MILWAUKEE - Soaring health insurance costs drove the Epilepsy Foundation of Wisconsin to make a big change 10 years ago: It moved to a smaller office with cheaper rent.

Now, executive director Art Taggart hopes federal health reform will bring more relief. He's not sure if his 15 employees will get insurance through a new public exchange, but coverage for uninsured people could help reduce the 15 percent average premium increases he has seen in recent years, he said.

"I'm paying for the high cost of the uninsured," Taggart said.

But as Madison-area employers and health insurance companies prepare for the exchange, many questions remain -- including which plans will participate and how affordable the coverage will be.

The exchange, a hallmark of the 2010 federal health reform law, is a government-run marketplace expected to enroll many small businesses and individuals beginning Oct. 1 in private coverage effective Jan. 1. Lower-income enrollees will qualify for government subsidies.

Insurance companies must apply by Tuesday to be on Wisconsin's exchange, which will be run by the federal government. But details on the cost and coverage of the plans likely won't be released until summer, and the insurers might not get final federal approval until September.

Plans can't deny people who already have medical conditions, and they must cover maternity care, children's dental care and other "essential health benefits." Those and other factors will drive up premiums, insurance industry representatives say.

The federal government is fine-tuning or delaying some provisions. Officials said this month, for example, that small businesses on the exchange will be limited to one plan next year instead of being able to give their workers choices.

"We probably get six to 10 new clarifications a week," said Tom Luddy, marketing officer for Physicians Plus Insurance Corp. in Madison. "There are obviously some concerns."

Whether larger employers keep the insurance they offer or pay a penalty to drop coverage and steer employees to the exchange depends in part on how affordable the exchange plans are, said Brad Niebuhr, with the Madison office of M3 Insurance, a brokerage firm.

"It's going to be an ongoing discussion between now and late summer," Niebuhr said. "Most employers are going to continue with the status quo, but if the plans (on the exchange) are good and premiums low, that could change."

Waiting to make decisions

The Epilepsy Foundation buys insurance with other nonprofits through M3.

Taggart said it's too early to say whether the foundation or the nonprofit pool will use the exchange, but he's hoping to avoid the double-digit rate increases he's had to absorb.

"It's not easy when our grants, when we're fortunate, go up by 2 or 3 percent a year," he said.

Jeff Ver Voort, human resources director at Morgan Murphy Media, which owns WISC-TV (Ch. 3), said the company -- which has about 225 employees in Wisconsin -- offers three levels of Physicians Plus insurance to its Madison-area workers.

The company won't make decisions about potential changes until it knows what the exchange looks like, Ver Voort said. Many companies believe they need to keep offering insurance to attract and retain good employees, he said.

"I don't think anybody is going to want to be the first to not offer it," he said.

Nationally, some employers are looking at becoming self-insured to avoid some requirements of the health reform law, such as premium taxes. Self-insured companies pay most of their workers' health care costs directly instead of buying an insurance plan.

There's been some interest among Madison-area employers in becoming self-insured, said Cheryl DeMars, CEO of The Alliance, a Madison-based group of 180 self-insured employers who buy health care services together.

But making the shift should be a long-term decision, not just a way to escape taxes, DeMars said.

Large workplaces such as American Family Insurance, which has about 3,600 employees in the Madison area, and Epic, with about 6,400 employees in Verona, don't plan to change the coverage they provide, spokespersons said.

Area insurers mixed on exchange

Health insurance companies in the Madison area have a variety of strategies about the exchange.

Group Health Cooperative of South Central Wisconsin in Madison is "going to go all in," said Al Wearing, marketing director.

Group Health intends to have 24 plans on the exchange, offering various levels of coverage, Wearing said. The main target is the small business market, though activity likely will be lower than initially projected because of the government's recent shift to providing one plan, he said.

Still, "the exchange creates new markets, and we want to be part of those new markets," said Kevin Hayden, Group Health's CEO.

Physicians Plus is "fully prepared to get onto the exchange," Luddy said, but the insurer hasn't decided whether to participate in the individual market, the small group market or both.

Insurance companies face uncertainty not knowing which competitors will be in each sector, he said.

"If we don't show up, who does show up?" Luddy said. "What if we're the only ones that show up?"

WPS Health Insurance in Monona isn't going to be on the exchange next year, but its Green Bay-based subsidiary, Arise Health Plan, will apply, said Michael Hamerlik, CEO of WPS.

For large companies with substantial reserves, such as WPS, the requirement to insure people who already have medical conditions is especially risky, Hamerlik said.

But "we do want to and expect to be on the exchange in the future," he said.

Dean Health Plan in Madison will apply to be on the individual exchange, but that doesn't necessarily mean it will participate, spokesman Pete Thompson said.

"We will not make a final decision about whether or to what extent we are going to participate on the exchange until late summer," Thompson said.

Kyle Humphrey, spokesman for Unity Health Insurance in Sauk City, wouldn't say if Unity will apply to be on the exchange.

But Humphrey said some of the factors expected to drive up premiums on the exchange will also increase the cost of coverage off the exchange, such as plans for larger employers.

"We have to capture those fees in our pricing," he said.

Help for consumers

Meanwhile, the Dane County Board could soon authorize the use of $1.4 million in state money to hire 34 economic support workers to help consumers move into new pro-

grams next year because of health reform.

In addition, community groups can apply by June 7 for $830,000 in federal grants to help consumers navigate the exchange. Winners are expected to be announced in August.

Bobby Peterson, executive director of ABC for Health, a nonprofit law firm in Madison that helps people get health care, said the organization is "definitely taking a serious look at (applying.)"

Navigators will help people qualify for subsidies on the exchange, determine out-of-pocket costs and sign up for coverage.

Navigators could also help about 95,000 adults on Wisconsin's Medicaid program shift to the exchange under Gov. Scott Walker's proposed budget.

The Wisconsin Hospital Association, the Wisconsin Medical Society and other health care groups asked legislators this month to modify Walker's Medicaid plan, which would reduce eligibility for Medicaid coverage to the federal poverty level, or $11,490 a year for an individual.

The groups asked for eligibility to be at 133 percent of the federal poverty level, or $15,282 a year. Federal money would cover all of the extra cost until 2016 and then at least 90 percent of it, but Walker and other Republicans say federal funding could fall through. ___

Its name is derived from the tech term for step-by-step instructions.

There’s a gamification angle as well to separate the technologists from the IT pros to the technologist-wannabes.

Users are assigned reputation points, or crumbs, based on their activity, according to the website. Users receive points by asking and answering questions and get even more points if their input is voted up or selected as “Best Answer”. Points identify the most relevant users.

“We saw this as a clear way to improve the EMR world,” according to a voice on the company’s introductory video on YouTube.

Among a sampling of the questions from the website, launched in March, are: What’s the best support strategy post-live for a large, multi-hospital & clinic organization? What are the factors to consider when switching from print group (LPG) medication labels to smart text ones? As a pharmacy director, how can I get my staff engaged and excited about Willow and Epic?  Predictably, Epic is the number one topic, but ambulatory and meaningful use also appear among the popular question topics.

It seems like a website long overdue considering the complex health IT issues facing healthcare providers, ranging from interoperability particularly those that are just shifting over  to electronic files now. Maybe it will even help overcome some of the issues that have been undermining the performance of some providers’ systems. It’s offering a free trial for 45 days before it begins to each user, after which it will start charging $170 per month.

[Photo Credit: Confused from Big Stock Photos]

Wisconsin Investment Partners, a Madison-based angel investing group, has been named by the Halo Report as the most active angel investing group in the Great Lakes region.

Wisconsin Investment Partners, known as WIP, was founded in 1999 and is the state's oldest angel groups. The group has about 75 members and joins in many early-stage funding rounds here. Most recently, the group said it had participated in a $1 million round for Aver Informatics Inc., a De Pere health information technology start-up.

In 2012, WIP invested about $2.5 million in 16 companies, six of which were new companies and ten of which were additional investments in existing companies, said Brad Taylor, a co-manager for the group.

