In brief: Better Health funding, prior auth bill, Optum DME Navigator (2024)

SAN FRANCISCO – Better Health, a medical supply provider, has received $14 million in strategic funding, including investments from Healthworx, the innovation and investment arm of CareFirst Inc., UHealth - University of Miami Health System, and Mosaic General Partnership.

Better Health will use the funding to bring a more comprehensive solution to payers and providers, while also expanding into new categories to better serve members with chronic conditions. The company is also actively exploring how incorporating AI into its value stream can further enhance and accelerate its already best-in-class experience for patients, payers, and providers.

“We’ve seen a remarkable 86% of the people who went through the Better Health Peer Support program reported they were able to avoid an unnecessary ER or doctor visit,” says Dr. Robert Mirsky, Better Health clinical advisor and the former chief medical officer of Aetna Medicare. “Receiving coaching from someone with similar lived experience builds trust, helps patients gain more knowledge and confidence, and as a result be more compliant with their treatment. This enables Better Health to drive impact on health outcomes and cost of care.”

This financing builds on Better Health’s previous $10 Million Series A round and includes participation from new investor Samsung Next, which continues to expand its investment in health care solutions.

Established in 2019 by Naama Stauber Breckler, Better Health provides support and medical supplies for people with chronic conditions, such as ostomy, chronic wounds, diabetes, chronic retention and incontinence. The company's care model incorporates peer coaching, education and home delivery of medical supplies, focusing on driving engagement and adherence, improving outcomes and reducing costs.

• Read what Naama Stauber Breckler had to say about serving as a central access for medical supplies.

Permobil brings home the gold - twice

NASHVILLE, Tenn. – Permobil and Doug Garven, designer and product manager, have won two prestigious international design awards for the TiLite CR1 manual wheelchair.

They won gold in both the A’ Design Award & Competition and International Awards Associate MUSE Design Awards.

Garven, who has been designing manual wheelchairs for more than 30 years, began working on the CR1 in 2018.

“It is an honor for us to be the recipient of both of these awards and it is without a doubt a career highlight. It is fantastic that our commitment to leading edge design and innovation at Permobil is recognized in this way,” said Garven, principal product manager. “Our vision was to create the ultimate, daily-use chair. We drew inspiration from previous designs, Formula 1 race cars and even elements from the stealth fighter jet F-22 Raptor.”

Garven and Permobil received the Gold Award for the A' Product Engineering and Technical Design category.

The MUSE Design Awards gave Permobil and Garven their “Gold Winner” designation for the category of Product Design – Medical Devices. The TiLite CR1 was one of the winners chosen from more than 8,500 entries around the world.

"Doug Garven's tireless dedication and personal experience as a wheelchair user have propelled Permobil to win dual gold honors in international design, affirming our commitment to innovation and user-centric solutions,” said Audra Watt, vice president of marketing. “These awards are a testament to the employees and users who make up the Permobil brand and our TiLite products.”

Lawmakers reintroduce prior auth bill

CHICAGO – Members of the House of Representatives and Senate have reintroduced bipartisan legislation to streamline and standardize the use of prior authorization within Medicare Advantage. The Improving Seniors’ Timely Access to Care Act, which has the support of the American Medical Association, features targeted policy changes to reduce the scored cost of the legislation, an obstacle last Congress. “We thank the sponsors for writing the bill so it will attract even more support,” the AMA stated. “We came close last Congress to passing this much-needed reform. Our patients know all too well that prior authorization needs a dramatic overhaul. We think this is the year to get this bill over the finish line.” In the 117th Congress, the bill garnered 378 bipartisan co-sponsors in the House and Senate and passed the full House of Representatives. The legislation also secured endorsem*nts from more than 500 outside organizations, including the AMA and numerous national and state medical associations. The bill has similar widespread support this year. The sponsors of the new bill: Sens. Roger Marshall, M.D., R-Kan.; Krysten Sinema, I-Ariz.; John Thune, R-S.D., and Sherrod Brown, D-Ohio; and Reps. Mike Kelly, R-Pa.; Suzan DelBene, D-Wash.; Ami Bera, M.D., D-Calif.; and Larry Bucshon, M.D., R-Ind.

Optum launches DME benefits manager

EDEN PRAIRIE, Minn. – Optum Insight has launched DME Navigator, an end-to-end solution for DME benefits management that will speed the process of delivering DME to patients, while improving health outcomes and reducing costs. “Ensuring patients have timely access to DME is a growing challenge,” said Beth Merle, senior vice president, Affordability and Value Enablement, Optum. “DME Navigator will help health plans and DME suppliers deliver the equipment patients need more quickly and affordably.” DME Navigator addresses several challenges ensuring patients get the right medical equipment at the right time, including a digital experience that allows clinicians to fill orders 90% faster, a more transparent way to communicate that allows clinicians to chat with suppliers directly, and a quicker way to access appropriate care to help clinicians make the most informed and clinically appropriate decisions. Optum collaborated with CareCentrix, which is owned by Walgreens, on the solution.

