November 6th, 2017

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December 4, 2017

Two Qualifying Conditions Added for Minnesota’s Medical Cannabis Program


Autism spectrum disorders and obstructive sleep apnea have been added as qualifying conditions for the state’s medical cannabis program.


“Any policy decisions about cannabis are difficult due to the relative lack of published scientific evidence,” said Ed Ehlinger, MD, Minnesota commissioner of health. “However, there is increasing evidence for potential benefits of medical cannabis for those with severe autism and obstructive sleep apnea.”


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November 27, 2017

Three Health Care Organizations Partner to Form Carris Health


ACMC Health, CentraCare Health, and Rice Memorial Hospital are collaborating to create a new entity called Carris Health that will serve as a health care hub serving West Central and Southwest Minnesota.


Initial discussions about the partnership began in May, when the organizations signed a letter of intent to join forces. After months of discussion, strategy meetings, and town hall meetings, the Willmar city council voted unanimously to approve plans for the city-owned Rice Memorial Hospital to join the new health care system on Nov. 20 and ACMC Health’s board of directors and its 89 physician shareholders also voted to proceed with the integration with a final decision made at a shareholder’s meeting, also on Nov. 20. Carris Health will be a subsidiary of CentraCare Health.


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November 20, 2017

Opioid Prescription Limits Recommended for Physicians


Minnesota’s Opioid Prescribing Work Group adopted a new rule on Nov. 16 that limits opioid prescriptions for doctors who participate in the state’s Medicare program. It requires approval by Minnesota human services commissioner Emily Piper before it will take effect.


The rule states that nonsurgical physicians and dentists can have no more than half of their opioid prescriptions exceed 100 morphine milligram equivalents, which is about 20 five-milligram Vicodin or Percocet pills. Surgeons can have no more than 200 morphine milligram equivalents per outpatient prescription. The limits only apply to outpatient prescriptions meant to manage short-term or acute pain.


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November 13, 2017

Health Licensing Boards Implement Criminal Background Check Program


The Minnesota Health Licensing Boards have cooperatively established the Criminal Background Check Program to help new applicants for licensure efficiently complete the mandatory fingerprint-based criminal background check now required by Minnesota law.


Mandatory criminal background checks for professionals regulated by the Minnesota Board of Medical Practice will be implemented in phases—on Nov. 10 for acupuncturists, traditional midwives, and respiratory therapists; on Nov. 17 for physician assistants; and Dec. 1 for physicians, surgeons, and genetic counselors.


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November 6, 2017

MHA Study Projects Physician Shortage


A new study conducted by the Minnesota Hospital Association (MHA) has confirmed that a shortage of primary care physicians will develop in the state over the next decade.


MHA collects health care workforce data from most Minnesota hospitals each year and this year, for the first time, MHA called on Towers Watson, a global professional services company, to conduct a comprehensive review of the state of the primary care physician and registered nurse workforces in Minnesota. The company used publicly available data from the Bureau of Labor Statistics and the state of Minnesota in addition to the hospital workforce data provided to MHA.


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October 30, 2017

Medica Names New Chief Medical Officer


John Mach, Jr., MD, has been named Medica’s new chief medical officer. He steps into the role on Nov. 6, succeeding Alan Spiro, who held the position since July 5, 2016.


Mach has more than 31 years of medical experience. Most recently, he served as chief medical officer for Evolent Health in Arlington, VA. Before that, he served as the president of complex care management at Univita Health Inc., based in Miramar, FL. He has also served as chief medical officer at several organizations, including UnitedHealth Group, where he also served as chairman and chief executive officer of its Evercare division. He earned his medical degree at the University of Minnesota Medical School, where he also completed a residency in internal medicine.


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October 23, 2017

International Study Shows Immune Response to Ovarian Cancer May Help Predict Survival


A type of white blood cell called tumor-infiltrating lymphocytes has been found present in the tumors of patients with high-grade ovarian cancer, according to a team of international cancer researchers led by investigators from Mayo Clinic and the University of New South Wales Sydney. The discovery may help predict a patient’s survival.


“We know that a type of tumor-infiltrating lymphocyte called cytotoxic CD8 are present in the tumors of patients with high-grade ovarian cancer,” said Matthew Block, MD, PhD, an oncologist at Mayo Clinic that co-led the research team. “However, little was known about the role in fighting high-grade ovarian cancer, compared to other clinical factors.”


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October 16, 2017

New Allina Health Hastings Clinic Opening in November


Allina Health will open its new clinic in Hastings on Nov. 6. The facility is replacing the current Allina Health Hastings First Street Clinic location.


