously invested in other healthcare technology companies including Evolent Health and IMS Health.

News Article | August 11, 2017
Site: www.prweb.com

Public Insight, an analytics platform that transforms public and licensed data into actionable insights, today announces the launch of Hospital Interactives, the first self-service data analytics offering for the healthcare market. Hospital Interactives are a unique combination of blended, disparate health data and Microsoft® Power BI software to analyze vast quantities of data effortlessly. Interactives enable rapid decision-making insights for benchmarking, market analysis, business planning and forecasting eliminating the cost, time, and complexity associated with acquiring, integrating, and analyzing individual databases. Health data sources include: AHA Annual Survey Database™, Hospital Cost Report Information System (HCRIS) and Medicare Provider and Analysis Review (MedPAR) file as provided by OptumInsight®, and Centers for Medicare and Medicaid Services (CMS). The Hospital Interactive library of analyses provides key information about the entire landscape of the nation’s hospitals including financials, staffing, utilization, operations, and quality. Within seconds hospital decision makers and analysts can view comparisons of data, benchmark against peer institutions, and understand growth trends and other key insights to help drive strategic planning and assessment. Hospital Interactives also enable medical device manufacturers with valuable information on procedure volumes, trends and hospital targeting for sales strategy efforts. The Hospital Interactives Library is purchased as an annual subscription and includes the following hospital analyses as well as future releases: “Hospital Interactives enable anyone to easily perform repeatable, complex analysis within seconds using stunning visualizations to gain critical planning and decision-making insights,” explains Dan Quigg, Public Insight Chief Executive Officer. “Hospital Interactives significantly reduce the time and cost associated with hospital data acquisition, integration, analysis and reporting,” adds Quigg. To learn more and view examples and tutorials of Hospital Interactives visit: http://www.publicinsightdata.com/hospitalinteractives, or schedule a demonstration at https://my.timetrade.com/book/TSXZM About Public Insight Public Insight is an analytics platform for the healthcare and higher education markets that transforms disparate public and licensed data into actionable insights. Interactives, self-service data analysis powered by Microsoft® Power BI and cloud-hosted, enable anyone to easily perform repeatable complex analysis within seconds. Decision makers and analysts are able to understand growth trends, uncover new opportunities, and compare and benchmark institutions at local, regional and national levels. Visit http://www.publicinsightdata.com to learn more and view free examples of Interactives.

SAN MATEO, Calif.--(BUSINESS WIRE)--CCGroup has several patents protecting its physician efficiency methodology and system. Other patent applications are awaiting approval. The most recent patent was issued in May 2017. “CCGroup has invested significant time and effort to determine and develop the most appropriate methods to obtain reliable and stable physician efficiency scores. Our approach is narrowly defined, and one of many efficiency methodologies available on the market today,” defined Dr. Douglas G. Cave, President of CCGroup. The foundation of the CCGroup patent family is using a predefined or relevant set of medical conditions for a specialty type and calculating weighted episode of care across a predefined set of medical conditions. Other claims include the following: form medical condition episodes of care; assign episodes of care to a provider; calculate medical condition-specific episode of care statistics; calculate weighted episode of care statistics across medical conditions using a predefined set of medical conditions for a PCP or specialist; and determine efficiency scores for providers from the calculated weighted episode of care statistics for the provider and for the peer group. “We are defending our patent rights on CCGroup’s specific physician efficiency scoring. For example, a federal jury in April 2015 awarded CCGroup more than $12 million after determining that UnitedHealth Group’s subsidiary OptumInsight infringed CCGroup’s patent for measuring physician efficiency; the product name is Impact Intelligence. Also, CCGroup is presently in federal court with Truven Health Analytics, a subsidiary of IBM Watson Health; the product name is Physician Performance Assessment,” discussed Dr. Cave. He continued, “Some competitors may feel they are not infringing if they include either more medical conditions or sicker patient episodes of care within the predefined, relevant set of medical conditions.” However, the many specialty-specific marketbaskets listed in the embodiment of our patents are just exemplary, and the use of other relevant sets of medical conditions can still fall within the scope of our patents. “Similarly, including sicker patients does not necessarily avoid infringement. Other competitors may feel they are not infringing if they include an additional patient case-mix adjustment during the process of calculating the overall physician efficiency score. But, the claims merely require determining overall efficiency scores for physicians from the calculated weighted episode of care statistics for the physician and for the peer group. The fact that an analytical tool may incorporate additional patient case-mix adjustments does not avoid potential infringement,” stated Dr. Cave. CCGroup would like to encourage you to contact us if you believe you may require a license to the CCGroup efficiency measurement patent family. We recognize that our narrowly defined approach is just one of many physician efficiency methodologies being applied in the market today, but the approach provides valuable increased stability and is becoming widely adopted for that reason. Cave Consulting Group, Inc. is a software and consulting firm located in San Mateo, California. The company is focused on improving the efficiency (cost-of-care) and effectiveness (quality-of-care) of the healthcare delivery system. Senior management of CCGroup has assessed the performance of physicians and hospitals for over 27 years for health plans, HMOs, physician groups, health systems, TPAs, and employers.

