Eating disorders often start at a younger age, but they don’t solely affect this population. Recognizing this, virtual eating disorder support company Equip announced Tuesday that it is now treating adults as well as adolescents. The company also announced an investment from General Catalyst, which helped expand its platform to adults. The amount was not disclosed.
“There is a very pervasive, really dense stereotype that eating disorders only affect 15- to 25-year-old thin, White girls,” said Dr. Erin Parks, chief clinical officer and co-founder of Equip, in an interview. “That is true, it does affect them. But it is not only them.”
She added that because so few people have access to treatment, many older adults have had their eating disorder for a very long time and need support.
San Diego-based Equip, which was founded in 2019, previously focused on those ages 6 to 24. The startup is now expanding to serve people of all ages. The virtual company operates in all 50 states and is in-network with several insurance companies, including Aetna, Elevance, Optum, Cigna and UnitedHealthcare. It connects patients with a care team that includes a therapist, dietitian, physician and peer and family mentor.
Different ages require different kinds of treatment, according to Parks. With its younger patients, the company uses family-based treatment, in which the family is brought in to help care for the patient. For adults, the company is using a method called enhanced cognitive behavioral therapy, which is a highly individualized treatment that addresses thoughts, feelings and behaviors affecting the patient’s eating disorder.
Parks said that when it comes to adults, individual treatment is often the best way to go because they may not have a support group. Sometimes when adults have been sick for a long time, they’ve “pushed away” a lot of their family and peers, or they may be too busy with work to build that support group.
There are other virtual solutions for eating disorders as well, including Arise and Within. Arise offers coaching with a care advocate who has lived experience with an eating disorder, therapy, nutrition counseling, group support and psychiatry. Within provides access to a care team that includes dietitians, therapists, nurses and peers.
The expansion to adults was powered by a recent investment by General Catalyst. In total, Equip has raised more than $75 million. With the funding, the company brought on a new president, Nikia Bergan. It also updated its technology and trained its providers in treating adults. In addition, it’s planning to use the funding to gain more Medicaid contracts, Parks said.
Equip considers itself an alternative to brick-and-mortar eating disorder treatments, which often require patients to stay at the treatment facility for a certain period. Parks said the benefit of a virtual program is that patients can be treated as they live their normal lives.
“[If you take] someone out of their life and give them a bunch of skills, then all of the sudden they plop back into their life and have all these triggers that they aren’t equipped to deal with,” Parks argued. “One of the great things about getting treatment while still being able to go to school, still being able to go to your job, still being able to parent your kids, is that you get to work with your providers on your real-life triggers as they come up.”
Parks is likely looking to replicate the positive results it claims to have achieved in the adolescent population in this new, adult population. In its annual outcomes report published earlier this year, the company cited that 81% of its adolescent patients reached or maintained their target weight within one year.
Photo credit: Bohdan Skrypnyk, Getty Images
The commercial market has been slower to adopt value-based care than the public market, but there are ways to move the process along successfully, executives said Monday.
During a panel at the Oliver Wyman Health Innovation Summit 2023 held in Chicago, healthcare leaders discussed the challenges and opportunities in advancing value-based care in commercial health plans. The panelists were Mark Hansberry, senior vice president and chief marketing officer of HealthPartners; Ellen Kelsay, president and CEO of Business Group on Health; and Tiffany Albert, senior vice president of health plan business at Blue Cross Blue Shield of Michigan.
Bloomington, Minnesota-based HealthPartners, which is an integrated healthcare organization serving more than 1.8 million members, has had some success with value-based care in the commercial space, Hansberry claimed. He shared five rules for scaling value-based care in the commercial market:
1. Payers and providers in a value-based arrangement need to have a shared understanding of what value is for patients, Hansberry said.
“You have to have a universal definition of what value means so that when clinicians look at you as a payer … they need to acknowledge that what you’re saying a clinical outcome is is actually a good clinical outcome, a good measure of performance,” he stated.
2. It’s important to ensure that the providers in the value-based arrangement are able to and willing to take the risk associated with value-based care.
“Most care systems weren’t built to actually manage risk,” Hansberry said. “That wasn’t their job. Their job was to take care of sick people. Now we’re asking them to do something else. How do you actually support those individuals on that journey?”
