January 23, 2018


Vijay is Founder and CEO of PCYNE, a creative agency for
healthcare that creates and manages content for digital
displays within hospitals and pharmacies, which he founded
in 2011. Through digital signage and other mediums, PCYNE's
clients can disseminate information to staff and patients in
a simple, yet engaging manner.

Vijay is concurrently Creative Director of 986 Pharmacy,
which he founded in 2014. Early in his career, while still
earning his BS in Biochemistry from USC, in 2009, he
gravitated to the creative field, first as the President of
PKPromotions, then with marcom agencies Deutsch, as a
Creative Digital Assistant, and Bayard Advertising, as an
Account Executive. Post-graduation, he segued into his
serial entrepreneurial career as the Director of Sales for
Cyne Media, and Co-Founder and Creative Director of Newjoco.
Vijay has joined the Los Angeles Round Table.

  • 1/09 – Silicon Valley Round Table
  • 1/10 – San Francisco Round Table
  • 1/11 – East Bay Round Table
  • 1/18 – Sacramento Round Table
  • 1/19 – Los Angeles Round Table
  • 2/07 – Orange County Round Table


Everyone from politicians to 80% of
consumers have been complaining about high
drug prices. But at last, a group of
hospitals are actually doing something about

Like a frog in tepid water, generic drug prices have been slowly
rising for years. But, in October 2016, the frog jumped when the
American Hospital Association and Federation of American Hospitals
released a survey that gathered pricing data from 712 U.S. community
hospitals and two GPOs with several key findings, including:

  • Inpatient Drug Spending had increased on a per admission
    basis by 38.7% ($990/patient)
    between FY2013-15 – due to
    growth in unit price, not volume
  • Over 90% of Hospital Administrators Reported that Higher
    Drug Prices had a Moderate or Severe Impact on their Budgets
  • Inpatient Drug Spending Growth Eclipsed Retail
    Prescription Drug Spending Growth.

As Scott Knoer, chief pharmacy officer at the Cleveland Clinic,
said at the time of the survey's release, "With these drug prices so
far outpacing the consumer price index, hospitals are struggling to
come up with trade-offs to preserve access to affordable care for
our patients."

Obviously, some key decision makers read the report, took it
seriously, and now four nonprofit health systems – Intermountain
Healthcare, Ascension, SSM Health, and Trinity Health, which
together run over 300 hospitals
– are ready to start
manufacturing and marketing the generic drugs that have been
breaking their budgets. Intermountain, which is known for its
clinical cost accounting expertise, is leading the quartet of
hospitals in this newco. And, as the person responsible for leading
the initiative, Dan Lijenquist, VP of the enterprise initiative
office at Intermountain, said: the new nonprofit will set its own
prices, and will "understand our production costs really well" –
without having to report to Wall Street.

Already, clients – like the VA and other hospitals around the
country – are lining up to purchase the tablets, patches, and
sterile injectable medicines the group plans to make. And, hospitals
aren't the only ones ready to support this bold move:
philanthropists are also expressing their interest, according to
Liljenquist, "because they are interested in solving this problem."

Who isn't?

Percent Change in Key Pharmaceutical Prices/Unit
Used in Hospitals CY2013 to CY2015:



Proposal Would Allow Insurance Coverage that Doesn't Include
ACA's Mandatory Benefits

The Trump administration is proposing
changes that would let millions of small
businesses and the self-employed buy
health-insurance plans that don't comply
with all ACA requirements. The proposal
would allow businesses that share geography
or an industry in common to form an
association and sell members health policies
that are exempt from some of the health
law's requirements, according to a senior
Labor Department official. They would no
longer have to comply with an ACA rule that
they offer a mandatory array of benefits.
The senior official said there are
nondiscrimination provisions in the rule, a
draft of which was released last week, that
would prevent an association from
cherry-picking employers with healthy
workforces or charging higher premiums to
less-healthy people. An association couldn't
charge different premiums to different small
employers based on health factors, the
official said. The regulation wouldn't
preempt state law, the Labor Department
official said, adding that states still have
a critical role to play. Because every state
regulates insurance, an association that
sold plans in two states, for example, could
be subject to two different sets of rules. (,

Judge Dismisses Hospital Industry Suit that
Attempted to Stop Medicare Subsidy Cuts

A federal judge in Washington recently ruled
the Trump administration can make sharp cuts
to subsidies Medicare pays some hospitals
for pharmaceuticals, a blow to the American
Hospital Association and others fighting in
court and Congress to halt the reductions.
The hospital association and two other
healthcare trade groups had filed a lawsuit
against the Department of Health and Human
Services in an attempt to stop the cuts. But
U.S. District Judge Rudolph Contreras in
late December dismissed the case, saying the
plaintiffs cannot sue before exhausting
other avenues to challenge the cuts, as
required by law. Judge Contreras's ruling
means Medicare was able to proceed with the
cuts, scheduled to start January 1. The
administration estimates the cuts will
reduce annual drug spending by Medicare and
beneficiaries – who pick up some of the cost
of certain drugs – by about $1.6 billion.

