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Engagement and building trust mean speaking patients’ language

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Engagement and building trust mean speaking patients' language


L-R: Kevin Truong, Abner Mason, Mike Tarino, Hope Kragh, Gaspard de Dreuzy

The American Consumer Satisfaction Index last year gave the health insurance industry a score of 73. To put that in perspective, compare it with other perennially unpopular industries. Payers received the same score as airlines, while scoring above the 62 that internet service providers got, but coming in further behind banks, which got 81.

In other words, health insurers aren’t getting a lot of love from consumers, something that is especially important with exit polls in the midterm election showing healthcare to be the top issue on voters’ minds. In response, several firms have formed to improve the relationship between payers and consumers, and their activities were the topic of a Wednesday panel discussion at the recently concluded MedCity ENGAGE conference in San Diego.

The panel, “How Payers Are Innovating in Engagement,” was moderated by MedCity News reporter Kevin Truong, with panelists Abner Mason, CEO of ConsejoSano; Mike Tarino, human experience lead at Bind; Hope Kragh, vice president of client success at Collective Health; and Gaspard de Dreuzy, president of Pager.

Mason recalled an informal poll he took at a recent regional healthcare conference, when he asked representatives of 24 payers assembled if any of them used text messages in patient engagement, and not one raised their hand. “Most of healthcare is in the Dark Ages,” he said. “If you’re not using mobile, you may as well be using Morse code.”

However, Mason pointed out that while text messaging is a preferred means of communication for many people, health plans are unable to freely use it due to a narrow interpretation of the Telephone Consumer Protection Act of 1991. As a result, plans are not engaging with members the way they want to be engaged. “Society has changed, so we have to change the law,” he said.

Another issue is consumers’ trust – or rather, lack thereof – in payers. “People don’t think the health system or benefits industry has their interests at heart,” said Kragh, who has worked in healthcare since the mid-1980s and noted that the trust issue has always existed. For Collective Health, a big part of building trust is facilitating human interaction, which is also meant to reduce the confusion and frustration that was the impetus for the company’s founding. “The role that payers play first and foremost is to provide a financial tool,” Tarino said. Bind, he added, was founded to address the issue of confusion, providing patients with information that filters out the noise and complexity and answers basic questions consumers are asking, such as whether services are covered

“Without trust, nothing is possible – that is a prerequisite,” de Dreuzy said. Pager was established to “establish a conversion,” in part by making technology as invisible as possible because, he said, patients want to interact with people more than with technology.

How one interacts with patients also plays a role in building trust. Mason pointed out that while most healthcare companies simply translate their materials into patients’ native languages, it is more important to factor in culture first. “We start with culture – who they are, what they believe, where they come from, what they fear,” he said, before layering in language.

Another important consideration is transparency. Indeed, consumers are tired of opacity, Kragh said, such as not knowing whether the care they receive will be covered or how much it will cost. For example, during the question-and-answer portion of the panel, an audience member pointed to his experience of receiving bills months after medical procedures and having no idea what had led to his being billed.

Photo: Alaric DeArment, MedCity News



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Nike Zoom Pegasus Turbo Running Shoe Review

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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



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AstraZeneca lung cancer immunotherapy trial fails, dealing blow to company

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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



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How UnitedHealthcare members can pay for their Apple Watch by walking

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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.

Picture: Apple



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