Overcoming patient transportation barriers to care

Posted: Jan 14, 2020 | Posted by Kassy Perry

Physicians Practice
By Steph Weber
January 14, 2020

According to the American Hospital Association (AHA), transportation challenges prevent a staggering 3.6 million Americans from receiving medical care each year. A 2019 survey by Kaiser Permanente found that one-third of Americans frequently or occasionally experience stress over their families’ transportation needs.

While access to a reliable personal vehicle or public transit system can affect virtually any patient at any point in time, it can be persistently problematic for the roughly one-in-five patients residing in rural areas who experience commutes 17 minutes longer and 10.5 miles farther than their urban and suburban counterparts. Associated travel expenses pose additional barriers, especially for those with mobility-limiting conditions requiring specialized vehicles or with chronic conditions requiring repeated visits.

When lack of transportation leads to missed, canceled, or delayed appointments, the impact on patients and providers is significant, interrupting continuity of care and compromising patient outcomes as well as the successful management of complex comorbidities. The rise in such scenarios has prompted the creation and implementation of targeted solutions. “Addressing social needs [like transportation] is the next frontier in healthcare,” says Edward Lee, MD, executive vice president of information technology and chief information officer at the Permanente Federation in Oakland, Calif. “An individual’s social needs can have a huge impact on their health; physicians are often the first professionals working in a community to identify those needs.”

Social determinants of health (SDOH)—where patients are born, live, learn, and work—are increasingly being studied as a way to stymie existing health inequities, improve access to both acute and preventive care, and address modifiable risk factors. According to the Centers for Disease Control and Prevention (CDC), genetic, biologic, and personal behaviors account for just 25 per cent of an individual’s wellness. The remaining 75 per cent is attributed to SDOH factors like housing, safe neighborhoods, food insecurity, and access to transportation and healthcare services.

The true cost of missed appointments

When patients cannot attend appointments, regardless of the reason, it creates a cascade of consequences for all involved. An interruption in the continuity of care and access to critical support services can leave patients struggling to independently maintain treatment regimens and make healthful decisions that advance their care plans.

According to a 2018 Journal of Primary Care and Community Health study, patients with a history of missed appointments are nearly five times more likely to miss subsequent appointments. Another study determined that patients with higher rates of no-shows are significantly more likely to have incomplete preventive cancer screenings, worse chronic disease control, and increased rates of acute care utilization for hospitalization and emergency department visits, adding to healthcare costs in an already overburdened system. Missed appointments are a risk factor for all-cause mortality, according to a 2019 BMC Medicine study, with mental health patients experiencing an eightfold increase in risk.

Healthcare organizations and providers feel the strain too. In the current healthcare environment where physician shortages are rampant, last-minute scheduling changes may result in unfilled timeslots, underutilization of valuable finite resources, and increased wait times for other patients. A secondary effect is the potential loss of revenues. While it is difficult to determine the economic repercussions, one estimate suggests that no-shows or last-minute cancellations result in an industry loss of $150 billion per year, compounding at an average rate of $200 per unused timeslot. When patient visits are infrequent or sporadic, quality metrics can suffer, resulting in financial penalties under emerging value-based reimbursement models.

Although several studies have reported no-show rates from three per cent up to 80 per cent, they vary broadly among providers and even within an institution’s own departments. “No-show rates average 15 percent for appointments across our system and around 50 per cent for behavioral health appointments,” says Lisa Brandt, MBA, BS, RDH, vice president of population health for Indiana University Health Physicians group in Indianapolis, Ind.

When care managers contacted emergency room patients post-discharge to ensure care plan adherence, a common theme quickly became evident. “We would often find out they had no social support to bring them to their appointments,” says Brandt. When patients inevitably became ill or required further treatment, they would resort to visiting the emergency room instead.

Ride-sharing partnerships 

Missed appointments due to a lack of transportation also tend to point to a patient’s overall socioeconomic status. Patients residing in communities with poor SDOH factors tend to face more barriers to care including less social support, fewer financial resources, and greater travel distances. “Lack of transportation is a significant barrier when accessing care, especially for patients that are low-income, disabled and/or suffer from a chronic condition,” says Liz Helms, president and CEO of the California Chronic Care Coalition in Sacramento.