Since inception, WIP has invested nearly $17 million in early-stage companies, Taylor said.

The Great Lakes region includes Wisconsin, Illinois, Indiana, Ohio and Michigan. Angels in the region invested about $135 million in nearly 100 early-stage companies in 2012. The leading sectors were Internet companies (about 30% of the deals) and healthcare companies (about 27% of the deals), the Halo Report said.

Nationally, the amount of money being invested by angels remains stable, but the sectors and geographies getting funding are shifting, the report said. Mobile and telecom companies are gaining share of angel investment deals and dollars, and healthcare companies are losing share of angel investments. Companies in the Northwest and the Southwest are gaining ground on the number of deals and total investments they receive over companies in California and New England, it said.

The Halo Report is produced by the Angel Resource Institute and Silicon Valley Bank with CB Insights. It highlights angel investment activity and trends in the U.S. ___

(Reuters) MILWAUKEE - Exact Sciences Corp said its molecular screening test for colorectal cancer met its goals in a large late-stage study, detecting the disease in more than 90 percent of patients, but its shares plummeted 30 percent on Thursday as the results were not as robust as some were expecting.

Exact's test, which identifies abnormal DNA in cells shed in a patient's stool, detected 92 percent of colorectal cancers and 42 percent of pre-cancerous polyps in a large late-stage study.

"Pre-cancerous sensitivity, which was the key metric investors were looking at, was well below expectations," Wedbush Securities analyst Zarak Khurshid said, adding that "lower pre-cancer sensitivity may limit the eventual addressable opportunity for the test."

Khurshid was expecting a 55 percent detection rate for pre-cancerous polyps.

Exact Sciences Chief Executive Kevin Conroy, speaking to investors on a conference call, acknowledged that the test's detection rates in the study were not as high as expected, even though they met the trial's main goals.

But he said the data confirm the value of the test in detecting cancer and pre-cancerous conditions.

"We don't believe this will be an impediment in any way to the ultimate adoption of this test by physicians and patients," Conroy said. "I understand that people may be disappointed, but clinically, it just won't make that much difference."

Exact's non-invasive test, called Cologuard, was developed to be a more accurate alternative to currently available non-invasive screenings and an option for people who are not getting a recommended colonoscopy.

The study compared the performance of the test to colonoscopy and fecal immunochemical testing that looks for blood in a stool sample. The test met the study's primary goals for cancer detection rates. It also met its secondary goals of detecting larger polyps and demonstrating non-inferiority to the FIT screening.

While a colonoscopy is considered the most accurate method of detecting colon cancer and polyps, many people avoid the test, which involves inserting a flexible tube into the colon. Nearly half of those over age 50 have not been screened as recommended.

The trial was conducted on 10,000 patients between the ages of 50 and 84, who were at average risk for colorectal cancer.

Madison, Wisconsin-based Exact Sciences plans to submit the study data to the U.S. Food and Drug Administration as part of its approval application.

Colorectal cancer is the third most-commonly diagnosed cancer in the United States, responsible for about 50,000 deaths a year.

The company's shares fell 30 percent to $7.18 in early trading on the Nasdaq.

(Editing by Roshni Menon and Maureen Bavdek)

MILWAUKEE - Aver Informatics Inc., a De Pere health information technology start-up, has been selected to participate in a three-year entrepreneurship program affiliated with GE and StartUp Health, an incubator for young companies that is based in New York.

The news comes on the heels of a $1 million funding round led by Tom Shannon, a successful entrepreneur and angel investor from the Milwaukee area.

Aver was one of 13 companies chosen for the entrepreneurship program out of a field of 400 applicants from 22 countries. It was the only company selected from Wisconsin and one of only two from the Midwest. Aver and the other companies will each have a GE executive assigned to them to help the companies grow through introductions to their connections.

"It's a game changer," said Kurt Brenkus, Aver's president and chief executive officer.

GE healthymagination, the company's $6 billion effort to lower health care costs and increase access, will also consider Aver and the other companies as potential investments, Brenkus said.

Since the announcement was made about Aver being selected for the program, Brenkus said he has received calls from well-known venture capitalists and big companies interested in learning more about his company. Aver uses big data sets to analyze health care services and experiences for large populations of patients. ___

Madison's new cluster of health care technology companies is coming into its own.

With at least five local businesses started by former Epic Systems Corp. employees that have created about 400 jobs in the past three years as well as other companies without Epic ties, a Madison health tech meetup group has been formed. The group has nearly 150 participants, organizer Jonathan Baran said.

"The premise is: How do we turn Madison into 'the' place to be for people looking to innovate in health care IT?" he said.

Baran, who's not from Epic, is co-founder of HealthFinch, which makes productivity applications for physicians. The two-year-old company has six full-time and three part-time employees.

The Madison area already has health care companies such as Epic; several hospitals; GE Healthcare; data analytics company Forward Health Group; and promising medical device companies such as Asthmapolis, said Baran, who was born in Appleton and grew up near Cincinnati.

Madison may not be able to become another Silicon Valley, Baran said. "But what we could be really good at is health care IT. And one of the reasons is Epic."

Leaders of the meetup group have a "grand vision," Baran said, with two main goals:

--Create a space where health care IT companies can set up shop together, preferably Downtown.

--Organize a summit to showcase local companies to potential investors and customers.

The president of St. Mary's Hospital, Dr. Frank Byrne, said he's excited about the innovative ideas the young entrepreneurs are bringing to the industry.

"I love the vibrancy that these bright folks ... bring to our community in general and bring to health care," Byrne said. "We have an obligation as a community to create an environment here where dreams can come true." ___

The U.S. Food and Drug Administration-cleared Asthmapolis device is small and unflashy, but that’s part of what’s making it so valuable across the spectrum of patients, physicians, payers and public health circles.

It’s a sensor that clips on to the top of an inhaler and communicates wirelessly with an accompanying mobile app, which tracks when and where that inhaler is used by a person with asthma and COPD. And the Madison, Wisconsin-based company that makes it has plans to keep building onto what it can do now that the company has closed a $5 million series A from the Social+Capital Partnership, the venture firm started by ex-Facebook exec Chamath Palihapitiya.

The device/app combo has already found traction among various groups. Patients use it to track triggers and symptoms over time, set up alerts and reminders, and share that information with their families or physicians. Payers like the WellPoint subsidiary Amerigroup cover use of the device for its members with asthma, which the Centers for Disease Control and Prevention estimates costs the U.S. healthcare system an average of $3,300 per person annually.

It’s also being used at the public health level by city leaders in Louisville, Kentucky, and by Dignity Health in Sacramento, California, to better understand when and where people with asthma develop symptoms.

A company representative could not be reached by phone today, but co-founder and CEO David Van Sickle told MobiHealthNews that the company plans to develop new sensors to work with the numerous inhaled medications being prescribed today and gain regulatory clearance in other countries like Canada and the UK.

The market for asthma management is crowded, but this startup seems to have a leg up with the sensor. Numerous asthma apps help patients track their symptoms and medication use — AsthmaMD, AsthmaSense, Asthma Buddy, to name a few. AT&T has also developed a sensor device to measure pollutants in the air that could trigger an asthma attack.

Asthmapolis was founded in 2010 and won FDA clearance in the summer of 2012.

[Photo from Asthmapolis]

MADISON - Physicians Plus lost $30.3 million last year after losing $10.5 million the year before, according to a financial statement the health insurance company filed this week.

Group Health Cooperative of South Central Wisconsin lost $5.5 million last year, and Unity lost $113,000, according to reports filed with the National Association of Insurance Commissioners. Dean Health Plan made $1.1 million.

The four HMOs insure most people in Dane County and many in surrounding counties.

Physicians Plus, part of Meriter Health Services, announced in June that it would limit access to UW Hospital starting in January and expand access to Meriter and three other hospitals: Mayo Clinic in Rochester, Minn., and Froedtert Hospital and Children's Hospital of Wisconsin, both in Milwaukee.

