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Post by thall on Aug 5, 2017 16:28:19 GMT -5
Oh my..... I believe the article that was posted about the 12 Diabetes America clinics having closed in Texas in the Spring refernced problems with insurers no longer paying for number of visits and they instead moved to a different model to pay for outcomes? No, they said they closed their clinics nationwide in May: diabetesamerica.com/
"After May 5, 2017, all Diabetes America locations will be closed permanently."
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Post by audiomr on Aug 5, 2017 17:05:54 GMT -5
Particularly interesting is the form added at the bottom. Wonder if anyone has taken them up on their offer to help others set up VDEX clinics. Would you do it if they are not yet profitable? Probably not, but I know nothing about VDEX's financials. The fact that its one current clinic is now a standalone operation is encouraging. On the other hand, the fact that there's still just one location does not suggest explosive demand. We'll see. It's nice to see that the site now expressly endorses Afrezza. |
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Post by agedhippie on Aug 5, 2017 18:44:00 GMT -5
Aged - can you explain the Integrated Diabetes model a little more? What type of coaching are they providing and for what cost? I am trying to guess what type of service Onduo is planning to provide and how that may be different than what Scheiner is providing. The Cleveland Clinic has also just partnered with Oscar Insurance and I suspect diabetes will be a big focus in this partnership. We also have Roche and their MySugr deal, Medtronic/IBM and others including Dachis/One Drop. How are they all planning on making money? It was a couple of years ago and I was paying $126 a month from memory but I could be wrong. That was for an initial in-person consultation and then everything else was remote. It worked pretty well and they have really good staff. You can see the staff profiles on-line, I would not use a service where they didn't do that because I have no idea who I am talking to. My numbers were all over the place at the time and they helped me get them straight. I was with them for about six months. I think they will survive just fine in the new world. Their service is at a different level to the others out there, I would not consider the others. The IDS people have been at it for a long time, know what they are doing, and have a lot of playbooks. |
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Post by brotherm1 on Aug 5, 2017 20:39:28 GMT -5
If IDS succeeded, so could VDEX and expand? Wonder f he's looking at VDEX I wonder how many other successful clinics there are in the US Dr Sheiner on his IDS website says some insurance reimburses the clients. I wonder how many and much? Could VDEX with Afrezza also get similar reimbursements for their clients? Why did VDEX open in California? I've got a lot more questions. Who can answer the aforementioned?
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Post by sportsrancho on Aug 5, 2017 21:10:42 GMT -5
I suspect because Bill lives here:-)
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Post by dreamboatcruise on Aug 5, 2017 21:31:21 GMT -5
If IDS succeeded, so could VDEX and expand? Wonder f he's looking at VDEX I wonder how many other successful clinics there are in the US Dr Sheiner on his IDS website says some insurance reimburses the clients. I wonder how many and much? Could VDEX with Afrezza also get similar reimbursements for their clients? Why did VDEX open in California? I've got a lot more questions. Who can answer the aforementioned? There are a lot of different insurance plans. Some PPOs pay some percent even for doctors "out of network". Some HMOs pay nothing and can even decline paying for drugs prescribed without a referral. Given that there are still significant numbers of insurers that either don't cover Afrezza or have restrictions such as step therapy with orals, it doesn't seem as if they would be all that open to adding the clinics as "in network" if the clinic is openly saying "Afrezza first. Afrezza Always". Maybe some of the insurers that do cover Afrezza, especially preferred or without restriction would be willing to add the clinics into their network. So it seems there is some evidence making money is possible and other examples showing that it can be difficult. Hard to know how VDex is doing unless they give some clue, or start expanding (which I would think a good indication of profitability). |
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Post by brotherm1 on Aug 5, 2017 22:01:46 GMT -5
Makes sense to me. Why is not Afrezza on Oscar's formulary? Oscar with the alleged technology savy insurance and being largely funded by Google (Google partnered with Dexcom), I would think would have Afrezza on the formulary. I'm thinking Google's partner in Verily, Sanofi, is throwing up roadblocks. If so Google should trash Sanofi and get Oscar to put Afrezza on their formulary, tier 1.