Although Medicaid frequently covers non-emergency medical transportation (NEMT) services, prior authorization requirements and varying coverage from state to state can undermine the program’s reach. If patients are forced to pay out-of-pocket for NEMT services, the expense may simply be too great. “These added costs are especially significant for patients who need to receive treatment at a certified clinic only a couple of minutes away from their home, but are [sometimes sent] to [centers in] other states their insurance will cover,” says Helms. “Costs include time away from work, accommodations, paying for a professional caregiver or having a family member provide transportation.”

2013 Journal of Community Health study found that transportation challenges disproportionately affect the elderly, children, minorities, and veterans, as well as patients who are low income, less educated, or chronically ill. To bridge the gap for the most vulnerable populations, Indiana University Health recently formed new ride-sharing partnerships to provide transportation to eligible patients. The initial focus is on the elderly, those with chronic diseases such as heart failure and diabetes, and Medicare Advantage and ACO health plan participants. High utilizers of emergency services and patients without social support or who have SDOH needs are also included.

“To avoid patients paying out of pocket, we are paying for transportation services if they meet our regulatory criteria and have financial need, based on information provided to our care managers and social workers,” says Brandt. While the program is still in its early stages, feedback has been positive and promising for reducing total no-shows. At an average per ride cost of less than $30, it’s significantly less than an emergency room visit and may likely prove more sustainable.

K.C. Kanaan, cofounder and CEO of Envoy America, a senior transportation provider headquartered in Tempe, AZ, has seen a shift in client demographics and needs. “Even though most of our marketing is focused on serving the elderly, we have clients as young as 20 years old,” says Kanaan, who estimates the organization has provided more than 100,000 NEMT rides through its network of medical partners which includes the Mayo Clinic as well as dentists, rehabilitation facilities, and kidney dialysis centers. His employees have also assisted parents traveling with young children, who may have otherwise struggled to find a way to easily and safely commute as a family.

Although formal data isn’t yet available for Envoy America’s program, demand has grown. “We estimate that our services are making a difference, because we are seeing our business grow,” says Kanaan. “Anecdotally, we have heard from some of our partners that our services help them in their overall goal to lower readmission rates.”

Once the impact of ride-sharing programs can be more fully measured, it’s possible the scope could be expanded into a modern version of the house call. “In the future, it could be used to send a healthcare provider to the patient’s home if that is a more efficient and cost-effective option,” says Brandt.

Telehealth and integrated solutions 

When physical commutes prove challenging, mobile may be the answer, especially now that cellphone ownership has reached an all-time high. According to Pew Research Center, 96 per cent of Americans own a cellphone and 81 per cent own a smartphone. Tapping into that technology can keep providers and patients connected for follow-ups, and perhaps even more importantly, create opportunities to access first-line care.

“Because many people have time and transportation barriers to their initial visit with a medical provider, virtual healthcare options speed time to initial evaluation,” says Blake McKinney, MD, cofounder and chief medical officer at CirrusMD, a text-based virtual care platform located in Denver, Colo. “[CirrusMD is] instantly available from any mobile or web device.”

Through partnerships with employers, payers, and integrated delivery networks, the service is offered at no cost to most patients, completely bypassing three of the most commonly cited barriers to care – transportation, distance, and money. Users of the platform, including more than 200,000 veterans, connect with a physician in less than 60 seconds. Avoidable emergency room visits have been reduced by as much as 40 per cent and utilization rates are three times that of national telehealth averages.

“Management of chronic diseases, such as heart failure, require a high touch clinical workflow. Currently, most hospitals and medical groups have programs staffed by highly trained nurse practitioners following evidence-based protocols who stay in touch and manage patients over the telephone – which these days means voicemail and can lead to many lost conversations,” says McKinney. “We live in a world where everyone texts, so it makes sense to use medical-grade texting capabilities for the management of chronic disease.”

Other telehealth services like patient portals and secure messaging partially circumvent the transportation gap and have slowly gained traction alongside EHRs. Unfortunately, rollouts are often clunky and interfaces not particularly intuitive, essentially trading one barrier for another. The key, experts say, is to offer patients accessible resources at every turn.

That’s exactly what Kaiser Permanente hopes to accomplish through their Thrive Local initiative, a comprehensive social health network designed to connect patients with SDOH needs to appropriate services. “A network of community resources will be integrated into Kaiser Permanente’s electronic health record. By doing so, our members with unmet social needs will be more efficiently connected to community services by our clinicians and staff,” says Lee.