The insurer also said about 9,000 members with primary care doctors at clinics owned by UW Hospital had to switch to Meriter network doctors.

"We know our approach will save our members and this community money in the long run," spokesman Scott Shoemaker said.

Physicians Plus has about 85,000 members, he said. That's down from 105,000 at the end of 2011.

Meriter Hospital made $22.4 million in 2011, the most recent year for which public information is available. Meriter Medical Group lost $14 million that year, and other parts of Meriter Health Services lost $3.9 million.

The Meriter system is "well positioned to grow under federal health care reform," Meriter spokeswoman Mary Reinke said.

Group Health spokeswoman Mary Carr Lee attributed the company's $5.5 million loss last year to "unexpected inpatient admission volumes." Group Health has about 71,000 members, up from 66,000 at the end of 2011, when it made $7.1 million.

Unity, owned by UW Health, has nearly 144,000 members -- up from 115,000 at the end of 2011, said spokesman Kyle Humphrey.

Unity's $113,000 loss last year was close to its predicted break-even budget and reflects a "very competitive" marketplace, Humphrey said. In 2011, Unity made $1.3 million.

Dean's $1.1 million gain last year follows a loss of $938,000 in 2011. Dean has about 256,000 members. ___

Photo credit: freedigitalphotos.net

MILWAUKEE - A Madison company said Thursday it has been awarded $16 million to manufacture stem cell lines for research.

Cellular Dynamics International Inc. will receive the grant from the California Institute for Regenerative Medicine, which was established with a $3 billion fund approved by taxpayers in California to accelerate stem cell research in that state.

Cellular Dynamics was awarded $16 million to create three stem cell lines -- called induced pluripotent stem cells, or iPSCs -- that can be used for research on Alzheimer's disease, autism spectrum disorders, liver diseases, cardiovascular diseases and many other ailments.

According to the National Institutes of Health, iPSCs -- although needing additional research -- already are useful tools for drug development and modeling of diseases, and scientists hope to use them in transplantation medicine.

The institute also awarded almost $10 million to Coriell Institute for Medical Research, of Camden, N.J., to set up and "biobank" the iPSC lines.

"The California Institute for Regenerative Medicine is a world leader in funding stem cell research," Bob Palay, chairman and chief executive of Cellular Dynamics, said in a statement. "Their human iPSC banking initiative will create the world's largest human iPSC bank."

Cellular Dynamics was founded in 2004 by James Thomson, a pioneer in human pluripotent stem cell research at the University of Wisconsin-Madison. ___

MILWAUKEE - In a powerful demonstration of reprogramming's potential to treat human disease and injury, scientists at University of Wisconsin-Madison turned a rhesus monkey's skin cells into early brain cells, then implanted them successfully in the monkey's brain.

The experiment, published Thursday in the journal Cell Reports, worked so well that the reprogrammed cells grafted onto the brain and appeared indistinguishable from the cells already there. Scientists were able to identify the new cells only because they had been tagged with a glowing green fluorescent protein.

Before being injected with their own cells, the three monkeys in the study were engineered to simulate the effects of Parkinson's disease.

Although the experiment was carried out on monkeys, the results suggest that such an approach could work in humans, raising the possibility that doctors might someday replace the neurons lost to Parkinson's or the cells damaged in spinal cord injuries.

"I think this is the first proof-of-principle demonstration that this personalized cell therapy may work," said UW neuroscientist and stem cell researcher Su-Chun Zhang, who led the study. "We designed this experiment specifically for mimicking future therapies in patients. That's why we used monkeys."

Zhang said his lab is now using a grant from the National Institutes of Health to do long-term studies of monkeys that receive injections of reprogrammed cells to determine whether the cells help improve symptoms. If the cell treatments prove beneficial, the next step would be to carry out clinical trials on human patients.

"I think it's extremely significant," said Eva L. Feldman, director of the Neuropathy Center at the University of Michigan. "I'm very excited about their paper and think it's got a great deal of scientific potential and hope."

Feldman, who was not involved in the UW experiments, said they mark an important moment in the discussion of what has been called personalized medicine -- the idea that a patient's own cells can be used to treat a broad spectrum of ailments. Such an approach would blunt the threat that a transplant might be rejected or send the immune system into battle.

Personalized medicine, Feldman said, "has been more of a theory to this point."

The theory gained momentum with discoveries in 2006 and 2007 that showed scientists could rewind the developmental clock, turning a skin cell into the equivalent of an embryonic stem cell, but without the destruction of an embryo. This frees medical science to envision a day when patients' blood, liver, brain and other cells may be banked and used to treat them when they suffer injury or disease.

The watershed of cell reprogramming was recognized last fall when the Nobel Prize in Medicine was awarded to Shinya Yamanaka of Japan and John B. Gurdon of England. But important work leading to the breakthrough came also from UW, where James Thomson became the first to isolate and grow human embryonic stem cells in 1998, then tied with Yamanaka in the race to reprogram human cells, achieving that landmark in 2007.

The UW study in rhesus monkeys now takes these advances and begins the long process of steering them toward medical practice.

Feldman said her lab has been taking skin biopsies from patients with amyotrophic lateral sclerosis, more commonly known as Lou Gehrig's disease, and reprogramming those cells. In doing so, Feldman's team can turn the skin cells into nerve cells to replace those destroyed by the disease. Similar experiments have been taking place all over the world, but most of the work has involved modeling and trying to treat diseases in a lab dish, not in an actual person.

Because of the physiological similarities between humans and monkeys, the UW experiment represents a significant step toward eventually attempting cell treatments in people with a host of ailments including heart disease, diabetes and Alzheimer's.

"This is a very significant paper in the development of cell therapies for Parkinson's disease," said Ole Isacson, a professor of neurology at Harvard Medical School who was not involved in the study. Isacson added that the UW lab's report demonstrates that reprogrammed cells from an "individual (primate) integrate well in the brain and could potentially restore function in a patient."

Zhang said the reprogrammed cells were injected into two areas of the monkey brain, the basal ganglia and the midbrain. Both areas help to coordinate movement and are damaged in Parkinson's disease. This is why people with the disease shake and have difficulty with walking and coordination.

One of the most significant findings of the UW study was that scientists could not identify the point at which injected cells grafted onto the monkey brain. That indicated that the animal's brain regarded the new cells as part of itself.

Zhang said the transplanted cells seamlessly forged connections and began functioning in the brain's networks. ___

A start-up company formed by the founder of a Milwaukee-area drug ingredient maker is proposing to build a pharmaceutical research-and-development facility in Mequon, creating 50 jobs.

Major Pharmaceuticals LLC wants to develop a two-story, 79,000-square-foot facility on a 7.7-acre parcel immediately south of Executive Drive and east of Commerce St., according to a filing with the city Plan Commission. That site is in Mequon Business Park, near the northeast corner of W. Donges Bay and N. Wauwatosa roads.

The company, which will produce injectable serums, expects to complete the $10 million office and laboratory by late 2013, the filing said.

Major Pharmaceuticals will have an estimated 50 full-time employees, including 10 chemists and pharmacists, 15 lab quality-assurance technicians and 25 process operators. The commission was to review the proposal at its Monday night meeting.

The company was launched by Michael Major, according to state corporation records.

Major is the founder of Cambridge Major Laboratories Inc., a Germantown supplier of active pharmaceutical ingredients to the biotech and pharmaceutical industries.

In 2011, he announced his retirement as Cambridge Major's chief executive officer but said he would remain as the company's nonexecutive chairman and scientific adviser.

Major made the corporate filing for his new company on Dec. 28, according to state records.

That was one day after Cambridge Major said its majority owner, Arlington Capital Partners, had sold its entire stake in the firm to another private-equity partner, American Capital Ltd. of Bethesda, Md. ___

A Wisconsin startup focused on retraining weakened mouth muscles that cause people to have difficulty swallowing has launched its first device and raised a $1 million series A as it prepares to roll out a second.

