“This is a beginning,” U.S. Rep. Debbie Dingell said Monday at the announcement at the health system’s headquarters in Southfield.
Pre-construction work has started for the centerpiece of Beaumont’s mental health-focused joint venture with Pennsylvania-based UHS.
They are developing a 100,000-square-foot facility across from Beaumont’s 632-bed Dearborn hospital, executives announced Monday morning.
Dingell, the Dearborn Democrat who has advocated for a national mental health strategy, highlighted the need for more comprehensive services for those with depression, anxiety, substance use and other mental health issues who have a tendency to fall through the cracks in traditional health care. She spoke during the Monday announcement, alongside Beaumont President and CEO John Fox and others.
The for-profit joint venture encompasses a new three-pronged strategy to help fill holes in the region’s mental health resource landscape, which includes the new hospital, new specialized academic training programs and expanded day programs and outpatient care.
Its ownership will be an approximately 70 percent-30 percent split between UHS and Beaumont, respectively. But UHS will pay for the construction of the new hospital, said Diane Henneman, UHS’s regional vice president. It will also manage day-to-day operations.
Henneman and Lee Ann Odom, the president of Beaumont Hospital, Taylor are overseeing the effort.
Construction is scheduled to begin early next year on 8 acres of empty land across from the 18101 Oakwood Blvd. campus. The facility is scheduled to open at the beginning of 2021. It will have 87 beds and grow to 150 when fully operational.
Neither the hospital nor the joint venture have names yet. The hospital will have its own executive team hired by the joint venture likely around late next year, Henneman said.
The general contractor and architect for the project have not yet been chosen.
The joint venture hospital is expected to contribute $59.1 million to the region’s gross area product; its estimated total impact on income is $99.4 million on businesses and industries in Southeast Michigan.
The bulk of Beaumont’s mental health services — for adult, pediatric and geriatric patients — will be consolidated into the new hospital. It currently has 87 beds at its three inpatient mental health units in hospitals in Taylor, Royal Oak and Farmington Hills, Odom said. Royal Oak, though, will retain some partial-day hospitalization services — around 12-18 patients per day — but its 30 inpatient beds will be moved.
The new hospital, Beaumont’s ninth, will serve those in need of inpatient treatment for mental illnesses, as well as outpatient services. Substance use disorder treatment will also be offered there for those diagnosed with a mental health disease. Officials at Monday’s event specifically mentioned addressing the opioid crisis.
The hospital will work closely with emergency rooms and offer assessment services 24 hours a day. UHS and Beaumont aim to shift those in need of specialized services away from visiting traditional emergency rooms, Odom said.
Those patients are often stuck in the ER until they can get placed in a center with more capacity to provide services they need.
“In our nine emergency rooms today we struggle,” Odom said. “We believe it’s better for a patient if we have a dedicated, specialized facility, versus care in a bunch of separate spaces, for coordination and care planning and care transitions.”
In Taylor, for example, Odom estimated that around 12 patients a day could be waiting to be transferred from an emergency room to a more appropriate center, and they often wait for days. Strain on emergency departments and those in need of mental health services are well-documented.
“It’s regional, it’s in every ER in Michigan, and it’s national, but we basically said it’s not going to get any better unless we do something very big and different,” Beaumont CEO Fox said.
“What we’ve done has been good, but it’s not going to meet the current requirements and certainly not the future,” Fox said after the event.
The joint venture expects to staff the hospital with approximately 300 employees, about half of whom will be new hires. The others will come from existing Beaumont hospitals.
Also under the joint venture, the two organizations plan to add new specialized Beaumont academic training programs and expand day programs and outpatient care.
The hospital will house multidisciplinary teams including psychiatrists, internal medicine physicians, other specialists, certified clinical pharmacists, social workers, psychologists, therapists and other clinical support staff, according to a news release.
Beaumont considered the option of creating the new mental health hospital on its own, Fox said. But UHS is a “national player” with specialized expertise that can make it “bigger and better,” Fox said. Odom added that UHS also brings in the necessary capital for construction of the facility.
The plan could also eventually include opening more outpatient centers to address needs in specific areas of Southeast Michigan, Odom and Henneman said, but additional details depend on how the initial facility takes shape. Beaumont also plans to grow its telemedicine program, using technology to offer remote health care access. It also wants to continue to grow specialized training, including adding Beaumont graduate medical education programs in psychiatry and psychopharmacology.
Universal Health Services operates more than 200 mental health hospitals across the country, many under a joint venture agreement like the one with Beaumont. It has more than 350 facilities total in the U.S., Puerto Rico and the U.K.
It has four locations in Michigan, according to its website: Havenwyck Hospital in Auburn Hills, Skywood Recovery in Augusta, Cedar Creek Hospital in St. Johns and Forest View Hospital in Grand Rapids.
Mental health is increasingly on the minds of health of health providers and lawmakers as the cases of mental disease swell in Michigan and the number of resources shrinks. The $2.6 billion Medicaid mental health system has been subject of hot debate regarding privatization, integration and overall improvement strategies.