Ultimately, the most effective solutions must focus on ease of use and streamlined access to providers. “Some believe that doctors need a bunch of information inputted before they can talk to you – that’s the paradigm of the office clipboard, right?” says McKinney. “What I prefer, and what I believe patients prefer, is to just let us connect and communicate as quickly and as personally as possible. A doctor you can communicate with is more relevant to your care than a doctor you have to wait weeks to see.”

Advances in Lung Cancer Treatment Drops U.S. Cancer Deaths

Posted: Jan 8, 2020 | Posted by Kassy Perry

GO2 Foundation for Lung Cancer points to targeted treatments and early screenings

(SAN CARLOS, Calif. and WASHINGTON) — Today’s report concerning improvements in cancer mortality is welcomed news. The recently released Cancer Statistics 2020 report shows that the decline in lung cancer deaths is driving the decrease in mortality rates for cancer overall. This is a tremendous development for anyone who is at-risk or managing a cancer diagnosis.

“This report validates what we have been advocating for many years. Lung cancer is a disease that has needed a better coordinated plan of action linking prevention to early detection to better treatment options and survivorship care. This comprehensive strategy is what will – and is – saving lives for our community,” said Laurie Fenton Ambrose, co-founder, president and CEO of GO2 Foundation for Lung Cancer. “GO2 Foundation is proud to continue to help bring responsible screening and personalized treatment into community settings across the country.”

GO2 Foundation’s focus on a coordinated plan of action linking prevention to early detection and targeted treatment options is helping save lives across the country. GO2 Foundation brings this screening and personalized treatment into community settings across the country through its Centers of Excellence program in more than 700 medical centers in the U.S.

The Centers of Excellence take a coordinated approach to lung cancer treatment including responsible screening, tumor genetic testing that allows for more targeted treatments and personalized clinical trial and treatment navigation.

“We are pleased to see the gains that GOFoundation has been working toward through its coordinated, patient-centered approach to lung cancer detection and treatment, reducing of lung cancer deaths in the U.S.,” said Dr. Geoffrey Oxnard, M.D. president of the GOFoundation’s Scientific Leadership Board and associate professor of Medicine at the Dana-Farber Cancer Institute and Harvard Medical School. “GOFoundation’s focus on implementing responsible screening and care in communities and identifying genetic changes in lung cancer are leading the way to more targeted treatments and better patient outcomes as evidenced in recent cancer statistic reports.”

In addition, GO2 Foundation also provides personalized clinical trial and treatment navigation for those diagnosed – and educational information about screening and where to be screened responsibly for the millions at risk.

Healthcare providers interested in joining GO2 Foundation’s Centers of Excellence network should contact us at info@go2foundation.org. Anyone with questions about risk and screening or questions about treatment should contact our helpline services (800-298-2436 or support@go2foundation.org).


About GO2 Foundation for Lung Cancer
Founded by patients and survivors, GOFoundation for Lung Cancer (formerly the Bonnie J. Addario Lung Cancer Foundation and Lung Cancer Alliance), transforms survivorship as the world’s leading organization dedicated to saving, extending, and improving the lives of those vulnerable, at risk, and diagnosed with lung cancer. We work to change the reality of living with lung cancer by ending stigma, increasing public and private research funding, and ensuring access to care.

California to Expand Innovative Adult Sickle Cell Disease Clinics Statewide

Posted: Nov 25, 2019 | Posted by Kassy Perry

Governor and legislature commit $15 million in funding to historically underserved Californians

LOS ANGELES – Today California advanced care for people with sickle cell disease (SCD) by launching a new initiative to establish a network of clinics for adults with SCD statewide, expanding services for those impacted by this chronic, debilitating disease.

The launch marks the grand opening of a new clinic site at the MLK Jr. Outpatient Center in Los Angeles. The Los Angeles County Board of Supervisors named the new clinic after Jeffrey Smith, the son of Gil Smith, Founding Mayor of the City of Carson, who died from SCD complications in 1982 at the age of 23.  These milestones come three years after the Los Angeles County Department of Health Services first opened the adult SCD clinic at MLK Jr. Outpatient Center in Los Angeles, with its partners the Sickle Cell Disease Foundation (SCDF) and the Center for Inherited Blood Disorders (CIBD).

Now with a commitment of $15 million, Californians across the state with SCD will finally receive the quality health care they deserve.

