Podcasts about hras

Send us a textPS. Whenever you're ready, here are some ways we can help with reducing your taxes... Ready to slash your tax bill? Schedule your free consultation and let's strategize your tax savings together! Book now at: https://www.prosperlcpa.com/apply Or, if you still need more time, here are some other ways to begin winning the tax game... Take our free Tax Planning Checklist & learn about what tax savings may be available for you in our minicourse at https://taxplanningchecklist.com  Tax planning isn't just for the wealthy—it's a vital strategy for people at all income levels that can accelerate the path to financial freedom through systematic wealth creation.• Tax savings are more valuable than income because they represent pure wealth creation without taxation• The tax code incentivizes certain behaviors regardless of income level, making strategies accessible to everyone• For middle-income earners and new entrepreneurs, tax savings can provide critical capital for growth and investment• Real client examples show how tax planning helped eliminate taxes and generate refunds for reinvestment• Don't let "zero tax" years go to waste—use them for Roth conversions and harvesting capital gains• Strategies like hiring family members, the Augusta rule, and HRAs can save tens of thousands without costing extra money• Solar panels and other energy investments can simultaneously reduce costs and create tax benefits• No fancy software or expensive advisors needed—educational resources make tax planning accessible• Every hour spent learning tax strategy typically yields higher ROI than hours worked at your regular job• Tax planning habits developed early create a powerful compound effect on long-term wealthVisit prosperalcpa.com/taxnavigator to learn about our accessible tax education resources designed to help everyday Americans take control of their tax situation.

In this episode, Alan Silver, President of Centene's ICHRA-focused Ambetter Health Solutions, joins the Jakob Emerson to discuss the rapid evolution of individual coverage HRAs, why large and small employers are embracing the model, and what it takes for insurers to succeed in this growing space.

In this episode, we break down how HRAs and HSAs work, their key advantages, and how they can complement each other to empower smarter employee healthcare decisions.Find us at https://www.bernieportal.com/hr-party-of-one/BerniePortal: The all-in-one HRIS that makes building a business & managing its people easy. http://bit.ly/2NEQ5QbWhat is an HRIS?https://www.bernieportal.com/hris/BernieU: Your free one-stop shop for compelling, convenient, and comprehensive HR training and courses that will keep you up-to-date on all things human resources. Approved for SHRM & HRCI recertification credit hours. Enroll today!https://www.bernieportal.com/bernieu/Join the HR Party of One Community!https://hubs.ly/Q02mNML90▬ Social Media ▬▬▬▬▬▬▬▬▬▬▬► LinkedIn: https://www.linkedin.com/company/bernieportal▬ Podcast▬▬▬▬▬▬▬▬▬▬▬▬► Apple Podcasts: https://podcasts.apple.com/us/podcast/hr-party-of-one/id1495233115► Spotify: https://open.spotify.com/show/5ViQkKdatT40DPLJkY2pgA► Amazon Music: https://music.amazon.com/podcasts/1874beb8-2a68-4310-8816-e704e6850995/HR-Party-of-One► iHeartRadio: https://www.iheart.com/podcast/269-hr-party-of-one-57127074/#► Pocket Casts: https://pca.st/o6e2auqq►RSS: https://feeds.captivate.fm/hrpartyofone/ ► Other: https://hrpartyofone.captivate.fm/listen#HR, #HumanResources, #HRTips, #HumanResourcesTips, #SmallBusiness, #HRPartyOfOne, #hsa, #hra

In this episode, Alan Silver, President of Centene's ICHRA-focused Ambetter Health Solutions, joins the Jakob Emerson to discuss the rapid evolution of individual coverage HRAs, why large and small employers are embracing the model, and what it takes for insurers to succeed in this growing space.

In this episode, Chase Cannon and Suzanne Spradley outline the latest proposed bill from the U.S. House of Representatives, potentially up for a vote in the coming weeks. Chase outlines a key element missing from the proposed bill ‒ caps, cuts, or elimination of the so-called employer tax exclusions for health insurance ‒ and explains why it's important for employer health plan sponsors. Chase and Suzanne spend the rest of the episode describing potential changes to HSAs and HRAs, including flexibility with HSA eligibility, increases on HSA contribution limits, and a new vehicle (called a “CHOICE arrangement”) for reimbursing an employee's individual policy premium.

Send us a textPS. Whenever you're ready, here are some ways we can help with reducing your taxes... Ready to slash your tax bill? Schedule your free consultation and let's strategize your tax savings together! Book now at: https://www.prosperlcpa.com/apply Or, if you still need more time, here are some other ways to begin winning the tax game...  Take our free Tax Planning Checklist & learn about what tax savings may be available for you in our minicourse at https://taxplanningchecklist.com  At the very least, get on our newsletter to gain access to free live events and exclusive insight you won't find anywhere else: https://www.prosperlcpa.com/newsletter-subscription Make the most of the available tax strategies for real estate investors and gain access to reliable guidance, expense templates and workpapers with our Essential Tax Planning for Real Estate Investors CourseWe explore powerful tax strategies involving HSAs and HRAs with Dan Pavic to transform medical expenses into significant tax benefits and wealth-building opportunities.• HSAs offer triple tax advantages: tax deduction for contributions, tax-free growth, and tax-free withdrawals for qualified expenses• Health Savings Accounts allow for investment opportunities and unlimited rollovers, making them effective wealth-building tools• Strategic HSA hack: pay medical expenses out-of-pocket, then reimburse yourself years later after funds have grown tax-free• HRAs provide unlimited reimbursement potential versus HSA's $7,000 annual contribution cap• Hiring your spouse creates a pathway for reimbursing family medical expenses through your business• C-Corporations offer unique advantages for health reimbursements due to owner/entity separation• You can combine HSAs and HRAs to maximize both unlimited deductions and tax-free growth• HRAs can serve as affordable alternatives to traditional health insurance for employees• Proper implementation requires formal documentation, compliant reimbursement procedures, and strategic entity structuringLearn more from Dan at: Dan.Pavek@tasconline.comGo to prosperlcpa.com/apply to explore how these strategies could fit your situation or email mark@prosperal.com for access to our upcoming workshop series on maximizing healthcare tax benefits.

In this episode, Council VP of Health Policy & Strategy Katie King sits down with Dave Kerrigan, founder and CEO of benefits solution aggregator BenefitPitch, to get his take on the trends driving brokers and employers to prioritize solutions that thread the needle on controlling costs and retaining employees. From AI in benefits to the growth of individual coverage HRAs, Kerrigan discusses which solutions are top of mind, which are falling out of favor, and where we might see the most trend growths in 2025.

In this episode of the Main Street Business Podcast, hosts Mark J. Kohler and Mat Sorensen break down the incredible tax advantages of Health Savings Accounts (HSAs). Learn how to save big with tax-deductible contributions, tax-free growth, and withdrawals for medical expenses, plus tips on FSAs, HRAs, and the IRA-to-HSA rollover strategy.Here are some of the highlights:Mark and Mat emphasize the importance of deducting 100% of health insurance premiums for self-employed individuals and S corporations.Reminder to use FSAs before the end of the year, including medical, co-pays, and dental expenses.An in-depth discussion on the ability to invest HSA funds in various assets, such as crypto, real estate, and small businesses.Explanation of the requirements for HSA qualifying plans, including high deductibles and out-of-pocket limits.HSAs do not require earned income for contributions, unlike IRAs and 401(k)s.Introduction to the HRA (Health Reimbursement Account) plan as an alternative for small business owners with high medical expenses.A strategy learned from the community, allowing S corporation owners to reduce FICA liability by having the corporation pay for HSAs. Grab my FREE Ultimate Tax Strategy Guide HERE! Are you ready to get certified in EVERY strategy I teach? Start your journey with a FREE 15-minute demo to explore the Main Street Tax Pro Certification. You don't want to miss this! Secure your tickets for the most significant tax & legal event of the year: Tax and Legal 360 Looking to connect with a rock star law firm? KKOS is only a click away! Check out our YOUTUBE Channel Here: https://www.youtube.com/markjkohler Craving more content? Check out my Instagram!

In this episode of The Move, host Larry Williams chats with Greg Gossett, Vice President of Client Success at Unlock Health, about the importance and impact of Health Risk Assessments (HRAs). Greg shares a personal story about how an HRA saved his father's life by identifying significant heart disease risk factors, which led to early intervention. They discuss how HRAs serve as personalized roadmaps that empower individuals to take control of their health by identifying risks and providing actionable recommendations. Additionally, they explore how HRAs can be effectively integrated into marketing strategies to generate high-quality leads and the importance of following up with participants to ensure seamless healthcare journeys. Greg also emphasizes best practices for data security and privacy, as well as emerging trends in the HRA space, including the role of AI and patient empowerment.

In episode 160, Coffey talks with Matt Morris about various health insurance options and strategies for employers, particularly small to medium-sized businesses. They discuss recent trends in health insurance cost increases; comparing traditional fully-insured plans to alternative funding methods; health savings accounts (HSAs) and health reimbursement arrangements (HRAs); level-funded and self-funded plans; captive insurance arrangements; reference-based pricing; the importance of employee education and communication; and criteria for selecting an insurance broker.Good Morning, HR is brought to you by Imperative—Bulletproof Background Checks. For more information about our commitment to quality and excellent customer service, visit us at https://imperativeinfo.com. If you are an HRCI or SHRM-certified professional, this episode of Good Morning, HR has been pre-approved for half a recertification credit. To obtain the recertification information for this episode, visit https://goodmorninghr.com. About our Guest:Matt is a Fort Worth native graduating from Aledo High School then Hardin-Simmons University where he obtained his BBA in Finance and Leadership, graduating with honors in 2002. He was a two-time NCAA All-American offensive lineman while working through college where he met his wife Sarah.  In 2006 Matt received his MBA from Texas Christian University while helping grow Gus Bates Insurance & Investments serving in operational, consulting, Team Lead and President roles from 2002-2020. In July of 2020 Gus Bates joined HUB in a very strategic move to merge 2 great offices within Fort Worth.  Matt then assumed the role of Area President and now leads the combined teams.  The HUB Fort Worth family is a passionate, energetic team with the guiding principle “Don't tell me how much you know, just show me how much you care.”  Matt leads by example.  He supports and encourages teams pushing themselves to “find the better way,” constantly.  He believes the "pursuit of excellence" is something that should never end!  Matt holds his Texas Life, Accident & Health, Texas Insurance Counselors, and Texas Property & Casualty licenses.  He also holds FINRA Series 7, Series 65, and Series 63 licenses, a Chartered Benefits Consultant Designation, among others.In his spare time, Matt enjoys spending time with his wife Sarah and two daughters, Lillian and Hannah.  As a family they enjoy anything outdoors, traveling, reading, coaching and competing in kids sports which often occupies their weekends.  They are active members of Christ Chapel Bible Church, part owners in the Aledo Volleyball Club, and Matt serves on numerous boards such as First Financial Bank's Advisory Board and Aledo's various Growth Committees, among others.Matt Morris can be reached at https://www.hubinternational.com/About Mike Coffey:Mike Coffey is an entrepreneur, human resources professional, licensed private investigator, and HR consultant.In 1999, he founded Imperative, a background investigations firm helping risk-averse companies make well-informed decisions about the people they involve in their business.Today, Imperative serves hundreds of businesses across the US and, through its PFC Caregiver & Household Screening brand, many more private estates, family offices, and personal service agencies.Mike has been recognized as an Entrepreneur of Excellence and has twice been named HR Professional of the Year. Additionally, Imperative has been named the Texas Association of Business' small business of the year and is accredited by the Professional Background Screening Association. Mike is a member of the Fort Worth chapter of the Entrepreneurs' Organization and volunteers with the SHRM Texas State Council.Mike maintains his certification as a Senior Professional in Human Resources (SPHR) through the HR Certification Institute. He is also a SHRM Senior Certified Professional (SHRM-SCP).Mike lives in Fort Worth with his very patient wife. He practices yoga and maintains a keto diet, about both of which he will gladly tell you way more than you want to know.Learning Objectives:1. Explore alternative funding methods like level-funded plans, self-funded plans, and captive arrangements to potentially reduce healthcare costs and increase flexibility.2. Implement effective employee communication strategies to educate staff about their health insurance options and the true costs of coverage.3. Evaluate insurance brokers based on their technological capabilities, customer service, and ability to provide ongoing education and support, rather than solely on premium rates.

In this episode of the Main Street Business Podcast, hosts Mark J. Kohler and Mat Sorensen unpack the advantages and disadvantages of putting your spouse on the payroll. They shed light on potential pitfalls, discuss savvy alternatives such as board roles and Roth IRAs, and highlight the benefits of Solo 401k contributions and HRAs.Here's what you can look forward to:Mark and Mat break down the common misconceptions about paying spouses.Additional payroll costs including FICA, Medicare, and unemployment taxes.The benefits of using board of directors/advisors roles for spouses.Outline of the advantages, including solo 401k contributions for spouses and maximizing retirement savings through payroll.Scenarios where spouses must be on payroll due to material participation.Ensuring compliance with tax laws and regulations. Are you ready to get certified in EVERY strategy I teach? Start your journey with a FREE 15-minute demo. You don't want to miss this! Secure your tickets for the most significant tax & legal event of the year: Tax and Legal 360 Curious what my new certification is all about? Learn More Looking to connect with a rock star law firm? KKOS is only a click away! Grab my FREE Ultimate Tax Strategy Guide HERE! Check out our YOUTUBE Channel Here: https://www.youtube.com/markjkohler Craving more content? Check out my Instagram!

On this episode of Ask Michelle, Michelle covers several health insurance topics such as PCORI fees, Section 1557 of the Affordable Care Act (ACA) and offers guidance on what to do if your organization's health plan experiences a data breach. Michelle answered questions regarding eligibility for health spending accounts under COBRA continuation, stand-alone HRAs for employees on spouse's plan, and employer reimbursement for individual plans. Curious about a compliance issue? Submit your questions to AskMichelle@imacorp.comand Michelle will answer them on the next episode.

In this episode of the ShiftShapers podcast, David Sloves, CEO of Nonstop Health, discusses the evolution and impact of Medical Expense Reimbursement Plans (MERPs) in the healthcare industry. He explains how MERPs differ from traditional health reimbursement arrangements (HRAs), HSAs, and FSAs by offering first-dollar coverage and customizable financial outcomes for both employers and employees. Sloves outlines the historical context of MERPs, their tax benefits, and how they aim to address the skyrocketing costs of healthcare and improve access to medical services. The conversation also covers the challenges of implementing MERPs, their role in enhancing employee satisfaction, recruitment, and retention, and the broader implications for the healthcare system in the United States. Through anecdotes and data, Sloves makes a case for MERPs as an ethical and effective solution to the current healthcare crisis.We wrap up by celebrating the successes of mission-driven companies in the healthcare industry, specifically how they've introduced advanced healthcare programs to employers. David Slove recounts overcoming initial skepticism and the strategies that led to significant financial benefits for clients, thanks to the MERP model. As we close, we reflect on the cascading impact of such inclusive healthcare initiatives. These efforts aren't just reshaping employee benefits—they're empowering businesses, stimulating the consulting community, and fostering a culture of retention and recruitment excellence from the heart of conservative states to the broader national arena.