3. Payers need to support providers engaging in value-based care with “real-time, actionable data and consultation,” Hansberry said.
“It’s not just a data dump or a big Excel file that you pass over and you say good luck with it,” he stated. “Because, by the way, if they perform well in those value-based contracts, you do too as a payer. You want them to perform well. So you want to provide them with good, insightful, actionable data that’s risk-adjusted, that is connected to their practice — not just an amorphous health system — but to their practice so they can take action on those insights. But then you also want to supplement that with that consultation along the way.”
4. The incentives in the value-based contract must be aligned to “enable that [provider] to reap the benefits of the value that they’re creating for those members,” according to Hansberry.
5. Ultimately, a value-based contract comes down to trust between all the parties. But Hansberry noted that this is easier for HealthPartners as an integrated health system.
“We’re fortunate because we’re both a health plan and a care system,” he said.
He added that success in value-based care doesn’t happen overnight, which is partially why it’s difficult to scale.
“It takes time to build trust,” Hansberry stated.
Photo: atibodyphoto, Getty Images
BAXTER — Final plans for Whiskey Creek were approved by the Baxter City Council and the long anticipated project will go out for bids.
The initiative aims to take 13 acres of the former golf course around Whiskey Creek, which funnels roughly 400 acres of drainage from commercial properties, and transform it into a habitat of native plants and wildlife to clean up polluted water runoff before it reaches the Mississippi River.
flowing from the highly developed Highway 371 commercial strip as it moves through Whiskey Creek to the Mississippi River. The project, moving step by step, included the city getting the land around Whiskey Creek. Some of the most visible stretches of the creek are right along Excelsior Road and Cypress Drive where wildlife from Canada geese to great blue herons and egrets find a way to coexist right in the city.
The undeveloped land provides Baxter
improvement area to help clean contaminated water draining from the commercial area and do so with a blank canvas instead of trying to shoehorn something in an already developed location.
The 80-acre former golf course property, purchased by the Good Samaritan Society in 2013, includes the headwaters of Whiskey Creek. The golf course, which dated back into the 1920s, ceased operations at the end of the 2004 season. While plans have come and gone for the site, the land was largely left undisturbed.
Tuesday, June 20, HR Green Consultant Engineer Bridget Osborn went over the project’s final plans with the City Council. The project’s primary goal is to
, termed total suspended solids, which will also help the city meet the state’s requirements and secondarily treat total phosphorus in the stormwater runoff, which can increase algae growth and decrease dissolved oxygen.
“So the project goals overall are to reduce the total suspended solids or sediment, sand, everything in the water that kind of makes the water murky and gross,” Osborn said.
The MPCA has a total maximum load of suspended solids for the area.
This project is expected to account for 37% of Baxter’s total maximum daily load, which the MPCA describes as the maximum amount of pollutant a water body can receive without violating the water quality standards.
Osborn said the location is a great spot to be able to treat the water with one facility.
An example of what could be created for the Whiskey Creek work included high marsh and deep water areas, plants and trees. A diverse creek or wetland bed with higher and lower elevations beneath the water work to help clean the water.
Osborn said they wanted something different than just a big stormwater pond and created a stormwater weapon against pollution. It has a forebay, or a pool before the water flowing in gets to the wetland to allow a lot of the sand, dirt and crud to settle out first, Osborn said.
“And then having a more filtered water reached the other parts of the wetlands so that the water to be, you know, taken up by a lot of the plants in the area, and also trying to prevent a little of that green nastiness,” Osborn said of algae growth.
Water coming in from the west with a 66-inch pipe brings water from the commercial corridor. After filtering through the forebay and wetland, the water would arrive at a permanent pool, along the way the underwater topography would have varying depths. The plan includes a flood plain with some riprap areas designed to help slow the water before it moves out to the channel. The design is expected to remove 67,400 pounds of total suspended solids a year and 160.6 pounds of total commercial phosphorus a year. Dredging and maintaining the basis is needed to
The water will enter via the pipe exiting on the east side of Golf Course Drive into the forebay settling basin and move through a pipe under a berm into the manufactured wetland, which snakes along the property, varying depth and providing different habitat along the way as many nutrients are captured to clean the water as possible. The creek will then end in another little pool area before it exits out a pipe to let Whiskey Creek continue on its way. Work is being designed to limit disturbance of existing wetlands and to put a pipe in place as the Design Road project begins. There will be a trail and some concrete area by the forebay to allow it to be cleaned more easily.