“We have waited too long to address the poor health outcomes and premature deaths suffered by individuals with Sickle Cell Disease in California,” said Diane Nugent, MD, president and medical director of the Center for Inherited Blood Disorders. “In the United States, life expectancy for individuals with Sickle Cell Disease is 61 years. In the United Kingdom, it’s 70 years. In the State of California, it’s a shocking 43 years. The program made possible by this funding due to the leadership of Assemblymember Gipson will give new hope to and extend the lives of our vulnerable and underserved Californians who suffer from this terrible disease.”

For the first time in California’s history, the governor committed $15 million statewide for sickle cell adult treatment programs statewide. In addition, this program will help train clinicians to quickly recognize and properly treat the many complications faced by adults with this complex and debilitating disorder so they can receive the best care possible. Decades of inadequate funding for California adults living with SCD resulted in this underserved community dying at younger ages and at higher rates. Californians with SCD have higher incidents of emergency room visits and hospitalizations than patients in other states. This program marks the first time California has provided significant funding for SCD, which is the world’s most common genetic disease affecting approximately 100,000 in the U.S. alone.

“Given that Jeffrey’s story was the impetus that drove me to introduce this budget proposal, it is fitting that the first of the clinics be named in his honor” said Assemblymember Mike Gipson. “Today, the majority of adults with SCD are forced to obtain care in hospital emergency departments and other non-SCD specialty settings. The Jeffrey Smith Sickle Cell Adult Center will be a center of excellence that understands adult patient’s unique needs and provide them with a quality of life that we would all want for ourselves. Moreover, the comprehensive outpatient center will avoid increased hospitalization costs for a Medi-Cal population.”

The new funding will help create a statewide network of regional adult SCD clinics modeled after the MLK Jr clinic. Developed within the existing health system infrastructures, the network will serve counties where the largest numbers of adults with SCD live, including Los Angeles; San Bernardino and Riverside; Alameda, Contra Costa and San Francisco; Sacramento and Solano; Kern; Fresno and Madera; and San Diego.

“Sickle cell disease is a complex condition that affects both the physical and mental health of patients, and it is critical that we provide them with first-rate care in the community,” Supervisor Mark Ridley-Thomas said. “Since 2016, LA County’s Department of Health Services and the Sickle Cell Disease Foundation have helped adults with sickle cell disease at the Martin Luther King Jr. Outpatient Center in Willowbrook. I’m thrilled to see this model expanded across the State.”

The budget allocation will help fund clinical workforce development to strengthen doctors’ and nurses’ understanding of current care guidelines, expand outreach and education, and increase tracking to better monitor care and outcomes through a partnership with the Sickle Cell Data Collection Program. This funding will improve the following outcomes:

  • African-Americans and Hispanic-Americans are disproportionately impacted, especially in the Los Angeles area where close to 2,000 patients live with SCD.
  • The average life expectancy for people with the most severe form of SCD is 30 years shorter than that of people withough SCD.
  • Patients with SCD have the highest rate of returning to the hospital within 30 days of being discharged compared to other health conditions.
  • The rate of stroke in adults (age 35-64 years) with SCD is three times higher than rates in African Americans of similar age without SCD.
  • The number of physicians trained and willing to treat SCD patients, especially adult patients, is severely limited.

“We are very grateful for this critical funding that will finally help ensure that Californians with Sickle Cell Disease can access the level of medical expertise needed to address the symptoms of their disease so they can live longer, more fulfilling and productive lives.” said Mary Brown, president and CEO of the Sickle Cell Disease Foundation of California.

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About the Center for Inherited Blood Disorders
Center For Inherited Blood Disorders (CIBD) has cared for hundreds of children and adults in Southern California, offering a safety net clinic that provides health care services specifically to patients with inherited blood disorders.  CIBD has been able to increase access to care for those who are economically challenged by providing medical care regardless of ability to pay.

About the Sickle Cell Disease Foundation of California
The mission of the Sickle Cell Disease Foundation of California (SCDF) is to provide life-enhancing education, services and programs for individuals living with sickle cell disease. SCDF broadens public awareness, delivers effective advocacy initiatives and promotes innovative therapies to ultimately find a cure.

About the MLK Jr. Outpatient Center
Serving as a model for accessible, culturally-sensitive healthcare, the Los Angeles County Department of Health Services’ Martin Luther King, Jr. Outpatient Center operates over 70 primary care and specialty care clinics to serve the health care needs of surrounding communities. The state-of-the-art facility is part of a revitalized medical campus which includes a 131-bed community hospital, psychiatric urgent care, recuperative care center, and Center for Public Health.