Find out how HRAs work, are different from other medical savings options, and how to use one to dramatically cut the cost of healthcare and save more money.Money Girl is hosted by Laura Adams. A transcript is available at Simplecast.Have a money question? Send an email to money@quickanddirtytips.com or leave a voicemail at 302-365-0308.Find Money Girl on Facebook and Twitter, or subscribe to the newsletter for more personal finance tips.Money Girl is a part of Quick and Dirty Tips.Links: https://www.quickanddirtytips.com/https://www.quickanddirtytips.com/money-girl-newsletterhttps://www.facebook.com/MoneyGirlQDThttps://twitter.com/LauraAdamshttps://lauradadams.com/

ShownotesOn The Elephant in the Room podcast it has been my endeavour to spotlight leaders from the global majority. I recently had the privilege to speak with Taisha Nurse, Global Senior Director, Diversity Equity and Inclusion at McDermott. As a senior HR practitioner she has been responsible for building Centre's of Excellence across multiple geographies before moving to her current role in 2020. A role she loves the most and believes that her various experiences have prepared her to navigate the web of challenges and opportunities she faces in the course of her work.The focus of the conversation was on an industry well known for its lack of diversity, and to her her views a female leader on all things DEIB/A. We covered many interesting topics including

How the government, particularly the IRS, looks at exercise and diet versus weight loss drugs and other pharmaceuticals is discussed in this episode with Calley Means and Robert F. Kennedy Jr. Here is part of an official statement from the Internal Revenue Service website: WASHINGTON — Amid concerns about people being misled, the Internal Revenue Service recently reminded taxpayers and heath spending plan administrators that personal expenses for general health and wellness are not considered medical expenses under the tax law. This means personal expenses are not deductible or reimbursable under health flexible spending arrangements, health savings accounts, health reimbursement arrangements or medical savings accounts FSAs, HSAs, HRAs, and MSAs. This reminder is important because some companies are misrepresenting the circumstances under which food and wellness expenses can be paid or reimbursed under FSAs and other health spending plans. Some companies mistakenly claim that notes from doctors based merely on self-reported health information can convert non-medical food, wellness and exercise expenses into medical expenses, but this documentation actually doesn't. Such a note would not establish that an otherwise personal expense satisfies the requirement that it be related to a targeted diagnosis-specific activity or treatment; these types of personal expenses do not qualify as medical expenses. Full statement: https://www.irs.gov/newsroom/irs-alert-beware-of-companies-misrepresenting-nutrition-wellness-and-general-health-expenses-as-medical-care-for-fsas-hsas-hras-and-msas --- Send in a voice message: https://podcasters.spotify.com/pod/show/rfkjr/message

Health Reimbursement Arrangements, or HRAs, are a modern way for employers to provide health benefits to employees. Rather than a one-size-fits-all group plan — or leaving employees to cover all of the costs of the plan on their own — employers can now offer their employees a tax-free allowance to purchase benefits that meet their unique needs. Listen as we cover: [2:16] Balancing high cost & still providing for employees [5:53] A new benefits model & how to take advantage of it [8:18] What HRAs help solve for [10:30] How to know if HRAs are right for your specific situation [12:25] How to get started with an HRA & potential cost savings Copyright © 2023 ADP, Inc. All rights reserved. This content may not be distributed, reproduced, modified, sold or used without the written permission of ADP. The information is provided "as is" without any expressed or implied warranty, is based on generally accepted HR practices and is advisory in nature. This content is provided with the understanding that neither the presenters nor the writers are rendering legal advice or other professional services. Employers are encouraged to consult with legal counsel for advice regarding their organization's compliance with applicable laws. This material is current as of the date of this episode (November 2023).

Health insurance professionals who in the employer market are acutely aware of health reimbursement arrangements, commonly shortened to HRAs, and how they work. However, the world of individual coverage HRAs, or ICHRAs, is a relatively new form coverage that employers and brokers alike are still learning how to utilize effectively. On this week's episode of the Healthcare Happy Hour, sponsored by Remodel Health, NABIP's Dan Parker is joined by Justin Clemets co-founder and chief ICHRA officer, Travis Hall, VP of marketing, and John Staub, director of outreach, to discuss how ALEs can utilize ICHRAs, tailoring ICHRAs for various employee classes, broader potential of ICHRAs for different types of reimbursements, and how the Family Glitch fits into all this. Sponsored by Remodel Health

Dr. Tariq Arshad is the Senior Vice President and Chief Medical Officer at Qualigen Therapeutics, addressing multiple types of RAS-driven cancers. While researchers understand RAS's role in tumorgenesis and have identified which cancers are RAS-driven, RAS has been considered an undruggable target. With a pan-RAS approach inhibiting KRAS, HRAS and NRAS, the three isoforms of RAS, Qualigen is identifying drug candidates showing strong anti-tumor efficacy.    Tariq elaborates, "That was so difficult to do because when you look at the KRAS protein itself, it's a complicated, three-dimensional structure that constantly changes. The opening, or the aperture, where a small molecule can attach and inhibit the G12C moiety or specifically the cysteine amino acid, which is targeted by these inhibitors, it appears for a very, very short period of time. It's nothing short of a miracle of bioengineering, and specifically medicinal chemistry that we've been able to identify these inhibitors that can target that subcomponent, that very small aperture within the overall KRAS protein, without, as you're saying, impacting the function of the overall protein." "The field is moving towards understanding why this lack of durability exists and is trying to understand whether it's due to the emergence of other mutations, whether it's due to the emergence of wild-type RAS, or whether it's due to other factors. One of the theories that is emerging behind the emergence of this KRAS resistance is the fact that there are other RAS isoforms that exist in the same tumor. They allow a mechanism in which the tumorigenesis can bypass KRAS, even though it's inhibited, and signal into the cell to convert it into a cancer cell. It now becomes important for us to understand how we can address that potential mechanism of resistance." #QualigenInc #RAS #KRAS #RASDrivenCancer #Cancer  QualigenInc.com Download the transcript here

Dr. Tariq Arshad is the Senior Vice President and Chief Medical Officer at Qualigen Therapeutics, addressing multiple types of RAS-driven cancers. While researchers understand RAS's role in tumorgenesis and have identified which cancers are RAS-driven, RAS has been considered an undruggable target. With a pan-RAS approach inhibiting KRAS, HRAS and NRAS, the three isoforms of RAS, Qualigen is identifying drug candidates showing strong anti-tumor efficacy.    Tariq elaborates, "That was so difficult to do because when you look at the KRAS protein itself, it's a complicated, three-dimensional structure that constantly changes. The opening, or the aperture, where a small molecule can attach and inhibit the G12C moiety or specifically the cysteine amino acid, which is targeted by these inhibitors, it appears for a very, very short period of time. It's nothing short of a miracle of bioengineering, and specifically medicinal chemistry that we've been able to identify these inhibitors that can target that subcomponent, that very small aperture within the overall KRAS protein, without, as you're saying, impacting the function of the overall protein." "The field is moving towards understanding why this lack of durability exists and is trying to understand whether it's due to the emergence of other mutations, whether it's due to the emergence of wild-type RAS, or whether it's due to other factors. One of the theories that is emerging behind the emergence of this KRAS resistance is the fact that there are other RAS isoforms that exist in the same tumor. They allow a mechanism in which the tumorigenesis can bypass KRAS, even though it's inhibited, and signal into the cell to convert it into a cancer cell. It now becomes important for us to understand how we can address that potential mechanism of resistance." #QualigenInc #RAS #KRAS #RASDrivenCancer #Cancer  QualigenInc.com Listen to the podcast here

ICHRA Explained - Everything You Need to Know About Individual Coverage HRA's with Kyle Estep Self-Funded with Spencer, hosted by Spencer Smith, is a podcast for those looking to strategically navigate the complex landscape of health insurance. In this episode, Spencer speaks with guest Kyle Estep from Take Command Health. Kyle Estep is the VP of Growth for Take Command Health. Kyle spent 8 years of his career early on consulting for Deloitte, one of the top consulting firms in the world. He also spent a year in South Africa for Awethu, focused on identifying, developing, and investing in world-class entrepreneurs. He worked alongside the CEO & COO to launch the incubator in Johannesburg, South Africa. His insurance-specific career began at Oscar Health, which was based in New York, and he was hired to help launch their Texas business unit. Kyle built out the sales and distribution team there, helping them scale across the country. His time at Oscar initially led to meeting Jack Hooper, the CEO and Founder of Take Command Health, which offers HRAs for small business health insurance. Specifically, for this episode, we focused on the value of an ICHRA, also known as an Individual Coverage Health Reimbursement Account. An ICHRA is a way for an employer to give tax-free money to its employees so that they can find the health insurance plan that best suits their needs. ICHRAs allow an off-ramp for employers who no longer want to be tasked with managing the risk of a health plan on behalf of their employees, but who still want to provide them with financial support to purchase their desired plans. It is NOT fit for every situation and sometimes depends on the affordability and diversity of plans being offered on the individual market in that specific geographic location. This is where Take Command comes in, in not only consulting around the employer's goals but also analyzing what individual plans are available to benchmark against group health options the employer is quoting as well. In addition to this analysis, Take Command's special sauce is their service around the seamless transition to an ICHRA so that the members still feel supported by their employer. If you have ever wondered what an ICHRA was, what types of companies it works for, and how an employer goes about switching to this arrangement, then this is the episode for you! #SelfFunded #Deloitte #HealthInsurance #ConsumerProtection #ICHRA #Tax #ACA #IndividualMarket #SmallBusinesses #AffordableCareAct #TakeCommand #PublicPrivatePartnership #AdviserOptions --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support

A new research paper was published in Oncotarget's Volume 14 on March 24, 2023, entitled, “Polyisoprenylated cysteinyl amide inhibitors deplete singly polyisoprenylated monomeric G-proteins in lung and breast cancer cell lines.” Finding effective therapies against cancers driven by mutant and/or overexpressed hyperactive G-proteins remains an area of active research. Polyisoprenylated cysteinyl amide inhibitors (PCAIs) are agents that mimic the essential posttranslational modifications of G-proteins. It is hypothesized that PCAIs work as anticancer agents by disrupting polyisoprenylation-dependent functional interactions of the G-Proteins. In their new study, researchers Nada Tawfeeq, Jassy Mary S. Lazarte, Yonghao Jin, Matthew D. Gregory, and Nazarius S. Lamango from Florida A&M University College of Pharmacy Pharmaceutical Sciences and Imam Abdulrahman bin Faisal University tested this hypothesis by determining the effect of the PCAIs on the levels of RAS and related monomeric G-proteins. “To investigate the hypothesized anticancer mechanisms of the PCAIs through disruption of G-protein function, we checked the effects of the PCAIs on the G-protein levels in lung cancer (A549 and NCI-H1299) and breast cancer (MDA-MB-231 and MDA-MB-468) cell lines.” Following 48 hours of exposure, they found significant decreases in the levels of KRAS, RHOA, RAC1, and CDC42 ranging within 20–66% after NSL-YHJ-2-27 (5 μM) treatment in all four cell lines tested, A549, NCI-H1299, MDA-MB-231, and MDA-MB-468. However, no significant difference was observed on the G-protein, RAB5A. Interestingly, 38 and 44% decreases in the levels of the farnesylated and acylated NRAS were observed in the two breast cancer cell lines, MDA-MB-231, and MDA-MB-468, respectively, while HRAS levels showed a 36% decrease only in MDA-MB-468 cells. Moreover, after PCAIs treatment, migration, and invasion of A549 cells were inhibited by 72 and 70%, respectively while the levels of vinculin and fascin dropped by 33 and 43%, respectively. Their results show that PCAIs deplete the protein levels of some significant G-proteins which are known to be involved in the migration and invasion of cells (i.e., metastasis) such as RAC1, RHOA, and CDC42. These findings implicate the potential role of PCAIs as anticancer agents through their direct interaction with monomeric G-proteins. “The initial findings presented here indicate how PCAIs can be used as potent agents in developing new anticancer therapeutics, therefore, more extensive studies need to be done to elucidate on its potency. Although we cannot conclusively explain the exact mechanism of action of PCAIs on how they affect the levels of some G-proteins yet, but we can say that these PCAIs have the ability to affect the progression of cancer.” Research paper: DOI: https://doi.org/10.18632/oncotarget.28390 Correspondence to: Nazarius S. Lamango - nazarius.lamango@famu.edu Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords: PCAIs, G-proteins, KRAS, RHOA, RAC1 About Oncotarget Oncotarget is a primarily oncology-focused, peer-reviewed, open access journal. Papers are published continuously within yearly volumes in their final and complete form, and then quickly released to Pubmed. On September 15, 2022, Oncotarget was accepted again for indexing by MEDLINE. Oncotarget is now indexed by Medline/PubMed and PMC/PubMed. To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: SoundCloud - https://soundcloud.com/oncotarget Facebook - https://www.facebook.com/Oncotarget/ Twitter - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Media Contact MEDIA@IMPACTJOURNALS.COM 18009220957

ICHRA Explained - Everything You Need to Know About Individual Coverage HRA's with Kyle Estep Self-Funded with Spencer, hosted by Spencer Smith, is a podcast for those looking to strategically navigate the complex landscape of health insurance. In this episode, Spencer speaks with guest Kyle Estep from Take Command Health. Kyle Estep is the VP of Growth for Take Command Health. Kyle spent 8 years of his career early on consulting for Deloitte, one of the top consulting firms in the world. He also spent a year in South Africa for Awethu, focused on identifying, developing, and investing in world-class entrepreneurs. He worked alongside the CEO & COO to launch the incubator in Johannesburg, South Africa. His insurance-specific career began at Oscar Health, which was based in New York, and he was hired to help launch their Texas business unit. Kyle built out the sales and distribution team there, helping them scale across the country. His time at Oscar initially led to meeting Jack Hooper, the CEO and Founder of Take Command Health, which offers HRAs for small business health insurance. Specifically, for this episode, we focused on the value of an ICHRA, also known as an Individual Coverage Health Reimbursement Account. An ICHRA is a way for an employer to give tax-free money to its employees so that they can find the health insurance plan that best suits their needs. ICHRAs allow an off-ramp for employers who no longer want to be tasked with managing the risk of a health plan on behalf of their employees, but who still want to provide them with financial support to purchase their desired plans. It is NOT fit for every situation and sometimes depends on the affordability and diversity of plans being offered on the individual market in that specific geographic location. This is where Take Command comes in, in not only consulting around the employer's goals but also analyzing what individual plans are available to benchmark against group health options the employer is quoting as well. In addition to this analysis, Take Command's special sauce is their service around the seamless transition to an ICHRA so that the members still feel supported by their employer. If you have ever wondered what an ICHRA was, what types of companies it works for, and how an employer goes about switching to this arrangement, then this is the episode for you! #SelfFunded #Deloitte #HealthInsurance #ConsumerProtection #ICHRA #Tax #ACA #IndividualMarket #SmallBusinesses #AffordableCareAct #TakeCommand #PublicPrivatePartnership #AdviserOptions --- Support this podcast: https://podcasters.spotify.com/pod/show/spencer-harlan-smith/support

What challenges do product managers face in highly regulated industries like healthcare and finance? In this episode of the Product Thinking podcast, Melissa Perri speaks with Colin Anawaty about his journey to co-founding First Dollar and the challenges of navigating a highly regulated industry. Colin shares his insights on Health Savings Accounts (HSAs), the benefits of utilizing them, and why he thinks they should be more widely available to all Americans. He also discusses the importance of personal and career growth within startups, and the value of providing clear career paths to employees. He describes how First Dollar evolved into a platform, and how their focus on addressing healthcare inequities and tying together healthcare and finance can lead to incentivizing better outcomes for all.  Colin Anawaty is the Chief Product Officer of First Dollar, a health wallet platform that provides its services to plan administrators to help consumers utilize their health benefits more easily and effectively. Colin has over six years of experience in healthcare and previously worked in the prepaid industry. Before joining First Dollar, Colin worked at athenahealth, where he and Melissa first met. Colin is a product management expert with a strong focus on healthcare and finance and has a passion for helping people make the most of their healthcare benefits. Here are some ideas you'll hear Colin and Melissa discuss: Health Savings Accounts (HSAs) are a type of account created by the US government to make healthcare more affordable through pre-tax contributions. Unlike other benefits, such as FSAs and HRAs, HSAs can be kept even after leaving employment and can be invested for future use. Colin believes that HSAs should be more widely available to all Americans. The healthcare and finance industries are complex and highly regulated, and it can be challenging for product managers to become subject matter experts in both areas. Colin and his team learned about the industries by using resources such as industry experts and advisory boards, and they also hired people who had a mix of product management experience and expertise in either healthcare or finance. When hiring product managers for a startup, Colin looks for people who have the drive to learn and grow, and who have taken courses in product management. It's important to align product managers with the product lines they oversee and to focus on problem discovery and working with customers. Product managers need to be curious and open to learning about new things, especially when dealing with complexity. Formal training, subject matter experts, and nonprofit organizations can all help product managers get up to speed on regulations and compliance. Embedding security ops and compliance into the culture of a company can make it less scary and more manageable for everyone involved. Creating a consumer advisory board or incorporating customer engagement into terms of service can help companies navigate legal and compliance issues when trying to work directly with end users. Big companies prioritize change management and stability, while startups prioritize velocity and rapid iteration to achieve product-market fit. First Dollar started with a mission to help people shop for care but pivoted to become a platform for HSAs and FSAs. Resources: Colin Anawaty on LinkedIn | Twitter | Instagram  First Dollar