“Our goal is for residents of Hastings and surrounding communities to receive comprehensive health care close to home and, at the same time, have access to specialists through the broader Allina Health network,” said Kevin Best, MD, lead physician for the clinic. ”


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MHA Study Projects Physician Shortage


A new study conducted by the Minnesota Hospital Association (MHA) has confirmed that a shortage of primary care physicians will develop in the state over the next decade.


MHA collects health care workforce data from most Minnesota hospitals each year and this year, for the first time, MHA called on Towers Watson, a global professional services company, to conduct a comprehensive review of the state of the primary care physician and registered nurse workforces in Minnesota. The company used publicly available data from the Bureau of Labor Statistics and the state of Minnesota in addition to the hospital workforce data provided to MHA.


“The current pipeline of graduates appears adequate to replace retirements as they occur. That, coupled with projected increases in demand because of an aging population, will result in a significant talent gap for physicians,” the review concluded.


Specifically, a cumulative shortfall of nearly 850 primary care physicians is projected for the Minnesota workforce by 2024 due to the lack of annual growth in Minnesota’s graduate medical education programs, including residency or clinical training positions. The study showed that the number of openings for residency programs has been frozen since 1996. However, the supply of registered nurses will likely meet the demand, assuming that education programs continue to grow at their expected rate.


In response to the findings, MHA is urging federal and state policy makers to lift the 17-year freeze on the number of physician residency positions available under Medicare funding; oppose cuts to federal Graduate Medical Education Funding; develop a statewide health care workforce plan; seek ways to increase funding of Minnesota’s Medical Education and Research Costs program; and support development of new primary care models, including telehealth technology. In addition, MHA is encouraging the Minnesota Department of Human Services to implement temporary payment increases for primary care services delivered to Medicaid patients as called for under federal law.


“Many of our hospitals, especially those in greater Minnesota, already have difficulty attracting physicians,” said Lawrence J. Massa, president and CEO of MHA. “I hope this new information will provide an impetus to policy makers to make the urgent decisions needed on both the state and federal levels to give our health professional students access to the clinical training and residency experience they need to become licensed to practice.”


Clinical Trial Shows Promise for Recurrent Brain Cancer Treatment


Results from a Phase 1 clinical trial at the University of Minnesota Medical School have shown that more than 25 percent of patients with recurrent high-grade glioma, a form of brain cancer, were alive more than three years after treatment.


“Given the deadly nature of this disease, three-year survival is rarely reported in the recurrent setting,” said Clark Chen, MD, PhD, Lyle French Chair in Neurosurgery and head of the University of Minnesota Medical School Department of Neurosurgery, who led the clinical trial. “It is notable that the survival benefit was seen across a range of patients and not just limited to patients with specific genetic mutations. This finding indicates that many patients could benefit from this treatment.”


Two steps were involved in the treatment of the 56 clinical trial participants. First, patients were injected with Toca 511, a replicating virus that only infects actively dividing tumor cells. Once the virus is inside the cancer cell, it delivers a gene for an enzyme, cytosine deaminase (CD). As the virus replicates and spreads to other cancer cells, it programs them to produce CD. Second, patients received a pill, Toca FC, an inert compound. Once CD was inside the cancer cell, it converted Toca FC into the anticancer drug 5-fluorouracil, which killed the cancer cell. The anticancer drug not only killed the cancer cells, but also killed certain immune suppressive myeloid cells, which boosted the patients’ immune systems to recognize and attack the cancer cells.


“The treatment we tested in this clinical trial delivers local chemotherapy specifically to the brain tumor,” said Chen. “Toca 511 and Toca FC work together to turn the brain tumor into a factory that produces an anticancer drug while also activating the immune system through a combination of mechanisms, which together work to attack the cancer.”


About 43 percent of patients who underwent Toca 511 therapy derived benefit from it. According to Chen, the median survival in this trial is nearly double that of historical data. Median survival was 14.4 months, compared to about eight months for historical controls.

“Brain cancer is one of the deadliest cancers, giving urgency to finding an effective treatment,” said Chen. “The 160,000 people diagnosed with high-grade gliomas worldwide each year—and high-profile cases including U.S. Sen. John McCain, Sen. Edward Kennedy, and Beau Biden—demonstrate the high unmet needs of this disease. The data generated in the Toca 511 research provides hope for patients with brain cancer and their families.”


An ongoing randomized phase II/III trial is in progress to confirm the safety and efficacy of the treatment.


Allina Health, HealthPartners Partnership Improves Care and Lowers Costs


An analysis of the Northwest Metro Alliance, an accountable care organization (ACO) partnership between Allina Health and HealthPartners, has shown that health care costs in Anoka and southern Sherburne counties are increasing at a slower pace than the metro area average. The ACO serves a community of about 600,000 people who receive care at Allina Health and HealthPartners clinics and Mercy Hospital.