Capitol insiders’ perspectives on Newsom’s first legislative session

Posted: Oct 16, 2019 | Posted by Kassy Perry

By Emily Boerger
State of Reform
October 16, 2019

Sunday marked the final deadline for Governor Gavin Newsom to take action on some of the 1,042 bills that passed out of the legislature this year. Newsom’s first legislative session was marked by big-lift, impactful health legislation like ensuring Medi-Cal coverage for undocumented young adults and expanding premium subsidies. Newsom also came under fire for certain actions during his first session, like his handling of the legislature’s vaccine bill.

We reached out to several “Capitol insiders” for their perspective on how Newsom’s first legislative session went down — both in terms of wins and miss-steps.

Anthony Wright, Executive Director at Health Access California, praised the governor for his leadership in pushing through major health care legislation, some of which advocates have been pushing for years.

“I think it was a landmark year for health reform and for health care consumers,” said Wright. “The governor started out strong with some bold, first-in-the-nation proposals… from expanding Medi-Cal coverage to young adults regardless of immigration status, to expanding affordability assistance in Covered California for low and middle-income Californians, to taking on prescription drug prices with a state purchasing pool, and appointing the first surgeon general. Some of these efforts were long sought by consumer and community advocates… So, Governor Newsom’s leadership was welcome and notable on day one.”

From a less favorable perspective, one lobbyist described the process of communication with the Newsom Administration as “slow and broken.”

“I think that there were some problems that were due to who [Newsom] staffed — the legislative unit and to a lesser extent the cabinet side. They weren’t that experienced; they probably didn’t really understand what the job truly entailed in terms of how you interact with the legislature and with the third house. I think they took too long to develop positions, maybe even digest what legislation was doing — internally they didn’t have a process for that.”

For many lobbyists, there was a lack of clarity about who to talk to within the administration, who the key decision-makers were, who was talking to the governor, and how decisions were prioritized.

“There’s still a lot of gaps in understanding who calls what shots… So, concerns continue to be: how are they going to manage legislative, regulatory, and administrative business? Do they have the right people in place? Are they getting the instructions from the governor? Are they getting instructions from the chief of staff?

I have seen administrations evolve and I understand how they put those together. I also am not sure how much attention the governor truly will want to give to things that are not within his priority list.”

A recent CalMatters piece by Laurel Rosenhall evaluates Newsom’s first session, specifically pointing to moments when Newsom “stumbled.”

“He sowed confusion with contradictory messages about his plans for high-speed rail. He garnered mistrust when he wavered on a bill to crack down on bogus medical exemptions from childhood vaccines — asking lawmakers to change the bill, and then, after they made the changes, taking to Twitter to demand more,” writes Rosenhall.

Kassy Perry, President and CEO of Perry Communications, acknowledged some of the bumps in the road that occurred this year, but says Newsom is getting settled in.

“Governor Newsom is more animated and opinionated in terms of his legislative agenda than past governors, and his style caught many off guard this past session,” said Perry. “Now that his healthcare team is coming together and the Horseshoe is settling in, the Capitol community should not expect controversies like the one surrounding Senator Pan’s vaccine legislation. We anticipate smoother sailing.”

On the Move: Fender Ups Christina Stejskal; March Communs. Hires Kelby Troutman; R&J Strategic Communs. Vet Dan Johnson Takes PR Chair at North Jersey’s Urban Land Institute; Perry Communications Brings On Kelley Rooney

Posted: Sep 20, 2019 | Posted by Kassy Perry

By Steve Barnes
O’Dwyer’s
September 20, 2019

Fender has promoted Christina Stejskal to vice president, communications, PR. Stejskal has been with Fender since 2016, and was responsible for building the company’s global PR function. Before coming to Fender, she was a senior vice president at DKC, and previously served as an account director at PMK•BNC. In her new role, she will lead consumer strategy for all of Fender’s outward facing communications as well as overseeing media relations and external strategic communications across global product launches, business initiatives, events, partnerships and influencer marketing. She will also assume responsibility for leading the marketing efforts for the recently launched Fender Play Foundation, a new charity designed to provide resources and music education opportunities to young people.