What challenges do product managers face in highly regulated industries like healthcare and finance? In this episode of the Product Thinking podcast, Melissa Perri speaks with Colin Anawaty about his journey to co-founding First Dollar and the challenges of navigating a highly regulated industry. Colin shares his insights on Health Savings Accounts (HSAs), the benefits of utilizing them, and why he thinks they should be more widely available to all Americans. He also discusses the importance of personal and career growth within startups, and the value of providing clear career paths to employees. He describes how First Dollar evolved into a platform, and how their focus on addressing healthcare inequities and tying together healthcare and finance can lead to incentivizing better outcomes for all.  Colin Anawaty is the Chief Product Officer of First Dollar, a health wallet platform that provides its services to plan administrators to help consumers utilize their health benefits more easily and effectively. Colin has over six years of experience in healthcare and previously worked in the prepaid industry. Before joining First Dollar, Colin worked at athenahealth, where he and Melissa first met. Colin is a product management expert with a strong focus on healthcare and finance and has a passion for helping people make the most of their healthcare benefits. Here are some ideas you'll hear Colin and Melissa discuss: Health Savings Accounts (HSAs) are a type of account created by the US government to make healthcare more affordable through pre-tax contributions. Unlike other benefits, such as FSAs and HRAs, HSAs can be kept even after leaving employment and can be invested for future use. Colin believes that HSAs should be more widely available to all Americans. The healthcare and finance industries are complex and highly regulated, and it can be challenging for product managers to become subject matter experts in both areas. Colin and his team learned about the industries by using resources such as industry experts and advisory boards, and they also hired people who had a mix of product management experience and expertise in either healthcare or finance. When hiring product managers for a startup, Colin looks for people who have the drive to learn and grow, and who have taken courses in product management. It's important to align product managers with the product lines they oversee and to focus on problem discovery and working with customers. Product managers need to be curious and open to learning about new things, especially when dealing with complexity. Formal training, subject matter experts, and nonprofit organizations can all help product managers get up to speed on regulations and compliance. Embedding security ops and compliance into the culture of a company can make it less scary and more manageable for everyone involved. Creating a consumer advisory board or incorporating customer engagement into terms of service can help companies navigate legal and compliance issues when trying to work directly with end users. Big companies prioritize change management and stability, while startups prioritize velocity and rapid iteration to achieve product-market fit. First Dollar started with a mission to help people shop for care but pivoted to become a platform for HSAs and FSAs. Resources: Colin Anawaty on LinkedIn | Twitter | Instagram  First Dollar

Listen in to Thomas's story this month, as he shares about being diagnosed with stage 4C medullary thyroid cancer in 2020 after having not been to the doctor in about 6 years. He shares about the difficult process of diagnosis, along with being told that he has metastasis in his spine/hips and that he has the HRAS mutation (which doctors have told him impact the ability for them to treat him). He is honest about continuing to have difficult emotional days, but has also found ways to cope with his diagnosis (he shares about finding others diagnosed with MTC, his support system, and cycling). He has plans to cycle across every US state before he dies, we are cheering for you Thomas!**Please be aware that Thomas shares in this episode about getting a bone biopsy without sedation (minutes 13:34-15:50).Please note: This podcast is unedited and represents the opinions, experiences and views of those speaking. Please consult your own medical doctor(s) or therapist for all matters involving your health and medical care.

Health insurance professionals, particularly those who work on the employer-sponsored end of things, are acutely aware of health reimbursement arrangements, or HRAs. But exactly how many and what types of employers are adopting and utilizing their HRAs? And what about the growth of other types of HRAs, including the relatively new individual coverage HRAs, or ICHRAS? On this week's episode of the Healthcare Happy Hour, we are joined by special guests Mark Mixer and Robin Paoli of the HRA Council to discuss the Council's inaugural report on growth trends for ICHRA and QSEHRA.

Health insurance professionals, particularly those who work on the employer-sponsored end of things, are acutely aware of health reimbursement arrangements, or HRAs. But exactly how many and what types of employers are adopting and utilizing their HRAs? And what about the growth of other types of HRAs, including the relatively new individual coverage HRAs, or ICHRAS? On this week's episode of the Healthcare Happy Hour, we are joined by special guests Mark Mixer and Robin Paoli of the HRA Council to discuss the Council's inaugural report on growth trends for ICHRA and QSEHRA.

Health insurance professionals, particularly those who work on the employer-sponsored end of things, are acutely aware of health reimbursement arrangements, or HRAs. But exactly how many and what types of employers are adopting and utilizing their HRAs? And what about the growth of other types of HRAs, including the relatively new individual coverage HRAs, or ICHRAS? On this week's episode of the Healthcare Happy Hour, we are joined by special guests Mark Mixer and Robin Paoli of the HRA Council to discuss the Council's inaugural report on growth trends for ICHRA and QSEHRA.