An executive summary of the first seven years of the partnership shows that costs rose on average by less than 3 percent per year, compared to a more than 8 percent increase in the year before it began.

The health care systems attribute the reduction in annual cost increases to care improvements such as reducing hospital readmissions, increased use of generic medications, and expanded access to outpatient mental health care. Since the partnership began, the rate of preventable readmissions decreased by more than 25 percent, saving about $11,220 to $13,000 per readmission, and prescriptions for generic medications have increased from 75 percent to 91 percent, saving an estimated $3.4 million per year in drug costs. The Alliance also opened a short-term residential facility for mental health with 16 beds and expanded Mercy Hospital’s partial hospital day-treatment mental health program to serve more than 4,500 patients per year, helping offset the more than 5,000 visits to the Mercy Hospital emergency department each year.


“Allina and HealthPartners recognized that our patients, members, and community needed access to quality care that is more affordable,” said Andrea Walsh, president and CEO of HealthPartners. “Through our partnership we have expanded access to mental health services, reduced hospital readmissions, and lowered health care costs.”


“The Northwest Metro Alliance is an extraordinary care model because we are competitors and are collaborating to do what is best for patients,” said Penny Wheeler, MD, president and CEO of Allina Health.


The Alliance continues through 2019, with an opportunity to extend the partnership.

CentraCare Expanding in Central Minnesota


CentraCare has opened a new walk-in clinic in the Cash Wise grocery store in Waite Park and broken ground on its Coborn Cancer Center’s Coborn Healing Center in St. Cloud for patients who have experienced cancer.


The new quickClinic at Cash Wise is in partnership with Coborn’s, Inc, owner of the Cash Wise grocery store chain. It has two exam rooms and offers treatment for common health concerns, including skin conditions, cold and flu, minor injuries, vaccinations, wellness screenings, and physicals. Two more quickClinics are set to open in the coming months at Coborn’s-owned grocery stores in Foley and Sartell.


“Health care is changing—and so are the needs of our community,” said Ken Holmen, MD, president and CEO of CentraCare Health. “And by partnering with those within our community, we can achieve our goal of improving the health of every patient every day by making access to care convenient for those we serve.”

The 6,500-square-foot Coborn Healing Center will offer services for the mind, body, and spirit for people who begin or continue their cancer journey at Coborn Cancer Center. Programming will include art and music therapy, support groups, spiritual well-being, fitness classes, integrative therapy (such as acupuncture, massage, and healing touch), and an interactive kitchen/classroom. Its estimated completion date is summer 2018. The CentraCare Health Foundation raised more than $3 million over the last two years through community, private, and business donations to cover the cost of the project. No new jobs are expected in the new building, as resources will be shifted from within the CentraCare health care system.


Hot Flashes, Night Sweats in Middle Aged Women Linked to Sleep Apnea Risk


Researchers at Mayo Clinic have found that the hot flashes and night sweats that more than 80 percent of middle-aged women deal with may be linked to an increased risk of obstructive sleep apnea. This most common form of sleep apnea can affect quality of sleep and lead to serious health concerns in women, including increased risks of coronary heart disease, high blood pressure, and stroke.


For the study, researchers used the Data Registry on Experience of Aging, Menopause, and Sexuality, which contains health information on women seen at Mayo Clinic’s Women’s Health Clinic. They analyzed data for women seen between May 2015 and December 2016 and discovered that self-reported severe hot flashes and night sweats were linked to an intermediate to high risk of obstructive sleep apnea. Those who had high blood pressure and were obese were at an especially high risk, but it was also seen in women with a healthy body mass index.


“Obstructive sleep apnea is often thought of as a man’s disease, and men’s symptoms are more outwardly noticeable, in large part because of snoring,” said Stephanie Faubion, MD. “However, the risk for obstructive sleep apnea in women goes up in their menopausal years. The symptoms they face—headache, insomnia, anxiety, depression, in addition to the more common symptoms of snoring and fatigue—may not be as audible or visible to others, but they pose just as much risk to overall health.”


Two years after clinical consultations, 65 percent of women who self-reported these symptoms and demonstrated intermediate or high risk of obstructive sleep apnea had yet to be diagnosed with

the condition.


“Hot flashes and night sweats may be overlooked as a risk of something more serious,” said Faubion. “The implementation of screening tools during evaluation can help determine what symptoms women are facing, and put us on track to detect and intervene with serious health issues, such as obstructive sleep apnea, sooner.”