Closing the Quality-Affordability Gap in Workplace Mental Health Presented by Medcity News

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Featured Story   Novartis Makes a Splash in a Hot Area for Cancer Drug R&D The deal Novartis is expanding its oncology pipeline by acquiring startup Myricx Bio for $1.1 billion up front and up to $400 million tied to the achievement of milestones. Oncology represents Novartis’s largest therapeutic area measured by revenue. The Myricx deal is the pharma company’s second cancer acquisition this year, following the purchase of Pikavation Therapeutics for $2 billion up front. What's different about these drugs Myricx is developing next-generation therapies in the class of medicines called antibody drug conjugates (ADCs). Such therapies are made by linking a toxic drug payload to a targeting antibody. Myricx’s ADCs use a novel payload that works by inhibiting NMT, an enzyme key to the growth and survival of cancer cells. That sets it apart from payloads used in ADCs from companies such as AstraZeneca, Daiichi Sankyo, GSK, Roche, and BioNTech. Why this matters ADCs offer the ability to deliver a targeted strike to tumors. But cancers can develop resistance to the payloads used by currently available ADCs. The toxicity of these drugs can also limit the dosing of such therapies. Novartis and Myricx contend that an NMT-inhibiting drug payload could address those limitations. Soundbite “ADCs have become an important part of cancer treatment, but there remains a clear need for new payload mechanisms to overcome resistance and expand their impact for patients,” said Fiona Marshall, president of biomedical research at Novartis. “Myricx Bio has developed a promising [NMT inhibitor] payload platform with a differentiated mechanism that could broaden the use of ADCs across multiple tumor settings.” —By Frank Vinluan Sponsored   Closing the Quality-Affordability Gap in Workplace Mental Health Presented by Medcity News In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable. Learn more Top Stories   Report Highlights Private Equity’s Lesser-Known Strategy: Nonprofit Joint Ventures The skinny It’s well known that private equity has drastically increased its presence in the healthcare industry, acquiring hospitals, physician practices and other providers. These acquisitions have received scrutiny following the bankruptcies of numerous health systems like Steward Health Care and Prospect Medical Holdings. But a new report from the Private Equity Stakeholder Project (PESP) details a lesser-known private equity strategy: joint ventures with nonprofit health systems. Nonprofit joint ventures PESP is a nonprofit focused on bringing transparency and accountability into the private equity industry. The organization explains in the report that joint ventures are when two or more parties create a single enterprise together for profit. Usually, the parties “each contribute something to the venture, including capital, labor, assets, skills, experience, or knowledge, and generally, a joint venture involves an agreement to form a joint venture, some form of joint control, and a way to share profits and losses,” the report states. Private equity firms are pursuing joint ventures because they allow them to expand into new markets, while benefiting from the reputation and relationships associated with nonprofit health systems. Joint ventures also allow private equity firms to share financial risk with nonprofit partners and continue to grow through partnerships that may have different regulatory requirements than traditional acquisitions. The findings PESP found that more than 500 healthcare facilities currently operate under nonprofit-private equity joint ventures. This is likely an undercount as the number is only based on publicly identifiable arrangements. These joint ventures include hospitals, inpatient rehabilitation, hospice, home health, behavioral health, ambulatory surgery centers, urgent care and other providers. In addition, 21.4% of private equity-owned hospitals are owned via joint venture arrangements with nonprofit health systems. — By Marissa Plescia Why Penn Medicine Is Deploying AI Agents for Patient Intake The skinny Penn Medicine teamed up with K Health to integrate the startup’s AI-powered patient intake tools into its virtual primary care service. The partners are tracking whether adding an AI "team member" into the patient-provider relationship can improve outcomes. K Health’s intake agents collect information from patients, such as current symptoms and details from their medical history, and then turn it into a structured summary that feeds directly into the clinician’s existing workflow. The technology helps patients figure out what kind of care they actually need before a visit, and it also benefits providers because they enter appointments already informed, explained Ran Shaul, K Health’s co-founder