The subsidy, called 340B, was first created more than two decades
ago and was expanded under the ACA. The program requires
pharmaceutical companies to sell some drugs at a steep discount to
hospitals and clinics that care for large numbers of low-income or
uninsured patients. Medicare has paid hospitals slightly more than
the average sales price for the drugs. Hospitals have argued the
difference helps pay for expanded services for patients. Medicare
will now slash what it pays hospitals eligible for the program,
under a new rule the administration released in November. Lower
Medicare subsidies would reduce hospitals' profit under the program,
but not eliminate it, the administration said as it issued a final
rule on the cuts. It also exempted some hospitals in the program
from the cut, allowing the more generous payments to continue for
some rural, children's and cancer hospitals, the administration
said. (,


Healthcare Has Become U.S.'s Largest Employer

In the last quarter, for the first time in
history, healthcare has surpassed
manufacturing and retail, the most
significant job engines of the 20th century,
to become the largest source of jobs in the
In 2000, there were 7 million more
workers in manufacturing than in healthcare.
At the beginning of the Great Recession
[~Dec. 2007], there were 2.4 million more
workers in retail than healthcare. In 2017,
healthcare surpassed both. There are several
drivers of the healthcare jobs boom. The
first is that Americans, as a group, are
getting older. By 2025, one-quarter of the
workforce will be older than 55. That share
will have doubled in just 30 years. The
graying of the nation will have widespread
economic and political implications, like
declining productivity and electoral
showdowns between a young, diverse workforce
and an older, whiter retirement bloc. But
the most obvious effect of an aging
country is that it needs more care – and
that means more workers.
healthcare is publicly subsidized, in
several ways. Most directly, the U.S. spends
hundreds of billions of dollars each year on
Medicare, Medicaid, and healthcare benefits
for government employees and veterans. More
subtly, the U.S. subsidizes private
insurance in several ways, including through
a tax break for employers that sponsor
healthcare. This public support makes
healthcare employment practically
invincible, even during the worst downturns.

Incredibly, healthcare employment increased
every month during the Great Recession [Dec.
2007 to June 2009].

Third, the two most destabilizing forces for labor in the last
generation have been globalization and automation. Together, they
have hurt manufacturing and retail by offshoring factories,
replacing human arms with robotic limbs, and dooming fusty
department stores. But healthcare is substantially resistant to
both. Recently, the growth in healthcare employment is stemming more
from administrative jobs than physician jobs. The number of
non-doctor workers in the health industry has exploded in the last
two decades.
The majority of these jobs aren't clinical roles,
they are mostly administrative and management jobs. This isn't the
end of healthcare's run; it's just the beginning. Of the 10 jobs
that the Bureau of Labor Statistics projects will see the fastest
percent growth in the next decade, five are in healthcare and
elderly assistance.
The two fastest-growing occupations –
personal-care aides and home-health aides – are projected to account
for one in every 10 new jobs
in that time. The entire
healthcare sector is projected to account for a third of all new


Alvaka Provides Insights on Power Management & Meltdown/Spectre
Cyber Threats

On January 30, Alvaka Networks will host a
Lunch & Learn session –
Power Management: Don't lose money to bad
, from 11:30 a.m. to 1 p.m., in
Irvine. Dan Coffman, CEO of UPS Protection,
will discuss how protecting the
infrastructure that your business relies on
can help prevent excessive costs due to
unforeseen power interruptions. With outages
being an unavoidable occurrence, it's
critical that companies get protection for
their systems. By being proactive in their
power protection needs, companies can save
money that would otherwise be spent on the
effects of power disturbances. Meanwhile,
Alvaka has published two blog posts:
Meltdown & Spectre: How to avoid the biggest
cyber threat in modern computing
"Are the risks from Meltdown and Spectre
overblown?" asks an IT professional.

(Oli Thordarson, Orange County)

207 East Memory Lane
Santa Ana, CA 92705

| Fax:
(714) 245-1428


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