Almost one in five U.S. adults live with a mental illness, according to the National Institute of Mental Health. About 44.7 million Americans were diagnosed with a mental disease in 2016.
Gov. Rick Snyder approved a plan in 2016 to essentially combine mental health care, which is managed by 10 quasi-governmental prepaid inpatient health plans, with the $9 billion physical health system, which is managed by private HMOs. That plan was put on hold, and the future of mental health management falls on the shoulders of the Legislature and Michigan’s next governor.
Additionally, many mental health agencies that serve the Medicaid population in Southeast Michigan have been adjusting to payment changes begun four years ago by the state Department of Health and Human Services. MDHHS cut state Medicaid funding to the three county authorities in Southeast Michigan — Wayne, Oakland and Macomb — by more than 5 percent each year since 2013. Michigan mental health authorities argue that the state is shortchanging them by $100 million.
Nike Zoom Pegasus Turbo Running Shoe Review
Since its launch last year the Nike Vaporfly 4% has established itself as a game-changing running shoe, especially for those seeking to set a marathon PB. In fact, the only real problem with the Vaporfly is that it’s very hard to come by, selling out in the blink of an eye on the few occasions it has been made available.
There are a few reasons for the Vaporfly’s success but one of the main ones is the ZoomX foam in the midsole which is soft, responsive and very light – everything you could want when running fast for a long period. Until now ZoomX has only been used in the Vaporfly 4% and Vaporfly Elite shoes (the latter being even more tricky to come by for the amateur athlete), but the new Pegasus Turbo shoe will bring the material to a much wider audience.
The story behind the Pegasus Turbo is that Nike’s elite athletes wanted a shoe that felt like the Vaporfly 4% for their training, but ditched the carbon plate in the sole which made the shoe a little too firm for easy efforts. The Turbo is therefore pegged as an everyday trainer by Nike, but after a few runs in the Pegasus Turbo I can say with little hesitation that what might make for an easy day trainer for the likes of Eliud Kipchoge makes for a great all-rounder trainer/racer for everyone else.
The ZoomX foam in the midsole and the featherweight upper both contribute to the lightness of the Pegasus Turbo – 238g (men’s size 9) compared to the standard Pegasus 35’s 281g. But the numbers do little to explain how light it really feels on the foot. It’s a shoe that makes you want to run all day, because it somehow doesn’t feel taxing to keep picking up your feet.
Despite its lightweight frame, comfort is central to how enjoyable the Turbo is to run in. I used it for three days on the trot straight after a weekend when my feet had been completely wrecked by walking 100km (an absurd charity event, never do it) and I was dreading how running might feel. The stack of ZoomX and React cushioning on the Turbo dispelled all concerns within the first few steps. It’s bouncy, soft and even somewhat plush, not at all what you’d expect from such a light shoe.
I slowly increased my speed through my first run in the Turbo and the ride never strayed from being comfortable and bouncy, but I was more surprised by how good they felt on the track the next day. I did a range of distances – one mile, 400m and 200m reps – and when going all-out on the shorter sprints in particular, the heel-to-toe transition and pop off the toe felt fast and smooth like a racing shoe, only without the firm feel of the ground beneath you that racers give.
I thought the Turbo would really excel on long runs and it didn’t disappoint. I took it out for a 90-minute session in the woods – it’s not an ideal trail shoe, but the hot summer had baked Epping Forest dry enough for road shoes – and maintaining a steady-to-fast pace throughout was very comfortable. With this shoe I found that, however hard the run felt, glancing down at my watch usually revealed I was running slightly faster than I thought.
The bounce in the stride is more noticeable over longer distances. The ZoomX foam feels similar to Adidas’s Boost foam, but the shoe is far lighter than a Boost shoe with equivalent amounts of cushioning like the UltraBoost, which only adds to the spring in your step.
As a result, it’s undoubtedly a good option for marathon or half marathon runners who want more cushioning than that found in a typical racer but don’t want the extra heft or overly soft feel that often comes with cushioning. That’s assuming you, like most people, don’t have a few pairs of the Vaporfly 4% stashed at the back of your wardrobe.
The upper is exceptional as well – so lightweight that it virtually disappears when you start running. I had no concerns about it being too snug or not tight enough to stop the foot slipping around, but it’s worth noting that it’s a roomier fit and if you do want it to be a bit snugger around the foot then maybe go half a size down.
I was disappointed by the Pegasus 35, which I found too firm to excel on easy runs and too hefty to fly through speedier sessions. In many ways, the Pegasus Turbo is exactly what I’d wished the Pegasus 35 was – a lightweight, comfortable but pacy daily trainer that will also be a great choice for longer races for most runners.