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Post by promann on Aug 6, 2017 6:08:12 GMT -5
I suspect because Bill lives here:-)  |
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Post by lakon on Aug 6, 2017 7:08:44 GMT -5
Particularly interesting is the form added at the bottom. Wonder if anyone has taken them up on their offer to help others set up VDEX clinics. Would you do it if they are not yet profitable? When was Amazon's first profit? |
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Post by dreamboatcruise on Aug 6, 2017 7:45:03 GMT -5
Would you do it if they are not yet profitable? When was Amazon's first profit? I think first quarterly profit was Q4 2001, and they've had positive operating cash flow ever since. I'm no Amazon historian, so correct me if I'm wrong. I didn't invest in them until a couple years ago. I guess bringing up that as analogy it means you have nearly unlimited capital to burn through until something does turn profitable. Would be great if you did invest it in a whole chain of Afrezza clinics then. That would be excellent. If you control the sort of financial resources Jeff Bezos has you stand a good chance of getting changes made to the health reimbursement landscape rather than just having to deal with it as is. Perhaps give MNKD a loan while you're at it |
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Post by dreamboatcruise on Aug 6, 2017 7:58:22 GMT -5
Makes sense to me. Why is not Afrezza on Oscar's formulary? Oscar with the alleged technology savy insurance and being largely funded by Google (Google partnered with Dexcom), I would think would have Afrezza on the formulary. I'm thinking Google's partner in Verily, Sanofi, is throwing up roadblocks. If so Google should trash Sanofi and get Oscar to put Afrezza on their formulary, tier 1. Actually if you look at their history of funding, Google is a rather small amount of Oscar's funding, so Sanofi having some control over Oscar via Verily probably isn't the case. Does Oscar use a PBM? If so and which could certainly influence whether Afrezza is on the formulary. Undoubtedly the RAA makers are throwing up roadblocks wherever they can with PBMs and insurers. |
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Post by agedhippie on Aug 6, 2017 10:22:45 GMT -5
If IDS succeeded, so could VDEX and expand? Wonder f he's looking at VDEX I wonder how many other successful clinics there are in the US Dr Sheiner on his IDS website says some insurance reimburses the clients. I wonder how many and much? Could VDEX with Afrezza also get similar reimbursements for their clients? Why did VDEX open in California? I've got a lot more questions. Who can answer the aforementioned? Integrated Diabetes does well because of Gary Scheiner initially. He is not a doctor, there are no doctors in IDS, which means if he took insurance the service would not be viable. Being out of network means that he he can set a rate that makes the business viable and the patients pay. That would be the death knell for most clinics, but IDS survives because Gary literally wrote the book on using insulin, and both he and the rest of the medical staff are Type 1 so they get it. As far as I am aware IDS don't prescribe, they are happy to liaise with your doctor over that. |
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Post by thall on Aug 6, 2017 10:42:30 GMT -5
Makes sense to me. Why is not Afrezza on Oscar's formulary? Oscar with the alleged technology savy insurance and being largely funded by Google (Google partnered with Dexcom), I would think would have Afrezza on the formulary. I'm thinking Google's partner in Verily, Sanofi, is throwing up roadblocks. If so Google should trash Sanofi and get Oscar to put Afrezza on their formulary, tier 1. From their website: www.hioscar.com/glossary/prescription-drugs Oscar seems to operate only in Texas, California, and New York and they appear to use Caremark/CVS for their drug formulary, but afrezza doesn't appear on the CVS formulary: www.caremark.com/portal/asset/Value_Formulary.pdf
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Post by nylefty on Aug 6, 2017 13:17:11 GMT -5
When was Amazon's first profit? I think first quarterly profit was Q4 2001, and they've had positive operating cash flow ever since. I'm no Amazon historian, so correct me if I'm wrong. I didn't invest in them until a couple years ago. MAY 23, 2017 @ 09:57 AM The Amazon Era: No Profits, No Problem Jon Markman , CONTRIBUTOR Analyzing tech stocks through the prism of cultural change. There is a new calculus in corporate boardrooms. Profits are so yesterday. Now it’s all about vision and great storytelling. Blame Amazon.com. The online behemoth cracked the code. Despite posting just a handful of profitable quarters in its two-decade history, it’s the fourth-largest public company at almost $470 billion in market capitalization. Now, its copycats are changing the game. |
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Post by scoy on Aug 6, 2017 14:01:23 GMT -5
I think first quarterly profit was Q4 2001, and they've had positive operating cash flow ever since. I'm no Amazon historian, so correct me if I'm wrong. I didn't invest in them until a couple years ago. MAY 23, 2017 @ 09:57 AM The Amazon Era: No Profits, No Problem Jon Markman , CONTRIBUTOR Analyzing tech stocks through the prism of cultural change. There is a new calculus in corporate boardrooms. Profits are so yesterday. Now it’s all about vision and great storytelling. Blame Amazon.com. The online behemoth cracked the code. Despite posting just a handful of profitable quarters in its two-decade history, it’s the fourth-largest public company at almost $470 billion in market capitalization. Now, its copycats are changing the game. There are a set of attributes every successful company has. They don't mean success is inevitable, they mean success is possible. In every single attribute Amazon gets great marks and has for many years. Shorts prey on companies that get failing marks in those attributes. It's like having fuel in the tank of a race car. Having fuel doesn't guarantee success. Not having fuel makes success highly improbable. Amazon's tank is full of fuel. Amazon has more revenue than the 3rd-largest public company which is Microsoft. Amazon's revenue is growing faster than Microsoft's revenue. When I refer to attributes of successful companies it has nothing to do with subjective things such as vision and story telling. Writers write about such things because most people are not interested in analyzing facts and figures. |
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