Kelby Troutman
Kelby Troutman

March Communications has hired Kelby Troutman as vice president. Troutman joins March from Nuance Communications, where he led global PR, analyst relations, social media strategy and execution, messaging creation, executive content creation, and crisis communication for Nuance Document Imaging. He previously led PR teams at such agencies as Schwartz Communications, Digital Influence Group and Racepoint Group. Troutman has developed and executed on communications strategies for technology companies in a variety of industries, including healthcare, security, enterprise tech, telecom and utilities.

Dan Johnson
Dan Johnson

R&J Strategic Communications announced that Dan Johnson, a senior account executive at the firm, has been appointed to Urban Land Institute Northern New Jersey’s advisory board as PR chair for FY 2020 and 2021. Johnson, who currently heads R&J’s commercial real estate practice, will work to increase awareness of ULI Northern Jersey’s key research and education initiatives while increasing engagement from members and industry influencers. ULI Northern Jersey is a multidisciplinary real estate nonprofit research and education organization dedicated to providing responsible leadership in the use of land in order to enhance the total environment.

Kelley Rooney
Kelley Rooney

Perry Communications Group has brought on Kelley Rooney as vice president. Rooney was previously state director and political director at North State Solutions as well as political and digital director at Cornerstone Solutions. She has worked on candidate, independent expenditure, issues management and bond campaigns. At PCG, Rooney is responsible for developing and managing legislative advocacy and communications programs on behalf of the agency’s health care clients. PCG has also promoted Alexandra LamirandeBrooke Witzelberger and Megan Yee to account executive.

Perry Communications Group Expands Award-winning Team

Posted: Sep 19, 2019 | Posted by Kassy Perry

(SACRAMENTO, CA) – Perry Communications Group (PCG), a leading California-based public affairs firm, today announced the addition of four new staff members, to support the firm’s issue management, coalition building, grassroots advocacy and digital strategies. In addition, PCG recently promoted three of the four new staff members. 

“From campaign management to international business, and from social media to digital marketing, our talented new team members are valuable additions and will help advance client goals. Their varying backgrounds enhance our team’s current offerings,” said Kassy Perry, president and CEO of PCG. “Our three newly minted Account Executives blew us out of the water in their first couple of months and we’re thrilled to support their advancement as they continue to succeed on behalf of PCG clients.”

Vice President Kelley Rooney brings political campaign and digital advocacy experience to the firm. She has spent her career working on candidate, independent expenditure, issues management and bond campaigns. She is responsible for developing and managing legislative advocacy and communications programs on behalf of PCG’s health care clients.

Account Executive Alexandra Lamirande – one of PCG’s recent promotions – worked in international relations and for a California public affairs firm prior to joining PCG. She plays an integral role in client-service focused on legislative policy research, media relations, digital campaign execution and grassroots outreach support.

The second recent promotion, Account Executive Brooke Witzelberger, worked for a longtime California assemblymember and as a legislative assistant for one of California’s top lobbying firms. At PCG, she focuses on legislative advocacy and issue management programs and implements social media and digital campaigns.

Account Executive Megan Yee, also promoted recently, began her career working in the tech hub of San Francisco developing online marketing programs. Since joining PCG, she incorporates new digital technologies, implements communication programs and supports advocacy efforts.

For 21 years, Kassy Perry and PCG have shaped ideas, galvanized opinions and influenced decisions ultimately leading to social change. The PCG team helps clients positively impact pressing issues not only in Sacramento, but throughout California and the nation.

For more information, visit PCG at www.perrycom.com, like us on Facebook, follow us on Twitter, or call (916) 658-0144.


About Perry Communications Group
Perry Communications Group (PCG) is an independent, full-service strategic communications firm specializing in public affairs. We work at the center of issues that matter and give new perspective to the issues and events making headlines today as well as those that will in the future. The bottom line for us is always the same – we’re invested in the causes we promote because our clients’ goals are our goals.

Open Forum: Why Congress should ratify Trump’s NAFTA replacement

Posted: Sep 19, 2019 | Posted by Kassy Perry

By Linda Dempsey
San Francisco Chronicle
September 19, 2019

U.S.-China relations have been in focus this summer, with trade negotiations in flux and tensions rising. American manufacturers agree with Congress and President Trump that China must do more to eliminate unfair trade practices and distortions. Manufacturers also rely on certainty and open, rules-based trade, so volatility and new barriers to commerce with one of our major trading partners make them less optimistic and less competitive. For those reasons, manufacturers are calling for a robust, enforceable agreement on a fairer, more open U.S.-China commercial relationship sooner rather than later.

