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Our Take: HCA Healthcare partners with J&J to improve health equity, patient outcomes, support for nurses

Aug 15, 2022

Nashville, Tenn.-based HCA Healthcare announced Tuesday that it is collaborating with Johnson & Johnson (J&J) to address a range of issues affecting the health care industry, with an initial focus on three specific areas.

One is a scalable pilot project to increase early identification of lung cancer among Black patients. Citing the American Cancer Society as its source, HCA noted in the announcement that lung cancer is the leading cause of cancer death in this population.

Another is an initiative to incorporate J&J’s nursing resources within HCA and its affiliate, Galen College of Nursing. According to HCA, the health system has more than 93,000 registered nurses. The collaboration with J&J will center on health equity issues focused on educational programming, training, and other programs, HCA said.

The third area is cardiovascular health — HCA Healthcare Research Institute will collaborate with J&J on a retrospective analysis of patients with heart arrhythmia, and the two entities will also explore the role that digital health technology plays in clinical outcomes for patients with coronary artery disease and peripheral artery disease.

The announcement said the companies would work on the pilot program for identifying early-stage lung cancer in the coming months. No timeline was mentioned for the other two initiatives, nor were the financial terms of the partnership provided.

Our Take: J&J has been restructuring for months, preparing to spin off its consumer health segment into a stand-alone company so it can focus more intently on its pharmaceutical and medical device lines of business.

Teaming up with one of the country’s largest health care providers — HCA operates 182 hospitals and approximately 2,300 ambulatory sites of care — could be a shrewd move for J&J. HCA says it uses data for more than 35 million annual patient encounters to improve care. Theoretically, J&J will gain access to at least some of that data through the collaboration, which it can then use to inform the development of new drugs and medical devices.

The partnership could also benefit J&J by giving the company an implicit preferred status with HCA. We’re not saying that HCA would purposely choose J&J’s drugs and medical devices over a competitor’s, but let’s face it — if you already have a relationship with a business that can provide what you need, how much effort are you going to put into shopping around elsewhere, especially if the cost is on par?

J&J has taken some hits to its reputation (and its bottom line) over the last few years. Among them are adverse rulings in lawsuits pertaining to the company’s pelvic mesh and talc-based baby powder products. Bloomberg just reported on Friday that J&J intends to stop selling its legacy baby powder products globally next year; the company pulled those products from the U.S. market in 2020.

There’s also the updated recommendations from the Centers for Disease Control and Prevention in December that placed J&J’s COVID-19 vaccine second in line after the mRNA vaccines by Pfizer-BioNTech and Moderna because of the increased risk of rare but severe blood clots associated with J&J’s vaccine. Although sales of J&J’s vaccine are increasing elsewhere in the world, demand has dropped here in the U.S., leading to lower-than-expected sales for the last two quarters.

J&J could use some good press to bolster its image in the public eye. The collaboration with HCA may provide that. Or, it may just be an opportunity for J&J and HCA to do some good work together.

“No one company can solve society’s most pressing health challenges alone — it takes collaboration,” Joaquin Duato, J&J’s CEO, said in HCA’s announcement of the partnership. “That’s why we’re working with HCA Healthcare to improve patient access and outcomes, address the nursing crisis, and advance health equity. We are united in our focus to improve patient care.”

Pharmaceutical manufacturers have been talking about “partnering” with hospitals and health systems for years. These efforts are typically brand-agnostic and either focus on education programs or population health collaborations. At Darwin, we’ve done extensive research on manufacturer-provider engagement for almost a decade, and the reality is that there is more talk than action when it comes to true partnerships. The latest initiative from J&J and HCA is multi-faceted and shows real promise of improving patient care.

Disclosure: Johnson & Johnson is a client of Darwin Research Group.