Dr. Vamsi Velcheti and Dr. Benjamin Neel, of the NYU Langone Perlmutter Cancer Center, and Dr. John Heymach, of MD Anderson Cancer Center, discuss new therapeutic approaches for KRAS-mutant lung cancers and therapy options for RAS-altered tumors.   TRANSCRIPT Dr. Vamsidhar Velcheti: Hello, I'm Dr. Vamsidhar Velcheti, your guest host for the ASCO Daily News podcast today. I'm the medical director of the Thoracic Oncology Program at Perlmutter Cancer Center at NYU Langone Health. I'm delighted to welcome two internationally renowned physician-scientists, Dr. John Heymach, the chair of Thoracic-Head & Neck Medical Oncology at the MD Anderson Cancer Center, and my colleague, Dr. Benjamin Neel, the director of the Perlmutter Cancer Center at NYU Langone Health, and professor of Medicine at NYU Grossman School of Medicine. So, we'll be discussing new therapeutic approaches today for KRAS-mutant lung cancers, and we will talk about emerging new targeted therapy options for RAS-altered tumors. Our full disclosures are available in the show notes, and the disclosures of all the guests of the podcast can be found on our transcript at: asco.org/podcast. Dr. Heymach and Dr. Neel, it's such a great pleasure to have you here for the podcast today. Dr. John Heymach: My pleasure to be here. Dr. Benjamin Neel: Same here. Dr. Vamsidhar Velcheti: Dr. Neel, let's start off with you. As you know, RAS oncogenes were first discovered nearly four decades ago. Why is RAS such a challenging therapeutic target? Why has it taken so long to develop therapeutic options for these patients? Dr. Benjamin Neel: Well, I think a good analogy is the difference between kinase inhibitors and RAS inhibitors. So, kinase inhibitors basically took advantage of an ATP-binding pocket that's present in all kinases, but is different from kinase to kinase, and can be accessed by small molecule inhibitors. So, the standard approach that one would've thought of taking, would be to go after the GTP-binding pocket. The only problem is that the affinity for binding GTP by KRAS is three to four orders of magnitude higher. So, actually getting inhibitors that are GTP-binding inhibitors is pretty much very difficult. And then, until recently, it was felt that RAS was a very flat molecule and there weren't any surfaces that you could stick a small molecule inhibitor in. So, from a variety of biochemical and medicinal-pharmacological reasons, RAS was thought to be impervious to small molecule development. But as is often the case, a singular and seminal insight from a scientist, Kevan Shokat, really broke the field open, and now there's a whole host of new approaches to trying to drug RAS. Dr. Vamsidhar Velcheti: So, Dr. Neel, can you describe those recent advances in drug design that have enabled these noble new treatments for KRAS-targeted therapies? Dr. Benjamin Neel: So, it starts actually with the recognition that for many years, people were going after the wrong RAS. And by the wrong RAS, the overwhelming majority of the earlier studies on the structure, and for that matter, the function of RAS centered on HRAS or Harvey RAS. We just mutated in some cancers, most prominently, bladder cancer, and head & neck cancer, but not on KRAS, which is the really major player in terms of oncogenes in human cancer. So, first of all, we were studying the wrong RAS. The second thing is that we were sort of thinking that all RAS mutants were the same. And even from the earliest days, back in the late eighties, it was pretty clear that there were different biochemical properties in all different RAS mutants. But this sort of got lost in the cause and in the intervening time, and as a result, people thought all RASes were the same and they were just studying mainly G12V and G12D, which are more difficult to drug. And then, the third and most fundamental insight was the idea of trying to take advantage of a particular mutation in KRAS, which is present in a large fraction of lung cancer patients, which is, KRAS G12C. So, that's a mutation of glycine 12 to cysteine and Kevan's really seminal study was to use a library of covalently adducting drugs, and try to find ways to tether a small molecule in close enough so that it could hit the cysteine. And what was really surprising was when they actually found the earliest hits with this strategy, which was actually based on some early work by Jim Wells at Sunesis in the early part of this century, they found that it was actually occupying the G12C state or the inactive state of RAS. And this actually hearkens back to what I said earlier about all RASes being the same. And in fact, what's been recently re-appreciated is that some RAS mutants, most notably, G12C, although they're impervious to the gap which converts the active form into the inactive form, they still have a certain amount of intrinsic ability to convert from the inactive form. And so, they always cycle into the inactive form at some slow rate, and that allows them to be accessed by these small molecules in the so-called Switch-II Pocket, and that enables them to position a warhead close enough to the cysteine residue to make a covalent adduct and inactivate the protein irreversibly. Scientists at a large number of pharmaceutical companies and also academic labs began to understand how to access various other pockets in RAS, and also even new strategies, taking advantage of presenting molecules to RAS on a chaperone protein. So, there's now a whole host of strategies; you have a sort of an embarrassment of riches from an impoverished environment that we started with prior to 2012. Dr. Vamsidhar Velcheti: Thank you, Dr. Neel. So, Dr. Heymach, lung cancer has been a poster child for personalized therapy, and we've had like a lot of FDA-approved agents for several molecularly-defined subsets of lung cancer. How clinically impactful is a recent approval of Sotoracib for patients with metastatic lung cancer? Dr. John Heymach: Yeah. Well, I don't think it's an exaggeration to say this is the biggest advance for targeted therapies for lung cancer since the initial discovery of EGFR inhibitors. And let me talk about that in a little more detail. You know, the way that lung cancer therapy, like a lot of other cancer therapies, has advanced is by targeting specific driver oncogenes. And as Dr. Neel mentioned before, tyrosine kinases are a large percentage of those oncogenes and we've gotten very good at targeting tyrosine kinases developing inhibitors. They all sort of fit into the same ATP pocket, or at least the vast majority of them now. There are some variations on that idea now like allosteric inhibitors. And so, the field has just got better and better. And so, for lung cancer, the field evolved from EGFR to ALK, to ROS1 RET fusions, MEK, and so forth. What they all have in common is, they're all tyrosine kinases. But the biggest oncogene, and it's about twice as big as EGFR mutation, are KRAS mutations. And as you mentioned, this isn't a tyrosine kinase. We never had an inhibitor. And the first one to show that it's targetable, to have the first drug that does this, is really such an important breakthrough. Because once the big breakthrough and the concept is there, the pharmaceutical companies in the field can be really good at improving and modulating that. And that's exactly what we see. So, from that original insight that led to the design of the first G12C inhibitors, now there's dozens, literally dozens of G12C inhibitors and all these other inhibitors based on similar concepts. So, the first one now to go into the clinic and be FDA-approved is Sotoracib. So, this again, as you've heard, is inhibitor G12C, and it's what we call an irreversible inhibitor. So, it fits into this pocket, and it covalently links with G12C. So, when it's linked, it's linked, it's not coming off. Now, the study that led to its FDA approval was called the CodeBreak 100 study. And this was led in part, by my colleague Ferdinandos Skoulidis, and was published in The New England Journal in the past year. And, you know, there they studied 126 patients, and I'll keep just a brief summary, these were all refractory lung cancer patients. They either had first-line therapy, most had both chemo and immunotherapy. The primary endpoint was objective response rate. And for the study, the objective response rate was 37%, the progression-free survival was 6.8 months, the overall survival was 12.5 months. Now you might say, well, 37%, that's not as good as an EGFR inhibitor or the others. Well, this is a much harder thing to inhibit. And you have to remember in this setting, the standard of care was docetaxel chemotherapy. And docetaxel usually has a response rate of about 10 to 13%, progression-free survival of about 3 months. So, to more than double that with a targeted drug and have a longer PFS really is a major advance. But it's clear, we've got to improve on this and I think combinations are going to be incredibly important now. There's a huge number of combination regimens now in testing. Dr. Vamsidhar Velcheti: Thank you, Dr. Heymach. So, Dr. Neel, just following up on that, unlike other targeted therapies in lung cancer, like EGFR, ALK, ROS, and RET, the G12C inhibitors appear to have somewhat modest, I mean, though, certainly better than docetaxel that Dr. Heymach was just talking about; why is it so hard to have more effective inhibitor of KRAS here? Is it due to the complex nature of RAS-mutant tumors? Or is it our approach for targeting RAS? Is it a drug-related problem, or is it the disease? Dr. Benjamin Neel: Well, the short answer is I think that's a theoretical discussion at this point and there isn't really good data to tell you, but I suspect it's a combination of those things. We'll see with the new RAS(ON) inhibitors, which seem to have deeper responses, even in animal models, if those actually work better in the clinic, then we'll know at least part of it was that we weren't hitting RAS hard enough, at least with the single agents. But I also think that it's highly likely that since KRAS-mutant tumors are enriched in smokers, and smokers have lots of mutations, that they are much more complex tumours, and therefore there's many more ways for them to escape. Dr. Vamsidhar Velcheti: Dr. Heymach, you want to weigh in on that? Dr. John Heymach: Yeah, I think that's right. I guess a couple of different ways to view it is the problem that the current inhibitors are not inhibiting the target well enough, you know, in which case we say we get better and better inhibitors will inhibit it more effectively, or maybe we're inhibiting it, but we're not shutting down all the downstream pathways or the feedback pathways that get turned on in response, in which case the path forward is going to be better combinations. Right now, I think the jury is still out, but I think the data supports that we can do better with better inhibitors, there's room to grow. But it is also going to be really important hitting these compensatory pathways that get turned on. I think it's going to be both, and it seems like KRAS may turn on more compensatory pathways earlier than things like EGFR or ALK2, you know, and I think it's going to be a great scientific question to figure out why that is. Dr. Vamsidhar Velcheti: Right. And just following up on that, Dr. Heymach, so, what do we know so far about primary and acquired resistance to KRAS G12C inhibitors? Dr. John Heymach: Yeah. Well, it's a great question, and we're still very early in understanding this. And here, if we decide to call it primary resistance - meaning you never respond in the first place, and acquired - meaning you respond and then become resistant, we're not sure why some tumors do respond and don't respond initially. Now, it's been known for a long time, tumors differ in what we call their KRAS-dependence. And in cell lines and in mouse models, when you study this in the lab, there are some models where if you block KRAS, those cells will die immediately. They are fully dependent. And there's other ones that become sort of independent and they don't really seem to care if you turn down KRAS, they've sort of moved on to other things they're dependent on. One way this can happen is with undergoing EMT where the cell sort of changes its dependencies. And EMT is probably a reason some of these tumors are resistant, to start with. It may also matter what else is mutated along with KRAS, what we call the co-mutations, the additional mutations that occur along with it. For example, it seems like if this gene KEAP1 is mutated, tumors don't respond as well, to begin with. Now, acquired resistance is something we are gaining some experience with. I can say in the beginning, we all knew there'd be resistance, we were all waiting to see it, and what we were really hoping for was the case like with first-generation inhibitors with EGFR, where there was one dominant mechanism. In the first-generation EGFR, we had one mutation; T790M, that was more than half the resistance. And then we could develop drugs for that. But unfortunately, that's not the case. It looks like the resistance mechanisms are very diverse, and lots of different pathways can get turned on. So, for acquired resistance, you can have additional KRAS mutations, like you can have a KRAS G12D or V, or some other allele, or G13, I didn't even realize were commonly mutated, like H95 or Y96 can get mutated as well. So, we might be able to inhibit with better inhibitors. But the more pressing problem is what we call bypass; when these other pathways get turned on. And for bypass, we know that the tumor can turn on MET with MET amplification, NRAS, BRAF, MAP kinase, and we just see a wide variety. So, it's clear to us there isn't going to be a single easy to target solution like there was for EGFR. This is going to be a long-term problem, and we're going to have to work on a lot of different solutions and get smarter about what we're doing. Dr. Vamsidhar Velcheti: Yeah. Thank you very much, Dr. Heymach. And Dr. Neel, just following up on that, so, what do you think our strategies should be or should look like while targeting KRAS-mutant tumors? Like, do we focus on better ways to inhibit RAS, or do we focus on personalized combination approaches based on various alterations or other biomarkers? Dr. Benjamin Neel: Yeah. Well, I'd like to step back a second and be provocative, and say that we've been doing targeted therapies, so to speak, for a long time, and it's absolutely clear that targeted therapies never cure. And so, I think we should ask the bigger question, "Why is it that targeted therapies never cure?" And I would start to conceive of an answer to that question by asking which therapies do cure. And the therapies that we know do cure are immune therapies, or it's therapies that generate durable immune response against the tumor. And the other therapies that we know that are therapies in some cases against some tumors, and radiation therapy in some cases against some tumors. Probably the only way that those actually converge on the first mechanism I said that cures tumors, which is generating a durable immune response. And so, the only way, in my view, it is to durably cure an evolving disease, like a cancer, is to have an army that can fight an evolving disease. And the only army I know of is the immune system. So, I think ultimately, what we need to do is understand in detail, how all of these different mutations that lead to cancer affect immune response and create targetable lesions in the immune response, and then how the drugs we'd give affect that. So, in the big picture, the 50,000-foot picture, that what we really need to spend more attention on, is understanding how the drugs we give and the mutations that are there in the first place affect immune response against the tumor, and ultimately try to develop strategies that somehow pick up an immune response against the tumor. Now in the short run, I think there's also lots of combination strategies that we can think of, John, you know, alluded to some of them earlier. I mean one way for the G12C inhibitors, getting better occupancy of the drug, and also blocking this so-called phenomenon of adaptive resistance, where you derepress the expression of receptor tyrosine kinases, and their ligands, and therefore bypass through normal RAS or upregulate G12C into the GTP state more, that can be attacked by combining, for example, with the SHIP2 inhibitor or a SOS inhibitor. Again, the issue there will be therapeutic index. Can we achieve that with a reasonable therapeutic index? Also in some cases, like not so much in lung cancer, but in colon cancer, it appears as if a single dominant receptor tyrosine kinase pathway, the EGF receptor pathway, is often the mechanism of adaptive resistance to RAS inhibitors, and so, combining a RAS inhibitor with an EGF receptor inhibitor is a reasonable strategy. And then of course, some of the strategies they're already getting at, what I just mentioned before, which is to try to combine RAS inhibitors with checkpoint inhibitors. I think that's an expected and understandable approach, but I think we need to get a lot more sophisticated about the tumor microenvironment, and how that's affecting the immune response. And it's not just going to be, you know, in most cases combining with a checkpoint inhibitor. I think we ought to stop using the term immunotherapy to refer to checkpoint inhibitors. Checkpoint inhibitors are one type of immunotherapy. We don't refer to antibiotics when we mean penicillin. Dr. Vamsidhar Velcheti: Dr. Heymach, as you know, like, there's a lot of discussion about the role of KRAS G12C inhibitors in the frontline setting. Do you envision these drugs are going to be positioning themselves in the frontline setting as a combination, or like as a single agent? Are there like a subset of patients perhaps where you would consider like a single agent up front? Dr. John Heymach: So, I think there's no question G12C inhibitors are moving to the first-line question. And the question is just how you get there. Now, the simplest and most straightforward approach is to say, “Well, we'll take our standard and one standard might be immunotherapy alone, a PD-1 inhibitor alone, or chemo with the PD-1 inhibitor, and just take the G12C inhibitor and put it right on top.” And that's a classic strategy that's followed. That may not be that simple. It's not obvious that these drugs will always work well together or will be tolerated together. So, I think that's still being worked out. Now, an alternative strategy is you could say, “Well, let's get a foot in a door in the first-line setting by finding where chemotherapy and immunotherapy don't work well, and pick that little subgroup.” There are some studies there using STK11-mutant tumors, and they don't respond well to immunotherapy and chemotherapy and say, “Well, let's pick that first.” And that's another strategy, but that's not to get it for everybody in the first-line setting. That's just to pick a little subgroup. Or we may develop KRAS G12C inhibitor combinations by themselves that are so effective they can beat the standard. So, what I think is going to happen is a couple things; I think they'll first be some little niches where it gets in there first. I think eventually, we'll figure out how to combine them with chemotherapy and immunotherapy so it goes on top. And then I think over time, we'll eventually develop just more effective, targeted combos where we can phase out the chemo, where the chemo goes to the back of the line, and this goes to the front of the line. Dr. Vamsidhar Velcheti: And Dr. Heymach, any thoughts on the perioperative setting and the adjuvant/neoadjuvant setting, do you think there's any role for these inhibitors in the future? Dr. John Heymach: Yeah, this is a really exciting space right now. And so that makes this a really challenging question because of how quickly things are moving. I'll just briefly recap for everybody. Until recently, adjuvant therapy was just chemotherapy after you resected a lung cancer. That was it. And it provided about a 5% benefit in terms of five-year disease-free survival. Well, then we had adjuvant immunotherapy, like atezolizumab, approved, then we had neoadjuvant chemo plus immunotherapy approved; that's a CheckMate 816. And just recently, the AEGEAN study, which I'm involved with, was announced to be a positive study. That's neoadjuvant plus adjuvant chemo plus immunotherapy. So now, if you say, well, how are you going to bring a G12C inhibitor in there? Well, you can envision a few different ways; if you can combine with chemo and immunotherapy, you could bring it up front and bring it afterwards, or you could just tack it in on the back, either with immunotherapy or by itself, if you gave neoadjuvant chemo plus immunotherapy first, what we call the CheckMate 816 regimen. So, it could fit in a variety of ways. I'll just say neoadjuvant is more appealing because you can measure the response and see how well it's working, and we in fact have a neoadjuvant study going. But the long-term benefit may really come from keeping the drug going afterwards to suppress microscopic metastatic disease. And that's what I believe is going to happen. I think you're going to need to stay on these drugs for a long while to keep that microscopic disease down. Dr. Vamsidhar Velcheti: Dr. Neel, any thoughts on novel agents in development beyond KRAS G12C inhibitors? Are there any agents or combinations that you'd be excited about? Dr. Benjamin Neel: Well, I think that the YAP/TAZ pathway inhibitors, the TEAD inhibitors in particular, are potentially promising. I mean, it seems as if the MAP kinase pathway and the GAPT pathway act in parallel. There's been multiple phases which suggest that YAP/TAZ reactivation can be a mechanism of sort of state-switching resistance. And so, I think those inhibitors are different than the standard PI3 kinase pathway inhibitor, PI3 kinase mTOR inhibitor, rapamycin. I also think as we've alluded to a couple of times, the jury's still out in the clinic, of course, but it'll be very exciting to see how this new set of RAS inhibitors works. The sort of Pan-RAS inhibitors, especially the ones that hit the GTP ON state. So, the G12C inhibitors and the initial preclinical G12D inhibitors that have been recorded, they all work by targeting the inactive state of RAS, the RAS-GDP state. And so, they can only work on mutants that cycle, at least somewhat, and they also don't seem to be as potent as targeting the GTP or active state of RAS. And so, at least the Rev meds compounds, which basically use cyclophilin, they basically adapt the mechanism that cyclosporine uses to inhibit calcineurin. They basically use the same kind of a strategy and build new drugs then that bind cyclophilin and present the drug in a way that can inhibit multiple forms of RAS. So, it'll be interesting to see if they are much more efficacious in a clinic as they appear to be in the lab, whether they can be tolerated. So, I think those are things to look out for. Dr. Vamsidhar Velcheti: Dr. Heymach? Dr. John Heymach: Yeah, I agree with that. I'm excited to see that set of compounds coming along. One of the interesting observations is that when you inhibit one KRAS allele like G12C, you get these other KRAS alleles commonly popping up. And it's a little -- I just want to pause for a second to comment on this, because this is a little different than EGFR. If you inhibit a classic mutation, you don't get multiple other separate EGFR alleles popping up. You may get a secondary mutation in cyst on the same protein, but you don't get other alleles. So, this is a little different biology, but I think the frequency that we're seeing all these other KRAS alleles pop up tells us, I think we're going to need some pan-KRAS type strategy as a partner for targeting the primary driver. So for example, a G12C inhibitor plus a pan-KRAS strategy to head off these other alleles that can be popping up. So, I think that's going to be probably a minimum building block that you start putting other things around. And by partnering an allele-specific inhibitor where you might be able to inhibit it a little more potently and irreversibly with a pan-KRAS, you may solve some of these problems at the therapeutic window. You can imagine KRAS is so important for so many different cells in your body that if you potently inhibit all KRAS in your body, bad things are likely to happen somewhere. But if you can potently inhibit the mutant allele and then dampen the other KRAS signaling that's popping up, it's more hopeful. Dr. Benjamin Neel: There is a mouse model study from Mariano Barbacid's lab, which suggests that postnatal, KRAS at least, complete inhibition is doable. So, you could take out KRAS postnatally and the mice are okay. Whether that translates to human of course, is not at all clear. And you still have the other RAS alleles, the HRAS, the NRAS that you'd still have to contend with. Dr. John Heymach: Yeah, it's an interesting lesson. We've shied away from a lot of targets we thought weren't feasible. I did a lot of my training with Judah Folkman who pioneered targeting angiogenesis. And I remember hearing this idea of blocking new blood vessels. I said, "Well, everyone is just going to have a heart attack and die." And it turns out you can do it. You have to do it carefully, and in the right way but you can separate malignant or oncogenic signaling from normal signaling in an adult, pretty reasonably in a lot of cases where you don't think you could. Dr. Vamsidhar Velcheti: All right. So, Dr. Neel, and Dr. Heymach, any final closing comments on the field of RAS-targeted therapies, you know, what can we hope for? What can patients hope for, let's say five years from now, what are we looking at? Dr. John Heymach: Well, I'll give my thoughts I guess first, from a clinical perspective, I think we're already seeing the outlines of an absolute explosion in targeting KRAS over the next five years. And I think there's a really good likelihood that this is going to be the major place where we see progress, at least in lung cancer, over these next five years. It's an example of a problem that just seemed insolvable for so long, and here I really want to acknowledge the sustained support for clinical research and laboratory research focused around RAS. You know, the NCI had specific RAS initiatives and we've had big team grants for KRAS, and it shows you it's worth these large-scale efforts because you never know when that breakthrough is going to happen. But sometimes it just takes, you know, opening that door a little bit and everybody can start rushing through. Well, I think for KRAS, the door has been opened and everybody is rushing through at a frantic rate right now. So, it's really exciting, and stay tuned. I think the landscape of RAS-targeting is going to look completely different five years from now. Dr. Benjamin Neel: So, I agree that the landscape will definitely look different five years from now, because it's reflective of stuff that's been in process for the last five years. And it takes about that long to come through. I want to make two comments; one of which is to slightly disagree with my friend, John, about these big initiatives. And I would point out that this RAS breakthrough did not come from a big initiative, it came from one scientist thinking about a problem uniquely in a different way. We need a basic science breakthrough, it almost always comes from a single lab person, thinking about a problem, often in isolation, in his own group. What big initiatives can help with is engineering problems. Once you've opened the door, and you want to know what the best way is to get around the house, then maybe big initiatives help. But I do think that there's been too much focus on the big team initiative and not enough on the individual scientists who often promote the breakthrough. And then in terms of where I see the field going, what I'd really like to see, and I think in some pharmaceutical companies and biotechs, you're seeing this now, and also in academia, but maybe not enough, is that sort of breaking down of the silos between immunotherapy and targeting therapy. Because I agree with what John said, is that targeted therapy, is just sophisticated debulking. If we want to really make progress-- and on the other hand, immunotherapy people don't seem to, you know, often recognize that these oncogenic mutations in the tumor actually affect the immune system. So, I think what we need is a unification of these two semi-disparate areas of therapeutics in a more fulsome haul and that will advance things much quicker. Dr. Vamsidhar Velcheti: Thank you both, Dr. Neel and Dr. Heymach, for sharing all your valuable insights with us today on the ASCO Daily News podcast. We really appreciate it. Thank you so much. Dr. John Heymach: Thanks for asking us. Dr. Benjamin Neel: It's been great having us. Dr. Vamsidhar Velcheti: And thank you all to our listeners, and thanks for joining us today. If you value our insights that you hear on the ASCO Daily News podcast, please take a moment to rate, review and subscribe. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy, should not be construed as an ASCO endorsement. Follow today's speakers: Dr. Vamsi Velcheti @VamsiVelcheti Dr. Benjamin Neel @DrBenNeel Dr. John Heymach Want more related content? Listen to our podcast on novel therapies in lung cancer.    Advances in Lung Cancer at ASCO 2022 Follow ASCO on social media: @ASCO on Twitter ASCO on Facebook ASCO on LinkedIn Disclosures: Dr. Vamsi Velcheti: Honoraria: Honoraria Consulting or Advisory Role: Bristol-Myers Squibb, Merck, Foundation Medicine, AstraZeneca/MedImmune, Novartis, Lilly, EMD Serono, GSK, Amgen Research Funding (Inst.): Genentech, Trovagene, Eisai, OncoPlex Diagnostics, Alkermes, NantOmics, Genoptix, Altor BioScience, Merck, Bristol-Myers Squibb, Atreca, Heat Biologics, Leap Therapeutics, RSIP Vision, GlaxoSmithKline Dr. Benjamin Neel: None disclosed Dr. John Heymach: None disclosed    

In this episode, the Huddle Guys talk with Mark J. Kohler , a CPA, attorney, author, and podcast host. Mark is a Senior Partner at Kyler, Kohler, Ostermiller & Sorenson, LLP. He is also Fonder & CFO of Directed IRA, and a Senior Partner for Kohler & Eyre CPAs, LLP. Whew…when does Mark sleep?!? Listen as the Huddle Guys and Mark discuss ways to save on healthcare costs via Health Savings Accounts (HSAs) and Health Reimbursement Accounts (HRAs). In many regards, these are resources are underutilized tools; opportunities to save money are missed. They share information that is helpful to both tax preparer and tax payers. They also revisit topics related to the Inflation Reduction Act (IRA) which they believe will not save the average tax payer any money, especially if you are deemed to make too much money. (Checkout Episode 55 for more information about the IRA.) As usual, the Huddle Guys also have lots of fun with their guest, who also believes in the ‘mythical' Big Foot. Another first for this podcast! It's time to Huddle Up!