But while manufacturers seek action across the globe, we have a trade agreement ready for congressional approval much closer to home: the United States-Mexico-Canada Agreement, or USMCA. While China has the second-largest economy in the world, Canada and Mexico, the two largest foreign purchasers of U.S.-manufactured goods, are even more important to the U.S. economy — more than the next 11 countries (including China) combined.

The two countries purchase more than a quarter of California’s total manufacturing exports and support nearly 100,000 manufacturing jobs in the state, according to data released by the National Association of Manufacturers. Put simply, California’s more than 35,000 manufacturers depend in significant part on a strong, reliable trade relationship with Canada and Mexico.

While manufacturers have seen continued growth in our trade relationships with Canada and Mexico, we have also recognized the need to update the 25-year-old North American Free Trade Agreement. Technology and innovation have reshaped the economy and the way we do business over the past quarter-century, but the NAFTA rules remain unchanged.

The USMCA addresses these issues directly, updating several key aspects of NAFTA to reflect the modern economy.

The USMCA would bolster American innovation with best-in-class intellectual property protections and enforcement provisions that are vital to manufacturers. With stronger and clearer rules to protect patents, trade secrets, trademarks, copyrights and other forms of intellectual property, the USMCA would catalyze American innovation and help manufacturers stay on the leading edge of inventions that save lives, improve communities and the environment, and support well-paying jobs.

To address advances in digital trade, the agreement includes a chapter setting rules to ensure that manufacturers can rely on digital trade without discrimination or unfair treatment. These rules are increasingly important to small businesses that use the internet as a global storefront.

The USMCA would also provide more access to Canadian and Mexican markets for American goods and remove more of the red tape that often prohibits small and medium businesses from selling their products in other countries.

The trade deal includes additional provisions that level the playing field for U.S. manufacturers by raising standards on a broad range of issues, from transparency and fair competition to labor and the environment.

The benefits would extend to every state and throughout Canada and Mexico, offering businesses across North America new opportunities to grow and expand. The economic implications of a robust and open North American marketplace are difficult to overstate. And moving this deal forward would send a strong message to China and other countries about the standards and rules needed to foster fairer, more open commercial relationships. Manufacturers and businesses across the country are calling on Congress to move quickly to ratify the USMCA.

Linda Dempsey is the vice president of international economic affairs for the National Association of Manufacturers.

Commentary: Why legislation that promises patient protection is bad medicine

Posted: Sep 2, 2019 | Posted by Kassy Perry

CALmatters
By Eve Bukowski
September 2, 2019

We all agree that drug prices are high, but a proposal before the Legislature would make that situation worse, even as it seeks to solve the problem.

In fact, I’m concerned that this “cure” for high drug prices might just kill this patient.

You see, I shouldn’t be alive today.

For the past 11 1/2 years, my Stanford University physicians and I have fought Stage 4 metastatic colon cancer. I’ve been prescribed every available chemotherapy and immunotherapy option, endured five rounds of radiation and undergone 63 surgeries. My cancer is not in remission and we must outwit it constantly so I can remain alive to see my children grow up.

I’m also an advocate who has worked professionally with the life sciences industry for years and benefitted from the lifesaving research and development. I understand better than most people the complicated and convoluted drug supply chain. And I’ve seen first-hand the law of unintended consequences.

At issue is the critical need to get generic drugs to market faster and more efficiently, giving consumers access to lower-cost prescription medicine that can save them hundreds or even thousands of dollars each year.

The proposal before the Legislature, Assembly Bill 824 by Assemblyman Jim Wood, Democrat from Healdsburg, is ostensibly designed to prevent delays in bringing generic medicines to market, but it would have the opposite effect.

It seeks to complicate and discourage the use of settlement agreements to resolve patent lawsuits—settlements that actually increase access to lower-cost, life-saving generic medicine and speed their entry into the market.

The result of enactment of AB 824 would be to slow the process of bringing cost-saving generic drugs to market because it would limit the ability of drug manufacturers to settle patent litigation. Such an outcome would be disastrous for patients like me.

These settlements, which usually bring generic drugs to market years sooner than they otherwise would have been released, have made possible the launch of many generic drugs prior to the patent expiration date.

Access to affordable medicine, as soon as possible, is critically important for patients. Patent settlements have led to patient savings.

Proponents of AB 824 say they want to prevent any settlement agreement that would lengthen patent protections for a given medication. These so-called “pay for delay” provisions should in fact be outlawed; no settlement agreement should ever result in prolonging a brand-name patent.