Swallow Solutions’ first institutional round was led by Venture Management with participation from NEW Capital Fund, Wisconsin Investment Partners and individual investors, according to a company statement.

The company’s first product is an oral mouthpiece that uses sensors to measure pressure at five locations on the tongue. Called the Madison Oral Strengthening Therapeutic (MOST), the device connects to a computer and is designed to evaluate and strengthen the muscles used for swallowing. It’s already on the market and is being used in a multicenter clinical trial. A second device, Madison Oralever Resistance Exercise, is scheduled to hit the market this summer.

Dysphagia occurs when there are problems with neural controls or muscles involved in swallowing. It becomes especially prevalent as muscles weaken with age, but can also result from a host of other conditions such as disorders of the esophagus, stroke, head and neck cancers and Parkinson’s disease. If left unaddressed, it could lead to pneumonia, malnutrition, dehydration or aspiration, the entry of foreign material into the airway.

The most serious of treatments for dysphagia involves a feeding tube placed into the stomach to bypass the problem, but less invasive approaches involve muscle-strengthening exercises. This is where Swallow Solutions’ retraining treatments fit in. Competitors may include Empi’s VitalStim Therapy and Aspire Products’ Expiratory Muscle Strength Trainer, a device designed to build respiratory muscles in people with Parkinson’s disease that may improve their swallowing as well.

Swallow Solutions says its addressable market is 15 million adults and millions more infants.

The Madison, Wisconsin, company was formed on research done by Dr. JoAnne Robbins, a professor of gastroenterology and geriatrics/gerontology at the University of Wisconsin-Madison School of Medicine and Public Health.

[Photo from Swallow Solutions]

Biologic drugs are filling the pipelines of big pharmaceutical companies and niche biotech companies, and many expect the market for these drugs to soar.

But discovery and development of biologics is complex, time-consuming and expensive because they’re derived from living organisms. A new drug discovery company called Invenra Inc.  says it has a platform that could overcome some of the barriers that limit the discovery of new biologic drugs in areas like cancer, Alzheimer’s disease and diabetes.

The company disclosed in a securities filing that it has raised $3 million. Unfortunately, there’s not much else known about this Madison, Wisconsin, startup, and co-founder and President Roland Green did not respond to a request for more information.

According to its website, Invenra says peptide and protein drugs have the potential to hit many previously “undruggable” drug targets because of their molecular structure and size. Its proprietary technology allows the company’s scientists to “screen billions of novel peptides and proteins for intracellular biological activity in less than a week,” Invenra’s site says.

U.S. Securities and Exchange Commission filings reveal that the company, which was formed in 2011, raised $1.2 million last year.

It might look like something you’d see in a gym, but the machine above is actually designed for hospitals and nursing homes to help patients with impaired mobility regain strength in their legs.

The Rehab Chair designed by VibeTech delivers neuromusculoskeletal stimulation to people who cannot tolerate weight-bearing physical activity because of injury, surgery, disease or age-related reduction in mobility.

Here’s how it works: First, the foot piece of the machine applies compression forces to the leg to simulate partial body weight loading. How much pressure is applied is adjusted based on the patient’s needs. Then it vibrates, sending vibrations through the feet, up the legs and into the hips and lower back, stimulating contraction of numerous muscles.

Clinical tests of the system produced improved balance, improved foot sensation and better mobility in nursing home residents who used walkers, VibeTech founder Jeff Leismer said. The machine is used for 10 minutes at a time, three to five times per week. Notably,  residents also “absolutely loved” the treatment, he said, in stark contrast to how many people feel about physical therapy.

More than 300 studies have been published on whole-body vibration, Leismer said. A quick Internet search of the literature produced a mixed bag of findings for various medical conditions. In one study, whole-body vibration therapy didn’t prevent bone loss in older women. Other studies in cystic fibrosis patients and people who had a total knee arthroplasty showed it improved muscle function, but not more than traditional therapy alone. However, in a study of osteoarthritis patients, it resulted in significantly more gain in knee extension strength, and in stroke and Parkinson’s disease trials it’s helped with balance and mobility (PDF). Leismer said other studies have demonstrated its ability to relieve pain, increase circulation and even have positive hormonal effects on patients.

The chair is initially being geared toward elder-care providers, as older adults tend to have the most ailments that could benefit from the therapy, and hospitals and nursing homes are also the facilities that are most likely to benefit financially from purchasing the chair, he said. Reimbursement is available, and because the chair has more applications than site-specific muscle stimulation therapies or whole-body vibration therapies that require standing on a platform, it may provide those facilities with an option to treat previously untreatable patients.

“One of the ways I think this technology is going to be most useful is its use right before you do other physical therapy programs,” Leismer said. “If it reduces pain and increases circulation, it’s going to enable them to work a little bit harder.”

Leismer, a biomedical engineer by training, got the idea for the chair back in 2001 and built the first version in 2002. After completing his Ph.D. in mechanical and aerospace engineering, he incorporated the company in 2007 but didn’t have the financing to get it up and running full time, so he took a full-time job elsewhere.

Finally, at the end of  2010, he landed a $200,000 SBIR grant from the National Institutes of Health. In addition to the SBIR grant, VibeTech has brought in a small amount of private equity investment and some assistance through the Wisconsin Small Company Advancement Program.

VibeTech is now building out its production prototype and working with a large hospital chain in the Midwest, where it plans to implement the product there in early 2013. For now, it’s following the U.S. Food and Drug Administration class 1 exempt pathway to get commercial sales going, but will eventually pursue 510(k) clearance for certain indications. Leismer said he’s actively seeking investors and strategic partners to get the product out the door.

[Photo courtesy Jeff Leismer]

President Barack Obama has won re-election now the nation is awaiting how the Patient Protection and Affordable Care Act will help overhaul the health care industry and expand coverage to millions to uninsured American.

Tom Doney, president of Cypress Benefit Administrators, a Grand Chute-based company, which helps businesses nationally set up health plans, offered his insight on the possible path of the act for business and people moving forward:

As it regards health reform, it will basically be status quo for now. The fact that Obama retained the White House and the Democrats kept control over the Senate means that any desire the Republicans had to change the law has been rendered moot.

That said, we're starting to see certain parts of the law being recognized as almost impossible to practically enact in the time that the law calls for, so there will likely be delays and concessions made. Most of PPACA is supposed to be up and running by January 2014. That is looking more and more improbable.

Might some of the complex parts like state exchanges and Medicaid expansion be delayed or watered-down because of the tight time? Not only would it be an embarrassment, but everyone in big or small ways has been gearing up for Jan. 1, 2014. However, it may end up as the only option. It's a difficult process and an unpredictable turn may happen at any time.

A sign of the slowing progress is that states have been given until Dec. 14 to report to the Department of Health and Human Services if they plan to sponsor a state exchange or not. States say they are still waiting for needed federal guidance to sagely make the decision, and most are leery of jumping into what could be a new budget-busting program that could plague states into the future. Similarly, a delay until Feb. 15 has been given for states to say if they plan to have a federal-state partnership exchange.

Almost every PPACA regulation would have made some groups angry or provide attack-ad ammunition against the Obama reelection, so there was purposely a log-jam leading up to the election. Now the dam is broken, and regulations are being sent to the White House Office of Management & Budget at record pace for clearance to be issued.

The range of regulations you will see being announced in the media shows how broad PPACA is. It's a huge, nasty animal that will be hard to control over the coming 12 months.

There are so many things that businesses need to prepare for, they had better find someone, like a TPA or consultant who understands the regulations, and who can help them to ensure compliance. The requirement to publish summary of benefits documents in the prescribed format, required plan changes to eliminate lifetime and annual limits, changing dependent coverage to age 26, adding preventive services without copays or limits, changes to emergency room visit limitations, elimination of pre-existing conditions clauses, additional reporting requirements and so many more requirements under the law will put a lot of pressure on the employer.

The result? employers will probably have to prepare for additional costs associated with offering health benefits to employees. To say nothing of the coming confusion and misinformation that will be out there.