There’s only really two negatives to the shoe, as far as I can tell so far. One is the racing stripe, which is a colour called Hot Punch and just, well, not great. The other is the price – at £159.95 it’s a step away from the excellent value the Pegasus line has usually been known for (the Pegasus 35 is £104.95). It’s not completely out of step with high-end running shoes, and the long-lasting React foam on the sole in combination with the ZoomX should mean that the Turbo will be durable, but £160 is still a lot of moolah. That said, if you’re looking for an all-rounder trainer/racer and don’t mind pink racing stripes, it’s definitely the shoe I’d go for right now.
Buy from Nike | £159.95
AstraZeneca lung cancer immunotherapy trial fails, dealing blow to company
A cancer immunotherapy trial by AstraZeneca failed to show improved survival for patients, sending the company’s stock downward.
The British drugmaker said Friday that data from the Phase III MYSTIC study of PD-L1 inhibitor Imfinzi (durvalumab) and the CTLA4 inhibitor tremelimumab did not show an improvement in overall survival among patients with previously untreated metastatic non-small cell lung cancer when compared with platinum-based chemotherapy.
AstraZeneca’s shares opened down 3.5 percent Friday morning on the New York Stock Exchange.
The data showed that among patients in the trial receiving Imfinzi alone, the overall survival result did not reach statistical significance. The combination of Imfinzi with tremelimumab likewise did not show a significant OS improvement.
On the other hand, the company highlighted a potentially favorable hazard ratio of 0.76 among patients receiving Imfinzi alone, adding that the data support further subgroup analysis. “We are encouraged to see that Imfinzi monotherapy activity is in line with that of the anti-PD-1 class in previously untreated patients with Stage IV non-small cell lung cancer; however, we are disappointed that these results missed statistical significance,” AstraZeneca Chief Medical Officer Sean Bohen said in a statement. Stage IV refers to metastatic disease.
Currently, the only checkpoint inhibitor approved for first-line NSCLC is Merck & Co.’s PD-1 inhibitor Keytruda (pembrolizumab), alone or in combination with pemetrexed and platinum chemotherapy. The Food and Drug Administration granted full approval for the combination in August, having given accelerated approval in 2017. Two other checkpoint inhibitors – Bristol-Myers Squibb’s PD-1 inhibitor Opdivo (nivolumab) and Roche’s PD-L1 inhibitor Tecentriq (atezolizumab) – are approved for NSCLC that has progressed during or following chemotherapy treatment. Imfinzi has accelerated approval for urothelial carcinoma.
As such, MYSTIC’s failure is a significant setback for AstraZeneca, effectively taking its drugs out of the running as potential competitors to Keytruda in the large first-line NSCLC space. According to the American Cancer Society, NSCLC accounts for 80-85 percent of lung cancers, while cancers of the lung generally account for around 14 percent of new cancers overall. The organization estimates there will be about 234,030 new cases of lung cancer in the US this year.
Tremelimumab also failed in a Phase IIb study of mesothelioma published in 2017. Bristol-Myers Squibb already has a CTLA4 inhibitor on the market, Yervoy (ipilimumab), approved for treating melanoma, renal cell carcinoma and certain patients with colorectal cancer.
Photo: pictafolio, Getty Images
How UnitedHealthcare members can pay for their Apple Watch by walking
UnitedHealthcare, the country’s largest commercial insurer, has added the Apple Watch to their wearable device wellness program that encourages people to walk more by using financial incentives tied to step counts.
Under the new partnership, enrollees in the company’s Motion program can earn up to $4 a day if they meet certain fitness standards which include walking at least 10,000 total steps a day, walking 3,000 steps within 30 minutes daily and completing 500 steps in seven minutes an hour apart, six times a day.
Participants can either use their own device or purchase an Apple Watch up to a $300 version of the Apple Watch 3 using the “walk it off” option, which allows users to use their rewards to purchase the device if they meet six months of walking goals, while only paying taxes and shipping costs.
The program, which is directed mainly at large and mid-sized employers with high deductible health plans, caps rewards at $540 for six months.
Apple is trying to broaden the potential customer base past young and wealthy early tech adopters into the broader population through innovative purchasing and payment schemes and new features like the Apple Watch 4’s ability to perform an EKG and detect falls.
According to UnitedHealthcare, program participants have collectively walked more than 235 billion steps and earned $38 million in rewards. On average, enrollees walk 12,000 steps a day, compared to the 5,200 daily steps of the average American.
Interestingly, the company has found traction with chronic disease and diabetes patients, who are 20 and 40 percent more likely to participate in the Motion program, respectively.
Enterprise wellness programs are a growing business line for wearables companies looking to diversify past direct-to-consumer device sales. A recent example is Fitbit’s expanded partnership with Humana, which includes using the devices in the insurer’s wellness programs, but also additional health coaching applications.
The value proposition has become increasingly high for both employers and insurers looking to defray some of the rising healthcare costs generally and the top line cost drivers associated with chronic disease patients.
Besides its new integration with Apple, UnitedHealthcare’s Motion program also works with devices made by companies including Samsung, Fitbit and Qualcomm.
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