But their proposed solution would also disrupt legitimate patent settlements between pharmaceutical manufacturers. That approach is nonsensical and counterproductive, as it would result in reduced access to needed medicines and increased costs to consumers.

The California Attorney General and the Federal Trade Commission already have the authority to review settlements on a case-by-case basis, which is the best way to protect consumer interests. Under California’s strong anti-trust laws, the attorney general can act to invalidate any settlement if its effect is to limit market competition.

In fact, just a few weeks ago, three drug makers agreed to pay nearly $70 million to the state of California to settle “pay to delay” allegations. The system works. So AB 824 is a solution in search of a problem.

We need to stay focused on making sure that patients can get the medicines they need when they need them. If the goal is to make medicine more affordable and accessible, the last thing patients need is a new legal roadblock that will stifle access to lower-cost alternatives.

That’s a prescription for disaster.

Eve Bukowski is a stage 4 cancer patient and life sciences industry advocate from Davis. evebukowski@gmail.com. She wrote this commentary for CalMatters.

Civility, respect, courtesy: Disappearing words and actions

Posted: Aug 30, 2019 | Posted by Kassy Perry

Turlock Journal
By Jeffrey Lewis
August 30, 2019

Turmoil in local city government, compounded by a general lack of clarity on the economic front at home and globally, has caused some in our area to take a giant step backward.

Taxpayers are angry and frustrated, in part due to Turlock’s inability to solve problems primarily caused by inherited economic miscalculations. But that isn’t all that’s at play. At the root of this turmoil lies fear and uncertainty.

Turlock, like many other localities, is witnessing an unprecedented race to the bottom, in which elected officials from both political parties are vying to outpace each other. This failure to collaborate is symptomatic of the tawdry politics of today, further exacerbated by angry citizen emails and social media attacks on elected officials for trying to do their jobs.

Many years ago, the government was once an inspiring place of grand ideas and magnanimous spirit. Today, though, what passes for debate more closely resembles a disheartening hotbed of moral ambiguity and confusion.  Politicians and community members are using social media tools to argue their point of view, often peppered with insults and innuendo.  The worst part, it has gotten personal.

What happened to Turlock?  To our society?  Disagreement once opened opportunities for robust discussion, which might ultimately lead to consensus, or at least an attempt to find it through respectful debate.

Opinions are not character faults.  However, when mixed with personal attacks on gender, race, body type, hairstyle and clothing choices, they push civility, and substance, out the window.  In doing so, the City slips into becoming a place where businesses may not settle.

Turlock is a community of great pride and history – a faith-based community that truly cares for its neighbors when they are in trouble.  When the economy took a nosedive, people pulled together to help.  Our focus should be on families and helping to keep them healthy, fed and intact.

Given the economic nemesis that the City cannot escape from, there is no greater opportunity than today to come together with one voice, one solution, predicated on honest debate and complete transparency.

It is important that we not forget that social media can help educate and provide a forum for discourse, but it can also be a distraction and deterrent for finding solutions.

Civility and leadership are the fabric that holds our nation together. Divisiveness can rip a community to shreds. Our leaders must rise above personal and partisan agendas and work together, to find solutions to our problems here at home.

It is Labor Day, a time to celebrate working women and men, something Turlock has a long and rich history of doing. Part of that celebration should be re-invoking kindness and respect.  Are you willing to start anew, learn to challenge the status quo respectfully?

— Jeffrey Lewis is the President and CEO of Legacy Health Endowment in Turlock.  He can be reached at jeffrey@legacyhealthendowment.org. The views expressed here are his own and not those of the Foundation.

Fastest Growing Companies: Check out this year’s list

Posted: Aug 8, 2019 | Posted by Kassy Perry

By Sonya Sorich
Sacramento Business Journal
August 8, 2019

The Sacramento Business Journal celebrated the area’s fastest growing companies with an Aug. 8 luncheon at the Hilton Sacramento Arden West.

The luncheon coincides with the release of our Fastest Growing Companies list. Companies were ranked by percent of revenue growth from 2016 through 2018.

Granite Bay-based Verus Insurance Services ranked No. 1. Read about the company in this profile. [PERRY COMMUNICATIONS GROUP RANKED NO. 45]

Check out the slideshow above to see the 51 companies that appear on this year’s list, and stay tuned for more profiles in upcoming days.

VIEW SLIDESHOW