The project is expected to cost $990,890, which includes a 15% contingency fund of $129,250.
Extra expenses, to stockpile earth removed for the project, for a 48-inch pipe, and a 15% contingency for the extra expenses, comes to $55,640 in separate project expenses.
Baxter and the Crow Wing Soils and Water Conservation District received a grant of $890,000 from the Board of Water and Soil Resources Clean Water Fund and $860,000 of that is designated for the city’s portion of construction.
Osborn said they realize costs right now are more than the grant, but they are waiting to see what bids come in. She said they are finding savings as Good Sam is allowing them to stockpile excavated earth on the site.
“We do have an alternative plan for a smaller stormwater wetland,” Osborn said in case they need to reduce costs even more as an option. For the city, the pipe with the Design Road project may be paid for from a different funding source.
Recent earth-moving work on the former golf course was to remove mercury contaminated soil found on the site. Good Samaritan was cleaning up that soil around former tee boxes.
The council voted in favor of plans and ordered advertising for bids for the project. Mayor Darrel Olson was absent.
Renee Richardson, managing editor, may be reached at 218-855-5852 or firstname.lastname@example.org. Follow on Twitter at @DispatchBizBuzz.
I had to do a double-take the other day when I saw a video about Minnesota and all the amazing ways we can explore it. Basically, it was a commercial for the land of 10,000 lakes. We know our lakes are awesome and the Northern shoreline is breathtaking but I did a double-take because front and center in the video were a few popular spots in Southeast Minnesota.
Four Popular Spots in Rochester, Minnesota Featured in Latest Minnesota Commerical
I had a proud mom moment this morning as I saw, front and center, my town featured not just once, but 4 times in a commercial showcasing Minnesota. Yes, Rochester gets some of the “favorite child” type of recognition in the state because of Mayo Clinic but there is a lot more going on in this area than just scrubs and great medical care. In fact, the latest commercial made by Explore Minnesota is showing off some of those “other” parts of the Rochester community.
It’s really cool because not just one but FOUR spots in Rochester are front and center in the latest Explore Minnesota commercial including the following:
- One of Rochester’s newer downtown restaurants that features an amazing patio, delicious Thai food, and specialty cocktails that many in the Med City seem to love.
- This historic hotel was built in 1921 and was established as an upscale hotel but also had floors for Mayo Clinic Hospital. According to their website, The Kahler Grand Hotel has a proud legacy and “is all about making every guest experience memorable”. They have been hosts to many dignitaries including several United States Presidents.
Threshold Arts at 311 Broadway Ave. South in Rochester (Get Directions Here) and at the Historic Chateau Theater located at 15 1st Ave. SW in Rochester
- This is a community arts organization that has a storefront with items from 70 featured artists, and help make connections in the community for artists to showcase their talent and provide vibrant spaces. Read more about their vision and ways to collaborate on the Threshold Arts website here.
- Home of Social-ICE, where some of Thursdays Downtown happens, free fitness classes, and surrounded by great hotels, shops, and restaurants, the Peace Plaza is what some call the “Heart of the City”.
Watch The New Explore Minnesota Commercial Featuring 4 Rochester Locations (VIDEO)
If you haven’t had a chance to watch the video yet, just click on it below. Pay attention and see if you can catch all of the featured Rochester spots.
What other parts of Rochester do you think the commercial should have featured?
Personally, I think it would have been amazing if one of our local breweries was featured. We have quite a few and they are all so unique – from the penny tables at Forager to the fun food trucks and outdoor games that are available at several of the other spots.
It’s a Minnesota Bucket List! 50 Things You Must Do and See in Minnesota
The land of 10,000 lakes has so many amazing places to visit and explore! Scroll through this Minnesota Bucket List of 50 places and things to do and see how many you’ve crossed off the list.
BRAINERD — Crow Wing County announced an environmental assessment worksheet has been prepared for the development of 16.56 acres of land in Crow Wing County for a 71-unit cold storage facility.
The proposed project would be located at the old drive-in movie theater location north of Brainerd on Hartley Lake. The proposed project would also include a clubhouse, wash bay, stormwater catchment basins, and associated amenities located in the First Assessment District.