Wimo A.,Karolinska Institutet | Jonsson L.,OptumInsight | Bond J.,Northumbria University | Prince M.,King's College London | Winblad B.,Karolinska Institutet
Alzheimer's and Dementia | Year: 2013

Objective: To acquire an understanding of the societal costs of dementia and how they affect families, health and social care services, and governments to improve the lives of people with dementia and their caregivers. Methods: The basic design of this study was a societal, prevalence-based, gross cost-of-illness study in which costs were aggregated to World Health Organization regions and World Bank income groupings. Results: The total estimated worldwide costs of dementia were US$604 billion in 2010. About 70% of the costs occurred in western Europe and North America. In such high-income regions, costs of informal care and the direct costs of social care contribute similar proportions of total costs, whereas the direct medical costs were much lower. In low- and middle-income countries, informal care accounts for the majority of total costs; direct social care costs are negligible. Conclusions: Worldwide costs of dementia are enormous and distributed inequitably. There is considerable potential for cost increases in coming years as the diagnosis and treatment gap is reduced. There is also likely to be a trend in low- and middle-income countries for social care costs to shift from the informal to the formal sector, with important implications for future aggregated costs and the financing of long-term care. Only by investing now in research and the development of cost-effective approaches to early diagnosis and care can future societal costs be anticipated and managed. © 2013 The Alzheimer's Association. All rights reserved.

Objective: The objective of this study was to analyze the comparative gastrointestinal tolerability of proprietary versus generic alendronate in patients treated for primary osteoporosis. Methods: The study was based on all patients starting therapy with alendronate in Sweden between 2005 and 2009. The primary outcome measure was the start of treatment with a gastroprotective agent and the secondary outcome was hospitalization for gastrointestinal adverse event (GIAE). The incidence of both outcomes was measured within the first six months after the initiation of the alendronate treatment. Results: The crude incidence of gastroprotective treatment during the first six months following the start of the alendronate therapy was 5.45% (bootstrapped CI95 4.09%-7.19%) and 5.04% (bootstrapped CI95 4.74%-5.38%) for patients prescribed proprietary and generic alendronate, respectively. The crude six-month incidence of hospitalization for GIAE was 0.43% (bootstrapped CI95 0.14%-1.29%) and 0.71% (bootstrapped CI95 0.55%-0.91%) for proprietary and generic alendronate, respectively. Controlling for age, sex, and other available covariates, there was no significant difference in the risk of GIAEs between proprietary and generic alendronate. Conclusions: No significant difference in the incidence of GIAEs was identified between patients prescribed proprietary and generic alendronate between 2005 and 2009 in Sweden. More research is needed to provide conclusive evidence of the gastrointestinal tolerability profiles of proprietary and generic alendronate. © 2012 Elsevier Inc.

Strom O.,Karolinska Institutet | Landfeldt E.,OptumInsight
Osteoporosis International | Year: 2012

Summary Automatic generic substitution of alendronate products, used to reduce drug costs, and medication persistence was studied retrospectively between 2006 and 2009. During this period the number of, and the rate of substitution between, alendronate products increased while persistence decreased. Patient preferences should be considered when designing and evaluating generic policies. Introduction Automatic generic substitution (AGS) was implemented in Sweden in 2002. The objective of this study was to investigate the association between AGS and persistence with alendronate treatment of primary osteoporosis in Sweden. Methods An open historical cohort of women and men (n= 36,433) was identified in the Swedish Prescribed Drug Register through filled prescriptions for alendronate or risedronate between 2005 and 2009. Co-morbidity data was extracted from the National Patient Register. The association between AGS and medication persistence was investigated using non-parametric and parametric survival analysis. Results Between 2006 and 2009, the number of alendronate products increased from 15 to 25, the proportion of prescriptions constituting a substitution increased from 10.8% to 45.2%, and the proportion of patients persisting with alendronate treatment for 12 months fell from 66.9% to 51.7%. Patients starting alendronate treatment in 2006 had lower risk of stopping treatment compared with those starting in 2007 (HR 1.34, 95% CI 1.29-1.39), 2008 (HR 1.49, 95% CI 1.43-1.55), and 2009 (HR 1.50, 95% CI 1.40-1.60). No difference was observed in persistence with proprietary risedronate during the same period. Individuals who had their alendronate product substituted at the first prescription refill had significantly higher probability of discontinuation (HR 1.25, 95% CI 1.20-1.30). Conclusion AGS causes increased product substitution which appears to be associated with reduced treatment persistence. Poor health outcomes and associated costs due to forgone drug exposure should be taken into account in the design and evaluation of policies implemented to encourage utilisation of generic medicines. © International Osteoporosis Foundation and National Osteoporosis Foundation 2011.