What remains unanswered revolves around how this law is going to be regulated and how much the government will pay attention. At this point, it's such a huge undertaking that I think at least for the short term, the Feds will just want to see that an employer is making their best effort to comply and that corrective action is being taken when they are found to be out of compliance.

Additionally, as the regulation writers, who are expected to issue interpretations of the law, dig deeper into how it should be regulated, there may be changes that nobody has even thought about today. It's a crap shoot, I think. And given the "fiscal cliff" that looms on the horizon with the government, nobody can predict with any accuracy whether or not some parts of the law will be "unfunded" by the congress, essentially rendering those parts useless. So only time will tell.

In a word, probably. Adding benefits and having previously uncovered employees forced to join the plan can do nothing but raise costs. That's why it's imperative for employers to look to the expertise that exists in the market from those that deal with these things every day.

Many employers will be looking to self funding their plan in order to avoid some of the regulations in the law and to take control over their destiny as opposed to relying on a fully insured plan over which they have no control. So there are options out there and ways for employers to deal with these changes, but they have to be willing to investigate, find the right options for them and enact those changes.

This is where Cypress can help. Our clients nationally experienced costs that are 31 percent below national averages for health insurance and have limited their year-over-year cost increases to 3 percent annually over the last five years.

Our clients have been willing to make changes to their plans, enact appropriate cost control measures and find ways to engage their employees, but it only gets done if the employer becomes willing to consider the necessary changes to their benefit offerings. I think you'll see more and more employers looking to make those changes.

Probably the biggest thing is that if they don't have coverage today they'll be required to do so, or pay the penalty for eschewing coverage. Most of the uninsured in the country are so because they have chosen to do so, not because they just can't get coverage, despite what you've been told by the supporters of PPACA. Many may choose to pay the penalties rather than take on the expense of required coverage (ironically, the penalties are far less costly than buying coverage for many).

Some employers have already talked about reducing hours worked for employees to below the 30-hour "full time" definition so they won't be required to offer health benefits. I believe the CEO of the Papa John's Pizza chain recently came out and said that's his plan, so people may see lower income rates as a result.

Another big question is whether or not the public will have access to coverage via a state health exchange and whether or not those exchanges will be cost competitive for them. Wisconsin, for example, has decided not to sponsor an exchange.

-- Larry Avila: 920-933-1000, ext. 292, or lavila@postcrescent.com; on Twitter @LarryAvila ___

(c)2012 The Post-Crescent (Appleton, Wis.)

Visit The Post-Crescent (Appleton, Wis.) at www.postcrescent.com

Distributed by MCT Information Services

One in three seniors enrolled in Medicare doesn’t understand the government program, according to a new survey. And those are just the ones who admit to it.

65 Incorporated, a startup focused on educating the Medicare-eligible population about the program, used an outside company to conduct an online survey of nearly 900 aged 65-plus Americans enrolled in Medicare. It found that there was confusion even among those who said they were well educated about the program.

Nearly 30 percent of the seniors surveyed who said they understood at least the majority of Medicare were unable to identify their Medicare path or coverage types.

“If you don’t understand your coverage, you’re probably not going to be satisfied,” said Diane Omdahl, the co-founder of 65 Incorporated.

The confusion caused by Medicare reform and the evolving insurance industry comes at a time when more Americans are expected to be enrolling. “Now when people turn 65, they’re not entitled to Social Security just yet, and many of them are continuing to work. How does Medicare fit in?” Omdahl questioned.

There are plenty of online resources dedicated to Medicare information like UnitedHealthcare’s Medicare Made Clear, Medicare.org and the Medicare Plan Finder. But oftentimes, these sources are hard to navigate, skimp on important details or are created by biased parties like insurance companies, she said. (By those same standards, then, this survey is also subject to criticism.)

“But if you find some good info on a website, when things get a little tricky, they’ll pass you on to Medicare.gov,” she said, a website that in the survey actually caused people to have more difficulty dealing with Medicare compared to those using other resources. The same was true for the Medicare helpline.

Omdahl, a registered nurse by trade, has spent most of her career in healthcare administration and education, working in hospitals, long-term care facilities and home health companies. She and her husband started Beacon Health in the late 1980s to provide educational tools to home health professionals. She sold that business in 2010 and has now moved on to educating a new population of healthcare stakeholders.

Milwaukee-based 65 Incorporated just launched amid the Medicare open-enrollment period. Right now, it’s populated with free infographics, articles and educational materials on Medicare topics like the open-enrollment period and the Part D doughnut hole. The next phase will be targeted at soon-to-be Medicare policyholders and will provide them with tools to get to know Medicare, Omdahl said. The third phase will likely be a service component to help people navigate their Medicare options.

The self-funded venture will earn revenue from sponsored educational sections (not advertisements, Omdahl reiterated), videos and booklets that will later be sold on the site, and an eventual service platform that she hopes to have in place next year.

Although seniors are the least likely age group to go online, Pew research from this year indicated that still more than half of them use the Internet. And the almost-Medicare-eligible age group comprises the most frequent online shoppers.

“We want to get the population that’s turning 65 out on the right foot,” she said.

Conservatives and tea party groups applauded Gov. Scott Walker's decision Friday not to set up a state-run health insurance exchange under the federal health reform law.

Business and health care groups joined Democrats in saying a federal exchange isn't best for Wisconsin.

Exchanges, virtual marketplaces for individuals and small businesses to buy private coverage beginning in 2014, can be run by states, the federal government or through state-federal partnerships.

Walker said the three options would be similar for consumers but a state-run exchange would put state taxpayers most at risk.

"If we take on the risk of running the exchange, it commits us to long-term spending obligations," he said. "Eventually, as the federal funding dries up, costs for Wisconsin taxpayers could skyrocket."

Operating the exchange would cost $45 million to $60 million a year, and federal funding is guaranteed only through 2014, Walker spokesman Cullen Werwie said.

Both of the state's health insurance associations, along with other health care groups, said a state-run exchange would best protect Wisconsin's competitive insurance market.

"We are hopeful that this is not the final chapter, that obstacles preventing Wisconsin from choosing to run its own exchange can still be addressed down the road," Eric Borgerding, executive vice president of the Wisconsin Hospital Association, said in a statement.

Walker opposed 'Obamacare'

Walker opposed the 2010 health law, known as "Obamacare," returning a $38 million federal grant to implement an exchange and joining 25 other states in a lawsuit against the requirement that nearly everyone have insurance.

But Walker said Friday he's no longer fighting the law, which was affirmed by a U.S. Supreme Court ruling in June and President Barack Obama's re-election last week.

Wisconsin will carry out the law through a federal exchange, he said.

"The law is the law," Walker said. "We will comply with the law."

Friday was the deadline under the law for states to say they would run their own exchanges. On Thursday, the Obama administration extended the deadline to Dec. 14, but Walker said he had made up his mind.

The exchange is expected to cover about 250,000 people in Wisconsin, many through government subsidies. Another 170,000 people could gain coverage through the law's Medicaid expansion, made optional by the Supreme Court.

Walker hasn't decided whether to expand Medicaid, but he said doing so might also put state taxpayers at risk.

Tea party groups and some Republicans, including state Assembly Speaker-elect Robin Vos, R-Rochester, praised Walker's decision against a state-run exchange.

The conservative group Americans for Prosperity "is proud of Governor Walker for taking a principled stand to reject these exchanges," said state director Luke Hilgemann.

The powerful Wisconsin Manufacturers and Commerce supported a state-run exchange. But Walker "makes a good case for not doing so," president Kurt Bauer said in a statement.

The state chapter of the National Federal of Independent Business also preferred a state-run exchange but called Walker's decision "a reasonable one that we respect."

Regional participation

The Wisconsin Association of Health Plans "will seek to build on what works in our state -- such as regional participation of Wisconsin-based health plans," senior executive officer Phil Dougherty said in a statement.

One concern is that federal officials might allow only statewide health plans to participate in an exchange, said Al Wearing, marketing director for Madison-based Group Health Cooperative of South Central Wisconsin.