An environmental assessment worksheet is a document that is designed to set out the basic facts necessary to determine whether an environmental impact statement is required for a proposed action. The purpose of the environmental assessment worksheet process is to disclose information about potential environmental impacts of a project. The worksheet contains 20 questions focusing on the project’s environmental setting, the potential for environmental harm, and plans to reduce the harm.
Public comments on the environmental assessment worksheet should be submitted in writing to:
or mailed to: Crow Wing County Land Services Department Attn: EAW, 322 Laurel Street, Suite 15, Brainerd, MN 56401.
The public can review a copy of the environmental assessment worksheet at the Crow Wing County Land Services Building or at the County website at
Comments must be submitted to Crow Wing County by 5 p.m. July 5. The Crow Wing County Board of Commissioners will decide on the need for an environmental impact statement at its regularly scheduled County Board meeting on July 11.
Contact the Land Services Office at 218-824-1010 or email
to discuss land use activities. Crow Wing County information and resources can be found at
It’s no secret that hospitals and health systems have been facing severe financial woes in the past couple years. These money problems have forced many providers to make what they likely felt were tough but necessary choices — such as shuttering underperforming service lines, laying off staff and using debt collection agencies to obtain payment from patients.
Some of these tactics have even invited negative scrutiny
. However, a new report argued that commercial payers should shoulder some of the blame when it comes to how hospitals are managing their dire financial circumstances.
Compared to government payers, commercial payers take significantly longer to pay hospitals and deny claims at a higher frequency — often without a justifiable reason to do so — according to the report published by consulting firm Crowe. These delays mean that hospitals are waiting longer than they need to receive commercial payments — during a time when they need cash flow to be expedited, not needlessly delayed, the report said.
Crowe analyzed data from the more than 1,800 hospitals that use its revenue cycle analytics platform and found that about 45% of a typical hospital’s patient population is covered by a commercial health insurance carrier.
Commercially insured patients have conventionally been thought of as hospitals’ preferred population. This is because hospitals can negotiate prices with commercial payers, and these payers usually pay higher rates than government payers like Medicare and Medicaid. For the average net revenue per inpatient case, commercial plans pay $18,156.50 compared to $14,887.10 from Medicare. For outpatients, commercial plans pay $1,606.86 for the average patient case, compared to $707.30 paid by Medicare.
Reimbursement rates may be higher among commercial payers, but getting them to pay in a timely manner is an entirely different story, per the report. During the first quarter of this year, commercial payers initially denied 15.1% of inpatient and outpatient claims compared to 3.9% for Medicare over the same period, according to the report.
Crowe analyzed the claim denial category of prior authorization and precertification denials. These occur when a payer denies a claim based on their decision that a provider did not get prior approval for care before it was delivered or that the care rendered wasn’t necessary based on the patient’s medical diagnosis.
Last year, the prior authorization/precertification denial rate for inpatient claims among commercial payers was 2.8%, up from 2.4% in 2021. This rate increased to 3% during the first three months of 2023, but the denial rate for traditional Medicare was just 0.2% during the same period.
Another claim denial category that the report examined is the request for information (RFI). RFI denials happen when a payer decides not to process a claim because it is missing some type of required documentation, such as a signature or copy of the medical record. In this category, commercial payers’ denial rate is 12 times higher than Medicare, the report found.
Most of the claims that commercial payers deny eventually get paid. However, the administrative effort required for hospitals to turn an initially-denied claim into a payment costs a good deal of time and money — two things in short supply at hospitals
To obtain payment from a denied claim, a provider must investigate the claim, determine what they have to do to rectify the problem and resubmit the claim — a process that can take weeks — said Colleen Hall, the managing principal for Crowe’s healthcare consulting group, in a recent interview. This process creates “an aging accounts receivable situation” for the provider and delays them from receiving much-needed cash.
“There certainly are several for-profit insurers out there. I won’t name names, but I think that those for-profit entities are in direct conflict with the nonprofit hospitals. I don’t know what goes on in the for-profit payer side of things, but could there be actions that they’re deploying to delay payments? Potentially. There have certainly been denials that our clients, as providers, have to manage only to find were denied for no reason,” Hall declared.