Svedbom A.,OptumInsight
Archives of osteoporosis | Year: 2014

This report describes the epidemiology, economic burden and treatment of osteoporosis in Switzerland. Osteoporosis is characterized by reduced bone mass and disruption of bone architecture, resulting in increased risks of fragility fractures which represent the main clinical consequence of the disease. Fragility fractures are associated with substantial pain and suffering, disability and even death for the affected patients and substantial costs to society. The aim of this report is to describe the epidemiology and economic burden of fragility fractures as a consequence of osteoporosis in Switzerland, as a detailed addition to the report for the European Union (EU27): "Osteoporosis in the European Union: Medical Management, Epidemiology and Economic Burden". The literature on fracture incidence and costs of fractures in Switzerland was reviewed and incorporated into a model estimating the clinical and economic burden of osteoporotic fractures in 2010. Furthermore, data on sales of osteoporosis treatments and the population at high risk of fracture were used to estimate treatment uptake and treatment gap. It was estimated that approximately 74,000 new fragility fractures were sustained in Switzerland in 2010, comprising 14,000 hip fractures, 11,000 vertebral fractures, 13,000 forearm fractures and 36,000 other fractures (i.e. fractures of the pelvis, rib, humerus, tibia, fibula, clavicle, scapula, sternum and other femoral fractures). The economic burden of incident and previous fragility fractures was estimated at CHF 2,050 million for the same year. Incident fractures represented 76 % of this cost, long-term fracture care 21 % and pharmacological prevention 3 %. Previous and incident fractures also accounted for 24,000 quality-adjusted life years (QALYs) lost during 2010. When accounting for the demographic projections for 2025, the number of incident fractures was estimated at 98,786 in 2025, representing an increase of 25,000 fractures. Hip, clinical vertebral (spine), forearm and other fractures were estimated to increase by 4,900, 3,200, 3,500 and 13,000, respectively. The burden of fractures in terms of costs (excluding value of QALYs lost) in Switzerland in 2025 was estimated to increase by 29 % to CHF 2,642 million. Though the uptake of osteoporosis treatments increased from 2001, the proportion of patients aged 50 or above who received treatment remained at low levels in the past few years. The majority of women at high fracture risk do not receive active treatment. In spite of the high cost of osteoporosis, a substantial treatment gap and projected increase of the economic burden driven by an aging population, the use of pharmacological prevention of osteoporosis is significantly less than optimal, suggesting that a change in health care policy concerning the disease is warranted.

Karampampa K.,OptumInsight
Multiple sclerosis (Houndmills, Basingstoke, England) | Year: 2012

Multiple sclerosis (MS) is a common cause of neurological disability in young adults. The TRIBUNE study provides a detailed exploration of costs in relation to relapses and disease severity, and assesses the quality of life impact on MS patients in terms of utilities, fatigue and activities of daily living (ADL). Patients in five European countries (France, Germany, Italy, Spain and the United Kingdom) completed a self-administered web-based questionnaire capturing information on demographics, disease characteristics and severity (EDSS), co-morbidities, relapses, resource consumption, utilities, fatigue, and activities of daily living. In total, 1261 MS patients completed the questionnaire. More than half of the patients (68%) had the relapsing-remitting form of the disease; 87% of the sample reported receiving MS treatments. Costs were higher with advancing disease severity; for mild patients (EDSS score ≤ 3) the costs ranged between €13,534 and €22,461 across countries; for moderate (EDSS score 4 - 6.5) between €28,524 and €43,948; for severe (EDSS ≥ 7) between €39,592 and €65,395. Relapses were also associated with increasing costs; the difference in the cost per patient per year for relapsing-remitting patients with EDSS score ≤ 5 that did experience at least one relapse during the past 12 months and those who did not ranged between €3321 and €9430. The quality of life of patients decreased with disease progression and existence of relapses. The TRIBUNE study provides an important update on the economic burden of MS in an era of more widespread use of disease-modifying therapies. It explores the cost of MS linked to relapses and disease severity, and examines the impact of MS on additional health outcomes beyond utilities such as ADL and fatigue.

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