Medicare Advantage (MA), otherwise known as the “money machine,” is often the most profitable parts of many payers' business lines. Medicare Advantage plans can make a lot of cash if they are good at what they do. Look at any of these large, consolidated carriers' financial statements to get the magnitude of that statement. Also, in 2022, Medicare Advantage plans have enrolled 28 million participants between them, which represents 45% of all Medicare beneficiaries. This marks a three-point improvement in penetration over 2021 and a total program enrollment growth of 9%.   All of this is not a secret. So, what's happening right now is that this administration is looking carefully at Medicare Advantage plans and what they have been up to. We have had an amping up of government oversight, including regulatory actions and program audits. In this healthcare podcast, I am speaking with Betsy Seals, who is CEO and cofounder of Rebellis Group, which is a managed care consulting firm working with Medicare Advantage plans. Betsy says (and this is what we talk about in the interview) that there's three main areas that the government is currently scrutinizing: Sales and marketing. There have been these third parties, it seems, these field marketing organizations who were hired to do marketing and sales for some of the Medicare Advantage plans. And because they were third parties, it seems that many of them felt themselves to be excluded from CMS (Centers for Medicare & Medicaid Services) regulations and able to basically mislead prospective members with sales pitches that were highly suspect. Betsy gives some examples of these, and when you hear them, you will see why CMS is cracking down. Recouping improper payments is another area that CMS is all over. Interestingly, as Betsy Seals says in this interview, this might be one area where the government is actually ahead of private sector plans from a technology and analytic standpoint. CMS seems to have better analytics capabilities and is better at detecting fraud schemes and improper payments than the plans themselves. These plans are not sophisticated enough to notice stuff that CMS detects when it gets ahold of the plan data. But as unusual as this situation is where the government is ahead of the business sector, I can't say I'm shocked. We have had one guest on this show after another talking about just how far in the past some of these health plans are lagging. Dan O'Neill probably said it most eloquently and notably (EP359).   But I digress. So, recouping improper payments has the eye of CMS. This means two things largely. It means finding “outlier” codes that some MA plan paid for but which are clearly errors and should not have been paid. Another improper payment is when plans themselves do a little fancy upcoding so that they make more money than they should in their risk-adjustment payments. This has gotten some major attention lately. Let me quote from an OIG (Office of Inspector General) report:   “Our findings raise concerns about the extent to which certain MA companies may have inappropriately leveraged both chart reviews and HRAs [health risk assessments] to maximize risk-adjusted payments. We found that 20 of the 162 MA companies drove a disproportionate share of the $9.2 billion in payments from diagnoses that were reported only on chart reviews and HRAs, and on no other service records.” The sneaky idea here to get more money than they should from taxpayers is that someone somewhere puts down that a member has major depressive disease because someone somewhere said they did. But the patient clearly doesn't have major depressive disease because they aren't getting any treatment for it and nothing anywhere would indicate that they are suffering from a major depressive disease. So, the plan winds up getting more money from the government to care for a patient who is suffering from major depressive disease, but the patient doesn't require any additional care because they don't have major depressive disease. It's a great way to make some dollars for shareholders that is coming right out of the pockets of taxpayers. In sum, the #2 area of additional oversight is recouping improper payments either from paying claims that should not have been paid for or by wild upcoding. This is just kinda like the general sort of compliance oversight that CMS does, meaning grievances and appeals and formulary administration and models of care for SNP plans (special needs plans), compliance program effectiveness—normal stuff like this—which will be interesting given all of the articles coming out right now about how patients on Medicare Advantage plans are less likely to get more costly diabetes treatments and how often there's denials for cancer care or NCI cancer centers aren't covered, etc. One point of note here that's kind of thought-provoking on a few levels: If you're an MA plan, it is super important for you to get members in for their annual screenings. For one, CMS requires that you document diagnoses each year; and you need to do this to reduce the chances that CMS will question a treatment being paid for because there's no underlying diagnosis to support it—and these diagnoses must be re-upped every year. Recall what I was just talking about re: improper payments and fraud schemes. If a patient isn't diagnosed with something, then why are taxpayers paying for its treatment? Also risk adjustment ... if you wanna upcode, it's not a bad idea to have a diagnosis documented in multiple different ways so that when the OIG/CMS/DOJ comes knocking, you can have your ducks in a row. Getting patients in for their annual screenings is how you can safely upcode. Further, one more reason why getting patients in for annual screenings matters to MA plans, member experience counts for an increasing piece of star ratings. Patients who never see their doctor and never interact with the plan don't usually give the plan they have nothing to do with stellar marks—and besides that, these members are tough to retain. Last big deal for an MA plan to get members in for their annual is this is when the doc gets into screening for care gaps, which is also part of star measures. All this about annual screenings is a bit of a sidebar, but it is kind of interesting to contemplate as we get into the conversation today about government oversight. (For a meme on this topic, check out this Tweet from Rik Renard.) My guest, as I mentioned earlier, is Betsy Seals. Listen to our conversation about how MA plans are in the hot seat right now. Later in the fall, Betsy will be coming back to talk about trends in the Medicare Advantage marketplace. You can learn more at rebellisgroup.com.   Betsy Seals is the CEO and cofounder of Rebellis Group, a consulting firm established to provide advisory and hands-on services to Medicare Advantage Organizations (MAOs) and their subcontractors. Betsy is a nationally recognized leader in the managed care industry with over 20 years of experience. Betsy brings to the table a solid mix of leadership and business acumen, as well as regulatory and strategic knowledge within the managed care landscape. Betsy's expertise is focused in the areas of mergers and acquisitions, compliance, sales and marketing, strategy, supplemental benefit landscape, innovative benefit design that address social determinants of health, and health plan operations. Prior to founding Rebellis Group, Betsy served as the chief consulting officer for Gorman Health Group (GHG). In this role, Betsy managed the Medicare consulting practice, including implementation of strategic initiatives, development of new practice areas, and oversight of day-to-day consulting operations. Prior to her role as chief consulting officer, Betsy served as senior vice president, compliance operations, where she assisted MAOs and Part D sponsors to attain and maintain compliance with the Centers for Medicare & Medicaid Services (CMS) regulations and guidance by conducting risk assessments, preparing organizations for CMS audits, performing mock CMS audits, and creating and implementing internal and delegated entity oversight programs. Before joining GHG, Betsy worked for MAOs, where she served in customer service and compliance with responsibility for creation and implementation of oversight programs, CMS audit preparation, implementation of internal corrective action plans, and the day-to-day management of compliance operations. Betsy has also worked as a CMS subcontractor to conduct CMS Compliance Program audits. 08:15 What's happening with sales and marketing in the healthcare industry? 11:04 What's happening with the focus on recouping improper payments? 13:32 “When you look at the fundamentals of it, these are federal dollars. And what we're talking about is federal dollars that were paid when they should not have been paid.” 15:39 Are improper claim payments an administrative problem, or something more intentional? 16:20 “The health plan has a responsibility to catch those issues.” 20:10 What are specialty pharmacy prescriptions being scrutinized for? 22:12 “If this is where CMS is headed … the health plan should've already been doing this.” 23:58 Why do you see a bigger focus on social determinants of health? 25:54 Do these health plan audits actually have any teeth? 27:01 What is the biggest penalty a health plan can face from an audit? 29:57 “Navigating the Medicare program … was near to impossible. I know the program, and even for me, it was hours and hours and hours and hours on the phone.” You can learn more at rebellisgroup.com.   @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth What's happening with sales and marketing in the healthcare industry? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth What's happening with the focus on recouping improper payments? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth “When you look at the fundamentals of it, these are federal dollars. And what we're talking about is federal dollars that were paid when they should not have been paid.” @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth Are improper claim payments an administrative problem, or something more intentional? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth “The health plan has a responsibility to catch those issues.” @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth What are specialty pharmacy prescriptions being scrutinized for? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth “If this is where CMS is headed … the health plan should've already been doing this.” @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth Why do you see a bigger focus on social determinants of health? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth Do these health plan audits actually have any teeth? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth What is the biggest penalty a health plan can face from an audit? @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth “Navigating the Medicare program … was near to impossible. I know the program, and even for me, it was hours and hours and hours and hours on the phone.” @betsyseals of @GroupRebellis discusses #MedicareAdvantage plans on our #healthcarepodcast. #healthcare #podcast #digitalhealth   Recent past interviews: Click a guest's name for their latest RHV episode! Dave Chase, Cora Opsahl (EP373), Cora Opsahl (EP372), Dr Mark Fendrick (Encore! EP308), Erik Davis and Autumn Yongchu (EP371), Erik Davis and Autumn Yongchu (EP370), Keith Hartman, Dr Aaron Mitchell (Encore! EP282), Stacey Richter (INBW34), Ashleigh Gunter, Doug Hetherington, Dr Kevin Schulman, Scott Haas, David Muhlestein, David Scheinker, Ali Ucar, Dr Carly Eckert, Jeb Dunkelberger (EP360), Dan O'Neill, Dr Wayne Jenkins, Liliana Petrova, Ge Bai, Nikhil Krishnan, Shawn Rhodes, Pramod John (EP353), Pramod John (EP352), Dr Eric Bricker, Katy Talento  

Call them what you will... HRAs, Presenter Announcements, Live Reads are a vital part of commercial audio both in podcasting and radio. The connection between a host and their audience is often labelled as the medium's "super-power" because of its ability to deliver incredibly effective brand or commercial messaging. However, that super-power is only accessible if the host read messages that are delivered in an effective way. In this episode of Sound Business Jim Salveson speaks to two individuals who have great pedigree in delivering such content. Tim Cocker (Virgin Radio, Eggchasers Rugby Podcast) is a radio host and podcast producer who has well over a decade of experience in delivering host-read messages in both audio formats whilst Paul Sylvester (Absolute Radio) has many years in the industry working with brands and presenters on the implementation of commercial campaigns to ensure partners experience great results. You will hear some fantastic insight (from both sides of the microphone) into what makes a great host read and some of the considerations when planning a campaign, while also getting some practical tools that can help when delivering such content. You can find Paul on Twitter via @paulsylvester75 and Tim is @Cocker plus you can listen to Tim's Rugby podcast "Eggchasers" here: https://podfollow.com/703611884 For help with your audio strategy, you can contact the Voiceworks team via voicecworks.ai Learn more about your ad choices. Visit podcastchoices.com/adchoices

Little help, please! There is so much to unpack when it comes to deciding if reimbursement benefits are right for you – and which option to choose. Reimbursement benefits offset expenses by setting aside pre-tax funds to pay for account-eligible expenses. FSAs, HSAs, and HRAs have a lot of rules around them that can make a reimbursement account tricky to use. Jolene and Sara are joined by resident-expert Prisilla who helps us figure out what to ask HR or your plan administrator so we can all use our plans better.

Every organization wants to provide quality benefits to their staff, but when it comes to healthcare there are too many options! This week on The Balance, Amy speaks with benefits wizard Chuck Newman about navigating the sea of PEOs and HRAs to make the best choice for you and your team. Further Resources: Amy Karson - Chief Executive Officer, Brand K Partners https://www.brandkpartners.com/ Chuck Newman - President and Managing Partner, Charles Newman Co. https://www.charlesnewman.com/

This is a time of change for employee benefits. Mental health is getting much-needed attention. And with more employees working from home, inside-the-office games and events are no longer appealing. Employers are needing more flexibility in how they address benefits and employee wellness. Lifestyle spending accounts and wellness HRAs are two options employers can turn to. But which is the right one for you? We'll break down these two accounts.

This week's episode is sponsored by PeopleKeep, who helps businesses offer hassle-free health benefits to their employees. Angela is joined by JD Cleary, VP of Marketing Development at PeopleKeep, to discuss how the company can greatly help out businesses and their employees, how JD got started in his own career, and how he focuses.  Many employers cannot offer traditional group benefits because of their high, unpredictable cost; complexity to manage; and lack of employee choice. HRAs are a simple, cost-efficient way to provide health benefits to employees. Be sure to visit PeopleKeep.com today to get started with them for your own business!

¡Lo leiste bien! ¡Y no es magia! Es solo fruto de un trabajo en equipo bien hecho ✨ Toni empezó como muchos, veía a corredores de Trail hacer lo suyo en la montaña y la idea de correr bajo esa exigencia y ese entorno le atrajo muchísimo, pero no se creía capaz de hacerlo. Es así que decide probar, a pesar que correr no era algo que le gustaba mucho, era el año 2016. Ahí es cuando decide buscarme, por un asesoramiento personalizado. Pasó de entrenar de 16 a 20 horas a 5 ó 6 horas semanales y sigue mejorando pero de forma más eficiente. Lo digo todo el tiempo, NO es necesario sumar tantas horas para lograr esos resultados en una carrera. Hace unos días, Toni participó en la La Maratón Vielha-Molières 43K, 4.200 d+, una carrera exigente donde se llega a los 3010 mts y lo hizo en 9 horas 28 min. ¡Felicitaciones Toni!💪 Espero que esta charla sea la chispa motivadora para empezar a lograr nuestros sueños.💫 🔻🔻🔻🔻🔻🔻🔻🔻 ¿Te imaginas disfrutar más de tus entrenamientos? ¿Olvidarte de pensar de qué forma tienes que entrenar y solo enfocarte en que vas a mejorar? Si quieres saber más envíame un mensaje para ver cómo puedo ayudarte. ✔️ Envíame un WhatsApp https://wa.me/34644076372 ✔️ https://www.ximescanellas.com

Programa mais do que especial, entrevistando o secretário de Estado da Saúde, Fernando Ayres, sobre a histórica inauguração do Hospital Regional do Alto Sertão (HRAS), em Delmiro Gouveia.