In the first quarter of this year, about a third of the claims that providers submitted to commercial payers took more than three months to get paid, the report found.
It’s difficult for hospitals to gain steady financial footing when the payers that have the best reimbursement rates are holding onto a third of their claims payments for more than 90 days, Hall pointed out.
Photo: santima.studio, Getty Images
Geraldine Tyler, now 94, lost her one-bedroom condo in Minneapolis over $2,300 in unpaid taxes, plus interest and penalties. Hennepin County sold the apartment for $40,000 and kept every penny.
Tyler’s lawyers say the county violated constitutional protections against having property taken without “just compensation” and excessive fines. The Supreme Court, which hears arguments Wednesday, will decide.
Minnesota is among roughly a dozen states and the District of Columbia that allow local jurisdictions to keep the excess money, according to the Pacific Legal Foundation, which is representing Tyler at the Supreme Court.
At least 8,950 homes were sold because of unpaid taxes and the former owners received little or nothing in those states between 2014 and 2021, according to Pacific Legal, a not-for-profit public interest law firm focused on property rights.
Other states are: Alabama, Arizona, Colorado, Illinois, Maine, Massachusetts, Nebraska, New Jersey, New York, Oregon and South Dakota, the group said.
There has been no explanation about why Tyler stopped paying her property taxes when she moved from the condo, where she had lived since 1999, to an apartment building for older people in 2010. She moved for “health and safety” reasons, Pacific Legal said.
The county said in court papers that Tyler could have sold the property and kept whatever was left after paying off the mortgage and taxes, refinanced her mortgage to pay the tax bill or signed up for a tax payment plan.
Instead, she did nothing for five years, the county said, until after authorities followed state law and sold the condo. The county wrote: Tyler believes “the Constitution required the State to serve as her real estate agent, sell the property on her behalf, and write a check for the difference between the tax debt and the fair market value.”
Lower courts sided with the county before the justices agreed to step in.
Minnesota and a handful of states and government associations are backing the county, warning that a Supreme Court ruling could tie the hands of local governments that rely on property taxes.
But the bulk of support in court filings is with Tyler, including AARP, business groups, real estate interests and other people who have gone through experiences similar to hers.
A Massachusetts man described his ongoing fight with authorities over a tax bill of $900 on a property he says is worth at least $330,000 in a beach town on Cape Cod Bay. In a filing from New York, property tax attorney David Wilkes and legal services groups wrote that New York’s rules “excessively takes far more than what is due to the government and go well beyond an appropriate deterrent to those homeowners who would ignore a tax delinquency.”
The Biden administration told the court that Tyler’s claim that her property was taken without just compensation, in violation of the 5th amendment, is the stronger of her arguments. The justices should reject the claim that Minnesota’s law violates the 8th amendment’s prohibition on excessive fines, Solicitor General Elizabeth Prelogar wrote.
Not until 2019 did the Supreme Court rule that the “excessive fines” clause applied to the states as well as the federal government.
A decision in Tyler v. Hennepin County, Minnesota, 22-166, is expected by late June.
Oshi Health — a virtual care provider for patients with digestive disorders — announced its first contract with a commercial insurer on Thursday. The New York-based company has entered into a value-based contract that provides Aetna members with in-network access to its specialized treatment.
Founded in 2019, Oshi built a virtual-first care platform designed to help patients achieve lasting control over chronic digestive conditions. The company hires gastroenterologists, nurse practitioners, dieticians and GI-specialized behavioral healthcare providers to quickly reach a diagnosis and guide individualized treatment. Patients are also assigned a care coordinator, who can help them find in-network providers if they need services like a colonoscopy or endoscopy.
The startup prides itself on providing whole-person care, which includes often-neglected dietary and psychosocial interventions, Oshi CEO Sam Holliday said in a recent interview.
“Over the past decade, there’s been a recognition that many gastrointestinal disorders are actually triggered by the signaling between your gut and your brain. A whole class of GI conditions has actually been renamed as disorders of the gut-brain interaction, or DGBIs,” he explained. “Things like gut-directed cognitive behavioral therapy can really reframe patients’ thought patterns and dampen the brain signaling that causes their symptoms, making symptoms feel less severe.”
Dietary interventions and behavioral therapy are proven methods to alleviate GI patients’ symptoms, and they’re often more effective than medication, Holliday pointed out. But these services are rarely available to GI patients because they haven’t been reimbursed historically, he added.