What else you need to know

Pfizer has agreed to acquire Global Blood Therapeutics (GBT), a biopharmaceutical firm based in South San Francisco, in a deal valued at approximately $5.4 billion. The two companies signed a definitive agreement in which Pfizer agreed to pay $68.50 per share in cash. GBT’s Oxbryta (voxelotor) received FDA approval in 2019 as a first-in-class treatment for sickle cell disease, and the firm has additional sickle cell drug candidates in its pipeline. The boards of both companies approved the transaction, which is subject to regulatory approval, GBT shareholder approval, and other closing conditions. GBT noted in an SEC filing that the deal could close as soon as the fourth quarter. If GBT were to receive a better offer and back out of the agreement, it would have to pay Pfizer a $217 million termination fee. If, however, the acquisition cannot be completed because of antitrust issues, then Pfizer will pay GBT a $326 million reverse termination fee.

A federal judge approved the $2.67 billion antitrust settlement in a lawsuit against the Blue Cross Blue Shield Association and affiliated companies. In the original class-action lawsuit, which was filed in 2012, the plaintiffs alleged that Blues plans split geographic areas to avoid directly competing with each other, resulting in higher prices for employers and plan members. In addition to the amount that is to be distributed, the settlement agreement also stipulates changes in certain business practices — for example, large national employers can seek bids from two Blues plans rather than having to work with the plan that offers coverage where the employer is based. Some plaintiffs opted out of the settlement because of the fees the attorneys stand to collect. Those plaintiffs have a separate case, which is ongoing.

Cigna has launched Cigna Pathwell Specialty, a medical specialty drug management solution that CEO David Cordani referred to as “a new approach to specialty care” during a recent earnings call. According to the webpage, the solution includes a narrow network for specialty injected and infused drugs, paired with an in-network-only benefit plan option. During the prior authorization review, Cigna determines if the prescribing provider is in the Cigna Pathwell Specialty Network. If not, then a care management team works with the prescribing provider and the patient to choose an in-network option. While Pathwell Specialty is available only to Cigna’s commercial health plans for now, Cordani said the company plans to offer it to more groups in the months ahead.

Amazon Care is partnering with Ginger to offer additional behavioral health services to members. According to the Amazon Care behavioral health webpage, Amazon Care’s primary care providers treat common behavioral health concerns, and care coordinators refer patients who have acute to moderate concerns to in-network behavioral health providers when possible. Ginger’s services will be available as an optional add-on for employers who offer Amazon Care to their employees. Ginger provides on-demand visits with behavioral health coaches, licensed therapists, and psychiatrists. Specifics about the arrangement between Amazon Care and Ginger have not been disclosed. Ginger merged with Headspace last year, creating a company called Headspace Health.

Dr. Marc Harrison will step down as Intermountain Healthcare’s CEO and president this fall. A news release stated that he is leaving to run a new health care business for venture capital firm General Catalyst. Intermountain Healthcare and General Catalyst announced a collaboration in May to accelerate digital innovation and expand value-based care. At the time, Dr. Harrison said the collaboration could “help turbocharge the movement towards population health and value-based care by connecting [Intermountain] with a network of innovators outside the traditional health care space.” The health system’s board of directors intends to name an interim CEO while conducting a search for his successor. Dr. Harrison has led Intermountain since 2016.

What we’re reading
Addressing Well-being Throughout the Health Care Workforce: The Next Imperative. JAMA, 7.18.22 
Lessons From Five Years Of The CMS Accountable Health Communities Model. Health Affairs Forefront, 8.8.22
Can Amazon Remake Health Care? The Harvard Gazette, 8.10.22

What else we’re reading
Linked: How Everything is Connected to Everything Else and What It Means for Business, Science, and Everyday Life by Albert-László Barabási. For those who want to be challenged during their summer beach reading, this page-turner (really!) on network science resonates powerfully following the COVID-19 pandemic. Parts of Linked feel dated — it was written before LinkedIn or Facebook — but it’s a good overview of network theory without all that nasty math.
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