"Do they have the same knowledge that (Walker's) staff has of our marketplace?" Wearing asked.

Terry Bolz, CEO of Unity Health Insurance, part of UW Health, said he hopes the federal government pays more for complex patients like the state does through Medicaid.

"When we're working with folks in Washington, it's a little bit more difficult to have our voice heard," Bolz said.

A state-run exchange would better coordinate with the state's Medicaid program to figure out who qualifies for which type of coverage, said Bobby Peterson, executive director of ABC for Health, a Madison nonprofit that helps people get health care.

Peterson called Walker's decision "a real missed opportunity for Wisconsin."

Robert Kraig of Citizen Action of Wisconsin accused Walker of giving in to "ideological extremists" from tea party groups.

U.S. Sen.-elect Tammy Baldwin, a Democrat, said Walker "chose to pass the buck and reject the opportunity to take ownership of this issue."

Walker said he usually prefers that states, not the federal government, run most programs. But even if states set up the exchanges, Washington will make most decisions about eligibility and benefits, he said.

"It's like saying you're going to get a house, but the federal government is going to design the interior, all the amenities, the furniture, everything else and the only thing left is they ask you whether you want blinds or curtains," he said. "But yet you're co-signing the mortgage."

State residents remain divided about the health law, and Republicans are also divided about whether states or the federal government should run exchanges, said Charles Franklin, Marquette Law School poll director.

Walker's decision "says which constituencies in the party are carrying the decision, it's those most opposed to Obamacare," Franklin said.

"There's also a sense we may have just missed the boat months ago by not participating in the planning and set up of the exchanges." ___

(c)2012 The Wisconsin State Journal (Madison, Wis.)

Visit The Wisconsin State Journal (Madison, Wis.) at www.wisconsinstatejournal.com

Distributed by MCT Information Services

With a federal deadline looming Friday, 10 states remain undecided about whether to build state-based online insurance markets designed to help millions of people buy health coverage starting next October.

Still wrestling with the decision are Idaho, Arizona, Nebraska, Tennessee, Pennsylvania, Indiana, North Carolina, New Jersey, Oklahoma and Wisconsin.

The markets, called exchanges, are a key component of the health care law which aims to expand health coverage to 30 million people. They are websites where individuals and small businesses can shop for coverage which will take effect Jan. 1, 2014, and also find out whether they are eligible for federal subsidies or for Medicaid, the state-federal insurance program for the poor.  

Some 17 states and the District of Columbia have committed to building the exchanges themselves. Those states are California, Oregon, Minnesota, Washington, Nevada, New Mexico, Utah, Colorado, Kentucky, West Virginia, New York, Vermont, Connecticut, Massachusetts, Mississippi, Rhode Island and Hawaii.

Tennessee Gov. Bill Haslam, a Republican, who was still weighing the decision Wednesday night, said he sees the benefit of to having more control over state insurance markets, but is not sure he can get enough votes in a GOP-controlled legislature to move forward on the state model. 

"Politically, it will be difficult," Haslam said Monday.

Spokesman David Smith said the governor believes states typically run programs better than the federal government, but “there are lot of unknowns and unanswered questions out of Washington.”

Four states -- Arkansas, Illinois, Delaware and Michigan-- have decided to partner with the federal government. Other states that decline to set up their own exchanges have another three months, until Feb. 15, to opt to partner with the federal government. The law requires the federal government to build and operate exchanges in states that don’t do it themselves. States can opt to run a state exchange in subsequent years, however.

Operating an exchange includes duties such as running call centers to handle customer questions, deciding the minimum benefits all plans must offer and determining whether health plans have enough doctors and hospitals.

Don Gaetz, Florida's incoming state Senate president and a Republican opposed to the health law, said that while it’s too late for his state to run its own exchange in 2014, officials will weigh whether to partner with the federal government.

"It would give the state a modicum of influence over how the entity operates," Gaetz said. "There could be some advantages in holding down costs for participating health plans."

Health insurers and most health providers favor state-run exchanges because they are likely to exert greater influence on rules affecting insurance costs and benefits.

The Obama administration has offered few details about how a federally run exchange would operate and some critics have questioned whether it is up to the task of running the programs in more than half the states.

Some conservative groups also question whether subsidies to help people buy coverage can be paid in the federally run exchanges—an argument discounted by Democrats and most legal experts.

Earlier this week, the Obama administration extended the deadline for states to submit detailed plans to operate a state exchange. The date had been Friday, and it's been extended until mid-December.  But the administration kept Friday as deadline for states to declare whether they intended to move forward on a state-based exchange.

That decision was criticized Wednesday by the Republican Governors Association which asked President Barack Obama to extend the deadline until after the administration publishes more rules about how the exchanges would work. 

"States are struggling with many unanswered questions and are not able to make comprehensive far-reaching decisions prudently," said the letter signed by Govs. Bob McDonnell of Virginia and Bobby Jindal of Louisiana. Both governors will face a federally run exchange, if they decide against the partnership model.

Alan Weil, director of the National Academy of State Health Policy, said he doesn’t think consumers should see a big difference in how the exchanges work regardless of whether they’re run by the state, the federal government or a combination of the two. The law prohibits plans from turning people away or charging them more because of their health status.

Nonetheless, health plans will face some different rules around the country and offer different coverage -- much as they do now. 

While the Obama administration hoped most states would run their own exchanges, officials say having three different models is not necessarily a bad thing.

"We have very high hopes for the effect the new marketplaces will have on buying coverage," Michael Hash, director of the Office of Health Reform for Department of Health and Human Services, said at a conference Wednesday. He added that the exchanges will give consumers a one-stop shop to compare plans.

"We will be ready for open enrollment in October," Hash said.

States, which have been weighing whether to build their own exchanges since the health law was signed in March 2010, cite several reasons for opting out of the state model. Some say they did not do sufficient planning while waiting for the Supreme Court to weigh in on the law’s constitutionality and the outcome of the presidential election. Others do not want to have anything to do with a law they have fought to repeal. Still others worry about the costs of running the exchange.  The marketplaces will get federal dollars to ramp up, but then must be self-sufficient.

Building exchanges has been a daunting task even for states such as Maryland which started the process two years ago.

"It’s been an enormous lift," said Tequila Terry, director of plan and partner management at the Maryland Health Benefit Exchange.

Maryland officials have not decided how they will fund the exchange’s operation, though she said the most probable options were a combination of state funds and charging insurers a surcharge on premiums, which would likely be passed onto consumers.

[Image courtesy of Flickr user Norman Bleventhal Map Center at the BPL]

Isomark, a Wisconsin, Madison-based medical device company, was founded back in 2005 with a goal to commercialize a technology developed at the University of Wisconsin-Madison that could detect blood infections early.

But lacking a focus on what market to pursue meant the company didn’t really start to raise money until 2010. That occurred shortly before Dave Kruse, currently interim CEO, came on board when the company decided it should focus on adults and children who are in the hospital and breathing with the assistance of a ventilator. Kruse first raised $300,000 in an angel round followed by $130,000 in a bridge round.

Now with a clinical trial complete, Isomark is hoping to hire a new CEO by the end of the year and raise a little over $1 million, all with the goal of launching the sepsis detection device in late 2014. Severe sepsis is estimated to affect 750,000 people annually in the U.S. and the infection has a 28.6 percent mortality rate. It kills more people than stroke and pneumonia.

So how the does the product spot sepsis early on? Board member and strategic adviser Neil Holland explains that unlike conventional methods of detection that measure heart rate, blood pressure and temperature, Isomark’s device actually measures two isotopes of carbon found in a person’s breath.

When the ventilated patient breathes out, the breath is captured in a bag and measured to determine the ratio between carbon 12 and carbon 13.

“When you have an infection in your body, the body actually preferentially uses carbon 13 in the metabolism associated with your infection,” explained Holland in a recent interview. “That was a very key finding that the University of Wisconsin scientists identified [in the early 1990s]. That finding causes the ratio between carbon 12 and carbon 13 to change very very slightly. ”

The patient’s sample goes into a spectrometer which uses infrared lasers to measure the amount of carbon 12 and carbon 13 in the carbon dioxide in the breath.