Louisiana passes vent bill

BATON ROUGE, La. – Louisiana Gov. Jeff Landry has signed HB 839, legislation that curbs the substitution of step therapy or fail-first protocols for prescribed ventilators when clinical evidence demonstrates that these protocols will be less effective or cause an adverse reaction to the patient. The measure was strongly supported in the Louisiana legislature, with just a single vote against it in the House (97-1) and unanimous approval in the Senate (35-0), according to a bulletin from AAHomecare. “The fail-first approach to treating individuals with severe respiratory challenges deserves a failing grade for the stress this practice causes for patients, families, and caregivers,” said David Chandler, AAHomecare’s senior director of payer relations. “Louisiana HME leaders and respiratory stakeholders have done a great job in explaining the importance of relying on clinical expertise when NIV is prescribed. We hope this success inspires other states to take action to limit the use of fail first and step therapy in acute respiratory care.” The measure applies to treatment of patients across the full spectrum of local health coverage plans in Louisiana and goes into effect on Aug. 1.

Sheehan to advise Adapt CEO

PLYMOUTH MEETING, Pa. – Gary Sheehan has rejoined AdaptHealth in the role of senior adviser to CEO Suzanne Foster. Sheehan, who rolled up his family business, Cape Medical Supply, into Spiro Health in 2020 before selling to AdaptHealth in 2021, left AdaptHealth in 2023 to launch Scorton Creek Capital. “I could not be more excited to work with Suzanne Foster and the entire Adapt leadership team to help advance the critical work we do in delivering health care services, with the home being our center of care,” said Sheehan in a LinkedIn post. “To my Adapt teammates, I cannot wait to collaborate with all of you to help us build the best version of Adapt that we can.” Foster assumed leadership of the company in May, succeeding interim CEO Richard Barusch.

ACU-Serve hires Neese to drive growth

AKRON, OHIO – ACU-Serve has added Kyle Neese, who has more than eight years of experience in the respiratory care industry, as senior account executive. Before joining ACU-Serve, Neese dedicated his career to driving PAP resupply growth for clients nationwide during his tenure at ResMed. "The HME industry continues to be affected by significant market changes, and I’m thrilled to deliver the services and solutions to the best customers in the industry through ACU-Serve,” said Neese. “From revenue cycle management to consulting to, now, resupply, ACU-Serve is a leader in the strategic growth of its clients. Having spent my career in the health care management space, I’m eager to leverage my experience to enhance the company's partnerships and drive growth with this incredible team." Neese's appointment comes at a pivotal time for ACU-Serve, as the company embarks on its next phase of growth under CEO Jim Knight's leadership. "We’re proud to welcome Kyle to the ACU-Serve team," said Knight. "His unique perspective, having traversed both sides of the client fence, coupled with his exceptional expertise in resupply, positions him for unparalleled success within our team. Kyle's proven track record and unwavering dedication to client success make him an invaluable addition as we propel forward, driving innovation and setting new standards in the health care industry."

Boscacci appointed to BC board of governors

RICHMOND, B.C. – Robert Boscacci, CEO of HME Home Health, has been appointed to the Business Council of British Columbia Board of Governors for a three-year term. The BCBC is a non-partisan business organization that provides policy advocacy on various issues to increase the province’s competitiveness. “HME has been a member of the BCBC for the past two years and I’m honored to be named to the board of governors,” said Boscacci. “The policy and advocacy work done by the BCBC not only increases the viability of companies across B.C., but also raises the prosperity for all British Columbians.” HME Home Health has seven locations and more than 120 employees in the province offering mobility and accessibility products and durable medical equipment.

Signifier gets large order

BOSTON – Signifier Medical Technologies has received a “milestone” order of 10,000 units of its eXciteOSA device, placed by Spectrum Sleep Solutions. This significant order comes on the back of South Carolina’s Human and Health Services Medicaid coverage for eXciteOSA, signaling a major step toward expanded accessibility and treatment for sleep apnea sufferers. "I am delighted discussions between Signifier and Spectrum Sleep Solutions have culminated in Signifier having achieved its largest ever commercial order, made ever more pertinent that it comes on the heels of a period of profound business consolidation, deepening our associations with technology to drive efficiencies whilst deploying capital in expanding our supply chain," said Mujtaba Chohan, head of finance and executive director of Signifier. “We are building a leading team, led by Yasser Zayni, Signifier’s eXciteOSA expert in conjunction with Spectrum Sleep Solutions and their established strategies in developing clinical channels. The decision by Spectrum Sleep Solutions to embrace eXciteOSA underscores its efficacy and its ability to revolutionize sleep apnea treatment.” Signifier’s eXciteOSA device uses neuromuscular electrical stimulation to move the upper airway muscles, working the intrinsic and extrinsic tongue muscles to improve endurance and prevent airway collapse during sleep. It recently received Medicaid coverage in South Carolina.