and chief product officer. Shaul compared the agent’s role to a medical resident. It gathers history, understands the complaint and then prepares the case — similar to how a resident presents a patient to an attending physician. The human clinician still makes the final decision, but the AI took care of the legwork beforehand, he said. The problem Penn is seeking to solve Dr. Mitchell Schnall, Penn’s senior vice president for data and technology solutions, said that the organization adopted K Health’s technology because it thought the agents could improve the experience for both patients and providers. “We anticipate the dynamic intake process will allow the provider to start the visit with important information at hand, and not burden the visit with as much information gathering. This is anticipated to provide additional time for the providers and patients to discuss management options and for a better quality visit,” Dr. Schnall stated. K Health’s other health system partners K Health’s agents are being used within similar virtual care programs at other health systems, including Cedars-Sinai, Mayo Clinic, Mass General Brigham and Hartford Healthcare, Shaul said. The underlying AI agent technology is the same across systems, though their use cases vary. Some health systems use it to attract new patients, and others deploy the technology to better serve populations lacking primary care access. — By Katie Adams Modernizing Program Integrity in Medicaid Self-Directed Care The issue Medicaid programs are in a period of heightened scrutiny, as states confront growing complexity in how these programs are administered and sustained. A recent Kaiser Family Foundation analysis highlights how states are grappling with rising program costs and tough tradeoffs, with total Medicaid spending projected to increase by 7.9% in FY 2026. In this environment, ensuring program integrity is no longer just about compliance, it’s central to sustaining access to care. Self-directed care Nowhere is that imperative more apparent than in self-directed care programs, where rapid growth and increased visibility have raised the stakes for getting oversight right. Too often, the conversation around program integrity is framed in terms of enforcement: audits, investigations, and clawbacks after the fact. But that model is increasingly out of step with how modern, scalable programs actually operate. Four key priorities To meet this moment, states must rethink how program integrity is designed and delivered by focusing on four key priorities that enable oversight to scale alongside these programs. The first priority is recognizing that program integrity cannot sit with a single team or function The second priority is reevaluating how core tools like Electronic Visit Verification (EVV) are used. EVV is often misunderstood as a mechanism for surveillance or enforcement. The third priority is strengthening eligibility verification as a proactive program integrity control. While it may not receive the same attention as other tools, eligibility plays a central role in preventing downstream issues. The fourth priority is embedding continuous monitoring into everyday operations. The most effective program integrity models are often the least visible because they prevent problems before they require intervention. — By MedCity Influencer Tara Himmel Video   Video: How Providers Help Patients Navigate Insurance Confusion Providers are spending a lot of time and resources hunting down reimbursement and helping patients navigate their coverage. Here’s more from Katie Adams at HFMA’s annual conference, where she spoke with James Lee, CFO of Multicare.

In Other News

The AI Playbook for Health Plans: 5 Steps for Leaders Who Don’t Know Where to Start It starts with a simple mindset shift, realizing that a successful AI journey begins with identifying a business problem, not with technology. The plans that make real progress embrace this mindset first then follow these five steps.  Closing the Quality-Affordability Gap in Workplace Mental Health [Sponsored] In an interview, Kyan Health Co-Founder and Chief Commercial Officer Konstantin Struck discussed how Kyan gives mid-market and enterprise employers access to premium workforce mental healthcare, at a price point that is affordable. AI in Mental Health: Why Clinicians Need to Be in the Room As clinicians, we learn not to be agreeable, we learn to challenge and sit in discomfort. We ask the hard questions underneath the one being asked. That is the work these tools are not yet built to do.

Podcast   MedCity Pivot Podcast: The Evolution of Palliative Care at Home In this month's pivot podcast, I speak to the chief medical officer of San Francisco-based Vynca, an innovative company in the world of palliative care that is providing serious disease management at home. View Now

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