“So if you have a very sensitive instrument that can measure both carbon 12 and carbon 13, you can detect changes in the ratio … that occur when the body is metabolizing in a certain way that is specifically associated with an infection, he said.

The clinical trial of 33 patients showed that Isomarks’ device could detect sepsis, in one case 48 hours before and in another case 12 hours earlier than conventional methods. These two patients became infected while they were being monitored, Kruse and Holland said.

The breath biomarker devised by Isomark is more reliable than heart rate and blood pressure because in many cases critically ill people on ventilators may also be trauma patients.

“One of the problems that clinicians today face in seeing the onset of infection is that often … vital signs [of sick people] are moving around for other reasons other than infection, Holland said. “Often an infection is masked by trauma. Also if they are on steroids they can have  their infections masked by other blood-based biomarkers. So one of the advantages our technology has is that it can see through those other fluctuating markers. We can not only detect earlier, we can give a more clear indication of an onset of an infection.”

Holland said there is no medical device per se that is currently available that helps to detect sepsis, while Kruse, interim CEO, believes a future partnership with a company like Covidien or GE Healthcare.

For now the task is to get a new round of funding and a new CEO. Consultant Joe Kremer of Kremer Ventures, the consulting firm helping to get a new CEO and sell the startup’s story to potential investors, said that Isomark has achieved proof of concept and done a clinical trial all for $430,000.

“The story is that the company has been very judicious with its money,” Kremer said. “It has really researched the technology, proven it out with its pre-clinical trial and then done it so on very few dollars.”

[Photo Credit: Blood poisoning from Big Stock Photo

The hard-fought campaign for an open Senate seat in Wisconsin—a centrist state that recently has become politically torn—has delved deeply into the politics of health policy and Medicare.

The two Senate nominees bring to the contest an unusual level of health-care expertise, helping focus the issue in the Badger State more than has been the case in other states. Voters' responses ultimately may help to point the way to middle ground on policy changes, say pollsters and others who have studied the race.

Democratic Rep. Tammy Baldwin has been an outspoken liberal during her 14 years in the House and is a veteran member of the Energy and Commerce Committee, where she promoted a Canadian-style, single-payer health care financing system.

She wrote during the 2009 congressional health care debate that including a public insurance option "will make health care affordable by increasing competition, providing more choices and keeping the insurance companies honest."

Republican Tommy Thompson was an innovative governor for 14 years before he became President George W. Bush’s Secretary of Health and Human Services. He was instrumental in the 2003 enactment of Medicare prescription-drug coverage. During the 2009 congressional health care debate he urged a bipartisan effort to "address the health care crises" in an article he wrote with former House Democratic Leader Richard Gephardt of Missouri.

Neither Baldwin nor Thompson got their way when President Barack Obama in 2010 signed the Affordable Care Act. And in some ways, their current contest to replace retiring Democratic Sen. Herb Kohl has revived that harsh partisan conflict over health care and the 2010 congressional campaign—which resulted in major Democratic setbacks, including the defeat of Wisconsin’s long-time progressive senator Russ Feingold. Thompson blasts Baldwin for supporting a "government takeover of Medicare" and she and her allies have blistered him for his support for changes to Medicare.

Those conventional partisan dynamics are highlighted in broadcast ads by the candidates' allies this month.

Former Wisconsin Governor and current Republican candidate for the state's U. S. Senate seat Tommy Thompson visits with workers and guests at Reed Switch Developments Corp. in Racine, Wisconsin (Photo by Scott Olson/Getty Images).

"Tommy [Thompson] says he’s the best person to do away with Medicare and turn it into a costly voucher program," according to a spot aired by the American Federation of State, County and Municipal Employees.

Crossroads GPS, which was organized by Republican strategist Karl Rove, has run an ad that attacked Baldwin for having "pushed an extreme takeover of your health care. It would go beyond Obamacare to create a government controlled health system."

The campaign -- in a state with historically deep pockets of  progressive and conservative legacies -- has taken shape in the shadows of two other key political developments: A costly recall election earlier this year in which liberals and national labor groups sought unsuccessfully to remove Republican Gov. Scott Walker and local GOP Rep. Paul Ryan’s rise as the leading advocate of conservative views on health and retirement issues and his selection as presidential nominee Mitt Romney’s running mate.

Ryan, 42, has described himself and the often confrontational Walker, 44, as "protégés of the Tommy Thompson farm team," but the 70-year-old Thompson has sought to distance himself from their policy embrace on broad social issues. Although he has called for overturning the health law and has endorsed the concept promoted by Ryan to give seniors premium supports to buy health coverage in order to keep the system from running out of money, Thompson also has said he would want significant revisions in that plan, such as increased federal payments and an expanded pool for high-risk patients.

"I am here to save Medicare, Medicaid and Social Security, but you have to make some adjustments," he told the Milwaukee Press Club this month.

Baldwin has been a fierce advocate for keeping the health law and for preserving Medicare’s current structure. 

A Marquette University Law School poll released Wednesday found that the race was dead even.

Yet despite the divisive campaign, a poll early this month by the school shows movement among voters in two ways that suggests the public may be beginning to break away from the health care polarization of the two parties and may be more accepting of change:

--Respondents split 46 percent to 45 percent on whether they approve or disapprove of the Affordable Care Act. When the survey in May asked how the Supreme Court should rule on the law’s constitutionality, 33 percent said that they wanted to keep the law, and 57 percent said that it should be overturned—in whole, or in part.

--65 percent of respondents said that they want Medicare to "continue as it is today, with the government guaranteeing seniors health insurance and making sure that everyone gets the same defined set of benefits."But the next question in that poll revealed that 51 percent said that "major changes will be required because the current system is too expensive to continue as it is," and only 45 percent said that Washington can "find ways to continue to support the current Medicare system."

"The negative stereotype is that people want to have their cake and eat it too," said Charles Franklin, the poll director. "But they are aware of the difficulties of paying for the system. This results in a tension for people who support the current system, but see it as hard to finance…. 20 to 25 percent want current Medicare, but say major change is required."

Similar trends have been evident in recent national polling on health-policy issues, including a September survey by The Kaiser Family Foundation, which found "malleable" public support for sweeping Medicare change. More than a quarter of the respondents wanted to keep Medicare the same and 37 percent favored change. But another 25 percent switched from wanting to keep the current system after being told that change in the system "is needed to sustain Medicare for future generations." (KHN is an editorially independent part of the foundation.)

Those tensions are reflected in Wisconsin’s Senate contest, according to Ted Marmor, a Yale University political science professor emeritus and scholar on the modern welfare state.

"With Baldwin versus Thompson, you have a moderation of those choices" compared to the national debates on health and Medicare, Marmor said in an interview. "Thompson won’t say that he’s for vouchers to pay for Medicare because he knows that Baldwin would attack him for that. Nor will Baldwin be as bold as Vice President Joe Biden [in the Oct 11 vice-presidential debate] in rejecting solutions to Medicare….This means that the broader public debate is becoming less idiotic."

Candidates in other high-profile Senate contests, by contrast, have handled these issues with the equivalent of sound bites.

In close Senate contests in liberal-leaning Massachusetts and Connecticut, Marmor said, Elizabeth Warren and Rep. Chris Murphy have taken "traditional Democratic positions," while Republicans Sen. Scott Brown and Linda McMahon "want to be more fiscally responsible." With a similar shift by Romney after last summer’s national conventions, Marmor added, the public debate has shifted toward the center.

Marmor added that he was heartened by the muted attacks in the presidential campaign. "The clarity of the differences between Democrats and Republicans has been blurred in the past weeks," he said.