The Oncology Journal Club - Delivering Oncology News DifferentlyThe Oncology Podcast, brought to you by Oncology News Australia, is proud to present Episode 34 in our series The Oncology Journal Club.This week we have another great episode for you in our usual format. Craig Underhill gets us started by talking us through primary tumour resection plus chemotherapy versus chemotherapy alone for metastatic colorectal cancer patients.Hans Prenen gets stuck into the use of tipifarnib in head and neck squamous cell carcinoma with HRAS mutations and Eva Segelov continues to guide us through what she calls a ‘manifesto for good study design' – a key paper from our friend Bishal Gyawali, addressing biases in study design that distort the appraisal of clinical benefit.Just a quick note – Eva started her analysis of this paper in last week's episode so I recommend listening to Episode 33 if you've not already. Today's quick bites are as diverse as ever covering estimates for cancer incidence and death to 2040, plasma cfDNA genotyping, the CROSS trial, targeting metabolism to enhance immunotherapy and an excellent paper by our friend Heidi Probst on the patient experience of radiotherapy for breast cancer. If you're not familiar with Heidi check out Episode 32 ‘When the Oncologist gets cancer'.With the usual top quality banter, papers you won't hear of anywhere else and expert analysis from our Hosts, you are in for another great episode of The Oncology Journal Club!Full bios and the list of all papers discussed are available on our website.For the latest oncology news visit www.oncologynews.com.au and for regular oncology updates for healthcare professionals, subscribe for free to get the weekly The Oncology Newsletter.The Oncology Podcast - An Australian Oncology Perspective

Hoy nos centramos en la investigación en cáncer y tenemos como invitado de lujo a Mariano Barbacid, investigador de referencia a nivel internacional y que cuenta con muchos logros, como haber aislado el oncogén humano HRAS en 1982. Podéis encontrar más información en la web del grupo que dirige: https://www.barbacidlab.es/ Nos ha contado diversas experiencias investigadoras y opiniones y algunos aspectos sobre cómo ha desarrollado su carrera, y entre otras cosas, algunas de las diferencias entre España y EEUU en cuanto a investigación en cáncer. También hemos hablado de su proyecto empresarial en Salamanca para desarrollar nuevos fármacos: https://www.lagacetadesalamanca.es/salamanca/barbacid-instala-su-empresa-en-salamanca-para-ponerla-en-el-epicentro-de-la-oncologia-EF7117776 y diversas opciones para conseguir financiación para investigación, entre sus logros también destaca haber conseguido dos veces la prestigiosa ERC grant: https://erc.europa.eu/ Os agradezco si dejáis aquí vuestra opinión, preguntas o comentarios sobre este episodio o sugerencias para próximos episodios ya sean temas o entrevistados: https://forms.gle/MAjcj3ErmJ3BquC56 Y aquí puedes acceder al resto de episodios del podcast: https://horacio-ps.com/podcast/ ¡Gracias! --- Send in a voice message: https://anchor.fm/horacio-ps/message

Bs episode is also available as a blog post: https://paylesstax.com/2021/03/26/tax-tip-podcast-blog-post-for-real-estate-professionals-protective-equipment-are-qualified-medical-expenses/ The following is the text of the podcast: Tax Tip Podcast or Blog Post for Real Estate Professionals with Protective Equipment being Qualified Medical Expenses IRS Announcement 2021-7 notifies taxpayers (including Realtors, Brokers, and Real Estate Professionals) amounts paid for personal protective equipment for the primary purpose of preventing the spread of the Coronavirus Disease 2019 are amounts paid for medical care under § 213(d) of the Internal Revenue Code. As a result, the announcement confirms that these amounts are qualified medical expenses eligible to be paid or reimbursed without being included in gross income under health flexible spending arrangements (health FSAs), Archer medical savings accounts (Archer MSAs), health reimbursement arrangements (HRAs), or health savings accounts (HSAs). In addition, the announcement notifies administrators of group health plans regarding the ability to make certain plan amendments pursuant to the announcement. Please contact the office of Don Fitch Accountancy at (760)567-3110 or Email Don.Fitch@CPA.com if you have any questions or would like additional information. DON FITCH, CPA 74478 Highway 111 #3 Palm Desert, CA 92260 Toll Free: (877)CPA-Help or (877)272-4357 Cell: (760)567-3110 Fax: (760)836-0968 Email: DonFitchCPA@paylesstax.com Website: https://www.paylesstax.com P.S. My firm is based upon referrals. Please feel free to refer my firm to anyone you know that is looking for a new CPA and/or tax preparer. Thank you in advance. --- Send in a voice message: https://anchor.fm/don-fitch/message

Depending on your state, open enrollment for health insurance runs from November 1st through December 15th.  Guest, Jesse Cheng from Take Command Health joins the show to share about using QSEHRAs (Qualified Small Employer Health Reimbursement Arrangements) and ICHRAs (Individual Coverage Health Reimbursement Arrangements) to provide tax-deductible benefits to employees in 2021 rather than trying to find + administering the right group health insurance plan for everyone in a company. HRAs do require some employer administration, but with the right platform this process becomes super easy. Learn the basics of using HRAs as a way to fund a specific dollar amounts of tax-deductible health benefits for people in your company.  Resources: Similar Interviews with Jack Hooper at Take Command Health HRA options for Small Business Owners - Start here

According to the UN Refugee Agency, some 40,000 people have attempted to cross from North Africa to Europe in 2020 alone, the size of this humanitarian crisis is further compounded when we learn that 400 of these migrants are reported to have lost their lives when making this dangerous journey.    The legal complexities of migrant rescue involves the application of international conventions and multi-jurisdictional and agency issues, all of which does nothing to alleviate the ship master's moral and legal obligation to respond to the plight of migrants when in distress at sea. It's in the DNA of those who work at sea, to save life at sea and in so doing, they often expose themselves, their vessels and their employers to safety, legal, security and commercial issues that can take time and money to resolve. In this podcast we will look at the legal and operational complexities of seaborne migrant rescue and we will point our listeners in the right direction to access freely available information, advice and support when caught in the crosshairs of the perhaps inevitable political standoff which may ensue when seeking a safe place to disembark those that you have saved at sea. Today Shoreline has the pleasure of speaking to two leading industry experts on this issue, namely; David Hammond – David is the CEO and founder of the Human Rights at Sea Organisation, HRAS is a not for profit, advocacy charity, that strives to deliver social change through legal and policy development to ensure human rights apply equally to those at sea as they do to those on land, and; Dr. Victoria Mitchell – Victoria is part of Control Risks' dedicated maritime security team, providing global analytical coverage of maritime security issues. Victoria is an expert in the law of the sea and holds a PhD that addresses this and maritime security cooperation.

What exactly is the “lost ark” of ERISA? Ed and Scott welcome Lockton’s very own tomb raider, Jay Kirshbaum, J.D., LLM, to find out. Together they decode a recent private letter ruling (PLR) from the IRS to discover a surprise lever that may allow employers to offer employees a nontaxable choice between employer contributions to a retirement plan or to a retiree HRA. Jay leads the boys through the labyrinth of tax rules like only someone with a master’s degree in tax law can and delivers up the holy grail of tax-favored benefits. Full of exciting twists and turns, this episode dives into: Is tax law interesting and provocative? (Hint: depends on who you ask) What exactly is a PLR? Does the recent PLR change the rules for offering employees a choice between HRA and retirement plan contributions? What is constructive receipt, and why do we care? How does the PLR promote the gloriously tax-advantaged vehicle that is an HRA? Why should employers care? What is an unfunded liability? Why does the term give Ed a fever? How can he get his hands on the Social Security trust fund? Where does COLI come into play? Is it even still legal? Has an employer that buys COLI “chosen wisely?”

This week, the group strap on their HRAs and delve into the world of Control to see if the game is still worth buying as the second expansion approaches (despite recent controversial business practices). Special thanks to Giorgio Volpe for joining us this week! Check him out: www.giovolpe.com Visit our Website: www.whimsicproductions.com Support us on Patreon: https://www.patreon.com/shouldibuy Buy us a Coffee: https://ko-fi.com/whimsic

ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. Every year, the ASCO Annual Meeting brings together attendees from around the globe to learn about the latest research in the treatment and care of people with cancer. This year, attendees from 138 countries worldwide gathered virtually for the ASCO20 Virtual Scientific Program, held Friday, May 29 through Sunday, May 31. In the annual Research Round Up podcast series, Cancer.Net Associate Editors answer the question, “What was the most exciting or practice-changing research in your field presented at the ASCO20 Virtual Scientific Program?” In this episode, editors discuss new research in the fields of head and neck cancer and melanoma. First, Dr. Ezra Cohen will discuss new research in squamous cell carcinoma of the head and neck and adenoid cystic carcinoma. Dr. Cohen is Co-Director of the San Diego Center for Precision Immunotherapy, Associate Director of Translational Science and leads the Solid Tumor Therapeutics research program at Moores Cancer Center at UC San Diego Health. He is also the Cancer.Net Associate Editor for Head and Neck Cancers. View Dr. Cohen’s disclosures at Cancer.Net. Dr. Cohen: Hi. This is Dr. Ezra Cohen from University of California, San Diego, Moores Cancer Center. And today I'll be reviewing head/neck cancer abstracts from the American Society of Clinical Oncology Annual Meeting. I have consulted for Merck in the past. As all of us know, this meeting was virtual this year, but we had an opportunity to see the broadcasts through the virtual website. And there were a few abstracts that I thought were relevant to not only current standards of care but also to the future of research in head/neck cancer. The first one I'll talk about is a Japanese study that compared post-operative chemo radiotherapy of 3 weekly cisplatin versus weekly cisplatin in high-risk patients with squamous cell carcinoma of the head and neck. This was indeed an adjuvant trial or a post-operative trial, and really addressed an important question in the field that had been controversial and perhaps continues to be going forward. The investigators compared a dose of 40 milligrams per meter squared given every week versus the standard 100 milligram per meter squared of cisplatin given every three weeks and assess patients for local-regional control and overall survival. Interestingly enough and as opposed to some prior reports, the combination of weekly cisplatin and radiation actually proved to be superior with respect to both local-regional control and survival while providing a regimen that was fairly well-tolerated and in the aggregate actually had a lower toxicity rate than the every 3 week cisplatin, suggesting that at least at 40 mg per meter squared, we may have a regimen that is in the post-operative setting more efficacious, and better tolerated, and that it may be time to revisit standards of care or at least to perhaps accept 2 different standards of care in the post-operative setting; one being high dose every 3 weeks cisplatin and the other being weekly cisplatin. The other relevant abstract from the oral session was another randomized trial, this time from South Korea. Looking at adenoid cystic carcinoma, here patients were randomized to either receive a vascular endothelial growth factor receptor inhibitor named axitinib vs. placebo in patients with metastatic disease. This class of agents that axitinib belongs to has been noted to be active in adenoid cystic carcinoma for some time, but there had never really been any randomized trials comparing axitinib to any treatment and certainly not to observation or placebo. Fifty-seven (57) patients were enrolled and progression-free survival was the primary endpoint, in fact, 6-month progression-free survival. And what the investigators found was that this was much better in the axitinib patients versus placebo. In fact, about 70% of patients in the axitinib arm failed to progress and were still alive versus only 23% in the placebo arm. Now, this was not a large enough trial to change registration or the label of the drug, but it certainly, for patients with adenoid cystic carcinoma who have very few treatment options, does provide a therapy that now is at the very least validated through a randomized phase II trial and gives us a little bit more confidence in using this entire class of agents in patients with adenoid cystic carcinoma. One of the other targeted therapy studies that I think is also worth highlighting from the meeting was that using tipifarnib in patients with HRAS mutations. This was a study conducted across several different cancer types, but the most commonly enrolled patients and, in fact, a specific cohort were for patients with head/neck squamous cell carcinoma. And interestingly enough, the investigators having enrolled 18 patients found an overall response rate of 56%, arguably much better than we would be able to do with chemotherapy in these patients or any other targeted agent for that matter. And again, not a study that would change the label or standards of care but certainly worthwhile watching the efficacy of this agent tipifarnib going forward in patients with HRAS mutations. And then from the poster discussion session, I think we saw some interesting data that may be a prelude to the future, especially with immunotherapy. Christine Chung presented the experience of cetuximab and nivolumab, an EGFR and a PD-1 antibody in combination, and found that to be quite active, again, in a non-randomized manner but certainly enough activity to think about taking that regimen forward. Dr. Roger Cohen presented the monalizumab and cetuximab data in patients with recurrent or metastatic disease in this time in a cohort that were both platinum and PD-1 refractory, so a heavily pre-treated patient population, and very nicely finding a response rate of 20% in patients with squamous cell carcinoma in the head/neck. And then lastly, along the lines of immunotherapy, an update on the data within ICOS agonist GSK3359609 in combination with pembrolizumab in patients who were treatment naïve with head and neck squamous cell carcinoma or at least PD-1 treatment naïve and again finding some promising activity with a response rate of about 24%. The latter 2 trials, the monalizumab-cetuximab and the ICOS agonist pembrolizumab studies, are in fact now moving on to Phase III studies. And so again, there may be a change in the standard of care using some novel I-O regimens, and it's something to look out for in the future. Thank you for listening to this review of head and neck cancer abstracts at the American Society of Clinical Oncology Annual Meeting and have a nice day. ASCO: Thank you, Dr. Cohen. Next, Dr. Ryan Sullivan will discuss several studies across the field of melanoma treatment. Dr. Sullivan is a medical oncologist and Attending Physician in the Division of Hematology/Oncology at Massachusetts General Hospital. He is also the Cancer.Net Associate Editor for Melanoma and Skin Cancer. View Dr. Sullivan’s disclosures at Cancer.Net. Dr. Sullivan: My name is Dr. Ryan Sullivan. I am the associate director of the melanoma program at Massachusetts General Hospital in Boston, and I'm here today to give a summary of some exciting data that was presented at the 2020 Annual ASCO Meeting which, of course, was presented virtually. I have a few disclosures, including that I have served on advisory boards for a number of companies whose data was presented, including Bristol Myers Squibb, Merck, Novartis, and Iovance. I'd like to start, really, by thinking about how a patient's journey with melanoma begins and then moves on through various stages of treatment, because there were a number of very interesting abstracts and presentations presented this year that include important breakthroughs in many different steps in the patient's journey. The first, of course, is a diagnosis, and soon after a diagnosis, often, the next step is surgery. There's been more and more data about treatment before surgery as a way of potentially improving outcomes for patients who have a significant amount of tumor in place, typically in lymph nodes. Treatment before a planned surgery is called neoadjuvant therapy. There's also been breakthroughs, and, at this year's ASCO, updates on these breakthroughs in treatment after surgery, which is done with curative intent. We call that type of treatment adjuvant therapy. There were some updates to studies in patients who have newly diagnosed metastatic disease, and then there were some very interesting presentations about data of patients who were treated after the first type of treatment, for a patient with metastatic disease, was ineffective, demonstrating some really promising second and even third lines of treatment that may be available for patients. So I'll start with that neoadjuvant therapy. This is, again, treatment that's given before somebody who could have surgery with curative intent, and the idea behind this is to potentially improve the outcomes of patients. It's also a really important type of research treatment because we can learn a ton about how tumors respond or don't respond to certain types of treatments, and there is a really wide path that's been created by the breast cancer community, who pioneered this type of treatment, and demonstrated that new and effective therapies can actually make it to the standard of care for patients in this setting. In melanoma, we've looked at a lot of the breakthrough therapies that have been approved in the metastatic and the stage 3 after surgery setting, including immunotherapies and BRAF-targeted therapies. And the background is a number of trials have occurred, and 1 very prominent group that has been leading a lot of these efforts is the group in the Netherlands, and Dr. Christian Blank presented some data on a follow-up study of almost 100 patients, who received a combination of two drugs, ipilimumab and nivolumab, at a schedule in dosing level that had been determined to be, probably, as effective as higher doses and more toxic therapy, but had a better safety profile than other regimens. That trial was called the OpACIN-neo, which randomized patients to 3 different dosing levels and strategies. So patients receive this, and then, in a really cool fashion, they knew that almost 70 or 80% of patients would have a major response to therapy - that was based on other data - but they also wanted to see if they get away with less surgery. And so what they did was, patients who had major responses were offered a smaller surgical resection. Patients who didn't have major responses ended up having a complete surgical resection of lymph nodes, and then they just followed along. And really, it was less a trial that will prove that this is the right thing to do, but more a trial to be built upon. And as more and more data comes out, this could be a strategy that we utilize for patients, where they may only get 2 doses of a treatment, and then if they have a major response to therapy, they could just be followed closely thereafter. So this trial is called the PRADO trial. Christian Blank was the presenter, and I would say it's promising, and maybe practice-changing as more data comes out and larger trials are performed to compare this strategy with other more standard strategies. The next set of data that was presented that's really interesting is in the adjuvant setting, so again, these are patients who've had surgery to cure them of their melanoma, but they're at high risk of the melanoma coming back and so receive treatment after surgery - we call that adjuvant therapy - to reduce the chance of disease coming back. There were 2 trials that were updated at this year's ASCO. One was the KEYNOTE-054 trial. This is randomizing a drug called pembrolizumab, an anti-PD-1 blocking drug, versus placebo. This trial was a positive study, and was published a few years back, and pembrolizumab was FDA approved, a few years back, for patients who have high-risk stage 3 melanoma, who have completed surgery. The follow-up data continues to show the superiority of the pembrolizumab compared to patients who received placebo, and importantly, that superiority is across virtually every subgroup that was analyzed, and demonstrates that this approach continues to be a standard approach for patients with melanoma who are high risk and have stage 3 disease that's been resected. A similar group of patients were enrolled on to a trial called the COMBI-D study. This is a trial that randomized BRAF mutated patients with stage 3 melanoma, whose disease had been removed, and received either dabrafenib and trametinib, which is a BRAF and MEK inhibitor, or 2 placebos. Again, this trial previously read out as a "positive study,” and this regimen has been FDA approved for this patient population. Importantly, the data continues to look really good. BRAF targeted therapy, initially, it was thought that it might prevent relapse during the treatment time and a little after the treatment time, but there was thoughts that the effects of it, and the effectiveness of it, might actually wane over time, but that doesn't seem to be the case. This is a 5-year update, and it still appears that this combination is associated with cures in patients with stage 3 melanoma, who would not have been cured if they didn't receive it. So again, really important follow-up data, and strengthens the idea that this is a very reasonable alternative to anti-PD-1 antibody therapy like pembrolizumab, which was described just a few minutes before, in the same setting, but in this case in patients who had BRAF mutated melanoma. There were some important trials, and one was a retrospective study of therapy in patients who had metastatic melanoma or unresectable disease, so this is melanoma that either presented in a widespread fashion, or was previously diagnosed and treated with surgery, maybe adjuvant therapy, and then metastasized. The standard front-line therapy is really 1 of 4 options: anti-PD-1 antibody with either nivolumab or pembrolizumab; BRAF targeted therapy, if a patient has a BRAF mutation; combination nivolumab and ipilimumab; and then enrollment onto a clinical trial. Many sets of data are out there in publications about the combination of ipilimumab and nivolumab in the frontline metastatic setting, and while it is associated with the highest response rates of immunotherapy in patients with melanoma, it's also associated with very high toxicity rates. And so ultimately, a decision is typically made upfront, and we balance the risk of the toxicities with the benefit of the therapy, and a decision is made about what to give. If a patient receives ipilimumab and nivolumab in the frontline setting, and then their tumor progresses thereafter, there aren't great second-line options unless a patient has a BRAF mutation, and then BRAF targeted therapy with 1 of the 3 BRAF/MEK combinations is an option. Patients who receive single-agent PD-1 therapy second-line treatment after disease progression-- could be single-agent ipilimumab, which was the first of these new immunotherapies to be approved. And so one of the questions, though, has been could you give combination ipilimumab plus a PD-1 blocking drug in that second-line setting, and have better outcomes than if you just gave ipilimumab? There's no randomized trial looking at this, but a group in Australia did a retrospective analysis and identified patients who received either single-agent ipilimumab, or a combination ipilimumab plus a PD-1 blocking drug. I should say that I was part of this retrospective analysis, and some of our patient data was part of this analysis. What was shown was that there were improvements in the response rate for patients who received combination ipilimumab plus a PD-1 blocking drug, versus single-agent ipilimumab, and it appeared that the benefit was about twice as good, meaning the response rate was about twice as good, and patients had about twice as solid progression-free survival, and they lived twice as long. Now, any retrospective analysis is really hard to make practice-changing decisions on, we really like randomized trials that are prospective, and so that data doesn't exist. There is a randomized prospective trial currently enrolling patients in the U.S. Cooperative Group setting, and it's randomizing patients, after PD-1 blocking drugs, to either ipilimumab or a combination of ipilimumab and nivolumab. So until that trial reads out, we won't know for sure that this is the right strategy, but the data certainly was suggestive that combination ipilimumab plus the PD-1 blocking drug makes sense. There actually also was data presented in a prospective study, 1 arm, so it wasn't randomized, that patients who'd been on a PD-1 blocking drug and then switched to pembrolizumab, a PD-1 blocking drug, and a low dose of ipilimumab after their disease had progressed on the PD-1 blocking drug. In that study, response rates were in the mid-20% range - I believe it was 27% - which is higher than we've seen with ipilimumab in that setting, for which the response rate would be expected to be about 10-15%. And so again, further data this time, prospective data, suggesting that there is an improved outcome for combination therapy in the second line. Importantly, toxicity, which we worry a ton about in the frontline, seemed to be less of an issue in the second line because we'd be comparing against ipilimumab, which is more toxic as a single agent than anti-PD-1 blocking drugs is, and in the second line, it seemed like combination therapy didn't seem to be any more toxic than single-agent ipilimumab. I think we also need to see the randomized data to firmly change the standard of care forever, but I think since this is a regimen that can be offered as standard care, with commercial product, it's an option for patients, and there's now data that really supports its use. The last study I'm going to talk about is a trial of a cellular product called lifileucel. In the '80s and '90s, in the National Cancer Institute, work led by Dr. Rosenberg and his colleagues, in the surgical branch there, developed the technique where they would remove a tumor, take out the T cells from the tumor, grow the T cells, expand them, and then give them back to patients after lymphodepleting chemotherapy, which would allow patients to receive and not destroy those T cells that were coming in, and then give IL-2 to grow those T cells and support them as they expand in the body. This is a very hard therapy to receive. At the NCI, it required patients to have an initial visit, have enough tumor to have it removed, be able to come back a few weeks later, have the tumor removed, and then the T cells had to grow, and we never really knew how many patients ended up showing up at the NCI to be evaluated for this, and then, ultimately, were treated. And so it is hard to know what to make of the response rates, which were remarkably high. As high as 50-55% in some studies when looking at the data. But the worry was that maybe only a quarter of patients that showed up ended up getting treated, and so the response rate would be a lot less, of all people that were screened. And so there's real interest in finding a commercial product that could not necessarily require the production of the cell product to be done at an individual institution, and certainly not 1 institution like the NCI, but that could be done centrally and commercially. And so lifileucel is a product that comes from patients’ tumors, again, requires a patient to have surgery, the tumor gets removed; it gets sent to a central laboratory where the T cells are isolated, grown, expanded; and then when the product is ready, patients, if they're still well, are able to be admitted to the hospital get lymphodepleting chemotherapy, receive the cells, receive IL-2, and then see what happens. The data that was presented at ASCO was an update from a year ago, which showed that patients-- and all of these patients had had anti-PD-1 antibody therapy, probably 70 or 75% of patients had ipilimumab, so heavily pretreated population of patients, and the response rate of patients who were able to receive treatment was 37%. So that's not everybody, obviously, and that's not even half the patients, but that's a pretty impressive response rate, for patients who weren't previously responding to immunotherapy. There's a lot of excitement about this data, and more importantly, there was data that suggested that 82% of patients that showed up for surgery ended up getting treated. So we actually have a denominator of patients screened. Ninety-four (94%), 95% of patients were able-- a product was able to be made, so the concerns about whether or not this is for most patients that end up having surgery, the answer is they probably can make a product for just about everybody. This is probably the 1 presentation, in the oral abstract session at ASCO, in the melanoma program, that is a regimen that would be new, and potentially practice-changing in the near future. So that's exciting, and we're hopeful that that will be an option for patients in the near future. With that, I'd like to finish by saying it was another great year for the melanoma research community. Lots of really interesting data presented. I touched upon some of the highlights, but lots of other really cool trials and data presented, as well, and I remain very hopeful for the future of, not just our research community, but more importantly for our patients, who are going to benefit from this wonderful research that's being done, which will hopefully continue to lead to better outcomes for our patients. And with that, I thank you for your attention. ASCO: Thank you, Dr. Sullivan. Learn more about the research presented at the ASCO20 Virtual Scientific Program at www.cancer.net/blog, and subscribe to Cancer.Net podcasts on Apple Podcasts or Google Play for additional episodes in the Research Round Up series, released throughout the summer. This Cancer.Net podcast is part of the ASCO Podcast Network. This collection of 9 programs offers insight into the world of cancer care, covering a range of educational, inspirational, and scientific content. You can find all 9 shows, including this one, at podcast.asco.org. Cancer.Net is supported by Conquer Cancer, the ASCO Foundation, which funds breakthrough research for every type of cancer, helping patients everywhere. To help fund Cancer.Net and programs like it, donate at conquer.org/donate.