That’s why these interventions are a core part of the care patients receive under Oshi’s new contract with Aetna.
“One of the challenges in GI is that there aren’t very good quality measures. Really, the main things we focus on as a country is getting people screened for colorectal cancer, But we don’t really have measures for what matters to patients, who are the people suffering. What we think is the best measure to use is symptom control,” Holliday explained.
The root cause of GI symptoms usually stems from dietary or behavioral health reasons, and traditional, medication-centric GI care does not address those underlying causes, he declared. Patients end up continually seeking care — and driving costs up — because their symptoms are still bothering them. Through Oshi’s value-based contract with Aetna, “the value aspect being measured is Oshi’s ability to reduce that utilization downstream,” Holliday said.
Oshi will measure its care teams’ ability to sustainably control patients’ symptoms through a mix of medication, dietary adjustments and gut-brain psychology interventions. The company will track metrics such as reductions in emergency department visits and patients’ reported symptoms.
“We get paid a certain amount as we’re providing the care. Then, if we’ve gotten to a good level of patient satisfaction, symptom control and reduced utilization at the end of the measurement period, we have a bonus opportunity. And if we don’t achieve certain levels, there is a downside,” Holliday explained.
Aetna shares in the upside if Oshi hits its goals, but the payer is protected against potential downside. If Oshi doesn’t achieve as good outcomes as the partners had hoped, Aetna won’t have to pay the startup the full amount for care, Holliday declared.
The partnership is in its first phase, meaning Aetna members can access Oshi’s services in the following six states: Florida, Maine, Massachusetts, Ohio, Pennsylvania and Texas.
Photo: TLFurrer, Getty Images
Paragonix Technologies — a company that launched in 2010 as a response to the lack of innovation in the donor organ preservation and transport process — closed a Series B funding round on Tuesday. The $24 million round was led by Signet Healthcare Partners.
The Cambridge, Massachusetts-based company provides transplant centers and organ procurement organizations (OPOs) with medical devices designed for the preservation and transportation of donor organs.
The traditional method of preservation requires the organ to be transported in a cooler of crushed ice. Due to unstable temperatures, many facilities that receive organs preserved in this manner report that they arrive frozen and damaged, said Paragonix CEO Lisa Anderson.
“Paragonix determined there was an opportunity for a more scientifically reproducible, measurable and reliable solution to transporting an organ from a donor to recipient,” she said. “We set out to create a new standard for organ preservation and transport that would provide the care and quality of handling commensurate with transporting such a valuable gift and improve patient outcomes worldwide.”
Paragonix’s devices are made from a series of interconnected systems that work together to provide a cool and sterile environment within a consistent range of 4-8° Celsius. The company sells three devices, each designed for a different organ (heart, lung and liver). All have been cleared by the Food and Drug Administration.
Each device works slightly differently based on specific user needs related to the organ type, Anderson said. For example, the heart preservation device has pouches filled with proprietary cooling solutions that keep the organ at optimal temperatures during transport. The heart is contained within a nested canister and is then housed in a wheeled shipper container that works to protect and insulate the inner contents.
All of Paragonix’s devices display the organ’s temperature while it is being transported. They also use bluetooth monitoring and tracking technology to allow surgeons to track the organ’s exact location throughout its journey, even in flight, Anderson pointed out.
Paragonix markets and sells its devices to transplant centers and OPOs across the U.S. and Europe. Last year, over one in five thoracic donor organs transplanted in the U.S. were preserved using a Paragonix device, Anderson declared. She also said that 19 out of the 30 largest U.S. heart transplant programs rely on Paragonix devices to safely preserve, track and transport organs to their intended recipients.
“Most other organ preservation devices are extremely complicated, labor intensive and require special personal or extensive training, while Paragonix’s devices are lightweight, user friendly, and a user can be trained in less than an hour,” she declared.
Anderson explained that her company’s main competition is the legacy way of transporting organs, as many organizations still receive damaged organs that were transported using the over-ice method. The medical industry needs to move away from this method of organ preservation because devices like the ones that Paragonix sells are clinically proven to improve patient outcomes and reduce the risk of post-surgical complications, she declared.
Picture: Getty Images, ThomasVogel