[Photo courtesy of Flickr user donkeyhotey] ]]> http://medcitynews.com/2012/10/heres-what-role-healthcare-reform-medicare-is-having-in-the-wisconsin-senate-campaign/feed/ 0 http://medcitynews.com/2012/10/health-it-firm-that-helps-in-setting-up-patientappointments-raises-1-5-million/ http://medcitynews.com/2012/10/health-it-firm-that-helps-in-setting-up-patientappointments-raises-1-5-million/#comments Wed, 10 Oct 2012 19:36:04 +0000 Arundhati Parmar http://medcitynews.com/?p=157765

Wisconsin health IT firm MyHealthDIRECT, that describes itself as the nation’s first and only “healthcare scheduling exchange,” has raised $1.5 million in convertible debt, according to a regulatory filing.

The company, founded in 2005, has a browser-based software that can organize and book available appointments in the community into a “searchable and schedulable inventory of healthcare services.”

“It’s based on supply and demand,” explained CEO Tom Cox, in an interview Wednesday.

Hospitals, clinics and other healthcare organizations have an inventory of available appointments and that is matched with patients seeking that appointment.

Cox said the money will be used to expand the size of the network of providers who participate in the company’s scheduling exchange. Customers are either these providers or health plans whose members are seeking appointments. Since the beginning of the year, MyHealthDIRECT has booked 150,000 appointments nationwide.

Cox declined to say how much money the company has raised, excluding this round, but regulatory filings show that it was at least $11.3 million since 2009.

The company has 25 employees and its main competitors are ZocDoc and HealthPost, Cox said.

[Photo Credit: freedigitalphotos user Salvatore Vuono]

The resections can sometimes require blood transfusions of large amounts of blood, which is an expensive proposition for hospitals who have to store and manage the blood. So much blood loss is also traumatic for patients.

If blood loss can be reduced, it would dramatically alter the surgery landscape. That is the belief of one company that has licensed a technology developed at the University of Madison that aims to do precisely that.

Medical Engineering Innovations (MEI) hopes that its new device with its blade-shaped electrode boasting a larger array, ability to coagulate large blood vessels and unique algorithms for delivering RF energy, will make liver resections less traumatic for patients and more efficient for physicians. The need for large amount of blood transfusions will also decline.

The company, which has developed a lab prototype, is hoping to raise some seed funding to the tune of $1 million by the end of the year, said Richard Schmidt, president and CEO, who joined the company in January. He expects that the product will be on the market in the first quarter of 2014.

What makes Schmidt confident about the Madison, Wisconsin-based company’s prospects? After all, in the seven years since the company was founded, MEI has only managed to do animal testing and develop a lab prototype.

Schmidt acknowledges that it’s a question that keeps popping up. It hasn’t helped that two of the inventors and co-founders of the technology have retired while some have also moved out of state. The company has survived on grants and founder investments

But one of those very inventors who moved out of state and is now James R. Hines professor of surgery and chief of gastrointestinal and oncologic surgery at Northwestern University Feinberg School of Medicine. His experience with doing resections with current tools has made him believe even more in the potential for MEI’s product, the one he helped develop, Schmidt said.

Here’s why:

Most coagulation devices have  a needle-shaped electrode with a small array. That requires the physician to insert the electrode and deliver the energy multiple times across the liver, which increases procedure times. Schmidt said MEI has a blade-shaped electrode with a large array.

“What we have done is that we have created a much larger array so that you can get across the entire liver in one shot,” he declared. “One competing device has a very small array. They can coagulate within one to two minutes, but the array needs to be replaced 10 to 15 times.”

By being able to insert, energize and coagulate the entire liver in one go, MEI’s SwiftBlade device reduces procedure times to three to six minutes from 10 to 30 minutes, Schmidt said.

The other advantage of the system also comes from the blade-shaped electrode. Because it has a larger surface area than needle-shaped electrodes, more power can be delivered across its surface area without charring the tissue that would come in contact with it.

Further, current devices on the market made by competitors like Medtronic, AngioDynamics and Covidien, cannot coagulate large blood vessels that can sometimes be up to 5 millimeters in diameter. They can only do up to 3 mm in diameter, Schmidt said. That complicates matters.

“When a physician runs into a blood vessel that is larger than [3 mm in diameter] either you get ineffective coagulation and excessive bleeding, which then has to be handled with a blood transfusion,” he said. “Or you have to stop what you are doing and go to an alternate tool with which you can do some sort of ligation, which increases the procedure time, increases the number of tools you have to use and also increases blood loss,” he said.

Because of the limitations of these devices, many liver cancer patients are not eligible for liver resections because their livers may already be weakened before the cancer took over and now cannot risk blood loss and transfusions. But the unfortunate reality is that the five-year survival rate for cancer patients who don’t receive a liver resection is under 1 percent, Schmidt explained.

“What we are trying to do is make the liver resection process a little less traumatic for the patient so that more people can be eligible for it,” he said.

Health IT company MyHealthDIRECT, which bills itself as the nation’s first and only appointment scheduling exchange, announced Friday that a new CEO will lead the company.

The Brookfield, Wisconsin company said that starting Aug. 1, current board member Tom Cox will become its chief executive. Cox replaces founder and CEO Jay Mason who will remain with the company as a board member. Cox became a board member less than a month ago.

Previously, Cox was chief operating officer of Healthways Inc., a global provider of wellness solutions, where he managed sales, marketing and communications.

“I’m thrilled to be joining MyHealthDIRECT,” Cox said in a news release. “The company’s approach to system-wide patient scheduling will be a critical part of helping our healthcare system become more efficient, effective and user-friendly.”

Founded in 2005, MyHealthDIRECT has a browser-based software that can organize and book available appointments in the community into a searchable and schedulable inventory of healthcare services.

In an interview in April 2011, Mason said the tool provides operational and financial efficiency for hospitals as well as managed care plans.

The venture-backed firm has proved that it can build innovative solutions. In response to the “Discharge Follow-Up Appointment Challenge” announced by the Department of Health and Human Services in January, MyHealthDIRECT used its technology to create an application that helped it garner the first place award.

“It’s great to see the U.S. government recognize and reward innovative companies that develop the technology needed to create system efficiencies and support new models of care,” said David Jones, Chairman & Managing Director of Chrysalis Ventures, in a news release. “Since we invested in the company two years ago the appetite for disruptive, game-changing technology in the healthcare system is really taking off.

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A Wisconsin pharmaceutical company developing anticancer compounds has raised $1.49 million, according to a regulatory filing.

Quintessence Biosciences compounds are based on EVade Ribonuclease technology that function by destroying the RNA or ribonucleic acid in cancer cells.

Of the compounds the company is developing, the one that has progressed the most is the QBI-139, which is currently being tested at the University of Texas M.D. Anderson Cancer Center and the University of Wisconsin Carbone Cancer Center. Forty patients have been treated in the company’s first in human trials.

Previously, the company has said that the compound “has shown significant tumor growth inhibition against human pancreatic, non-small cell lung, prostate and ovarian solid tumors” in vitro and in vivo.

Laura Strong is the president of Quintbio. Strong is a board member of the Wisconsin Biotechnology and Medical Device  Association served as the company’s vice president since 2000. A call to Strong was not returned.

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A Wisconsin orthopedics startup has already raised $881,668 in quest of $1 million, according to a recent regulatory filing.

Flex Biomedical is developing a polymer-based synthetic viscosupplement that would serve as an alternative to hyaluronic, acid-based, injectable viscosupplements that are meant to alleviate pain and boost joint movement in patients suffering from osteoarthritis.

Co-founder and CEO Sal Braico declined to comment on how the funds raised will be used. The company seems to have raised a total of $2.3 million including the current round based on earlier filings with the U.S. Securities and Exchange Commission.

Just a little over a year ago, Braico told MedCity News that he was looking to raise $5 million. The company has tested the so-called Flex Polymer in vitro and in vivo, which “confirmed the polymer’s superior mechanical properties and its biocompatibility,” according to the company.  The technology was commercialized out of Boston University.

In February, Canadian research firm Millennium Research Group estimated that the global hyaluronic acid viscosupplementation to grow to $2.4 billion by 2016.