Today's episode of The Broker Link Podcast is about How to use a Health Reimbursement Arrangement to purchase insurance. This is a replay of a webinar Mike Smith of the Brokerage hosted with Kyle Estep with Take Command Health.  They run through how this works.  If you have any questions, you can email Kyle at Kyle@takecommandhealth.com. Or visit www.thebrokerageinc.com to learn more.    

We spend this episode plowing through part of the lengthy list of "qualified" medical expenses for those with HSAs, FSAs and MSAs, but not necessarily HRAs*. Needless to say, hilarity ensues!The fun starts at about minute 8:00 and continues in the next episode.* (Health Savings Accounts, Flexible Spending Accounts, Medicare Savings Accounts but possibly not Health Reimbursement Accounts)Inspired by "MEDICARE FOR THE LAZY MAN 2020; Simplest & Easiest Guide Ever!" on Amazon and Barnes & Noble. Return to leave a short customer review & help future readers.Official website: https://www.MedicareForTheLazyMan.comSend questions & love notes: DBJ@MLMMailbag.com

Years of advocacy has brought victory in freeing the doctor patient relationship. The US Treasury has proposed a new rule that will allow you to use your money in tax deferred medical accounts (including FSAs, HRAs, and some HSAs) to pay for doctor care in Direct Primary Care relationships. Dr. Lee Gross, president of the Docs4PatientCare Foundation (D4PCF), joins host Hal Scherz to unpack the proposal, "the rule promises relief for patients and doctors fighting for survival." The long fought battle is not over. There is a sixty day comment period and several issues that must be corrected.

Neste Gambiarra Board Games Gustavo Lopes e Carolina Gusmão falam sobre o jogo de tabuleiro Broom Service, lançado no Brasil pela Grow, sobre a decisão da Grow de sair do ramo de jogos de tabuleiro moderno, sobre onde comprar jogos em Praga na Republica Checa se um dia você for lá e muito mais! Edição - Gustavo Lopes. Capa - Gustavo Lopes . Confira as fotos do jogo em nosso instagram instagram.com/gambiarraboardgames E-mail para sugestões: contato@papodelouco.com Padrim: padrim.com.br/papodelouco Picpay: app.picpay.com/user/papodelouco Facebook: facebook.com/papodeloucooficial Twitter: twitter.com/papodelouco_ Instagram: instagram.com/papodelouco_podcast Telegram: t.me/papodelouco Store: papodelouco.com/store Apoio Acessórios BG: www.acessoriosbg.com.br BGSP: boardgamessp.com.br/Agradecimento aos Padrinhos deste mês: Brendo Marinho; Cleiton Medeiros; Dalton Soares; Danilo Gonçalves; Deberson Nascimento; Diego Silva; Diego Cruz; Gustavo Leitão; Jota; Lucas Padilha; Pensador Louco; Rebeca Serra; Rhuan de Oliveira; Sebastião Nunes; Yure de Paula

Can employers provide one set of benefits to one group of employees and a different set to another? Short answer: in most cases, yes indeed. We have all sorts of laws preventing discrimination, but there are many ways employers can permissibly discriminate. Wait, what?  In this titanic episode, Ed and Scott jump into discrimination in the benefits world, and how employers can and cannot legally “discriminate” in their benefits offerings. How are regulations around self-insured healthcare benefits and fully insured healthcare benefits different? What does the IRS have to say about it? Who is considered a highly compensated individual and why are they suspect? (Hint: Scott’s not one, but he is suspect in other ways.) Can the same plan treat different groups of employees differently, and how would the plan be tested? Who bears the consequence of impermissible discrimination? Are there any easy ways to negate the problem? How do HRAs, FSAs, HSAs and cafeteria plans play into this? And what about dependent care? HIPAA? GINA? Why does Scott keep talking about crab cakes?

In episode 220 of Financially Simple, Justin answers a question about having a Health Reimbursement Arrangement. A listener of the podcast asks: I am a CPA about to get clients involved in a Spouse-Only HRA - What did you mean in your article “You must have a health plan to participate”? Justin responds, explaining what HRAs are, how they work, and what rules apply. Don’t forget to subscribe, and let us know how we are doing by leaving a review. Thanks for listening! _________________   TIME INDEX: 01:08 - Ask Justin: The HRA 01:55 - The Question 02:25 - Hiring a Spouse as an Employee 03:58 - What is an HRA? 05:18 - 1: The Business Sets a Monthly Allowance Amount 10:33 - 2: Employees Buy What Fit Their Personal Needs 11:15 - 3: Employees Submit Proof of Purchase 12:26 - 4: The Business Reimburses Employees 12:50 - Answering The Question 17:09 - Special Rules 19:19 - Summary _________________   RESOURCES: Ask Justin a Question Ask Justin a Question Financially Simple Educational Website Financially Simple on YouTube Financially Simple podcasts are recorded on a Blue Yeti Microphone & Samsung Notebook 9. Subscribe to the Financially Simple Newsletter NEW Book: The Ultimate Sale - A Financially Simple Guide to Selling Your Business for Maximum Profit Article: Hiring a Spouse as an Employee… A Smart Option with Many Benefits Article: Group Health Insurance for Businesses IRS Publication 502 _________________   BIO: Host Justin Goodbread, Certified Financial Planner, Certified Exit Planning Advisor, Certified Value Growth Advisor. He is a serial entrepreneur, author, speaker, educator, Investopedia Top 100 advisor, and business strategist with over 20 years of experience. Justin owns Heritage Investors LLC, a registered investment adviser with the State of Tennessee. Heritage Investors only transacts business in states where it is properly registered or is excluded or exempted from registration requirements. This material is for general information only and is not intended to provide specific advice or recommendations for individuals. To determine what is appropriate for you, please consult a qualified professional. The Financially Simple podcast provides information, guidance, and support to Small Businesses in the United States.

Wise health care strategies when you have an entity formed. This podcast will speak on different health care strategies entrepreneurs utilize with their small business like HSA and HRAs. DreamAgain HSA https://livelyme.pxf.io/DreamAgain https://dreamagain-metaverse.mn.co/ --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app

https://vimeo.com/364498947 https://www.currentfederaltaxdevelopments.com/podcasts/2019/10/5/2019-10-07-get-ready-for-the-2019-passthrough-forms   Current Federal Tax Developments for the week of October 7, 2019 Pennsylvania cites Wayfair in providing for sales only based income tax nexus Taxes on investment real estate under IRC §164 - no $10,000 limit? Drafts of 2019 Forms 1065, 1120-S and related K-1s released by IRS Proposed regulations for ALEs using individual coverage HRAs released

Current Federal Tax Developments for the week of October 7, 2019 Pennsylvania cites Wayfair in providing for sales only based income tax nexus Taxes on investment real estate under IRC §164 - no $10,000 limit? Drafts of 2019 Forms 1065, 1120-S and related K-1s released by IRS Proposed regulations for ALEs using individual coverage HRAs released Copyright 2019 Kaplan, Inc.

Medicare's annual election period marketing season is now underway as NAHU continues to work closely with CMS officials to resolve the significant challenges of the revised Medicare Plan Finder. On this week's episode, NAHU's Marcy M. Buckner and John Greene discuss the role that NAHU is playing in this process and how NAHU members can join us in working towards a solution. This episode also includes a regulatory roundup of President Trump's latest healthcare executive order, new guidance on the individual coverage and excepted benefit HRAs, and our comments to the hospital transparency proposed rule.

Medicare’s annual election period marketing season is now underway as NAHU continues to work closely with CMS officials to resolve the significant challenges of the revised Medicare Plan Finder. On this week’s episode, NAHU’s Marcy M. Buckner and John Greene discuss the role that NAHU is playing in this process and how NAHU members can join us in working towards a solution. This episode also includes a regulatory roundup of President Trump’s latest healthcare executive order, new guidance on the individual coverage and excepted benefit HRAs, and our comments to the hospital transparency proposed rule.

A Digital Conversations podcast discussion with Steve Lindsey from Banner Innovation Group In healthcare, high complexity combined with an extreme amount of regulatory red tape frequently hinder innovation and progress. Despite significant investments in technology, the industry continues to struggle implementing solutions that patients will understand and embrace.    At the same time, more than 10,000 baby boomers turn 65 each day and that is adding tremendous strains on Medicare and Medicaid programs. Innovation will be key, but there are big hurdles in getting elderly patients to engage with modern technology.     Grandmother-friendly IT? How many times have we heard something like this: “It has to be simple and intuitive in order to work. If my grandmother can’t understand it, it will never work.” If the goal is to engage Medicare patients with technology, grandmother MUST be able to figure it out. Banner Health sought to find a solution that its population of medicare seniors could embrace as part of their annual wellness visit -- a CMS program designed to keep patients engaged with their physicians on a regular basis. As part of the program, patients are required to fill out daunting questionnaires about their health. The process is cumbersome, frequently resulting in  high dissatisfaction rates, missed appointments and frustrated clinical teams. The Banner Innovation Group (BIG) had experienced success with LifeLink-powered patient engagement chatbots in their Emergency Departments. They were mobile, simple and intuitive. Would seniors embrace an advanced solution like a conversational chatbot to help streamline the annual wellness visit experience?    Breakthrough Operational Value and Engagement with Medicare Seniors In this episode of Digital Conversations, Greg Kefer was joined by Steve Lindsey, Program Director of Operations at Banner Innovation Group, to discuss how they transitioned their medicare annual wellness visit patients from clunky paper forms to conversational chatbots. Patients interacted with a conversational bot to complete their Health Risk Assessment prior to their annual annual wellness visit. The results were significant.    51% of patients interacted with the bot after cold outreach, with no advanced warning The completion rate was nearly 100% … if they started, they completed the process Providers could enter/review HRA data before appointment Among the patients that used the bot to complete their HRAs, Banner saw a 70% decrease in appointment cancellation rates They were also cancelling appointments less often If they did cancel, they did it 5 days earlier so the slots could be filled Banner is now rolling the HRA bot across more 30,000 medicare patients Steve also describes the Banner Innovation Group vision of anticipating future needs, designing solutions that create that model of healthcare, and how mobile chatbots fit into that picture.

This podcast highlights original research published in the September 2019 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. The objective of this study was to recognize that thyroid nodules with atypia of undetermined significance/follicular lesion of undetermined significance (AUS/FLUS; Bethesda III) have different risks of malignancy based on genetic mutation and to consider molecular testing of nodules with AUS/FLUS to help avoid unnecessary morbidity or cost. In conclusion, not all molecular mutations in thyroid nodules with AUS/FLUS have a high risk of malignancy. Of note, patients with BRAF and RET mutations in our population had a 100% risk of malignancy. Patients with PAX, HRAS, or NRAS mutations had a high risk of malignancy, while patients with KRAS mutations had a lower risk of malignancy. Further studies are needed to determine if the presence of certain molecular mutations can help personalize care and aid in the decision for thyroid surgery.   Click here to read the full article.

A Digital Conversations podcast discussion with Steve Lindsey from Banner Innovation Group In healthcare, high complexity combined with an extreme amount of regulatory red tape frequently hinder innovation and progress. Despite significant investments in technology, the industry continues to struggle implementing solutions that patients will understand and embrace.    At the same time, more than 10,000 baby boomers turn 65 each day and that is adding tremendous strains on Medicare and Medicaid programs. Innovation will be key, but there are big hurdles in getting elderly patients to engage with modern technology.     Grandmother-friendly IT? How many times have we heard something like this: “It has to be simple and intuitive in order to work. If my grandmother can’t understand it, it will never work.” If the goal is to engage Medicare patients with technology, grandmother MUST be able to figure it out. Banner Health sought to find a solution that its population of medicare seniors could embrace as part of their annual wellness visit -- a CMS program designed to keep patients engaged with their physicians on a regular basis. As part of the program, patients are required to fill out daunting questionnaires about their health. The process is cumbersome, frequently resulting in  high dissatisfaction rates, missed appointments and frustrated clinical teams. The Banner Innovation Group (BIG) had experienced success with LifeLink-powered patient engagement chatbots in their Emergency Departments. They were mobile, simple and intuitive. Would seniors embrace an advanced solution like a conversational chatbot to help streamline the annual wellness visit experience?    Breakthrough Operational Value and Engagement with Medicare Seniors In this episode of Digital Conversations, Greg Kefer was joined by Steve Lindsey, Program Director of Operations at Banner Innovation Group, to discuss how they transitioned their medicare annual wellness visit patients from clunky paper forms to conversational chatbots. Patients interacted with a conversational bot to complete their Health Risk Assessment prior to their annual annual wellness visit. The results were significant.    51% of patients interacted with the bot after cold outreach, with no advanced warning The completion rate was nearly 100% … if they started, they completed the process Providers could enter/review HRA data before appointment Among the patients that used the bot to complete their HRAs, Banner saw a 70% decrease in appointment cancellation rates They were also cancelling appointments less often If they did cancel, they did it 5 days earlier so the slots could be filled Banner is now rolling the HRA bot across more 30,000 medicare patients Steve also describes the Banner Innovation Group vision of anticipating future needs, designing solutions that create that model of healthcare, and how mobile chatbots fit into that picture.

In simpler times, health reimbursement arrangements, or HRAs, were furry, fluffy, friendly creatures in the benefits forest. But now …  not so much. They’re multiplying like crazy, and growing fangs and claws. In this episode, Ed and Scott track the current species of HRAs, in all their varieties. How do the endlessly evolving types of HRAs differ from each other? What kind of HRAs can an employer offer, and to whom, without getting bitten? What do Tesla sedans have to do with HRAs? (Ed is slow on the take-up, and still not clear.) Can an employer offer young (tan) Scott a group plan and old (probably dying) Ed an HRA and a one-way ticket to Medicare? What advantages or “free passes” from complex ACA regulation do some of the new HRAs offer employers?

In episode 179 of Financially Simple, Justin talks to Michael Crane of The Crane Group about Group Health Insurance. Group Health Insurance can be used to provide coverage to employees, at a reduced cost for the Business Owner. Justin and Michael discuss in this second episode of two, the ins and outs of Group Health Insurance and how it may apply to your business. TRANSCRIPT/BLOG: https://financiallysimple.com/group-health-insurance-information-for-businesses/ Don’t forget to subscribe, and let us know how we are doing by leaving a review. Thanks for listening! _________________   TIME INDEX: 01:08 - Group Health Insurance for Businesses, with Michael Crane 01:45 - What is Group Health Insurance? 02:49 - Types of Plans 06:40 - Different Plans for Different Groups? 08:56 - What Else: Agents vs. Direct 12:50 - Full Coverage vs. Partial 14:28 - HRAs and Business Owners 16:55 - Large Businesses 18:20 - Crossing State Lines 19:46 - Making Changes 23:03 - Wrap Up _________________   RESOURCES: Financially Simple Educational Website Financially Simple on YouTube Financially Simple podcasts are recorded on a Blue Yeti Microphone & Samsung Notebook 9. Subscribe to the Financially Simple Newsletter NEW Book: The Ultimate Sale - A Financially Simple Guide to Selling Your Business for Maximum Profit Michael Crane - The Crane Group _________________   BIO: Host Justin Goodbread, Certified Financial Planner, Certified Exit Planning Advisor, Certified Value Growth Advisor. He is a serial entrepreneur, author, speaker, educator, Investopedia Top 100 advisor, and business strategist with over 20 years of experience. Justin owns Heritage Investors LLC, a registered investment adviser with the State of Tennessee. Heritage Investors only transacts business in states where it is properly registered or is excluded or exempted from registration requirements. This material is for general information only and is not intended to provide specific advice or recommendations for individuals. To determine what is appropriate for you, please consult a qualified professional. The Financially Simple podcast provides information, guidance, and support to Small Businesses in the United States.

The new rules will allow employer funded HRAs to be used to pay for individual health insurance policies and create a new type of stand-alone HRA. However, there are a lot of details to consider before diving in. Listen in to learn more about these new options.

Just what does it mean to “nurture” digital customers? In this episode, hosts Reed Smith and Chris Boyer discuss lead nurturing and how digital marketers in health systems can use marketing automation, email and other digital touchpoints to develop effective ways to nurture customers on their journey. They are joined by Greg Gossett, CEO of HealthAware, in which he discusses how online health risk assessments (HRAs) are an effective part of any nurturing strategy.  Mentions from the Show:What is Lead Nurturing (Marketo article)7 Amazingly Effective Lead Nurturing Tactics - HubspotArming the Marketer: Getting Started with Nurturing in Healthcare - eVariantBrand Strategy: Differentiation Versus Centrality Greg Gossett on LinkedInHealthAware websiteSHSMD Connections 2019 2019 Mayo Clinic Social Media Network Annual Conference 2019 Healthcare Internet Conference Find Us Online: Touchpoint podcast TwitterReed Smith TwitterChris Boyer TwitterChris Boyer websiteSocial Health Institute

* Guest: Scott Bradley – To Preserve The Nation – FreedomsRisingSun.com. * What is a Catholic Feast Day? The Catholic Church assigns one date out of the year for each and every canonized saint — known as the saint’s feast day. The saints are remembered on their individual feast days with special mention, prayers, and possibly a scripture reading. A saint’s feast day can be the day of their actual death or a day assigned by the Church. * Deep State - Support Pouring In For Imprisoned Congressman Steve Stockman - Rachel Alexander. * Foundation: AFFORDABLE CARE ACT UNCONSTITUTIONAL - MoralLaw.org. The Fifth Circuit is expected to decide the case later this year, after which it will likely be appealed to the Supreme Court. * Trump Quietly Revelutionizing Health Insurance - Rule for HRAs 'destroys Dem case for socialized care' - WND.com. --- Support this podcast: https://anchor.fm/loving-liberty/support

The Trump Administration released its final rule on the expansion of health reimbursement arrangements last week that established new individual-coverage HRAs and excepted-benefit HRAs. This week, NAHU's Marcy Buckner and Chris Hartmann join us to review the nearly-500 page final regulation and key compliance considerations for employers and brokers to keep in mind, along with the remaining concerns NAHU has with the final regulation that we raised in formal comments submitted to the proposed rule. The episode also looks into the possibility of the rule facing legal hurdles that could undermine its full implementation, as well as a recap of the ongoing legal challenges to the association health plan and short-term plan final rules.

The Trump Administration released its final rule on the expansion of health reimbursement arrangements last week that established new individual-coverage HRAs and excepted-benefit HRAs. This week, NAHU’s Marcy Buckner and Chris Hartmann join us to review the nearly-500 page final regulation and key compliance considerations for employers and brokers to keep in mind, along with the remaining concerns NAHU has with the final regulation that we raised in formal comments submitted to the proposed rule. The episode also looks into the possibility of the rule facing legal hurdles that could undermine its full implementation, as well as a recap of the ongoing legal challenges to the association health plan and short-term plan final rules.

https://vimeo.com/342468445 https://www.currentfederaltaxdevelopments.com/podcasts/2019/6/15/2019-06-17-bring-on-the-new-hras Current Federal Tax Developments for the week of June 17, 2019: Bring on the New HRAs IRS to stop faxing transcripts, only mail them to taxpayer’s address of record Final regulations issued for state tax credit donations and new way to report credit as tax paid IRS finalizes regulations creating two new HRAs

This week we look at: IRS to stop faxing transcripts, only mail them to taxpayer’s address of record Final regulations issued for state tax credit donations and new way to report credit as tax paid IRS finalizes regulations creating two new HRAs Copyright 2019, Kaplan, Inc.

The IRS finalizes regulations creating two new types of HRAs for 2019 and dealing with state tax credits., as well as announcing changes in transcript delivery.

There’s a lot of “alphabet soup”

In October 2017, President Trump issued an Executive Order calling on the departments to take action on a handful of specific tasks, one of which was to expand the use of Health Reimbursement Arrangements (HRAs). We finally saw proposed guidance on this in late October 2018 when two new types of HRAs were introduced. Listen in to learn more about these proposed HRAs and how they might impact employers.

Newly proposed regulations allow employers to pay for employees' individual market coverage with HRAs. Gain a better understanding of the regulations and learn what provisions you'll need to pay close attention to.

This week's podcast recaps recent developments in legislation and regulations, or as we call them, “legs and regs.” NAHU's Vice President of Government Affairs Marcy M. Buckner and Vice Presidents of Congressional Affairs John Greene and Chris Hartmann sit down with Director of Policy Engagement Dan Samson to review the latest efforts on market stability, the Congressional calendar ahead, an overview of the 2019 market rule and “grandmothering” bulletin, a recap of the status on regulations on association health plans, short-term plans, and HRAs, and the recent Medicare Advantage guidance.

This week’s podcast recaps recent developments in legislation and regulations, or as we call them, “legs and regs.” NAHU’s Vice President of Government Affairs Marcy M. Buckner and Vice Presidents of Congressional Affairs John Greene and Chris Hartmann sit down with Director of Policy Engagement Dan Samson to review the latest efforts on market stability, the Congressional calendar ahead, an overview of the 2019 market rule and “grandmothering” bulletin, a recap of the status on regulations on association health plans, short-term plans, and HRAs, and the recent Medicare Advantage guidance.

Tim Schuster, a manager in EisnerAmper’s Private Business Services Group, examines the differences between health savings accounts (HSAs), health reimbursement accounts (HRAs), and flexible savings accounts (FSAs). Tim looks at things like who funds the plan, who owns it, taxation, contribution limits and what happens to unused funds at year’s end.

On October 12, 2017, President Trump signed an Executive Order directing the federal agencies in charge of implementing the ACA to propose new regulations or to revise existing guidance to expand access to association health plans, short term insurance plans, and HRAs. Separately, the President issued notice to stop the government’s reimbursement of cost-sharing reduction payments made by insurance carriers that participate in the ACA’s Health Insurance Marketplaces. Is this the beginning of the end for the ACA? Tune in to learn why these things make a difference to the future of the ACA.

NAHU Vice President of Government Affairs Marcy M. Buckner and Vice Presidents of Congressional Affairs Chris Hartmann and John Greene walk us through President Trump's executive order addressing association health plans, short-term policies, and HRAs. This 25-minute installment helps to answer many of the questions you may have...

NAHU Vice President of Government Affairs Marcy M. Buckner and Vice Presidents of Congressional Affairs Chris Hartmann and John Greene walk us through President Trump’s executive order addressing association health plans, short-term policies, and HRAs. This 25-minute installment helps to answer many of the questions you may have...

PCORI Fees, also known as the Patient-Centered Research Outcome Institute fees, are due July 31, 2017. While carriers will pay these fees directly for fully insured plans because they are built into the premium, self-funded medical plans, HRAs that integrate with a fully insured medical plan, and self-funded minimum essential coverage (MEC) plans must pay them directly to the IRS via Form 720. Listen in learn more about these fees and how to calculate and pay them.

HRAs are funded exclusively by employers. In the last episode I taught you a little bit about Health Savings Accounts. I said they’re a great tool for lowering your group health insurance costs and I explained how they work… but, I didn’t explain how they actually lower your costs A Health Reimbursement Arrangement (HRA) is…

Who's using health risk assessments (HRAs), and how are they administered? What are the top incentives driving HRA completion, and what are the top three uses for HRA data? What completion rates can be expected? In this month's healthcare benchmarks podcast, Healthcare Intelligence Network executive VP and COO Melanie Matthews shares the latest market research on HRA use. This month's metrics are derived from HIN's June 2010 survey on HRAs, with commentary from Dr. Marcia Wade, Aetna Medicare's senior medical director. More actionable data on ways that 116 healthcare organizations are using HRAs is contained in "2010 Performance Benchmarks in Health Risk Assessment Use," a 60-page resource providing metrics and measures on current and planned HRA initiatives as well as lessons learned and results from successful health assessment programs.

In a joint interview, Wes Alles, Ph.D., director of the Stanford University Prevention Research Center, and Yann Meunier, M.D., health improvement manager at Stanford School of Medicine Health Improvement Program, describe the interactions between their individual Stanford programs, the science and methods behind Stanford's health risk and behavior change assessments, and incentives that encourage Stanford employees to complete HRAs and participate in health promotion programs. Alles and Dr. Meunier, along with Gary Smithson, M.D., M.B.A, WorldDoc, will describe how HRAs are evolving and the impact these enhancements are having on both HRA data and results during an August 13, 2008 webinar, New Developments and Enhancements in Health Risk Assessments.